The World Bank Implementation Status & Results Report BASIC HEALTHCARE PROVISION FUND PROJECT (HUWE PROJECT) (P163969) BASIC HEALTHCARE PROVISION FUND PROJECT (HUWE PROJECT) (P163969) AFRICA WEST | Nigeria | Health, Nutrition & Population Global Practice | Recipient Executed Activities | Investment Project Financing | FY 2019 | Seq No: 5 | ARCHIVED on 29-Jun-2021 | ISR47270 | Implementing Agencies: Federal Ministry of Health, Federal Ministry of Finance Key Dates Key Project Dates Bank Approval Date: 13-Aug-2018 Effectiveness Date: 17-Jan-2019 Planned Mid Term Review Date: 30-Jun-2021 Actual Mid-Term Review Date: Original Closing Date: 30-Jun-2021 Revised Closing Date: 30-Jun-2021 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The project development objective (PDO) is to establish the accreditation, verification and payment mechanisms for the operationalization of the Basic Health Care Provision Fund in the participating states. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Strengthening Primary Health Care Services through the BHCPF.:(Cost $17.00 M) Strengthening Health Management systems for the BHCPF implementation.:(Cost $3.00 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Unsatisfactory Moderately Satisfactory Overall Implementation Progress (IP) Unsatisfactory Moderately Satisfactory Overall Risk Rating High High Implementation Status and Key Decisions The Basic Healthcare Provision Fund (BHCPF) project was approved by the Bank on August 13, 2018 and declared effective on January 17, 2019. The BHCPF is a National program implemented in accordance with the provisions of the 2014 National Health Act of the Government of Nigeria (GoN). The BHCPF is financed from Federal Government of Nigeria (FGoN) annual grant of not less than one per cent of the consolidated revenue fund, grants by international donor partners and funds from other sources. The payments from the BHCPF is primarily dedicated to funding a basic package of minimum health services delivered by primary healthcare providers which is key to improving access to health care and reducing out of pocket payments, as such the payments from BHCPF remains extremely relevant for human capital development and economic growth in Nigeria. Furthermore, as a statutory general budget transfer in an environment of dwindling public financing, the need to match public revenues for health to defined priorities makes verification of payments and beneficiaries a key relevant outcome. The Nigeria Economic Recovery and Growth plan and the National Strategic Health Development Plan II both explicitly recognizes the implementation of the BHCPF as a key driver of Nigeria’s Universal Health Coverage ambitions. The Nigeria CPF (FY21- 6/29/2021 Page 1 of 7 The World Bank Implementation Status & Results Report BASIC HEALTHCARE PROVISION FUND PROJECT (HUWE PROJECT) (P163969) FY25) has improvement of primary health care as its third core objective, under the investing in Human Capital pillar which is in full alignment with the focus of the services delivered under the BHCPF. The project objective to establish the accreditation, verification, and payment mechanisms for the operationalization of the Basic Health Care Provision Fund (BHCPF) in participating states remains highly relevant in the current context. In the BHCPF only Accredited and Verified facilities/beneficiaries receive Payments. These outcomes were fully achieved in the BHCPF project leading to the successful operationalization of the program. The processes and procedures leading to the three outcomes were adopted for the national operationalization of the BHCPF. All 36+1 Nigerian states have now operationalized the BHCPF adopting the processes developed for the three participating states under the project. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Substantial High High Macroeconomic High High High Sector Strategies and Policies Moderate Moderate Moderate Technical Design of Project or Program Substantial Substantial Substantial Institutional Capacity for Implementation and Substantial High High Sustainability Fiduciary High Moderate Substantial Environment and Social Low Low Low Stakeholders Moderate High Substantial Other -- -- -- Overall Substantial High High Results PDO Indicators by Objectives / Outcomes Component 1: Strengthening Primary Healthcare Services through the BHCPF IN01008905 ►Number of public primary health centers receiving operational expenses via Decentralized Facility Financing (DFF) mechanism (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 898.00 1,860.00 800.00 Date 01-May-2018 31-Dec-2020 11-Jun-2021 30-Jun-2021 IN01008956 ►Number of accredited facilities receiving payments for services financed through the Fee-for-Service (FFS) mechanism, disaggregated by public and private (Number, Custom) 6/29/2021 Page 2 of 7 The World Bank Implementation Status & Results Report BASIC HEALTHCARE PROVISION FUND PROJECT (HUWE PROJECT) (P163969) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 1,860.00 1,000.00 Date 01-May-2018 06-Dec-2018 11-Jun-2021 30-Jun-2021 IN01008957 Number of accredited facilities receiving payments for services financed through the Fee-for-Service (FFS) mechanism, public (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 1,860.00 750.00 Date 01-May-2018 06-Dec-2018 11-Jun-2021 30-Jun-2021 IN01008958 Number of accredited facilities receiving payments for services financed through the Fee-for-Service (FFS) mechanism, private (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 250.00 Date 01-May-2018 06-Dec-2018 06-Dec-2018 30-Jun-2021 IN01008959 ►Percentage of health facilities financed through the FFS mechanism whose claims are found to be valid (less than 10% discordant from their claims) as independently verified (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 100.00 90.00 Date 01-May-2018 06-Dec-2018 11-Jun-2021 30-Jun-2021 IN01008960 ►Average health facility quality-of-care score (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 28.00 56.00 56.00 43.00 Date 01-May-2018 30-Dec-2020 30-Dec-2020 30-Jun-2021 IN01008961 ►Number of beneficiaries receiving services financed through the FFS mechanism (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 633,446.00 600,000.00 Date 01-May-2018 06-Dec-2018 11-Jun-2021 30-Jun-2021 Intermediate Results Indicators by Components 6/29/2021 Page 3 of 7 The World Bank Implementation Status & Results Report BASIC HEALTHCARE PROVISION FUND PROJECT (HUWE PROJECT) (P163969) Component 1: Strengthening PHC services through BHCPF IN01008963 ►Number of outpatient visits per year, children and adults (sum of Abia, Niger and Osun) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 294,915.00 1,181,776.00 1,181,776.00 1,000,000.00 Date 01-May-2018 31-Dec-2020 31-Dec-2020 30-Jun-2021 IN01008965 ►Percentage of children (12-23) months with Pentavalent 3 vaccination (average in three states of Abia, Niger and Osun) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 57.00 68.70 68.70 67.00 Date 01-May-2018 31-Dec-2020 31-Dec-2020 30-Jun-2021 IN01008969 ►Percentage of births attended by skilled health personnel (average of Abia, Niger and Osun) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 70.00 79.47 79.47 75.00 Date 01-May-2018 31-Dec-2020 31-Dec-2020 30-Jun-2021 IN01008971 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 945,420.00 945,420.00 850,000.00 Date 01-May-2018 31-Dec-2020 31-Dec-2020 30-Jun-2021 IN01008972 People who have received essential health, nutrition, and population (HNP) services - Female (RMS requirement) (Number, Corporate Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 756,336.00 756,336.00 600,000.00 IN01008973 Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 302,534.00 302,534.00 200,000.00 Date 01-May-2018 31-Dec-2020 31-Dec-2020 30-Jun-2021 IN01008974 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target 6/29/2021 Page 4 of 7 The World Bank Implementation Status & Results Report BASIC HEALTHCARE PROVISION FUND PROJECT (HUWE PROJECT) (P163969) Value 0.00 60,506.00 60,506.00 100,000.00 Date 01-May-2018 31-Dec-2020 31-Dec-2020 30-Jun-2021 Component 2: Strengthening Health Management systems for the BHCPF implementation IN01008962 ►Numer of project facilities receiving payments on time (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 898.00 898.00 950.00 Date 01-May-2018 31-Dec-2020 31-Dec-2020 30-Jun-2021 IN01008964 Number of public FFS facilities receiving payments on time (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 795.00 500.00 Date 01-May-2018 06-Dec-2018 11-Jun-2021 30-Jun-2022 IN01008966 Number of private FFS facilities receiving payments on time (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 200.00 Date 01-May-2018 06-Dec-2018 06-Dec-2018 30-Jun-2021 IN01008967 Number of public primary health centers receiving operational expenses through DFF mechanism on time (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 898.00 898.00 450.00 Date 01-May-2018 31-Dec-2020 31-Dec-2020 30-Jun-2021 IN01008968 ►Percentage of health facilities enrolled in the DFF payment system that received supervision in the last quarter (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 95.00 100.00 75.00 Date 01-May-2018 31-Dec-2020 11-Jun-2021 30-Jun-2021 IN01008970 ►Percentage of public health facilities in the project area with functioning management committees having community representation (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 75.00 6/29/2021 Page 5 of 7 The World Bank Implementation Status & Results Report BASIC HEALTHCARE PROVISION FUND PROJECT (HUWE PROJECT) (P163969) Date 01-May-2018 06-Dec-2018 06-Dec-2018 30-Jun-2021 Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P163969 TF-A7938 Effective USD 20.00 20.00 0.00 11.50 8.50 58% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P163969 TF-A7938 Effective 13-Aug-2018 06-Nov-2018 17-Jan-2019 30-Jun-2021 30-Jun-2021 Cumulative Disbursements 6/29/2021 Page 6 of 7 The World Bank Implementation Status & Results Report BASIC HEALTHCARE PROVISION FUND PROJECT (HUWE PROJECT) (P163969) PBC Disbursement Achievement Disbursed amount in Disbursement % PBC ID PBC Type Description Coc PBC Amount Status Coc for PBC Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 6/29/2021 Page 7 of 7