The World Bank Implementation Status & Results Report Nagaland Health Project (P149340) Nagaland Health Project (P149340) SOUTH ASIA | India | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2017 | Seq No: 5 | ARCHIVED on 31-Dec-2018 | ISR34887 | Implementing Agencies: Republic of India, Department of Health and Family Welfare, Government of Nagaland Key Dates Key Project Dates Bank Approval Date: 19-Dec-2016 Effectiveness Date: 20-Mar-2017 Planned Mid Term Review Date: 14-Oct-2019 Actual Mid-Term Review Date: -- Original Closing Date: 31-Mar-2023 Revised Closing Date: 31-Mar-2023 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) To improve health services and increase their utilization by communities in targeted locations in Nagaland. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Community action for health and nutrition:(Cost $18.00 M) Health system development:(Cost $42.00 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Unsatisfactory Moderately Unsatisfactory Overall Risk Rating Moderate Moderate Implementation Status and Key Decisions The project is making progress towards achievement of project development objectives (PDO). As of September 21, 2018, the March 2019 annual targets for all (eight) but one of the outcome indicators have been achieved or surpassed. Progress on one remaining indicator related to number of ANC check-up is on track and will achieve the target by March 2019. The targets have been achieved or surpassed for ten out of thirteen intermediate indicators. The project has shown commitment for implementation of project activities though the progress has been mixed. Most of the actions agreed during the last mission including those related to contracting of auditor, development of bidding documents for all the civil works, technical specification for information communication technology (ICT) activities, conducting training for state level trainers of trainee (TOT) for bio-medical waste management and scale up of activities under Component 1 have been completed. On the other hand, progress towards procurement of works for 12/31/2018 Page 1 of 7 The World Bank Implementation Status & Results Report Nagaland Health Project (P149340) improvement of district hospitals, contracting of consultant for information communication technology (ICT) activities and design of the State warehouse have been slow. The activities of Component 1 (Community Action for Health and Nutrition) have made significant improvement in the last 6 months. The landscaping is completed in 370 out of 498 sites, training in 334 sites, the Memorandum of Understanding (MOU) is signed with 186 sites, one-time grant is released to 157 communities, and 60 sites have received the first results-based financing (RBF) payment on achievement of targets while 17 have received the second. The contracting of the third-party agency (TPA) for external verification of results achieved by the communities is completed and the first round of verification in five facilities and their catchment villages in Tuensang and Peren districts has begun. The final report is expected by end of October 2018. The project team will plan for dissemination of the results among State partners and use the findings for improving the implementation design. The progress under Component 2 (Health system development) has been mixed. The technical work for improvement of infrastructure at District Hospitals (DH), Community Health Centers (CHC) and Primary Health Center (PHCs) is completed. The activities for strengthening of procurement and supply chain management have made some progress but it need close monitoring to avoid any further delay. The technical design for the ICT activity is completed and the procurement process is under progress. The consultancy support for medical college has shown good progress, the procurement of civil works for medical college building is initiated, statutory clearance from central government and Medical Council of India (MCI) has been obtained. The preparation of the detailed activity plan for improvement of nursing, Auxiliary Nurse Midwife (ANM) and the Para-medical Technology Institute is completed. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance -- Moderate Moderate Macroeconomic -- Moderate Moderate Sector Strategies and Policies -- Moderate Moderate Technical Design of Project or Program -- Moderate Moderate Institutional Capacity for Implementation and Sustainability -- Substantial Substantial Fiduciary -- Substantial Substantial Environment and Social -- Moderate Moderate Stakeholders -- Low Low Other -- -- -- Overall -- Moderate Moderate Results PDO Indicators by Objectives / Outcomes Increase utilization of health service by communities in targeted locations. IN00647917 ►Children age under one year registered for immunization in targeted communities whose growth was recorded at least twice in the previous six months (Percentage) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 6.00 6.00 28.70 40.00 12/31/2018 Page 2 of 7 The World Bank Implementation Status & Results Report Nagaland Health Project (P149340) Date 01-Feb-2017 21-Jul-2017 29-Jun-2018 31-Mar-2023 IN00647920 Female children age under one year registered for immunization in targeted communities whose growth was recorded at least twice in the previous six months (Percentage) (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 6.00 6.00 33.00 40.00 Date 01-Feb-2017 21-Jul-2017 29-Jun-2018 31-Mar-2023 IN00647946 ►Children ages 9-11 months registered for immunization in targeted communities who have received all recommended immunizations (Percentage). (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 40.00 61.00 81.00 60.00 Date 01-Feb-2017 31-Dec-2017 29-Jun-2018 31-Mar-2023 IN00647947 Female children ages 9-11 months registered for immunization in targeted communities who have received all recommended immunizations (Percentage). (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 40.00 40.00 81.00 60.00 Date 01-Feb-2017 21-Jul-2017 29-Jun-2018 31-Mar-2023 IN00647948 ►Mothers who delivered in the previous 6 months in targeted communities who had at least 3 antenatal care check-ups (Percentage) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 55.00 54.11 54.11 75.00 Date 01-Feb-2017 31-Dec-2017 29-Jun-2018 31-Mar-2023 IN00657414 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 22,121.00 40,000.00 Date 01-Apr-2016 -- 30-Jun-2018 31-Mar-2023 IN00657415 Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 17,121.00 20,000.00 Date 01-Apr-2016 -- 30-Jun-2018 31-Mar-2023 IN00657491 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 5,000.00 20,000.00 12/31/2018 Page 3 of 7 The World Bank Implementation Status & Results Report Nagaland Health Project (P149340) Date 01-Apr-2016 -- 30-Jun-2018 31-Mar-2023 Improve health services. IN00647918 ►Community health workers (ASHAs) in targeted communities supplied with complete kits (Percentage) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 4.50 41.00 70.00 Date 01-Feb-2017 31-Dec-2017 29-Jun-2018 31-Mar-2023 IN00647919 ►Targeted health facilities with at least one functional handwashing facility with running water (Percentage) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 31.00 5.00 33.00 70.00 Date 01-Feb-2017 31-Dec-2017 29-Jun-2018 31-Mar-2023 Intermediate Results Indicators by Components Health system development IN00647951 ►Targeted health facilities with at least one functional flush or pour flush toilet facility (Percentage) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 46.00 30.00 30.00 70.00 Date 01-Feb-2017 21-Sep-2018 21-Sep-2018 31-Mar-2023 IN00647953 ►Community electricity connections constructed (Number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 14.00 14.00 100.00 Date 01-Feb-2017 21-Sep-2018 21-Sep-2018 31-Mar-2023 IN00647954 ►A procurement manual based on National Health Mission guidelines is adopted by the Department of Health and Family Welfare and staff are trained on its use (Yes/No) (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No No Yes Date 01-Feb-2017 21-Sep-2018 21-Sep-2018 31-Mar-2023 IN00647957 ►Common database, integrated with the Health Management Information System, recording all service delivery data reported by health facilities (Yes/No) (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target 12/31/2018 Page 4 of 7 The World Bank Implementation Status & Results Report Nagaland Health Project (P149340) Value No No No Yes Date 01-Feb-2017 21-Sep-2018 21-Sep-2018 31-Mar-2023 IN00647959 ►Health personnel receiving training (number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 250.00 250.00 5,000.00 Date 01-Feb-2017 21-Sep-2018 21-Sep-2018 31-Mar-2023 IN00647961 ►Health facilities constructed, renovated, and/or equipped (number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 57.00 57.00 100.00 Date 01-Feb-2017 21-Sep-2018 21-Sep-2018 31-Mar-2023 Community action for health and nutrition IN00647950 ►Target villages where a village health and nutrition day was organized in the previous month (Percentage) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 14.00 23.73 23.73 50.00 Date 01-Feb-2017 21-Sep-2018 21-Sep-2018 31-Mar-2023 IN00647952 ►Births in targeted communities in the previous year for which birth certificates were issued (Percentage) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 80.00 80.00 30.00 Date 01-Feb-2017 21-Sep-2018 21-Sep-2018 31-Mar-2023 IN00647955 2.a. Female births in targeted communities in the previous year for which birth certificates were issued (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 77.70 77.70 30.00 Date 01-Feb-2017 21-Sep-2018 21-Sep-2018 31-Mar-2023 IN00647956 ►Targeted Village Health Committees that have received training (Percentage) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 68.70 68.70 70.00 Date 01-Feb-2017 21-Sep-2018 21-Sep-2018 31-Mar-2023 IN00647958 12/31/2018 Page 5 of 7 The World Bank Implementation Status & Results Report Nagaland Health Project (P149340) ►Targeted Village Health Committees that received Health and Nutrition Incentives in the previous year (Percentage). (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 31.50 31.50 70.00 Date 01-Feb-2017 21-Sep-2018 21-Sep-2018 31-Mar-2023 IN00647960 ►Targeted Village Health Committees with a female co-chair (Percentage). (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 40.00 40.00 70.00 Date 01-Feb-2017 21-Sep-2018 21-Sep-2018 31-Mar-2023 IN00647962 ►Citizens and/or communities involved in planning/implementation/evaluation of development programs (Yes/No) (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 01-Feb-2017 21-Sep-2018 21-Sep-2018 31-Mar-2023 Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P149340 IDA-59270 Effective USD 48.00 48.00 0.00 3.52 44.48 7.3% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P149340 IDA-59270 Effective 19-Dec-2016 16-Jan-2017 20-Mar-2017 31-Mar-2023 31-Mar-2023 Cumulative Disbursements 12/31/2018 Page 6 of 7 The World Bank Implementation Status & Results Report Nagaland Health Project (P149340) Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 12/31/2018 Page 7 of 7