The World Bank Implementation Status & Results Report Paraguay Public Health Sector Strengthening (P167996) Paraguay Public Health Sector Strengthening (P167996) LATIN AMERICA AND CARIBBEAN | Paraguay | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2019 | Seq No: 4 | ARCHIVED on 24-Feb-2021 | ISR45611 | Implementing Agencies: Ministry of Public Health and Social Welfare, Republic of Paraguay Key Dates Key Project Dates Bank Approval Date: 28-May-2019 Effectiveness Date: 26-May-2020 Planned Mid Term Review Date: -- Actual Mid-Term Review Date: Original Closing Date: 31-Dec-2024 Revised Closing Date: 31-Dec-2024 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The objectives of this Project are to: (i) strengthen the public primary health care micro-networks; and (ii) expand access to quality primary health care services for the population covered by the Ministry of Public Health and Social Welfare (MSPBS). Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Investments to strengthen the service delivery capacity of Public Primary Health Care Micro-Networks:(Cost $94.61 M) Improvements in the access to quality health services through priority Integrated Care Sets:(Cost $15.00 M) Project Administration and Implementation Support:(Cost $5.10 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating High Substantial Implementation Status and Key Decisions The Project was approved by the Board of Directors on May 28, 2019 and the Loan Agreement was signed by the Minister of Finance on June 3, 2019. The Project has been declared effective on May 26, 2020 and implementation is underway. 2/24/2021 Page 1 of 8 The World Bank Implementation Status & Results Report Paraguay Public Health Sector Strengthening (P167996) Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance High High High Macroeconomic Low Low Low Sector Strategies and Policies Substantial Substantial Substantial Technical Design of Project or Program Substantial Substantial Substantial Institutional Capacity for Implementation and Substantial Substantial Substantial Sustainability Fiduciary High High Substantial Environment and Social Moderate Moderate Moderate Stakeholders Moderate Moderate Moderate Other -- -- -- Overall High High Substantial Results PDO Indicators by Objectives / Outcomes Strengthening the primary public health care micro-networks IN00957157 ►Number of new public primary health care micro-networks established that report performance through SIG (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 152.00 Date 31-Dec-2018 13-Aug-2019 13-Aug-2019 31-Dec-2024 PPHCMNs established referred to those that: (i) have been formalized in a document prepared by the Comments: LHC describing their composition and their referral and counterreferal mechanisms; and (ii) that have been validated by the MSPBS. PPHCMNs performance will be reported by the LHC through SIG IN00957160 ►Number of FHCCs operating according to the national standard (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 225.00 Date 31-Dec-2018 13-Aug-2019 13-Aug-2019 31-Dec-2024 Number of FHCCs that have been strengthened under the Project in terms of human resources, Comments: equipment or infrastructure and that are operating according to the national standard. 2/24/2021 Page 2 of 8 The World Bank Implementation Status & Results Report Paraguay Public Health Sector Strengthening (P167996) Expanding access for the population covered by the MSPBS IN00957158 ►Percentage of population covered by the MSPBS with access to PHC through the FHCCs (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 32.00 32.00 32.00 40.00 Date 31-Dec-2018 13-Aug-2019 13-Aug-2019 31-Dec-2024 Numerator: Number of people covered by the MSPBS with access to PHC through the FHCCs Comments: Denominator: Number of people covered by the MSPBS. Access to PHC through the FHCC means that there is an operating FHCC ready to provide PHC services to the population in its catchment area. Improving quality primary health care services IN00957156 ►Percentage of pregnant women with early prenatal checkups (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 31.00 31.00 31.00 40.00 Date 31-Dec-2017 13-Aug-2019 13-Aug-2019 31-Dec-2024 Numerator: Number of pregnant women covered by the MSPBS receiving at least one prenatal checkup Comments: service before the 20th week of pregnancy. Denominator: Number of estimated pregnant women covered by the MSPBS IN00957159 ►Percentage of hypertension patients correctly diagnosed (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 32.00 32.00 32.00 40.00 Date 31-Dec-2017 13-Aug-2019 13-Aug-2019 31-Dec-2024 Numerator: Number of people covered by the MSPBS aged 18 - 65 years diagnosed with hypertension Comments: Denominator: Number of estimated people covered by the MSPBS aged 18-65 with hypertension according to the national risk factor survey. This indicator will be measured disaggregated by gender. IN00957161 Percentage of hypertension women correctly diagnosed (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 32.00 32.00 32.00 40.00 Date 31-Dec-2018 13-Aug-2019 13-Aug-2019 31-Dec-2024 IN00957162 Percentage of hypertension men correctly diagnosed (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 32.00 32.00 32.00 40.00 Date 31-Dec-2018 13-Aug-2019 13-Aug-2019 31-Dec-2024 IN00957163 2/24/2021 Page 3 of 8 The World Bank Implementation Status & Results Report Paraguay Public Health Sector Strengthening (P167996) ►Percentage of TB cases diagnosed (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 78.00 78.00 78.00 88.00 Date 31-Dec-2017 13-Aug-2019 13-Aug-2019 31-Dec-2024 Numerator: Number of new and relapsed TB cases of people covered by the MSPBS Denominator: Comments: Number of estimated people covered by the MSPBS with TB according the WHO incidence. This indicator will be measured disaggregated by gender. Overall Comments PDO Project's indicators will be updated after the next mission scheduled for the beginning of April 2021. Currently, the PIU is collecting the information to report the indicator's performance. Intermediate Results Indicators by Components Investments to strengthen the service delivery capacity of Public Primary Health Care Micro Networks IN00957164 ►Number of new FHCCs built (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 152.00 Date 31-Dec-2018 13-Aug-2019 13-Aug-2019 31-Dec-2024 Comments: FHCC built according to the standard design defined by the MSPBS IN00957166 ►Number of health staff trained (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 2,500.00 Date 31-Dec-2018 13-Aug-2019 13-Aug-2019 31-Dec-2024 Number of public health staff working at the central, regional, local or provider level who received training per year on: (i) health system management; (ii) MCH and prevalent diseases prioritized under the Project; Comments: or (iii) Information systems. The number of total staff trained is reported on an accumulated basis since the beginning of the Project. IN00957168 ►Number of Clinical Practice Guidelines revised (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 9.00 Date 31-Dec-2018 13-Aug-2019 13-Aug-2019 31-Dec-2024 2/24/2021 Page 4 of 8 The World Bank Implementation Status & Results Report Paraguay Public Health Sector Strengthening (P167996) Number of Clinical Practice Guidelines related to MCH conditions or prevalent diseases prioritized under Comments: the Project that have been revised and updated when necessary. The number of total Clinical Practice Guidelines revised is reported on an accumulated basis since the beginning of IN00957170 ►Percentage of population assigned to a FHCC with patient-level information in a centralized database (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 70.00 Date 31-Dec-2018 13-Aug-2019 13-Aug-2019 31-Dec-2024 Numerator: Number of people assigned to an operating FHCC with patient-level information in a Comments: centralized database Denominator: Number of people assigned to an operating FHCC IN00957172 ►Health Information System for medicine stock control developed (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No No Yes Date 12-Mar-2019 13-Aug-2019 13-Aug-2019 31-Dec-2021 Comments: Health information system with a special module for medicine stock control developed Improvements in the access to quality health services through priority Integrated Care Sets IN00957165 ►Percentage of LHCs with Results Management Agreements signed (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 60.00 Date 31-Dec-2018 13-Aug-2019 13-Aug-2019 31-Dec-2024 Numerator: Number of LHCs with Results Management Agreements signed with the MSPBS Comments: Denominator: Number of LHCs IN00957167 ►Percentage of FHCCs with work program agreed with LHC (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 60.00 Date 31-Dec-2018 13-Aug-2019 13-Aug-2019 31-Dec-2024 Numerator: Number of FHCCs with work program on the prioritized ICS agreed with LHC Denominator: Comments: Number of FHCCs IN00957169 ►Percentage of municipalities implementing social accountability actions (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 60.00 2/24/2021 Page 5 of 8 The World Bank Implementation Status & Results Report Paraguay Public Health Sector Strengthening (P167996) Date 31-Dec-2018 13-Aug-2019 13-Aug-2019 31-Dec-2024 Numerator: Number of municipalities with a work program agreed with the LHC implementing social accountability actions for the community. Denominator: Number of municipalities with a work program Comments: agreed with the LHC. This indicator will track municipalities, through their LHCs, that present to their communities the action plan and activities developed under the Project and the results achieved. IN00957171 ►Percentage of LHCs that report work progress through SIG (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 60.00 Date 31-Dec-2018 13-Aug-2019 13-Aug-2019 31-Dec-2024 Numerator: Number of LHCs with Performance Agreement signed with the MSPBS that report work Comments: progress related to the ICS through SIG Denominator: Number of LHC with Performance Agreement signed with the MSPBS IN00957173 ►Number of Progress reports produced by the MSPBS's Health Programs on the ICSs based on the SIG (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 23.00 Date 31-Dec-2018 13-Aug-2019 13-Aug-2019 31-Dec-2024 Number of Progress reports on the performance of the prioritized ICS produced by the MSPBS's Health Comments: Programs based on the information provided by SIG IN00957174 ►Screening for global health risk (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 30.00 Date 31-Dec-2017 13-Aug-2019 13-Aug-2019 31-Dec-2024 Numerator: Number of people aged 18-65 covered by the MSPBS with the body mass index measured Comments: Denominator: Number of people aged 18-65 covered by the MSPBS This indicator will be measured disaggregated by gender. IN00957175 ►Percentage of men aged 15 or older voluntarily screened for HIV (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1.30 1.30 1.30 4.00 Date 31-Dec-2017 13-Aug-2019 13-Aug-2019 31-Dec-2024 Numerator: Number of men aged 15 or older covered by the MSPBS voluntarily screened for HIV Comments: Denominator: Number of men aged 15 or older covered by the MSPBS IN00957176 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target 2/24/2021 Page 6 of 8 The World Bank Implementation Status & Results Report Paraguay Public Health Sector Strengthening (P167996) Value 0.00 0.00 0.00 19,115.00 Date 31-Dec-2017 13-Aug-2019 13-Aug-2019 31-Dec-2024 IN00957177 Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 19,115.00 Date 31-Dec-2017 13-Aug-2019 13-Aug-2019 31-Dec-2024 Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P167996 IBRD-89630 Effective USD 115.00 115.00 0.00 1.70 113.30 1.5% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P167996 IBRD-89630 Effective 28-May-2019 03-Jun-2019 26-May-2020 31-Dec-2024 31-Dec-2024 Cumulative Disbursements 2/24/2021 Page 7 of 8 The World Bank Implementation Status & Results Report Paraguay Public Health Sector Strengthening (P167996) 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. 2/24/2021 Page 8 of 8