The World Bank Implementation Status & Results Report Guinea Health Service and Capacity Strengthening Project (P163140) Guinea Health Service and Capacity Strengthening Project (P163140) AFRICA WEST | Guinea | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2018 | Seq No: 7 | ARCHIVED on 21-Sep-2021 | ISR47754 | Implementing Agencies: Ministry of Public health and Hygiene, Ministry of Finance Key Dates Key Project Dates Bank Approval Date: 25-Apr-2018 Effectiveness Date: 24-Dec-2018 Planned Mid Term Review Date: 17-Jan-2022 Actual Mid-Term Review Date: Original Closing Date: 27-Jun-2023 Revised Closing Date: 27-Jun-2023 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) Improve the utilization of reproductive, maternal, neonatal and child health services in target regions Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Strengthen supply of basic RMNCH services in target regions:(Cost $28.00 M) Strengthen the demand for basic RMNCH services in target regions:(Cost $9.00 M) Strengthen health financing capacity of the MOH to guide sector reform and long-term transformation:(Cost $15.00 M) Strengthen project management, implementation, and donor coordination capacity:(Cost $3.00 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Satisfactory Overall Risk Rating Moderate Moderate Implementation Status and Key Decisions The project and the Financing Agreements between the Government of Guinea and the World Bank Group were signed on June 27, 2018 and effectiveness of the project was declared on December 24, 2018. Throughout 2020, activities slowed down because of the COVID-19 pandemic and the presidential election period. However, the pace of implementation of the project has been on track since January 2021 and 45.3% of the overall budget was disbursed as of September 15, 2021. The main activities undertaken include the provision of 10 medicalized ambulances to health posts in the two project regions to improve the management of obstetric emergencies through timely referral to hospitals; the provision of 44 motorcycles to statistical data officers; support for the implementation, monitoring and supervision activities of health posts at the deconcentrated level; identification of 175,115 indigents, printing of 170, 810 indigent cards, distribution of 162,729 indigent cards, provision of free health care to 5,792 indigents, and awareness-raising activities to increase health care use by indigents; recruitment of two verification agencies and launching of 9/21/2021 Page 1 of 8 The World Bank Implementation Status & Results Report Guinea Health Service and Capacity Strengthening Project (P163140) quantitative and qualitative verification activities, as part of the results-based financing program; and support for the service availability and readiness assessment and conduct of national health accounts. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Substantial Moderate Substantial Macroeconomic High Moderate Moderate Sector Strategies and Policies Substantial Low Low Technical Design of Project or Program Substantial Low Low Institutional Capacity for Implementation and Substantial Moderate Moderate Sustainability Fiduciary Substantial Moderate Moderate Environment and Social Moderate Moderate Moderate Stakeholders Moderate Moderate Moderate Other -- -- -- Overall Substantial Moderate Moderate Results PDO Indicators by Objectives / Outcomes Improve the utilization of reproductive, maternal, neonatal and child health services in target regi IN01024184 ►Number of deliveries assisted by trained health personnel (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 66,544.00 188,105.00 245,743.00 94,320.00 Date 01-Dec-2017 30-Nov-2020 31-Mar-2021 01-Apr-2023 IN01024185 ►Number of pregnant women who received 4 antenetal care visits (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 77,951.00 188,105.00 247,880.00 141,479.00 9/21/2021 Page 2 of 8 The World Bank Implementation Status & Results Report Guinea Health Service and Capacity Strengthening Project (P163140) Date 01-Dec-2017 30-Nov-2020 31-Mar-2021 01-Apr-2023 IN01024186 ►Number of children (0-11 months) fully vaccinated (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 94,640.00 200,636.00 262,125.00 136,239.00 Date 01-Dec-2017 30-Nov-2020 31-Mar-2021 01-Apr-2023 IN01024187 ►Number of children (6-11 months) receiving vitamin A supplementation every 6 months (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 11,407.00 29,463.00 35,774.00 70,740.00 Date 01-Dec-2017 30-Nov-2020 31-Mar-2021 01-Apr-2023 IN01024188 ►Number of women who have received modern contraception (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 52,812.00 175,813.00 243,664.00 1,117,899.00 Date 01-Dec-2017 30-Nov-2020 31-Mar-2021 01-Apr-2023 Overall Comments PDO All five PDO indicators are on track. The end target of three has already been exceeded. The three PDO indicators which have been exceeded are (i) number of deliveries assisted by trained health personnel, (ii) the number of pregnant women who received 4 antenatal care visits, and (iii) the number of children (0-11 months) fully vaccinated. Additionally, the target of the number of children (6-11 months) receiving vitamin A supplementation every 6 months reached 50% attainment as of March 31, 2021. Intermediate Results Indicators by Components Strengthen supply of basic RMNCH services in target regions IN01024189 ►Proportion of health centers with access to water (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 71.00 71.00 71.00 90.00 Date 01-Dec-2017 30-Nov-2020 31-Mar-2021 01-Apr-2023 IN01024193 ►Proportion of health centers with more than 30 percent of stock-outs of tracer drugs (Percentage, Custom) 9/21/2021 Page 3 of 8 The World Bank Implementation Status & Results Report Guinea Health Service and Capacity Strengthening Project (P163140) Baseline Actual (Previous) Actual (Current) End Target Value 100.00 95.00 97.00 25.00 Date 01-Dec-2017 30-Nov-2020 31-Mar-2021 01-Apr-2023 IN01024196 ►Proportion of health centers offering integrated management of childhood illnesses (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 30.00 98.00 90.00 Date 01-Dec-2017 30-Nov-2020 31-Mar-2021 01-Apr-2023 IN01024199 ►Number of health facility health workers trained in RMNCH competencies (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 400.00 400.00 400.00 Date 01-Dec-2017 30-Nov-2020 31-Mar-2021 01-Apr-2023 IN01024202 ►Proportion of health centers who benefited from at least one supportive supervision per timester (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 30.00 90.00 80.00 Date 01-Dec-2017 30-Nov-2020 31-Mar-2021 01-Apr-2023 Strengthen the demand for basic RMNCH services in target regions IN01024192 ►Number of women and children who utilized health centers for RMNCH services (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 458,412.00 1,936,191.00 2,496,996.00 733,596.00 Date 01-Dec-2017 30-Nov-2020 31-Mar-2021 01-Apr-2023 IN01024194 ►Number of new indigents covered under exemption mechanisms (identified and provided with card) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 500.00 5,792.00 150,000.00 Date 01-Dec-2017 30-Nov-2020 31-Mar-2021 01-Apr-2023 IN01024198 ►Satisfaction of users with basic RMNCH services provided (Percentage, Custom) 9/21/2021 Page 4 of 8 The World Bank Implementation Status & Results Report Guinea Health Service and Capacity Strengthening Project (P163140) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 60.00 Date 01-Dec-2017 30-Nov-2020 31-Mar-2021 01-Apr-2023 IN01024200 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 418,204.00 543,642.00 301,992.00 Date 04-Apr-2018 30-Nov-2020 31-Mar-2021 01-Apr-2023 IN01024203 Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 94,640.00 200,636.00 262,125.00 136,239.00 Date 04-Apr-2018 30-Nov-2020 31-Mar-2021 03-Apr-2023 IN01024204 Number of women and children who have received basic nutrition services (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 5,177.00 35,774.00 70,740.00 Date 04-Apr-2018 30-Nov-2020 31-Mar-2021 03-Apr-2023 IN01024205 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 66,544.00 188,105.00 245,743.00 94,320.00 Date 04-Apr-2018 30-Nov-2020 31-Mar-2021 01-Apr-2024 Strengthen project management, implementation, and donor coordination capacity IN01024190 ►Proportion of health centers transmitting health data on time (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 85.00 100.00 90.00 Date 01-Dec-2017 30-Nov-2020 31-Mar-2021 01-Apr-2023 Strengthen health financing capacity of the MOH to guide sector reform and long-term transformation IN01024191 9/21/2021 Page 5 of 8 The World Bank Implementation Status & Results Report Guinea Health Service and Capacity Strengthening Project (P163140) ►Number of health centers under results-based financing mechanisms receiving due payments for their results on time (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 46.00 Date 01-Dec-2017 30-Nov-2020 31-Mar-2021 01-Apr-2023 IN01024195 Number of RBF Contracts Signed between the purchasing Agency and identified RBF facilities (Number, Custom Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 46.00 IN01024197 ►Health Financing Strategy Produced (incorporating evidence from PER and NHA) (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 01-Dec-2017 30-Nov-2020 31-Mar-2021 01-Apr-2023 IN01024201 NHA and PER produced (Yes/No, Custom Supplement) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Overall Comments IR Out of the 12 main intermediate results indicators, 7 (58%) were attained or surpassed as of March 31, 2021. The other 5 experienced some delays but are now on track: 1. The proportion of health centers with access to water and electricity. The contracts for providing health centers with water and solar energy were signed in April and May 2020, respectively, and the contractor (UNICEF) was paid in May and June 2020. The related activities have started and were supposed to be completed by June 30, 2021. However, UNICEF postponed their achievement date to December 31, 2021, for the water supply, and November 30, 2021, for the solar energy supply. 2. The proportion of health centers with more than 30 percent of stock-outs of tracer drugs. The COVID-19 pandemic hindered health facilities from obtaining regular supplies of drugs and consumables from approved wholesalers. A special request has been sent to UNICEF in this regard. 3. The number of new indigents covered under exemption mechanisms. Evaluation of the free health care program in the previous health project showed that indigents are reluctant to use health services for fear of being stigmatized. To address this issue, awareness-raising activities are being undertaken and will be intensified. 4. Satisfaction of users with basic RMNCH services provided. Activities related to this indicator have not yet started. The project is actively looking for a qualified non-governmental organization to conduct the surveys. 5. The number of health centers under results-based financing mechanisms receiving due payments on time for their results. Activities related to this indicator were launched in January 2021 and quantitative and qualitative verification, a step necessary to remunerate health centers, is underway. Performance-Based Conditions 9/21/2021 Page 6 of 8 The World Bank Implementation Status & Results Report Guinea Health Service and Capacity Strengthening Project (P163140) Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P163140 IDA-62300 Effective USD 22.50 22.50 0.00 7.47 14.58 34% P163140 IDA-D3040 Effective USD 22.50 22.50 0.00 7.47 14.58 34% P163140 TF-A7042 Effective USD 10.00 10.00 0.00 10.00 0.00 100% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P163140 IDA-62300 Effective 25-Apr-2018 27-Jun-2018 24-Dec-2018 27-Jun-2023 27-Jun-2023 P163140 IDA-D3040 Effective 25-Apr-2018 27-Jun-2018 24-Dec-2018 27-Jun-2023 27-Jun-2023 P163140 TF-A7042 Effective 25-Apr-2018 27-Jun-2018 24-Dec-2018 31-Dec-2021 31-Dec-2021 Cumulative Disbursements 9/21/2021 Page 7 of 8 The World Bank Implementation Status & Results Report Guinea Health Service and Capacity Strengthening Project (P163140) PBC Disbursement Achievement Disbursed amount in Disbursement % PBC ID PBC Type Description Coc PBC Amount Status Coc for PBC Restructuring History Level 2 Approved on 28-Jul-2021 Related Project(s) There are no related projects. 9/21/2021 Page 8 of 8