The World Bank Report No: ISR5254 Implementation Status & Results India IN: Integrated Disease Surveillance Project (P073651) Public Disclosure Copy Operation Name: IN: Integrated Disease Surveillance Project (P073651) Project Stage: Implementation Seq.No: 15 Status: ARCHIVED Archive Date: 20-Jun-2011 Country: India Approval FY: 2005 Product Line: IBRD/IDA Region: SOUTH ASIA Lending Instrument: Specific Investment Loan Implementing Agency(ies): Ministry of Health and Family Welfare, Ministry of Agriculture Key Dates Board Approval Date 08-Jul-2004 Original Closing Date 31-Mar-2010 Planned Mid Term Review Date 31-Jul-2007 Last Archived ISR Date 20-Jun-2011 Effectiveness Date 28-Oct-2004 Revised Closing Date 31-Mar-2012 Actual Mid Term Review Date 16-Jun-2008 Project Development Objectives Project Development Objective (from Project Appraisal Document) To support the Government of India (GOI) to strengthen the integrated disease surveillance system for epidemic-prone diseases by (i) enhancing central level monitoring and coordination functions, and (ii) improving state/district surveillance and response capacity with emphasis on selected (nine) states. Additionally, the project will support GOI efforts to timely prepare for, detect and respond to influenza outbreaks in humans and animals. Has the Project Development Objective been changed since Board Approval of the Project? ● Yes No Component(s) Component Name Component Cost Component 1: Central Surveillance Monitoring and Oversight 6.01 Component 2: Improving State/District Surveilance and Response Capacity 23.66 Component 3a: Influenza Surveillance and Response: Human Health 4.53 Component 3b: Influenza Surveillance and Response: Animal Health 26.00 Public Disclosure Copy Overall Ratings Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Satisfactory Overall Risk Rating Implementation Status Overview The restructured Integrated Disease Surveillance Project (IDSP) has entered the final four months of implementation with good progress having been logged on most activities agreed for both the human health as well as the animal health components of the project. For the human health component, the capacities of the Central Surveillance Unit (CSU), the State Surveillance Units (SSU) and the District Surveillance Units (DSU) have been strengthened with recruitment of technical and IT personnel and their training. The priority states Page 1 of 6 The World Bank Report No: ISR5254 have demonstrated a progressively improving performance over time in terms of timeliness and consistency of reporting of epidemic prone diseases on the web-based portal through health facility level surveillance. A slow start has been made in involving the private sector health facilities for disease reporting. Disease outbreak reporting has improved significantly, with the priority states accounting for more than 60% of outbreaks reported in India till date, during 2011. 17 District Priority Labs (DPLs) and a network of 65 referral labs have been strengthened with hardware and software support to improve lab access for disease and outbreak confirmations. In addition, 12 labs have been strengthened with 11 labs Public Disclosure Copy being operational for testing of human samples for avian influenza. For the animal health component, four prefabricated Bio Safely Level (BSL) III labs have been installed in the country for testing animal samples for avian influenza, of which three are operational. Locations Country First Administrative Division Location Planned Actual India Bengal State of West Bengal ✔ India State of Tamil Nadu State of Tamil Nadu ✔ India State of Rajasthan State of Rajasthan ✔ India State of Punjab State of Punjab ✔ India State of Maharashtra State of Maharashtra ✔ India State of Karnataka State of Karnataka ✔ India State of Gujarat State of Gujarat ✔ India State of Gujarat State of Gujarat ✔ India State of Andhra Pradesh State of Andhra Pradesh ✔ India Uttarakhand State of Uttarakhand ✔ Results Project Development Objective Indicators Indicator Name Core Unit of Measure Baseline Current End Target Improved diagnostic capacity for H5N1 and Number Value 9.00 14.00 18.00 Public Disclosure Copy H1N1 Date 30-Mar-2010 30-Sep-2011 31-Mar-2012 Comments For Human Health: 7 labs For Human Health: 11/12 labs Human Health: 12 labs Animal Health: 2 Biosafety functional Animal Health: 6 BSL3 labs Level III (BSL3) Animal Health: 3/6 BSLIII labs are functional No: of functional diagnostic laboratories for Number Value 7.00 12.00 12.00 human influenza established Sub Type Date 30-Sep-2009 30-Sep-2011 31-Mar-2012 Page 2 of 6 The World Bank Report No: ISR5254 Breakdown Comments Of twelve units, seven are 11 of 12 HH AI labs functional functional. NEGHRIMS, Shillong is the only lab which is yet to test any human Public Disclosure Copy samples for either H5N1 or H1N1. No: of functional BSL3 laboratories for animal Number Value 2.00 3.00 6.00 influenza established Sub Type Date 30-Sep-2009 30-Sep-2011 31-Mar-2012 Breakdown Comments of six labs, only two are Three prefabricated BSL III functional labs at Kolkata, Jallandhar and Bangalore are functional. The lab at Bareilly, though installed, is pending electrical connectivity for operationalization. % of responses to disease specific outbreaks Percentage Value 45.00 73.00 75.00 assessed to be adequate as measured by 3 Date 30-Mar-2010 30-Sep-2011 31-Mar-2012 essential criteria in 9 priority states Comments Over all 45% of outbreaks For the first essential criterion, (based on first criterion). 73% of responses are Range is : TN & KA-66, UK, assessed to be adequate; for WB, MH=50%, AP-20% the second criterion, 63% Rajasthan 10% PB=0 responses are adequate; and for the the third criterion 5% of responses are assessed to be adequate % of districts providing surveillance reports Percentage Value 25.00 47.00 70.00 timely and consistently in 9 priority states Date 30-Mar-2010 30-Sep-2011 31-Mar-2012 Comments 25% of priority state districts On an average 92% of report timely and consistently districts report on 'P' and 'L' on 'P' forms from Primary forms. % of districts providing Health Centres. Data for all timely and consistent 'P' other 4 sub indicators (% of forms from Primary Health Public Disclosure Copy districts reporting timely and Centers is 47%, from consistently for 'P' forms from hospitals with outpatient and hospitals with Outpatient and inpatient surveillance is 37%. Inpatient surveillance;% lab %of lab confirmed outbreaks confirmation for outbreaks; % is 19%; 88% of district public of district priority labs health labs report routinely; reporting routinely and % of 78% of labs from the referral labs from referral network network report are reporting. reporting routinely) is not available Page 3 of 6 The World Bank Report No: ISR5254 Intermediate Results Indicators Indicator Name Core Unit of Measure Baseline Current End Target Health personnel receiving training Number Value 0.00 5312.00 Public Disclosure Copy Date 29-Mar-2010 30-Sep-2011 Comments 1033 master trainers trained in 9 priority states; 2632 master trainers trained in other 26 states, 641 state surveillance teams trained, 217 district surveillance officers trained in FETP from priority states, 473 district surveillance officers trained in remaining states in FETP, 316 technical staff (epidemiologists, microbiologists and entomologists trained), 641 State Surveillance Teams trained. Induction training completed; epidemiologists/ Percentage Value 40.00 89.80 90.00 microbiologists and entomologists in position Date 30-Sep-2009 30-Sep-2011 Comments 94% of posted epidemiologists are trained, 89.5% of microbiologists are trained and 86% of the posted entomologists are trained. Number of CSU supervision missions in each Number Value 2.00 3.00 4.00 of the nine states (per year) Date 30-Mar-2010 30-Sep-2011 31-Mar-2012 Comments TN-1 visit, AP-2 visits, Punjab-5 visits, Uttarakhand-3 visits, West Bengal-4 visits, Public Disclosure Copy Gujarat- 3 visits, Karnataka-2 visits, Rajasthan-4 visits and Maharashtra-1 visit. % of epidemiologists, microbiologists and Number Value 40.00 48.10 90.00 entomologists in position Date 30-Mar-2010 30-Sep-2011 31-Mar-2012 Comments 102/231 sanctioned positions of epidemiologists filled (35 additional epidemiologists from regular service available Page 4 of 6 The World Bank Report No: ISR5254 to IDSP for Gujarat & Punjab), 19/26 sanctioned microbiologists positions filled; and 7/9 sanctioned Public Disclosure Copy entomologist positions. 94% of posted epidemiologists are trained, 89.5% of microbiologists are trained and 86% of the posted entomologists are trained. Number of meetings between health officials Number Value 0.00 2.00 2.00 and animal husbandry officials Date 30-Mar-2010 30-Sep-2011 31-Mar-2012 Comments Monthly (in high risk states)/ at least once every six months bi-monthly meetings are called in at-risk states by the Additional Chief Secretary and the PrincipalHealth Secretary inviting all other line department secretaries % of major hospitals enrolled, doing IP , OP & Percentage Value 20.00 60.00 50.00 Lab Surveillance , and sharing P & L forms Date 30-Mar-2010 30-Sep-2011 31-Mar-2012 Comments less then 20% average 60% for P form (hospital) and average 65% for L form (lab) % of districts with IT network for on portal data Percentage Value 25.00 92.00 80.00 entry, videoconferencing and inter-voice Date 30-Sep-2009 30-Sep-2011 31-Mar-2012 connection between states & have access to Comments Portal =40% VCF =50% TFA= - % of districts with 80% for all 3 facilities toll free 1075 25% Portal data entry = 92 % throughout the year - % of districts utilizing VC facility (since Sept. 2010) = 95% - % of districts having Public Disclosure Copy Toll free no.1075 connectivity = 95% Data on Financial Performance (as of 13-Jan-2012) Financial Agreement(s) Key Dates Project Loan No. Status Approval Date Signing Date Effectiveness Date Closing Date P073651 IDA-39520 Effective 08-Jul-2004 23-Sep-2004 28-Oct-2004 31-Mar-2012 Disbursements (in Millions) Page 5 of 6 The World Bank Report No: ISR5254 Project Loan No. Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P073651 IDA-39520 Effective XDR 46.90 31.09 15.81 17.45 13.64 56.00 Public Disclosure Copy Disbursement Graph Key Decisions Regarding Implementation IDSP has requested the Bank through the Department of Economic Affairs (DEA) for a cancellation of USD 15.954 million from the allocation for human health component and USD 0.324 million from the allocation for the animal health component. The Task Team has completed the processing of this cancellation request pertaining to the human health component and the same has been communicated to the DEA on 13th January 2012, while the amount of cancellation required from the animal health component has been requested to be re-assessed in view of the delay in construction of two animal health labs. The closing implementation support review and the Learning Implementation Completion Report (ICR) mission for IDSP is planned for February/March 2012 following which a final project ISR will be filed. Restructuring History Public Disclosure Copy Board Approved on 10-Jan-2007, Board Approved on 13-Feb-2007, Level one Approved on 29-Mar-2010, Level two Approved on 09-Jan-2012 Related Projects There are no related projects. Page 6 of 6