The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) Transforming Health Systems for Universal Care (P152394) AFRICA | Kenya | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2016 | Seq No: 8 | ARCHIVED on 19-Dec-2019 | ISR39392 | Implementing Agencies: Kenya National Treasury, Ministry of Health Key Dates Key Project Dates Bank Approval Date: 15-Jun-2016 Effectiveness Date: 04-Jul-2016 Planned Mid Term Review Date: 11-Mar-2019 Actual Mid-Term Review Date: 25-Mar-2019 Original Closing Date: 30-Sep-2021 Revised Closing Date: 30-Sep-2021 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The project development objective is to improve utilization and quality of primary health care services with a focus on reproductive, maternal, newborn, child, and adolescent health services. Has the Project Development Objective been changed since Board Approval of the Project Objective? Yes Board Approved Revised Project Development Objective (If project is formally restructured) The project development objective is to improve utilization and quality of primary health care services with a focus on reproductive, maternal, newborn, child, and adolescent health services. Components Table Name Improving Primary Health Care Results:(Cost $150.00 M) Strengthening Institutional Capacity:(Cost $29.10 M) Cross-county and Intergovernmental Collaboration, and Project Management:(Cost $12.00 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 Substantial Substantial Implementation Status and Key Decisions The Transforming Health Systems for Universal Care Project (THS-UCP) aims to improve utilization and quality of primary healthcare services with a focus on reproductive, maternal, newborn, child, and adolescent health (RMNCAH) services. 12/19/2019 Page 1 of 7 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) An implementation support mission of the Project conducted during October 14 - 25, 2019 showed that overall implementation is on track. County governments are implementing activities prioritized in their annual work plans. Procurement of RMNCAH strategic commodities is ongoing. Eight hundred students are being trained at the Kenya Medical Training College to become nurse midwives. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance High High High Macroeconomic Moderate Moderate Moderate Sector Strategies and Policies Moderate Substantial Substantial Technical Design of Project or Program Substantial Substantial Substantial Institutional Capacity for Implementation and Sustainability High High High Fiduciary Substantial Substantial Substantial Environment and Social Low Moderate Moderate Stakeholders Substantial High High Other -- -- -- Overall Substantial Substantial Substantial Results PDO Indicators by Objectives / Outcomes Improved utilization and quality of primary health care services IN00768794 ►Children immunized with the third dose of Pentavalent (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 79.50 81.60 80.75 84.00 Date 31-Dec-2015 29-Jun-2018 30-Sep-2019 31-Dec-2021 IN00768795 ►Pregnant women attending at least four ANC visits (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target 12/19/2019 Page 2 of 7 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) Value 39.70 48.90 52.45 52.00 Date 31-Dec-2015 31-Dec-2018 30-Sep-2019 30-Jun-2021 IN00768811 ►Births attended by skilled health personnel (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 57.00 65.00 68.40 67.00 Date 31-Dec-2015 31-Dec-2018 30-Sep-2019 30-Jun-2021 IN00768812 ►Women between the ages of 15-49 years currently using a modern FP method (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 47.80 44.00 43.15 52.00 Date 31-Dec-2015 31-Dec-2018 30-Sep-2019 31-Dec-2021 Since 2018, this indicator has dropped below the baseline. The task team is working with MoH and Comments: county governments to increase utilization of modern FP methods. IN00768813 ►Inspected facilities meeting safety standards (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 50.00 Date 31-Dec-2015 29-Jun-2018 29-Jun-2018 31-Dec-2021 This indicator will be measured once county teams are trained - expected this financial year. Comments: IN00768814 ►Pregnant women attending ANC supplemented with IFA (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 31.00 66.00 71.80 73.00 Date 31-Dec-2015 31-Dec-2018 30-Sep-2019 31-Dec-2021 Intermediate Results Indicators by Components Component 1: Improved primary health care results IN00768824 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 3,596,557.00 6,562,330.00 10,060,000.00 Date 29-Sep-2016 29-Jun-2018 30-Sep-2019 30-Jun-2021 12/19/2019 Page 3 of 7 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) The baseline date corresponds the date at which the Project became effective. This is a corporate indicator capturing the cumulative number of people receiving essential health services over the Project Comments: lifecycle (# deliveries attended by skilled personnel and # children aged 0 to 5 who were immunized). No Nutrition services are supported by the Project. IN00768825 Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,921,376.00 3,487,223.00 5,400,000.00 Date 29-Sep-2016 29-Jun-2018 30-Sep-2019 30-Jun-2021 IN00768826 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,675,181.00 3,075,107.00 4,660,000.00 Date 29-Sep-2016 29-Jun-2018 30-Sep-2019 30-Jun-2021 Component 2: Strengthened institutional capacity IN00768815 ►Facilities inspected for safety standards (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 1,635.00 Date 11-Mar-2016 29-Jun-2018 30-Sep-2019 30-Jun-2021 There is no data available for this indicator. There has been a delay in inspections as the pilot in three counties has come to an ed. It is expected that the inspections will resume and be scaled up to the Comments: remaining counties this financial year. IN00768817 ►Reports submitted to DHIS in a timely manner. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 88.80 96.70 97.43 98.00 Date 31-Dec-2015 31-Dec-2018 30-Sep-2019 31-Dec-2021 IN00768819 ►Births registered within 6 months of occurrence (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 65.90 60.90 73.60 80.00 Date 31-Dec-2015 29-Jun-2018 30-Sep-2019 30-Jun-2021 IN00768821 ►RMNCAH related operations research completed to inform policy/strategy (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 2.00 12/19/2019 Page 4 of 7 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) Date 11-Mar-2016 29-Jun-2018 30-Sep-2019 30-Jun-2021 IN00768822 ►A benefit package developed, costed, and disseminated (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 1.00 Date 11-Mar-2016 29-Jun-2018 30-Sep-2019 30-Jun-2021 A benefit package has been developed and costed but not yet disseminated. Comments: IN00768823 ►Lessons learned from UHC Phase I documented and disseminated (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No No Yes Date 20-Jun-2019 20-Jun-2019 30-Sep-2019 31-Dec-2019 This is a new indicator which was introduced after the mid term review of the project. Comments: Component 3: Cross-county/intergovernmental collaboration and project management IN00768816 ►Functional community units (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 302.00 4,120.00 4,895.00 5,331.00 Date 31-Dec-2015 31-Dec-2018 30-Sep-2019 30-Jun-2021 IN00768818 ►Grievances registered related to delivery of project benefits that are addressed (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 80.00 Date 31-Dec-2015 29-Jun-2018 30-Sep-2019 30-Jun-2021 The procurement of consultants to develop a GRM system has been delayed and is still in process. Meanwhile current systems and options are being explored. Initial awareness and Comments: strengthening the current system will be carried out before December 2018. Hence there is no evidence that the GRM is receiving and processing complaints. IN00768820 ►Implementing entities submitting the annual FM and technical report on time (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 95.00 Date 11-Mar-2016 31-Dec-2018 30-Sep-2019 30-Jun-2021 12/19/2019 Page 5 of 7 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P152394 IDA-58360 Effective USD 150.00 150.00 0.00 61.52 84.55 42% P152394 TF-A2561 Effective USD 40.00 40.00 0.00 21.32 18.68 53% P152394 TF-A2792 Effective USD 1.10 1.10 0.00 0.46 0.64 42% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P152394 IDA-58360 Effective 15-Jun-2016 04-Jul-2016 29-Sep-2016 30-Sep-2021 30-Sep-2021 P152394 TF-A2561 Effective 15-Jun-2016 04-Jul-2016 29-Sep-2016 30-Sep-2021 30-Sep-2021 P152394 TF-A2792 Effective 15-Jun-2016 04-Jul-2016 04-Jul-2016 30-Jun-2020 30-Jun-2020 Cumulative Disbursements 12/19/2019 Page 6 of 7 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) Restructuring History Level 2 Approved on 24-Jun-2019 Related Project(s) There are no related projects. 12/19/2019 Page 7 of 7