The World Bank Implementation Status & Results Report Emergency Tuberculosis Project (P160947) Emergency Tuberculosis Project (P160947) EAST ASIA AND PACIFIC | Papua New Guinea | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2017 | Seq No: 4 | ARCHIVED on 05-Dec-2018 | ISR35034 | Implementing Agencies: Department of Treasury, National Department of Health Key Dates Key Project Dates Bank Approval Date: 31-May-2017 Effectiveness Date: 25-Sep-2017 Planned Mid Term Review Date: 19-Nov-2019 Actual Mid-Term Review Date: -- Original Closing Date: 30-Jun-2022 Revised Closing Date: 30-Jun-2022 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) To Improve the quality and expand the coverage and utilization of health services to control the spread of tuberculosis in targeted areas of Papua New Guinea by strengthening programmatic management of tuberculosis. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Early detection of active tuberculosis patients:(Cost $3.55 M) Effective treatment of drug-susceptible and drug-resistant tuberculosis patients:(Cost $7.70 M) Strengthening government systems for managing its health services delivery and tuberculosis response:(Cost $3.75 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Moderately Unsatisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Unsatisfactory Overall Risk Rating High High Implementation Status and Key Decisions The population screening for TB in Daru was completed on November 1, 2018; 7,260 individuals were screened, accounting for 66 percent of those eligible for screening. Of these, 51 individuals tested positive for TB, suggesting a 1 percent prevalence rate. Of those who were positive, 12 individuals were Rifampicin Resistant. TB treatment has commenced for 46 individuals, and 5 individuals await a decision on the appropriate course of treatment in order to commence. A mop-up operation to cover the remaining eligible population is expected to begin in January 2019. The Project Coordinator has been recruited, and the Government of PNG has signed a contract with the World Health Organization to provide technical support for the national TB effort. Progress also continues on other activities highlighted in the previous Implementation Status Report, notably: 12/5/2018 Page 1 of 8 The World Bank Implementation Status & Results Report Emergency Tuberculosis Project (P160947) • Support for active case finding and treatment support through NGO service providers in the National Capital District; and • Contracting UNOPS to provide logistics support to the TB effort. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance High High High Macroeconomic Substantial Substantial Substantial Sector Strategies and Policies Substantial Substantial Substantial Technical Design of Project or Program Low Low Low Institutional Capacity for Implementation and Sustainability High High High Fiduciary High High High Environment and Social Low Low Low Stakeholders Substantial Substantial Substantial Other -- -- -- Overall High High High Results PDO Indicators by Objectives / Outcomes To Improve the quality and expand the coverage and utilization of health services to control the spr IN00601549 ►Number of people receiving tuberculosis treatment in accordance with the national guidelines (NCD) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 6,169.00 6,169.00 5,982.00 7,100.00 Date 31-Aug-2016 30-Aug-2017 31-May-2018 30-Jun-2022 IN00601550 ►Number of people receiving tuberculosis treatment in accordance with the national guidelines (Daru/South Fly District, Western Province) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1,659.00 1,659.00 786.00 1,900.00 Date 31-Aug-2016 30-Aug-2017 31-May-2018 30-Jun-2022 IN00601596 12/5/2018 Page 2 of 8 The World Bank Implementation Status & Results Report Emergency Tuberculosis Project (P160947) ►The proportion of TB patients who have received drug-sensitivity testing (DST) (NCD) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 20.00 20.00 1.50 80.00 Date 31-Aug-2016 30-Aug-2017 31-May-2018 30-Jun-2022 IN00601597 ►The proportion of TB patients who have received DST (Daru/South Fly District,Western Province) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 41.00 41.00 4.50 80.00 Date 31-Aug-2016 30-Aug-2017 31-May-2018 30-Jun-2022 IN00601598 ►TB treatment success rate for DS TB (NCD) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 56.00 56.00 77.00 85.00 Date 31-Aug-2016 30-Aug-2017 31-May-2018 30-Jun-2022 IN00601599 ►TB treatment success rate for DS TB (Daru/South Fly District,Western Province) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 71.00 71.00 83.00 85.00 Date 31-Aug-2016 30-Aug-2017 31-May-2018 30-Jun-2022 IN00601600 ►TB treatment success rate for DR TB (NCD) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 44.00 44.00 44.00 75.00 Date 31-Aug-2016 30-Aug-2017 30-Aug-2017 30-Jun-2022 No update available. Comments: IN00601617 ►TB treatment success rate for DR TB for females (NCD) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 75.00 Date 31-Aug-2016 30-Aug-2017 31-May-2018 31-Dec-2021 No update available. Comments: IN00601601 ►TB treatment success rate for DR TB (Daru/South Fly District,Western Province) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target 12/5/2018 Page 3 of 8 The World Bank Implementation Status & Results Report Emergency Tuberculosis Project (P160947) Value 49.00 49.00 79.00 75.00 Date 31-Aug-2016 30-Aug-2017 31-May-2018 30-Jun-2022 IN00601618 ►TB treatment success rate for DR TB for females (Daru/South Fly District,Western Province) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 71.40 71.40 0.00 75.00 Date 31-Aug-2016 30-Aug-2017 31-May-2018 30-Jun-2022 Update not available Comments: IN00601619 ►Number of BMUs where all clinical staff have been trained/ retrained on TB and DR TB (NCD & Western Province) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 20.00 20.00 Date 31-Aug-2016 30-Aug-2017 31-May-2018 30-Jun-2022 Overall Comments PDO In the semi-annual progress report submitted, it was noted that the National TB Program has had difficulties with obtaining data from the Basic Management Units (BMUs), with only 74 percent of BMUs reporting in the 4th quarter of 2017, and 40 percent in the 1st quarter of 2018. This may be one explanation for the results reported above, where some indicators have declined over the baseline. Further explanation is needed, and will be sought, for the indicators that have declined since baseline. Intermediate Results Indicators by Components Early detection of active tuberculosis patients IN00601602 ►Population-based screening in Daru is complete (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No -- Yes Yes Date 31-Aug-2016 -- 01-Nov-2018 30-Jun-2022 Population screening in Daru completed on November 1, 2018. A mop up operation is planned in January Comments: 2018 to cover individuals who could not be covered in the screening. IN00601603 ►Number of BMUs with functioning TB Smear microscopy (NCD & Western Province) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target 12/5/2018 Page 4 of 8 The World Bank Implementation Status & Results Report Emergency Tuberculosis Project (P160947) Value 12.00 -- 16.00 20.00 Date 31-Aug-2016 -- 31-May-2018 30-Jun-2022 IN00601608 ►Number of BMUs with functioning Xpert MTB/Rif (NCD & Western Province) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 5.00 -- 6.00 16.00 Date 31-Aug-2016 -- 31-May-2018 30-Jun-2022 Effective treatment of drug-susceptible and drug-resistant tuberculosis patients IN00601609 ►Smear conversion rate among DS TB cases (by 2 months for new cases and 3 months for retreatment cases) (NCD) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 73.00 -- 76.00 85.00 Date 31-Aug-2016 -- 31-May-2018 30-Jun-2022 IN00601604 ►Smear conversion rate among DS TB cases (by 2 months for new cases and 3 months for retreatment cases) (Daru/South Fly District,Western Province) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 78.00 -- 81.00 85.00 Date 31-Aug-2016 -- 31-May-2018 30-Jun-2022 IN00601605 ►Culture conversion rate among DR TB cases (At 6 months for normal course and 4 months for shorter course) (NCD) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 75.00 Date 31-Aug-2016 -- 31-May-2018 30-Jun-2022 No update available Comments: IN00601606 ►Culture conversion rate among DR TB cases (At 6 months for normal course and 4 months for shorter course) (Daru/South Fly District,Western Province) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 65.00 -- 0.00 75.00 Date 31-Aug-2016 -- 31-May-2018 30-Jun-2022 No update available Comments: IN00601610 ►A reduction in lost to follow up of DS TB patients (Daru/South Fly District,Western Province) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target 12/5/2018 Page 5 of 8 The World Bank Implementation Status & Results Report Emergency Tuberculosis Project (P160947) Value 15.00 -- 6.00 6.00 Date 31-Aug-2016 -- 31-May-2019 30-Jun-2022 IN00601611 ►A reduction in lost to follow up of DR TB patients (NCD) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 12.00 -- 21.00 5.00 Date 31-Aug-2016 -- 31-May-2018 30-Jun-2022 IN00601607 ►A reduction in lost to follow up of DS TB patients (NCD) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 10.00 -- 21.00 4.00 Date 31-Aug-2016 -- 31-May-2018 30-Jun-2022 IN00601612 ►Number (cumulative) of DR TB patients on shorter regimen (NCD & Western Province) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 59.00 400.00 Date 31-Aug-2016 -- 31-May-2018 30-Jun-2022 Strengthening government systems for managing its health services delivery and tuberculosis response IN00601616 ►The conduction of semi-annual review meeting which involves TB development partners and government agencies to review the progress and make the consolidated, integrated work plan and budget (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No -- Yes Yes Date 31-Aug-2016 -- 31-May-2018 30-Jun-2022 IN00601614 ►Citizens and/or communities involved in planning/implementation/evaluation of development programs (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No -- Yes Yes Date 31-Aug-2016 -- 31-May-2018 30-Jun-2022 Multi-sectoral TB Alliance in Daru are supporting awareness raising for mass screening Comments: IN00601615 ►Project-supported organization(s) publishing reports containing information on feedback received from citizens and/or communities and if/how this feedback has been used (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No -- No Yes 12/5/2018 Page 6 of 8 The World Bank Implementation Status & Results Report Emergency Tuberculosis Project (P160947) Date 31-Aug-2016 -- 31-May-2018 30-Jun-2022 IN00601613 ►Timely delivery of annual report compiled by NTP (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No -- No Yes Date 31-Aug-2016 -- 31-May-2018 30-Jun-2022 Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P160947 IDA-60670 Effective USD 15.00 15.00 0.00 0.06 15.68 0.4% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P160947 IDA-60670 Effective 31-May-2017 19-Jul-2017 25-Sep-2017 30-Jun-2022 30-Jun-2022 Cumulative Disbursements 12/5/2018 Page 7 of 8 The World Bank Implementation Status & Results Report Emergency Tuberculosis Project (P160947) Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 12/5/2018 Page 8 of 8