The World Bank Report No: ISR4542 Implementation Status & Results Solomon Islands SB Health Sector Support Project (TA) (P097671) Public Disclosure Copy Operation Name: SB Health Sector Support Project (TA) (P097671) Project Stage: Implementation Seq.No: 5 Status: ARCHIVED Archive Date: 11-May-2011 Country: Solomon Islands Approval FY: 2008 Product Line: IBRD/IDA Region: EAST ASIA AND PACIFIC Lending Instrument: Technical Assistance Loan Implementing Agency(ies): Ministry of Health and Medical Services Key Dates Board Approval Date 20-Mar-2008 Original Closing Date 31-Mar-2011 Planned Mid Term Review Date 02-Sep-2010 Last Archived ISR Date 11-May-2011 Effectiveness Date 14-Jul-2008 Revised Closing Date 31-Dec-2011 Actual Mid Term Review Date 02-Sep-2010 Project Development Objectives Project Development Objective (from Project Appraisal Document) The Project's development objective is to improve the institutional capacity of MHMS in the areas of public expenditure management and sector performance monitoring. Such capacity development would be critical to the overall success of the Program in improving health services delivery and outcomes. Has the Project Development Objective been changed since Board Approval of the Project? Yes No Component(s) Component Name Component Cost Public Expenditure Management 0.19 Sector Performance Monitoring 0.89 Training and Capacity Building 0.16 Overall Ratings Previous Rating Current Rating Public Disclosure Copy Progress towards achievement of PDO Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Unsatisfactory Overall Risk Rating Implementation Status Overview The Health Sector Support Program - Technical Assistance (HSSP-TA) grant supported the Ministry of Health and Medical Services (MHMS) to strengthen its public expenditure management, health sector planning, and sector performance monitoring. MHMS used the grant to develop the National Health Strategic Plan (NHSP) for 2011-2015, its associated monitoring and evaluation framework, and, a Medium Term Expenditure Framework (MTEF). The grant closed on 31 December 2011. Locations Page 1 of 6 The World Bank Report No: ISR4542 Country First Administrative Division Location Planned Actual Solomon Islands Guadalcanal Province Guadalcanal Province ✔ ✔ Public Disclosure Copy Results Project Development Objective Indicators Indicator Name Core Unit of Measure Baseline Current End Target Completion of the first rolling medium term Text Value MTEF finalised and MTEF developed and sector expenditure program linking resources distributed finalised with priorities Date 05-Dec-2011 31-Dec-2011 Comments The final MTEF formed the basis for the resource envelope for the new NHSP and subsequently informed the development of annual operational plans. Increased proportion of health sector Text Value Provincial grants have Increased by 17% the expenditures on primary health services and increased expenditure on proportion of health provincial health programs primary health care by expenditure on primary health 25-30%. Provincial secondary services and provincial health health expenditure has also programs increased. Overall provincial health expenditure has increased to approximately 37%. Date 05-Dec-2011 31-Dec-2011 Comments The MHMS is working with the Ministry of Provincial Government and the Ministry of Finance to develop Imprest accounts to enable Public Disclosure Copy decentralization of expenditures. The Ministry of Finance is yet to develop a system (with associated charter of accounts) that enables full appropriation of national programs to the provincial level. System development will take time. Page 2 of 6 The World Bank Report No: ISR4542 Participatory joint annual reviews conducted Text Value Formal joint annual reviews Joint reviews conducted conducted in 2009, 2010, and annually. 2011. Public Disclosure Copy Date 01-Feb-2008 30-Sep-2011 31-Dec-2011 Comments Less substantial reviews were undertaken in 2007 and 2008. Intermediate Results Indicators Indicator Name Core Unit of Measure Baseline Current End Target Increased community participation in health Text Value Increased involvement of Increased community services planning at the provincial level provincial health staff and participation in provincial communities in service health services planning planning. Date 01-Feb-2008 05-Dec-2011 31-Dec-2011 Comments All health planning had been There has been a gradual conducted in a centralized increase in community and top-down manner prior to involvement in health service the preparation of the new planning at the provincial NHSP. level. Provincial plans were developed by provincial level officials with guidance from the Planning team. Partnerships between stakeholders and the community continue to develop and strengthen in the provinces. Budget planning and development, and Text Value Agreements were reached on Accounting processes accounting processes enhanced and coding structures, the use of enhanced and institutionalized MYOB and initial training institutionalized. activities Date 01-Feb-2008 01-Apr-2011 31-Dec-2011 Public Disclosure Copy Comments All financial systems were A financial controller was fragile. At the provincial level, recruited and systems are the system was unable to being further developed and separate expenditures from institutionalized. These, the hospital and primary systems (though still fragile) health care programs. are being used for the NHSP and its operational plans. The MHMS has reached out to the Ministry of Finance to develop a chartof accounts that will Page 3 of 6 The World Bank Report No: ISR4542 enable full appropriation of budgets to provinces and provincial programs as per requirements of the MHMS. Public Disclosure Copy Inthe meantime, the MHMS continues to run MYOB to monitor budgets and expenditures by program, at the national and provincial level. Comprehensive sector performance indicators Text Value NHSP 2011-2015 with a Comprehensive sector and monitoring system developed comprehensive M&E performance indicator and framework developed monitoring system developed. Date 01-Feb-2008 05-Dec-2011 31-Dec-2011 Comments Health information systems are very fragile, unsystematic and often subject to delays in processing. MHMS Executive making decisions based on Text Value MHMS executive are making Evidence-based decision Monitoring and Evaluation reports decisions based on a range of making by the MHMS assessments executive Date 23-Feb-2007 05-Dec-2011 31-Dec-2011 Comments Previously the executive team At the National Health placed less priority on the Conference, the MHMS need for timely information to Executive demonstrated a inform their strategic growing commitment to decisions. evidence-based planning at both the national and provincial levels. Continued strengthening of information systems will enable this demand to be more fully institutionalized. Public Disclosure Copy Provincial planning process including medium Text Value Operational plans with Provincial planning process term plan and annual operational planning stronger M&E framework and operational plans adopted system adopted with strong M&E framework developed and adopted Date 07-Feb-2008 05-Dec-2011 31-Dec-2011 Comments The Ministry had top-down The new NSHP emphasizes annual operational planning the important role of system without strong and provinces and their enhanced timely M&E framework. responsibility for planning and implementing programs. The MTEF signals a need for the Page 4 of 6 The World Bank Report No: ISR4542 MHMS to more fully develop five-year plans consistent with the resource envelope. Fragile budgeting systems Public Disclosure Copy and limited preparation timeframes mean the Ministry has difficulty linking budgeting and planning, particularly at the provincial level. This remains an ongoing challenge. Provincial health plans developed, Text Value Provincial health plans Provincial operational plans implemented and monitored for progress developed with M&E developed against agreed targets framework Date 14-Feb-2008 05-Dec-2011 31-Dec-2011 Comments Provincial plans were top- Provincial operational plans down and often comprised of developed for 2010 formed a series of activity lists without the basis for monitoring of a strategic program focus or provincial expenditures and M&E framework. program outcomes for2011. The timelines for provincial planning and its problematic link to budgeting cycles (as noted above) continue to mean there is significant room for improvement in ex-ante planning and budgeting. Data on Financial Performance (as of 02-Aug-2011) Financial Agreement(s) Key Dates Project Loan No. Status Approval Date Signing Date Effectiveness Date Closing Date P097671 IDA-H3600 Closed 20-Mar-2008 14-Apr-2008 14-Jul-2008 31-Dec-2011 Public Disclosure Copy Disbursements (in Millions) Project Loan No. Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P097671 IDA-H3600 Closed XDR 1.00 1.00 0.00 0.66 0.34 66.00 Disbursement Graph Page 5 of 6 The World Bank Report No: ISR4542 Public Disclosure Copy Key Decisions Regarding Implementation A draft Implementation Completion and Results Report (ICR) for the Project will be finalised in the first quarter of 2012. Restructuring History Level two Approved on 28-Sep-2010 Related Projects There are no related projects. Public Disclosure Copy Page 6 of 6