Public Disclosure Copy The World Bank Implementation Status & Results Report Uttarakhand Health Systems Development Project (P148531) Uttarakhand Health Systems Development Project (P148531) SOUTH ASIA | India | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2017 | Seq No: 3 | ARCHIVED on 21-Apr-2018 | ISR31833 | Implementing Agencies: Government of India, Department of Medical Health and Family Welfare, Government of Uttarakhand Key Dates Key Project Dates Bank Approval Date:26-Jan-2017 Effectiveness Date:23-May-2017 Planned Mid Term Review Date:06-Apr-2020 Actual Mid-Term Review Date:-- Original Closing Date:30-Sep-2023 Revised Closing Date:30-Sep-2023 Project Development Objectives Project Development Objective (from Project Appraisal Document) The Project Development Objective (PDO) is to improve access to quality health services, particularly in the hilly districts of thestate, and to expand health financial risk protection for the residents of Uttarakhand Has the Project Development Objective been changed since Board Approval of the Project Objective? No PHRPDODEL Components Name Innovations in engaging the private sector:(Cost $80.00 M) Stewardship and system improvement component:(Cost $45.00 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  Substantial  Substantial Implementation Status and Key Decisions 4/21/2018 Page 1 of 8 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Uttarakhand Health Systems Development Project (P148531) The mission was pleased to note that there has been some progress on institutional arrangements of the project following extended delays. The Government of Uttarakhand (GoUK) has finally established the critical Project Governing Board (PGB) and the Project Steering Committee (PSC). The PIT is also better staffed now. With the PGB and PSC established and team composition strengthened, faster clearance of project activities and expedited implementation are anticipated. As the appropriate implementation arrangements have only recently been put in place, implementation progress on key project activities remains a concern. To increase the likelihood of success in the third round of bidding for hiring of a provider from the private sector to maintain and operate a cluster of facilities in Tehri district, the GoUK revised the bidding documents, developed FAQs, and conducted roadshows in Dehradun and Delhi for potential bidders. The pre-bid meeting took place on March 29, 2018, and the process is expected to be completed by June 15, 2018. The GoUK is working on a roadmap for the revitalization of MSBY including its seamless integration/coordination with the recently announced NHPM by the Centre. It has been decided that the activities related to expansion of the primary care package under the project will be reviewed and undertaken once there is clarity on MSBY/NHPM and the recently announced Comprehensive Primary Health Care Wellness Program. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance  --  Moderate  Moderate Macroeconomic  --  Moderate  Moderate Sector Strategies and Policies  --  Moderate  Moderate Technical Design of Project or Program  --  Substantial  Substantial Institutional Capacity for Implementation and Sustainability  --  Substantial  Substantial Fiduciary  --  Substantial  Substantial Environment and Social  --  Moderate  Moderate Stakeholders  --  Substantial  Substantial Other  --  --  -- Overall  --  Substantial  Substantial Results Project Development Objective Indicators PHINDPDOTBL  Number of outpatient visits to Primary Health Centers (PHCs), CHCs, and mobile vans per year, disaggregated by districts (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 774,926.00 -- -- 1,150,000.00 Date 31-Mar-2016 -- -- 31-Mar-2023 4/21/2018 Page 2 of 8 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Uttarakhand Health Systems Development Project (P148531) PHINDPDOTBL  Number of persons who used the Health Helpline to receive information or lodge grievances, disaggregated by gender (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 81,192.00 -- -- 160,000.00 Date 25-Nov-2016 -- -- 31-Mar-2023 PHINDPDOTBL  Patients contacted by the Health Helpline that are satisfied with the health services provided to them (per year, disaggregated by gender) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- -- 70.00 Date 25-Nov-2016 -- -- 31-Mar-2023 PHINDPDOTBL  Number of government and non-government healthcare facilities in the state issued with an entry (or higher) level certification by the National Accreditation Board for Hospitals (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 2.00 -- -- 8.00 Date 25-Nov-2016 -- -- 31-Mar-2023 PHINDPDOTBL  Number of hospital admissions and outpatient consultations covered by any form of health insurance supported by the project (RSBY and MSBY), disaggregated by gender (Number, Custom) 4/21/2018 Page 3 of 8 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Uttarakhand Health Systems Development Project (P148531) Baseline Actual (Previous) Actual (Current) End Target Value 46,040.00 -- -- 100,000.00 Date 29-Jul-2016 -- -- 31-Mar-2023 Overall Comments Intermediate Results Indicators PHINDIRITBL  People with access to any form of health insurance in the state during the year, disaggregated by gender (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 921,584.00 -- -- 3,000,000.00 Date 31-Dec-2014 -- -- 31-Mar-2023 PHINDIRITBL  Number of children covered under the expanded health insurance program who received an annual health assessment during the year, disaggregated by gender (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- -- 200,000.00 Date 25-Nov-2016 -- -- 31-Mar-2023 PHINDIRITBL  Number of children immunized during the year (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 140,631.00 -- -- 180,000.00 Date 31-Mar-2016 -- -- 31-Mar-2023 4/21/2018 Page 4 of 8 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Uttarakhand Health Systems Development Project (P148531) PHINDIRITBL  Number of patients who use the services provided by the mobile health vans, disaggregated by gender (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 104,122.00 -- -- 300,000.00 Date 25-Nov-2016 -- -- 31-Mar-2023 PHINDIRITBL  Number of mobile medical units complying with the requirement of having at least one female doctor with sonology certification (>90% compliance on a day-to-day basis) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- -- 9.00 Date 25-Nov-2016 -- -- 31-Mar-2023 PHINDIRITBL  Number of outsourced CHCs with utilization of emergency services reported during each month (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- -- 8.00 Date 25-Nov-2016 -- -- 31-Mar-2023 PHINDIRITBL  Number of outsourced CHCs where at least one emergency caesarean section was reported during each quarter (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- -- 6.00 Date 25-Nov-2016 -- -- 31-Mar-2023 4/21/2018 Page 5 of 8 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Uttarakhand Health Systems Development Project (P148531) PHINDIRITBL  Benefit package of child health services finalized and piloted (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target 'yes' from year Value 0.00 -- -- 2 Date 25-Nov-2016 -- -- 31-Mar-2023 PHINDIRITBL  Benefit package of NCDs services finalized and piloted (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target "no" for the first three years and Value 0.00 -- -- "yes" from year 4. Date 25-Nov-2016 -- -- 31-Mar-2023 PHINDIRITBL  Share of eligible households successfully enrolled under RSBY/MSBY during the year (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 45.70 -- -- 50.00 Date 31-Dec-2014 -- -- 31-Mar-2023 PHINDIRITBL  Number of specialists working in the outsourced health facilities (and augmenting the positions functionally vacant in the public system) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 25.00 -- -- 50.00 Date 25-Nov-2016 -- -- 31-Mar-2023 4/21/2018 Page 6 of 8 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Uttarakhand Health Systems Development Project (P148531) PHINDIRITBL  Health personnel receiving training financed by the project- cumulative (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- -- 5,000.00 Date 25-Nov-2016 -- -- 31-Mar-2023 PHINDIRITBL  Development and periodical update of a comprehensive disaster response plan at the state level (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Done by year 2, updated by Value 0.00 -- -- year revised by year 6. Date 25-Nov-2016 -- -- 31-Mar-2023 Overall Comments Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed Disbursed P148531 IDA-59480 Effective USD 100.00 100.00 0.00 0.05 99.95 0% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P148531 IDA-59480 Effective 26-Jan-2017 23-Mar-2017 23-May-2017 30-Sep-2023 30-Sep-2023 Cumulative Disbursements 4/21/2018 Page 7 of 8 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Uttarakhand Health Systems Development Project (P148531) Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 4/21/2018 Page 8 of 8 Public Disclosure Copy