Public Disclosure Copy The World Bank Implementation Status & Results Report Kosovo Health Project (P147402) Kosovo Health Project (P147402) EUROPE AND CENTRAL ASIA | Kosovo | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2014 | Seq No: 9 | ARCHIVED on 11-Oct-2017 | ISR29532 | Implementing Agencies: Ministry of Health, Republic of Kosovo, Ministry of Health Key Dates Key Project Dates Bank Approval Date:13-May-2014 Effectiveness Date:20-May-2015 Planned Mid Term Review Date:30-Oct-2017 Actual Mid-Term Review Date:-- Original Closing Date:30-Oct-2019 Revised Closing Date:30-Oct-2019 Project Development Objectives Project Development Objective (from Project Appraisal Document) To contribute to improving financial protection from health spending for the poor and quality of care for priority maternal and child health and non communicable disease services. Has the Project Development Objective been changed since Board Approval of the Project Objective? No PHRPDODEL Components Name Improving financial protection and quality of care:(Cost $11.20 M) Strengthening primary care:(Cost $12.50 M) Project management:(Cost $1.80 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO  Moderately Unsatisfactory  Moderately Unsatisfactory Overall Implementation Progress (IP)  Moderately Satisfactory  Moderately Satisfactory Overall Risk Rating  Substantial  Substantial Implementation Status and Key Decisions 10/11/2017 Page 1 of 7 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Kosovo Health Project (P147402) Agreement was reached with the Government to organize the Project Mid Term Review (MTR) during October 30-November 3, 2017. The MTR will provide an opportunity to discuss the following with all project stakeholders: (i) achievements against the project development objectives, (ii) relevance of the project components/activities, and (iii) status of the indicators included in the Project Results Framework. Overall, limited progress is achieved in project implementation. Some progress has been achieved in some project activities, although with delay, including: (i) capacity building of the Health Insurance Fund (HIF): a high-level Advisor to the Director of the HIF was contracted in mid-September 2017; (ii) purchasing of medical equipment: procurement process has been initiated; and (iii) preparation of the action plan for the introduction of Diagnostic- Related Groups (DRGs) at the hospital level: this is completed; (iv) study on the population’s perception of the quality of services in primary health care (PHC) facilities and expectations regarding the drug benefit scheme: the contract has just been signed; and (v) Health Insurance Fund Information System (HIFIS): the coming assessment of the HIFIS has just been confirmed. Meanwhile, no progress has been achieved so far in implementation of other key activities, including: (i) outpatient drug benefit scheme: preparation has been stalled since March 2017; (ii) hiring of a company to carry out the communication campaign on health financing reforms: activity has not yet been launched; and (iii) improvement of the Institute of Public Health Information System: this activity has been repeatedly delayed. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance  --  Substantial  High Macroeconomic  --  High  High Sector Strategies and Policies  --  Substantial  High Technical Design of Project or Program  --  Substantial  Substantial Institutional Capacity for Implementation and Sustainability  --  Substantial  High Fiduciary  --  Moderate  High 10/11/2017 Page 2 of 7 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Kosovo Health Project (P147402) Environment and Social  --  Low  Low Stakeholders  --  Substantial  Substantial Other  --  --  -- Overall  --  Substantial  Substantial Results Project Development Objective Indicators PHINDPDOTBL  Percentage of the poor enrolled in mandatory health insurance (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 90.00 Date 13-May-2014 04-Apr-2017 04-Sep-2017 30-Oct-2019 PHINDPDOTBL  Outpatient (OP) drug benefit scheme established and functional based on pre-defined operational criteria (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value N N N Y Date 13-May-2014 04-Apr-2017 04-Sep-2017 30-Oct-2019 PHINDPDOTBL  Percentage of participating municipalities where at least 75 percent of the agreed quality targets were achieved in the preceding one year (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 75.00 Date 13-May-2014 04-Apr-2017 04-Sep-2017 30-Oct-2019 Overall Comments There is no progress toward the end target for PDO indicators 1 and 2 (Percentage of the poor enrolled in mandatory health insurance; and Outpatient (OP) drug benefit scheme established and functional based on pre-defined operational criteria). The third PDO indicator (Percentage of participating municipalities where at least 75 percent of the agreed quality targets were achieved in the preceding one year) is not applicable. At the moment, capitation based performance payments are based on a formula that is not associated with a target. 10/11/2017 Page 3 of 7 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Kosovo Health Project (P147402) Intermediate Results Indicators PHINDIRITBL  Direct project beneficiaries (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 1,170,000.00 Date 13-May-2014 04-Apr-2017 04-Sep-2017 30-Oct-2019 PHINDIRITBL  Female beneficiaries (Percentage, Custom Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 48.00 0.00 0.00 48.00 PHINDIRITBL  Female project beneficiaries, as % of number of project beneficiaries (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 48.00 Date 13-May-2014 04-Apr-2017 04-Sep-2017 30-Oct-2019 PHINDIRITBL  Percentage of resident population enrolled in mandatory health insurance (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 65.00 Date 13-May-2014 04-Apr-2017 04-Sep-2017 30-Oct-2019 10/11/2017 Page 4 of 7 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Kosovo Health Project (P147402) PHINDIRITBL  Achievement of key benchmarks for functioning health insurance system (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value N N N Y Date 13-May-2014 04-Apr-2017 04-Sep-2017 30-Oct-2019 PHINDIRITBL  Health personnel receiving training (number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 849.00 1,000.00 Date 13-May-2014 04-Apr-2017 04-Sep-2017 30-Oct-2019 PHINDIRITBL  Number of municipalities who have entered into performance agreements with the MoH/ HFA/ HIF and MoF (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 6.00 6.00 25.00 Date 13-May-2014 04-Apr-2017 04-Sep-2017 30-Oct-2019 PHINDIRITBL  Percentage of participating municipalities with a performance improvement action plan (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 90.00 Date 13-May-2014 20-Sep-2016 04-Sep-2017 30-Oct-2019 10/11/2017 Page 5 of 7 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Kosovo Health Project (P147402) PHINDIRITBL  Percentage of capitation-based performance payment budget spent at municipality level (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 48.42 95.00 Date 13-May-2014 04-Apr-2017 04-Sep-2017 30-Oct-2019 PHINDIRITBL  Health facilities constructed, renovated, and/or equipped (number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 11.00 8.00 Date 13-May-2014 04-Apr-2017 04-Sep-2017 30-Oct-2019 Overall Comments Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed Disbursed P147402 IDA-54420 Effective USD 25.50 25.50 0.00 2.15 21.03 8% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P147402 IDA-54420 Effective 13-May-2014 15-Jan-2015 20-May-2015 30-Oct-2019 30-Oct-2019 Cumulative Disbursements 10/11/2017 Page 6 of 7 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Kosovo Health Project (P147402) Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 10/11/2017 Page 7 of 7 Public Disclosure Copy