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: 10 | ARCHIVED on 16-Apr-2018 | ISR32169 | 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:30-Oct-2017 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 Unsatisfactory Overall Risk Rating  Substantial  High Implementation Status and Key Decisions 4/16/2018 Page 1 of 7 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Kosovo Health Project (P147402) The Project Mid Term Review (MTR) was held during the periods of October 30-November 3, 2017, February 12-23, 2018 and March 2, 2018. Disbursements and commitments to date are US$2.6 million and US$1.83 million, respectively, together representing only 17% of the total credit amount of US$25.5 million. Based on limited achievements, the Bank team and the Government agreed during the MTR that the initial Project Development Objectives and the scope of the Project were exceedingly ambitious and made the decision to restructure the KHP as follows: Revised Project Development Objectives (PDO). The initial PDO was: “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”. The Government and the Bank team agreed to revise the formulation of the PDO as follows: “To contribute to (i) developing the building blocks to introduce Social Health Insurance (SHI); and (ii) strengthening primary health care (PHC).” Revised Project Components and Costs. The Bank team and the Government confirmed the need to restructure the operation in a manner that would optimize the benefit for the population, and ensure consistency with the agreed revised PDO. Additional criteria were feasibility of implementation by the Project Closing Date (October 30, 2019), sustainability of interventions beyond that date, and technical soundness. Based on these principles, the Government and the team agreed to revise the Project Components and related costs with a focus on: (i) the development of social health insurance building blocks; and (ii) Primary Health Care strengthening. Revised Results Framework. The Government and the World Bank team agreed to revise the Results Framework to ensure consistency with the revised PDO and components. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance  --  High  High Macroeconomic  --  High  High Sector Strategies and Policies  --  High  High Technical Design of Project or Program  --  Substantial  High Institutional Capacity for Implementation and Sustainability  --  High  High 4/16/2018 Page 2 of 7 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Kosovo Health Project (P147402) Fiduciary  --  High  High Environment and Social  --  Low  Low Stakeholders  --  Substantial  Substantial Other  --  --  -- Overall  --  Substantial  High 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-Sep-2017 10-Apr-2018 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-Sep-2017 10-Apr-2018 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-Sep-2017 10-Apr-2018 30-Oct-2019 Overall Comments 4/16/2018 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-Sep-2017 10-Apr-2018 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-Sep-2017 10-Apr-2018 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-Sep-2017 10-Apr-2018 30-Oct-2019 4/16/2018 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-Sep-2017 10-Apr-2018 30-Oct-2019 PHINDIRITBL  Health personnel receiving training (number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 849.00 849.00 1,000.00 Date 13-May-2014 04-Sep-2017 10-Apr-2018 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-Sep-2017 10-Apr-2018 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 04-Sep-2017 10-Apr-2018 30-Oct-2019 4/16/2018 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 48.42 48.42 95.00 Date 13-May-2014 04-Sep-2017 10-Apr-2018 30-Oct-2019 PHINDIRITBL  Health facilities constructed, renovated, and/or equipped (number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 11.00 11.00 8.00 Date 13-May-2014 04-Sep-2017 10-Apr-2018 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 2.40 20.95 10% 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 4/16/2018 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. 4/16/2018 Page 7 of 7 Public Disclosure Copy