Public Disclosure Authorized AFRICA Congo, Democratic Republic of Health, Nutrition & Population Global Practice IBRD/IDA Investment Project Financing FY 2015 Seq No: 6 ARCHIVED on 25-Oct-2017 ISR29688 Implementing Agencies: Ministry of Health, Ministry of Health, Democratic Republic of Congo, Ministry Of Finances Public Disclosure Authorized Key Dates Key Project Dates Bank Approval Date:18-Dec-2014 Planned Mid Term Review Date:22-Jul-2019 Original Closing Date:31-Dec-2019 Project Development Objectives Effectiveness Date:30-May-2016 Actual Mid-Term Review Date:-- Revised Closing Date:31-Dec-2021 Public Disclosure Authorized Project Development Objective (from Project Appraisal Document) The proposed project development objective is to improve utilization and quality of maternal and child health services in targeted areas within the Recipient's Territory. Has the Project Development Objective been changed since Board Approval of the Project Objective? No PHRPDODEL Components Public Disclosure Authorized Name Additional FP, nutrition, adolescent health, and SGBV activities included in the RMNCACH PBF package of services both at health facility and community levels.:(cost $174.00 M) Community based interventions added focusing on demand side of the RMNCAH package of services.:(cost $90.70 M) A new sub-component on pension reform will be added to this component and additional activities will be financed to support supply chain and avaiilability of drugs & vaccines, and capacity building.:(cost $110.30 M) Component 4: Disease Surveillance System Strengthening and Response:(Cost $15.00 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating Substantial Substantial 10/25/2017 Page 1 of 11
Implementation Status and Key Decisions The Health System Strengthening for Better Maternal and Child Health Results Project has been implemented successfully since its effectiveness on May 31, 2016. Overall the project is satisfactory with performance based funding has been launched in all 11 provinces and contracts having been signed with over 2000 healthcare facilities. The results started to show improvement in utilization of services as fees have been reduced and quality of care has improved from 20% at the start of the project to 50% to date. 10/25/2017 Page 2 of 11
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Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance -- High High Macroeconomic -- Substantial Substantial 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 -- Low Moderate Stakeholders -- Moderate Moderate Other -- -- -- Overall -- Substantial Substantial 10/25/2017 Page 4 of 11
Results Project Development Objective Indicators PHINDPDOTBL Percentage of pregnant women having at least 3 antenatal care visits before delivery (Percentage, Custom) Value 57.00 59.00 41.00 65.00 PHINDPDOTBL People who have received essential Health, Nutrition, Population services (Number, Custom) Value 0.00 0.00 2,500,000.00 14,350,000.00 PHINDPDOTBL New curative consultations per capita per year (Text, Custom) Value 0.25 0.25 0.32 0.50 PHINDPDOTBL Percentage of Children Fully Immunized (Percentage, Custom) Value 54.00 56.00 62.00 65.00 10/25/2017 Page 5 of 11
PHINDPDOTBL Average score of the quality checklist at the health centers (Percentage, Custom) Value 20.00 20.00 49.50 55.00 Overall Comments Overall we see a progress in all project development objective indicators. The reason the indicator regarding pre-natal care has decreased is mainly due to completeness of data entry in the health management information system. Intermediate Results Indicators Number of new and existing acceptors of modern contraceptive use (Number, Custom) Value 194,480.00 233,376.00 214,319.00 500,000.00 Average number of days with stock out of tracer drugs in targeted health facilities on the day of the visit (Text, Custom) Value >30 days -- >30 days >15 days 10/25/2017 Page 6 of 11
First time adolescent girls acceptant of modern contraceptives (Number, Custom) Value 0.00 0.00 0.00 50,000.00 Percentage of children under 24 months participating in the Growth Monitoring and Promotion activities at community level (Percentage, Custom) Value 26.90 28.00 28.00 45.00 Date 31-Dec-2015 31-Dec-2016 30-Jun-2017 31-Dec-2021 Health facilities receiving Client Tracer and Satisfaction Survey feedback (Percentage, Custom) Value 0.00 0.00 20.00 80.00 Civil servants eligible for retirement in the Ministry of Health that have received their retirement indemnities/packages and retired from active service (Number, Custom) Value 0.00 0.00 1.00 4,000.00 10/25/2017 Page 7 of 11
Single contract signed and implemented at province level (Number, Custom) Value 2.00 2.00 6.00 11.00 Percentage of families participating in parental education sessions at community level (Percentage, Custom) Value 0.00 0.00 0.00 50.00 Exclusive breastfeeding for children under 6 months (Percentage, Custom) Value 0.00 54.00 54.00 66.00 Date 31-Dec-2015 31-Dec-2016 30-Jun-2017 31-Dec-2021 Percentage of pregnant women counseled and tested for HIV (Percentage, Custom) Value 17.50 23.00 30.00 38.00 10/25/2017 Page 8 of 11
Average quality of nutritional services (Percentage, Custom) Value 0.00 20.00 20.00 55.00 Date 31-Dec-2015 31-Dec-2016 30-Jun-2017 31-Dec-2021 Number of poor people benefiting from fee exemption mechanisms (Number, Custom) Value 5,248.00 5,300.00 5,429.00 6,500.00 Health personnel receiving training (number) (Number, Custom) Value 0.00 4,000.00 4,935.00 10,000.00 Number of Direct Beneficiaries, of which female (Number, Custom) Value 0.00 5,351,089.00 5,862,580.00 20,090,000.00 Overall Comments Some of the intermediate indicators didn't change as they involve activities that have been introduced in the additional financing and as this additional financing isn't effective yet, the project hasn't been able to start implementation. 10/25/2017 Page 9 of 11
Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed Disbursed P147555 IDA-55720 Effective USD 130.00 130.00 0.00 29.46 94.34 23% P147555 IDA-59980 Not Effective USD 120.00 120.00 0.00 0.00 124.74 0% P147555 IDA-D0210 Effective USD 90.00 90.00 0.00 31.98 53.48 36% P147555 TF-18375 Effective USD 6.50 6.50 0.00 0.92 5.58 14% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P147555 IDA-55720 Effective 18-Dec-2014 20-Jan-2015 30-May-2016 31-Dec-2019 31-Dec-2021 P147555 IDA-59980 Not Effective 31-Mar-2017 19-Apr-2017 -- 31-Dec-2021 31-Dec-2021 P147555 IDA-D0210 Effective 18-Dec-2014 20-Jan-2015 30-May-2016 31-Dec-2019 31-Dec-2021 P147555 TF-18375 Effective 20-Jan-2015 20-Jan-2015 30-May-2016 31-Dec-2019 31-Dec-2021 Cumulative Disbursements 10/25/2017 Page 10 of 11
Restructuring History Level 2 Approved on 01-Sep-2015 Related Project(s) P157864-DRC Health System Strengthening Additional Financing,P165435-DRC - Additional Financing Health System Strengthening Project for Better Maternal and Child Health Results 10/25/2017 Page 11 of 11