Public Disclosure Authorized AFRICA Swaziland Health, Nutrition and Population Global Practice IBRD/IDA Specific Investment Loan FY 2011 Seq No: 8 ARCHIVED on 17-Jun-2015 ISR19302 Implementing Agencies: Ministry of Health, Deputy Prime Minister's Office Public Disclosure Authorized Key Dates Key Project Dates Board Approval date:10-mar-2011 Planned Mid Term Review Date:30-Apr-2015 Original Closing Date:31-May-2016 Project Development Objectives Effectiveness Date:09-May-2012 Actual Mid-Term Review Date:24-Oct-2014 Revised Closing Date:31-May-2016 Public Disclosure Authorized Project Development Objective (from Project Appraisal Document) The project development objectives (PDOs) are: (i) to improve access to and quality of health services in Swaziland with a particular focus on primary health care, maternal health and TB, and (ii) to increase social safety net access for OVC. Has the Project Development Objective been changed since Board Approval of the Project Objective? No PHRPDODEL Components Name Strengthening the Capacity of the Health Sector:(Cost $3.90 M) Public Disclosure Authorized Facility-level Support to Improve Access, Quality and Efficiency of Services:(Cost $24.38 M) Strengthening of the Orphans and Vulnerable Children (OVC) Safety Net:(Cost $6.71 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Unsatisfactory Moderately Satisfactory Overall Risk Rating Substantial Substantial 6/17/2015 Page 1 of 9
Implementation Status and Key Decisions Following the October 2014 mid-term review (MTR) of project implementation, consolidated WB/EU disbursement increased from 14% to 22% of the total project funds. Disbursements are expected to increase over the next reporting period as civil works and other activities accelerate. Overall, solid progress has been made across all components, while the Bank and GOS are finalizing the restructuring of the project. Highlights of recent progress include: (i) the development of a TB infections, prevention and control (IPC) workplan; (ii) training of TB Screening Officers and training of nurses on MDR-TB; (iii) completion of costing for the Second National Health Sector Strategic Plan 2014-2018; (iv) the imminent launch of Component 3 of the project, the OVC cash transfer program, following the finalization of the key design and implementation features of the program; (v) ongoing renovations at the Mbabane Government Hospital Maternity Unit and construction at the Good Shepherd School of Nursing; and (vi) installation of three incinerators at the Matsanjeni, Mkhuzweni, and Dvokolwako Health Centers. 6/17/2015 Page 2 of 9
Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance -- Substantial Substantial Macroeconomic -- Moderate Moderate Sector Strategies and Policies -- Moderate Moderate Technical Design of Project or Program -- Moderate Moderate Institutional Capacity for Implementation and Sustainability -- High High Fiduciary -- Substantial Substantial Environment and Social -- Moderate Moderate Stakeholders -- Moderate Moderate Other -- -- -- Overall -- Substantial Substantial Results Project Development Objective Indicators 6/17/2015 Page 3 of 9
PHINDPDOTBL Health facilities that provide at least five public health services (Percentage, Custom) Value 56.30 70.00 70.00 80.00 Date 31-Dec-2010 25-Nov-2013 25-Nov-2013 31-May-2016 PHINDPDOTBL Births delivered by a skilled attendant at a health facility (Percentage, Custom) Value 74.00 82.00 82.00 85.00 Date 31-Dec-2010 14-May-2013 14-May-2013 31-May-2016 PHINDPDOTBL TB case notification rate (Number, Custom) Value 801.00 716.50 716.50 941.00 Date 31-Dec-2010 25-Nov-2013 25-Nov-2013 31-May-2016 PHINDPDOTBL OVC beneficiaries that receive cash transfers regularly (as defined in the Implementation Manual) (Percentage, Custom) Value 0.00 0.00 0.00 75.00 Date 01-Jan-2011 30-May-2014 30-May-2014 -- Overall Comments Of the four original PDO indicators, they will be revised in the level II restructuring as follows: Original PDO indicators 1. Percentage of health facilities that provide at least five public health services 2. Percentage of births delivered by a skilled attendant in a health facility 3. TB case notification rate 4. Percentage of OVC beneficiaries that receive cash transfers regularly (as defined in the OVC Implementation Manual) Revised PDO indicators 6/17/2015 Page 4 of 9
5. Percentage of health facilities that provide at least five public health services 6. Caesarean deliveries as a percentage of institutional deliveries at health facilities 7. TB treatment success rate 8. Percentage of OVC beneficiaries that receive cash transfers quarterly (as defined in the OVC Implementation Manual) Intermediate Results Indicators People Living with HIV who are screened for TB (Percentage, Custom) Value 55.00 100.00 100.00 80.00 Date 31-Dec-2010 30-Apr-2014 30-Apr-2014 31-May-2016 Targeted health facilities with TB infection control measures in place (Percentage, Custom) Value 0.00 0.00 0.00 100.00 Date 31-Dec-2010 30-Apr-2014 30-Apr-2014 31-May-2016 Targeted health facilities with health care waste management facilities in place (Percentage, Custom) Value 15.80 0.00 0.00 100.00 Date 31-Dec-2010 25-Nov-2013 25-Nov-2013 31-May-2016 6/17/2015 Page 5 of 9
Clinics that have had at least 6 supervision visits in the last 12 months (Percentage, Custom) Value 35.80 81.00 81.00 80.00 Date 31-Dec-2010 31-Dec-2013 31-Dec-2013 31-May-2016 OVC directly supported through this cash transfer pilot (Number, Custom) Value 0.00 0.00 0.00 8000.00 Date 01-Jan-2011 30-May-2014 30-May-2014 31-May-2016 Health facilities constructed, renovated, and/or equipped (number) (Number, Core) Value 0.00 0.00 12.00 15.00 Date 01-Jan-2011 30-May-2014 31-Mar-2015 31-May-2016 Quarterly progress reports produced by the Management Information System, according to agreed reporting standards (Percentage, Custom) Value 0.00 0.00 0.00 75.00 Date 01-Jan-2011 30-May-2014 30-May-2014 31-May-2016 6/17/2015 Page 6 of 9
Health facilities that submit HMIS reports on time (Percentage, Custom) Value 77.00 100.00 60.00 85.00 Date 31-Dec-2010 30-Apr-2014 31-Mar-2015 31-May-2016 Women who deliver at target health facilities (Number, Custom) Value 5247.00 5400.00 5400.00 6500.00 Date 01-Jan-2011 30-Apr-2014 30-Apr-2014 31-May-2016 Health centers that provide Basic EmONC services (Number, Custom) Value 0.00 0.00 0.00 5.00 Date 01-Jan-2011 30-Apr-2014 30-Apr-2014 31-May-2016 Students who are trained under the newly developed guidelines for mentorship & preceptorship (Number, Custom) Value 0.00 0.00 0.00 100.00 Date 01-Jan-2011 30-May-2014 30-May-2014 31-May-2016 Overall Comments Revisions to Results Framework original intermediate outcome indicators will be reported on once the level II restructuring is reflected in the next ISR. 6/17/2015 Page 7 of 9
Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed Disbursed P110156 IBRD-80190 Effective USD 20.00 20.00 0.00 4.46 15.54 22% P110156 TF-11740 Effective USD 8.55 8.55 0.00 4.16 4.39 49% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P110156 IBRD-80190 Effective 10-Mar-2011 14-Dec-2011 09-May-2012 31-May-2016 31-May-2016 P110156 TF-11740 Effective 04-Apr-2012 04-Apr-2012 09-May-2012 31-May-2016 31-May-2016 Cumulative Disbursements Restructuring History There has been no restructuring to date. 6/17/2015 Page 8 of 9
Related Project(s) There are no related projects. 6/17/2015 Page 9 of 9