Public Disclosure Copy The World Bank Implementation Status & Results Report Health Services Improvement Project (P074027) Health Services Improvement Project (P074027) EAST ASIA AND PACIFIC | Lao People's Democratic Republic | Health, Nutrition & Population Global Practice | IBRD/IDA | Specific Investment Loan | FY 2006 | Seq No: 14 | ARCHIVED on 30-Dec-2015 | ISR20167 | Implementing Agencies: The National Project Coordination Office Key Dates Key Project Dates Bank Approval Date:13-Sep-2005 Effectiveness Date:22-Feb-2006 Planned Mid Term Review Date:-- Actual Mid-Term Review Date:-- Original Closing Date:30-Jun-2011 Revised Closing Date:31-Dec-2015 Project Development Objectives Project Development Objective (from Project Appraisal Document) The Project Development Objective is to assist the Lao PDR to improve the health status of its population, particularly the poor and rural population, in eight Central and Southern Provinces. Has the Project Development Objective been changed since Board Approval of the Project Objective? Yes Board Approved Revised Project Development Objective (If project is formally restructured)PHRPDODEL To assist Lao PDR to increase utilization and quality of health services, particularly for poor women and children in rural areas in Project Provinces. Components Name Improving the Quality and Utilization of Health Services:(Cost $10.15 M) Strengthening Institutional Capacity for Health Service Provision:(Cost $12.28 M) Improving Equity, Efficiency, and Sustainability of Healh Care Financing:(Cost $2.57 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO  Moderately Satisfactory  Moderately Satisfactory Overall Implementation Progress (IP)  Satisfactory  Satisfactory Overall Risk Rating  Moderate  Moderate 12/30/2015 Page 1 of 8 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health Services Improvement Project (P074027) Implementation Status and Key Decisions Implementation of all components under the Project is now completed. The Government and other development partners has provided their financial support to implement Free MCH in 42 Districts in the 5 Project provinces, after the IDA funding funding was fully disbursed in December 2014. The provision of free maternal health has been constantly provided with the Government subsidies from January 2015 to present. Overall, the Project has made significant achievements towards the Project Development Objectives (PDO). Provisional estimates indicate that facility delivery rate increased from 24% to 39%, about 81,744 women delivered their baby at health facilities and about 204, 052 women received health care benefit from the project; the inpatient and outpatient discharge per capital for children under-five increased from 0.06 to 0.09 and from 0.24 to 1.18 respectively, which is about 11,487 and 150,611 of children under-five have received inpatient care and outpatient care; number of poor households with access to basic package of health services increased from 13,185 to 19,066; and total people received a basic package of health care, nutrition, or reproductive health services under the project support increased from 104,762 to 896, 320 which is almost 4 times higher than their targets. The key successes of the Project are i) development of internal and external verifications mechanism for the Free MCH provide platform for the Ministry of Health to improve the verification section in the National Guideline for the Free MCH; ii) launching of web-based health management information system - District Health Information System 2 (DHIS2) which now cover the whole country; iii) improvement of the quality checklist and standard medical equipment for district hospital and health center which has been included in the Health Governance and Nutrition Development Project. The Project began to incrementally transfer the responsibility in managing the project activities to technical departments which create a strong ownership and commitment to the Ministry of Health. The Project is closing on December 31, 2015, key lessons and recommendations offer a rich opportunity in assessing results-based financing interventions which provides a strong foundation to use the Disbursement-Linked Indicators (DLI) in the Health Governance and Nutrition Development Project Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance  --  Low  Low Macroeconomic  --  Moderate  Moderate Sector Strategies and Policies  --  Moderate  Moderate Technical Design of Project or Program  --  Moderate  Moderate Institutional Capacity for Implementation and Sustainability  --  Moderate  Moderate Fiduciary  --  Moderate  Moderate Environment and Social  --  Moderate  Moderate Stakeholders  --  Low  Low Other  --  --  -- Overall  --  Moderate  Moderate Results 12/30/2015 Page 2 of 8 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health Services Improvement Project (P074027) Project Development Objective Indicators PHINDPDOTBL  Percentage of deliveries occurring in a health facility (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 24.00 36.00 39.00 35.00 Date 01-Sep-2011 30-May-2015 30-Sep-2015 30-Sep-2015 Comments The 39% is 12 months data from October 2014-September 2015. PHINDPDOTBL  Child under-five inpatient discharges per capita (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.06 0.08 0.09 0.08 Date 01-Sep-2011 27-Oct-2014 30-Sep-2015 30-Sep-2015 Comments Implementation of the free child health covers 20 of the 42 project districts in the 5 project provinces. The intervention ceased in Salavan and Attapue provinces in December 2014, and in Savannakhet province in March 2015. The free child health continue from January to December 2015 with financial supported by Swiss Red Cross. PHINDPDOTBL  People with access to a basic package of health, nutrition, or reproductive health services (number) (Number, Core) Baseline Actual (Previous) Actual (Current) End Target Value 104762.00 391770.00 896320.00 500000.00 Date 01-Sep-2011 30-May-2015 30-Sep-2015 30-Sep-2015 PHINDPDOTBL  Average balanced scorecard quality score among health facilities implementing Paying for Quality (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value -- 0.00 62.00 85.00 12/30/2015 Page 3 of 8 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health Services Improvement Project (P074027) Date 01-Jul-2014 30-May-2015 30-Sep-2015 30-Sep-2015 Comments The measure for this indicator is changed from number to percentage according to the final implementation guideline for the pay for quality intervention. Implemenation of the activities was only 6 months from July-December 2014. As end of December 2014, the target reached 62%. PHINDPDOTBL  Number of poor households with access to a basic package of health services (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 13185.00 19066.00 19066.00 17000.00 Date 01-Sep-2011 30-May-2015 30-Sep-2015 30-Sep-2015 Overall Comments Intermediate Results Indicators PHINDIRITBL  Number of health facilities providing free maternal health services (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 25.00 295.00 295.00 290.00 Date 01-Sep-2011 30-May-2015 30-Sep-2015 30-Sep-2015 PHINDIRITBL  Pregnant women receiving antenatal care during a visit to a health provider (number) (Number, Core) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 150395.00 186775.00 180417.00 Date 30-Sep-2011 30-May-2015 30-Sep-2015 30-Sep-2015 12/30/2015 Page 4 of 8 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health Services Improvement Project (P074027) PHINDIRITBL  Health facilities constructed, renovated, and/or equipped (number) (Number, Core) Baseline Actual (Previous) Actual (Current) End Target Value 37.00 212.00 333.00 185.00 Date 01-Sep-2011 30-May-2015 30-Sep-2015 30-Sep-2015 PHINDIRITBL  Number of supervision visits to health centers in the last quarter (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 41.00 183.00 183.00 200.00 Date 01-Sep-2011 30-May-2015 30-Sep-2015 30-Sep-2015 PHINDIRITBL  Children immunized (number) (Number, Core) Baseline Actual (Previous) Actual (Current) End Target Value 58032.00 137454.00 218340.00 309144.00 Date 01-Sep-2011 30-May-2015 30-Sep-2015 30-Sep-2015 PHINDIRITBL  Children immunized - under 12 months against DTP3 (number) (Number, Core Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 58032.00 137454.00 218340.00 309144.00 Date 01-Sep-2011 30-May-2015 30-Sep-2015 30-Sep-2015 12/30/2015 Page 5 of 8 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health Services Improvement Project (P074027) PHINDIRITBL  Direct project beneficiaries (Number, Core) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 332701.00 351767.00 350000.00 Date 01-Sep-2011 30-May-2015 30-Sep-2015 30-Sep-2015 PHINDIRITBL  Female beneficiaries (Percentage, Core Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 81.30 70.00 PHINDIRITBL  Health personnel receiving training (number) (Number, Core) Baseline Actual (Previous) Actual (Current) End Target Value 332.00 1679.00 1518.00 1212.00 Date 01-Sep-2011 30-May-2015 30-Sep-2015 30-Sep-2015 Comments The 1518 are the actual number of scholars graduated during project implementation and financed 100% by the project. PHINDIRITBL  Number of cases of HEF assistance for the payment of health care costs (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 449943.00 580760.00 250000.00 Date 01-Sep-2011 30-May-2015 30-Sep-2015 30-Sep-2015 12/30/2015 Page 6 of 8 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health Services Improvement Project (P074027) PHINDIRITBL  Number of districts reporting HMIS indicators using the web-based system according to schedule (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 42.00 134.00 42.00 Date 01-Sep-2011 30-May-2015 30-Sep-2015 30-Sep-2015 Overall Comments Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed Disbursed P074027 IDA-H1830 Closed USD 15.00 14.99 0.01 16.02 0.00 107% P074027 IDA-H6950 Effective USD 10.00 10.00 0.00 9.72 0.00 97% P074027 TF-10518 Effective USD 2.40 2.40 0.00 2.40 0.00 100% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P074027 IDA-H1830 Closed 13-Sep-2005 08-Nov-2005 22-Feb-2006 30-Jun-2011 30-Jun-2012 P074027 IDA-H6950 Effective 09-Jun-2011 11-Oct-2011 04-Jan-2012 30-Jun-2014 31-Dec-2015 P074027 TF-10518 Effective 11-Oct-2011 11-Oct-2011 11-Oct-2011 30-Jun-2014 31-Dec-2015 Cumulative Disbursements 12/30/2015 Page 7 of 8 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health Services Improvement Project (P074027) Restructuring History Level Approved on 24-Apr-2012 Related Project(s) P124906-Health Services Improvement Project (AF) 12/30/2015 Page 8 of 8 Public Disclosure Copy