The World Bank Report No: ISR10617 Implementation Status & Results Moldova Strategic Planning of Health Information Management Reform in Moldova IDF (P131020) Public Disclosure Copy Operation Name: Strategic Planning of Health Information Management Project Stage: Implementation Seq.No: 1 Status: ARCHIVED Archive Date: 13-Jun-2013 Reform in Moldova IDF (P131020) Country: Moldova Approval FY: 2012 Product Line: Institutional Development Fund Region: EUROPE AND CENTRAL ASIA Lending Instrument: Implementing Agency(ies): Key Dates Board Approval Date 06-Apr-2012 Original Closing Date 30-Jul-2015 Planned Mid Term Review Date 20-Jan-2014 Last Archived ISR Date Effectiveness Date 30-Jul-2012 Revised Closing Date 30-Jul-2015 Actual Mid Term Review Date 20-Jan-2014 Project Development Objectives Project Development Objective (from IDF Proposal) The Grant will contribute to strengthening the Ministry of Health (MoH) capacity to identify and plan systemic, long-term reforms of health information management in Moldova, aimed at improving health information for both decision-makers and health workers. Specifically, the Grant will support MoH in preparation of Master Plan for introduction of unified information management in health care, including planning of (i) required changes in the legislative, regulatory, and institutional frameworks, and (ii) coordinated implementation of various health information systems in Moldova, most importantly in primary health care, but also secondary health care management information systems, public health information systems, pharmaceutical information systems, financial and health insurance information systems, etc. Has the Project Development Objective been changed since Board Approval of the Project? Yes No Component(s) Component Name Component Cost Capacity building 69940.00 Assessment of existing HMIS capacities 107900.00 Strategic planning and Master Plan for systemic introduction of unified information management 86200.00 Public Disclosure Copy Audit 13960.00 Overall Ratings Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Overall Risk Rating Moderate Implementation Status Overview Page 1 of 4 The World Bank Report No: ISR10617 In recent years the Ministry of Health has demonstrated commitment to pursuing systemic, long-term reforms of health information management in Moldova, as an instrument to support and optimize the daily business processes in health institutions, and to monitor and evaluate progress in implementing the reform agenda. The IDF grant has become effective on July 30, 2012 and has immediately gained momentum for a rapid implementation of its activities. Initially, the Grant was aimed at reforming Public Disclosure Copy health information management while being focused on building capacity for planning implementation of various health information systems in Moldova. At a later stage, the Ministry of Health has come up with a more ambitious vision of developing e-Health Strategy, extending the scope of engagement from health information management to the creation of e- Health services and implementing health open data initiative enabling citizen’s participation in the decision-making and monitoring of healthcare reforms. This grant implementation has also been made more challenging by two other initiatives co-ordinated and implemented by World Health Organization representation in Moldova. While the first measure focuses on building capacity for development of e-health solutions (US $65,000 financed by Estonian Government), the second initiative aims at provision of expertise/advice for e-Health strategy development (financed by Swiss Development Cooperation Agency). The interest of WHO and Estonian government on the same issues addressed by the activities under this Grant could have created further opportunities. However, because of the lack of a clear vision on the scope of health information management by the Ministry of Health, coupled with initial ineffective/weak coordination of donors, the effect has been significant overlap in activities financed by the three actors: Estonian Government, SDC and World Bank. In particular, some of activities envisaged under WB-funded IDF HMIS overlapped with activities proposed and funded by Estonian Government and SDC (e.g. organization of study tours, involvement of international expertise for strategy development and organization of capacity building workshops). The three sources of support increased over time their coordination (objectives of three initiatives came together to one goal, study tours were planned to be complementary in content, international consultants played complementary roles, etc.), but as a result, while most of activities under the Grant are completed, its disbursement is moderate, standing at 47%. In 2012 the Ministry of Health has nominated Chief Information Officer in charge of managing all health information reform initiatives and created a Task Force for eHealth strategy development. In spite of this, the institutional and human resource capacity remains still weak and subject to various stakeholders pressures. Based on the assessment of the existing HMIS capacities and consultation with relevant stakeholders, the e-Health Strategy has been drafted. However, Moldovan Government has embarked upon political decision to proceed with launching development of health information system for primary care before the final approval of e-Health Strategy. In May 2013 the Ministry of Health concluded a two-year contract for PHC software development for the amount of cca US $1.2 mln (MDL 19 mln) to be financed from the State Budget. In this respect, there are concerns related to the fact that implementation of MIS in primary care started before the finalization of the eHealth Strategy, as well as before the adoption of any eHealth functional, technical and quality standards. This would mean that PHC information system will actually introduce ad hoc standards that might create problems in the future integration with other systems and lead to potential double investments. Given the high risk of diligent implementation/enforcement of any information system, it is imperative to ensure its ownership at all the levels of users (central and mid-level users, and patients alike); all the stakeholders must widely be consulted on the final document as this would represent a framework for further donor engagement in the field of health sector information management. Given that there have been some savings in the process of eHealth Strategy development, there is financial space for supporting the following activities [subject to final agreement with MoH]: Public Disclosure Copy 1. Capacity building for Open Data initiative design and preparation; 2. Technical assistance on the development of regulatory framework critical for enabling eHealth Strategy implementation. 3. Capacity building and awareness raising activities supportive to eHealth strategy Locations No Location data has been entered Results Indicators Page 2 of 4 The World Bank Report No: ISR10617 Indicator Name Core Unit of Measure Baseline Current End Target The strategic planning team has been formed Text Value no strategic planning team Task Force for development Creation of a MoH-led and it is functional of eHealth established by interinstitutional Public Disclosure Copy MoH Order dated 17 team with the clear mandate September 2012 of strategic planning of health care information management reform in Moldova. Date 09-Mar-2012 30-Jul-2015 Comments target achieved The first draft of the Master Plan has been Text Value Moldova does not have any draft eHealth Strategy (Master The first draft of the Master produced according to theprocess outlined in strategic document for health Plan) produced Plan for health care this Grant proposal care information information management. management reform is produced. Date 09-Mar-2012 30-Jul-2015 Comments drafting in process The indicator will show the ability of the planning team to deliver specific strategic planning outcomes The Master Plan has been presented and Text Value there is no strategic planning discussions of the draft number of workshops to discussed within government, and with all other document developed and eHealth strategy launched discuss the eHealth Strategy stakeholders. (Master Plan) organised Date 09-Mar-2012 30-Jul-2015 Comments in progress Data on Financial Performance (as of 08-May-2013) Financial Agreement(s) Key Dates Project Ln/Cr/Tf Status Approval Date Signing Date Effectiveness Date Original Closing Date Revised Closing Date Public Disclosure Copy P131020 TF-12263 Effective 30-Jul-2012 30-Jul-2012 30-Jul-2012 30-Jul-2015 30-Jul-2015 Disbursements Project Ln/Cr/Tf Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P131020 TF-12263 Effective USD 0.28 0.28 0.00 0.13 0.15 47.00 Disbursement Graph Page 3 of 4 The World Bank Report No: ISR10617 Public Disclosure Copy Key Decisions Regarding Implementation • The management of IDF HMIS Grant by MoH shall be enhanced to ensure better communication with the World Bank and other stakeholders/counterparts to avoid inefficiencies and overlaps. • The activities funded by the HMIS Grant shall contribute to get maximum transparency, by raising awareness and ownership of the planned new information management system among all stake-holders. • In parallel with the approval of eHealth Strategy, Moldova’s Government shall take a decision on the Agency to be empowered with actual implementation of activities planned in the Strategy. • Project implementation and procurement plans shall be updated and adjusted to the current needs assessment and planning for future period. Restructuring History Public Disclosure Copy There has been no restructuring to date. Related Projects There are no related projects. Page 4 of 4