Public Disclosure Copy The World Bank Implementation Status & Results Report Nigeria States Health Investment Project (P120798) Nigeria States Health Investment Project (P120798) AFRICA | Nigeria | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2012 | Seq No: 16 | ARCHIVED on 17-Jun-2019 | ISR36956 | Implementing Agencies: Federal Ministry of Health, Federal Ministry of Finance, Federal Ministry of Finance, Federal Ministry of Finance, IERD/FMoF, National Primary Health Care Development Agency, Ministry of Finance, FMOH, FMOH (FED. MIN. OF HEALTH) Key Dates Key Project Dates Bank Approval Date: 12-Apr-2012 Effectiveness Date: 20-Aug-2013 Planned Mid Term Review Date: 09-Oct-2017 Actual Mid-Term Review Date: 27-Nov-2017 Original Closing Date: 30-Jun-2018 Revised Closing Date: 30-Jun-2020 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) To increase the delivery and use of high impact maternal and child health interventions and improve quality of care at selectedhealth facilities in the participating states. 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)HRPDODELs To increase the delivery and use of high impact maternal and child health interventions and improve quality of care available to the people in Nasarawa and Ondo and all the States in the NE. Components Table Name Component 1: Strengthening Service Delivery:(Cost $207.40 M) Component 2: Technical Assistance to the States:(Cost $57.00 M) Component 3 (NEW): Partnerships for strengthening service delivery:(Cost $18.00 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 Implementation Status and Key Decisions 6/17/2019 Page 1 of 8 Public Disclosure Copy The World Bank Implementation Status & Results Report Nigeria States Health Investment Project (P120798) There has been steady progress in the implementation of the project in the original NSHIP states of Ondo, Nasarawa and the NE States. NSHIP AF expanded the Performance-based financing (PBF) intervention from the parent project into five additional states in the North-East of Nigeria (Gombe, Yobe, Taraba, Bauchi and Borno) and it is showing strong and credible results. Six Contract Management and Verification Agents (CMVA) and three Independent Verification Agents (IVA) have been contracted by the National Primary Health Care Development Agency (NPHCDA) and have started their activities since April 2018. Project expanded rapidly to 39 LGAs to cover 13.3 million population across the five states. The project signed contracts with: (i) 437 Health Centers, (ii) 39 District Hospitals, (iii) 39 LGA Primary Health Care departments, (iv) Five State Primary Health Care Development Agencies, and (v) Five Hospital Management Boards/Hospital Departments. Overall results as at December 2018 shows that a total of 586,040 and 345,005 children have been fully vaccinated in Ondo and Nasarawa states, while the whole of the North East project states (including Adamawa) has fully vaccinated 1,058,291 children. Over the same period, 148,436 and 111,301 skilled birth attendance were taken in Ondo and Nasarawa states while 360,703 skilled birth deliveries were done in the North East states which includes Adamawa. The steady growth in these output indicators are well in line with meeting the set target for the project. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance -- Substantial Substantial Macroeconomic -- High High Sector Strategies and Policies -- Moderate Moderate Technical Design of Project or Program -- Moderate Moderate Institutional Capacity for Implementation and Sustainability -- Substantial Substantial Fiduciary -- Substantial Substantial Environment and Social -- Low Low Stakeholders -- Substantial Substantial Other -- -- -- Overall -- Substantial Substantial Results PDO Indicators by Objectives / Outcomes To increase the delivery and use of high impact MCH interventions and improve quality in 8 states IN00699689 ►Number of 12-23 month old children vaccinated with Penta3 (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 270,644.00 1,989,336.00 1,989,336.00 2,500,000.00 Date 31-Dec-2008 12-Dec-2018 12-Dec-2018 30-Jun-2020 IN00699690 Percentage of 12-23 month old children vaccinated with Penta3 (NE) (Percentage, Custom Supplement) 6/17/2019 Page 2 of 8 Public Disclosure Copy The World Bank Implementation Status & Results Report Nigeria States Health Investment Project (P120798) Baseline Actual (Previous) Actual (Current) End Target Value 27.40 48.40 48.40 49.00 IN00699691 Percentage of 12-23 month old children vaccinated with Penta3 (Nasarawa) (Percentage, Custom Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 39.40 58.80 58.80 65.00 IN00699692 Percentage of 12-23 month old children vaccinated with Penta3 (Ondo) (Percentage, Custom Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 67.30 72.20 72.20 75.00 IN00699693 Number of 12-23 month old children vaccinated with Penta3 (NE) (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 78,180.00 1,058,291.00 1,111,164.00 1,350,000.00 Date 31-Dec-2010 12-Dec-2018 29-May-2019 30-Jun-2020 IN00699694 Number of 12-23 month old children vaccinated with Penta3 (Nasarawa) (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 86,237.00 345,005.00 357,253.00 450,000.00 Date 31-Dec-2010 12-Dec-2018 29-May-2019 30-Jun-2020 IN00699695 Number of 12-23 month old children vaccinated with Penta3 (Ondo) (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 106,227.00 586,040.00 598,169.00 700,000.00 Date 31-Dec-2010 12-Dec-2018 29-May-2019 30-Jun-2020 IN00699696 ►Births (deliveries) attended by skilled health personnel (number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 76,960.00 620,440.00 620,440.00 700,000.00 Date 31-Dec-2010 12-Dec-2018 12-Dec-2018 30-Jun-2020 This indicator measures the cumulative number of women who delivered with the assistance of a health Comments: provider as a result of Bank-financed activities. IN00699697 Proportion of births attended by skilled health personnel (NE) (Percentage, Custom Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 55.50 70.30 70.30 75.00 IN00699698 Proportion of births attended by skilled health personnel (Nasarawa) (Percentage, Custom Supplement) Baseline Actual (Previous) Actual (Current) End Target 6/17/2019 Page 3 of 8 Public Disclosure Copy The World Bank Implementation Status & Results Report Nigeria States Health Investment Project (P120798) Value 62.50 68.00 68.00 75.00 IN00699699 Proportion of births attended by skilled health personnel (Ondo) (Percentage, Custom Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 55.50 70.30 70.30 75.00 IN00699700 Number of births attended by skilled health personnel (NE) (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 24,520.00 360,703.00 384,012.00 400,000.00 Date 31-Dec-2010 12-Dec-2018 29-May-2019 30-Jun-2020 IN00699701 Number of births attended by skilled health personnel (Nasarawa) (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 23,193.00 111,301.00 115,495.00 150,000.00 Date 31-Dec-2010 12-Dec-2018 29-May-2019 30-Jun-2020 IN00699702 Number of births attended by skilled health personnel (Ondo) (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 29,247.00 148,436.00 151,082.00 150,000.00 Date 31-Dec-2010 12-Dec-2018 29-May-2019 30-Jun-2020 IN00699703 ►Direct project beneficiaries (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 10,024,777.00 10,024,777.00 12,000,000.00 Date 31-Dec-2010 12-Dec-2018 12-Dec-2018 30-Jun-2020 Direct beneficiaries are people or groups who directly derive benefits from an intervention (i.e., children who benefit from an immunization program; families that have a new piped water connection). Please note Comments: that this indicator requires supplemental information. Supplemental Value: Female beneficiaries (percentage). Based on the assessment and definition of direct project beneficiaries, specify what IN00699704 proportion of the direct project beneficiaries are female. This indicator is calculated as a percentage. Female beneficiaries (Percentage, Custom Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 63.00 63.00 60.00 IN00699705 ►Number of outpatient visits by children under five (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 346,990.00 10,933,002.00 10,933,002.00 13,500,000.00 Date 31-Dec-2010 12-Dec-2018 12-Dec-2018 30-Jun-2020 6/17/2019 Page 4 of 8 Public Disclosure Copy The World Bank Implementation Status & Results Report Nigeria States Health Investment Project (P120798) Comments: Number of outpatient visits by children under five at Public Primary health facilities IN00699706 ►Average Health Facility Quality of Care Score (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 41.90 72.00 67.00 61.00 Date 31-Mar-2014 31-Oct-2017 29-May-2018 30-Jun-2020 Based on a composite Health Facility Quality Index covering domains of staff presence, staff knowledge, Comments: drugs & vaccines, basic equipment, condition of infrastructure and record keeping Intermediate Results Indicators by Components Component 1: Strengthening Service Delivery and Institutional Peformance IN00699707 ►Number of LGA with ongoing PBF (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 3.00 62.00 62.00 80.00 Date 31-Dec-2011 12-Dec-2018 12-Dec-2018 30-Jun-2020 Comments: Measured by the actual number of LGAs where facilities receive performance-based payments IN00699709 Number of LGA with ongoing PBF (NE) (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 1.00 46.00 50.00 64.00 Date 02-Oct-2013 12-Dec-2018 29-May-2019 30-Jun-2020 IN00699711 Number of LGA with ongoing PBF (Nasarawa) (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 1.00 7.00 7.00 7.00 Date 02-Oct-2013 12-Dec-2018 29-May-2019 30-Jun-2020 IN00699712 Number of LGA with ongoing PBF (Ondo) (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 1.00 9.00 9.00 9.00 Date 02-Oct-2013 12-Dec-2018 29-May-2019 30-Jun-2020 IN00699713 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target 6/17/2019 Page 5 of 8 Public Disclosure Copy The World Bank Implementation Status & Results Report Nigeria States Health Investment Project (P120798) Value 0.00 6,044,566.00 6,044,566.00 6,900,000.00 Date 02-Oct-2013 12-Dec-2018 12-Dec-2018 30-Jun-2020 IN00699714 People who have received essential health, nutrition, and population (HNP) services - Female (RMS requirement) (Number, Corporate Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 3,332,503.00 3,332,503.00 3,800,000.00 IN00699715 Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,989,336.00 1,989,336.00 2,500,000.00 Date 02-Oct-2013 12-Dec-2018 12-Dec-2018 30-Jun-2020 IN00699716 Number of women and children who have received basic nutrition services (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 3,434,790.00 3,434,790.00 3,700,000.00 Date 02-Oct-2013 12-Dec-2018 12-Dec-2018 30-Jun-2020 IN00699717 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 620,440.00 620,440.00 700,000.00 Date 02-Oct-2013 12-Dec-2018 12-Dec-2018 30-Jun-2020 Component 2: Technical Support IN00699708 ►Proportion of primary health facilities having essential medicines and commodities in stock (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 76.00 76.00 35.00 Date 02-Oct-2013 31-Oct-2017 31-Oct-2017 30-Jun-2020 Numerator: Number of facilities having essential medicines and medical supplies Denominator: Number of Comments: facilities surveyed for quality IN00699710 ►Proportion of on-duty technical staff present at health facility on the day of the survey (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 72.00 72.00 84.00 Date 02-Oct-2013 31-Oct-2016 31-Oct-2016 30-Jun-2020 Numerator: Number on duty technical staff present on the day of survey Denominator: Total number of Comments: technical staff working in thefacility 6/17/2019 Page 6 of 8 Public Disclosure Copy The World Bank Implementation Status & Results Report Nigeria States Health Investment Project (P120798) Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P120798 IDA-50940 Effective USD 150.00 150.00 0.00 134.23 3.93 97% P120798 IDA-58510 Effective USD 125.00 125.00 0.00 41.04 81.58 33% P120798 TF-13432 Effective USD 21.70 21.70 0.00 19.06 2.64 88% P120798 TF-A2591 Effective USD 20.00 20.00 0.00 5.83 14.17 29% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P120798 IDA-50940 Effective 12-Apr-2012 16-Apr-2013 20-Aug-2013 30-Jun-2018 31-May-2020 P120798 IDA-58510 Effective 07-Jun-2016 30-Aug-2016 27-Feb-2017 30-Jun-2020 30-Jun-2020 P120798 TF-13432 Effective 16-Apr-2013 16-Apr-2013 20-Aug-2013 30-Jun-2018 31-May-2020 P120798 TF-A2591 Effective 02-May-2016 30-Aug-2016 27-Feb-2017 30-Jun-2020 30-Jun-2020 Cumulative Disbursements 6/17/2019 Page 7 of 8 Public Disclosure Copy The World Bank Implementation Status & Results Report Nigeria States Health Investment Project (P120798) Restructuring History Level 2 Approved on 30-Jun-2018 Related Project(s) P149936-Nigeria State Health Investment Project (NSHIP) Additional Financing ,P157977-Additional Financing Nigeria State Health Investment Project 6/17/2019 Page 8 of 8