The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) Transforming Health Systems for Universal Care (P152394) AFRICA | Kenya | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2016 | Seq No: 7 | ARCHIVED on 23-Jun-2019 | ISR36505 | Implementing Agencies: Kenya National Treasury, Ministry of Health Key Dates Key Project Dates Bank Approval Date: 15-Jun-2016 Effectiveness Date: 04-Jul-2016 Planned Mid Term Review Date: 11-Mar-2019 Actual Mid-Term Review Date: 25-Mar-2019 Original Closing Date: 30-Sep-2021 Revised Closing Date: 30-Sep-2021 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The project development objective is to improve utilization and quality of primary health care services with a focus on reproductive, maternal, newborn, child, and adolescent health services. 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) The project development objective is to improve utilization and quality of primary health care services with a focus on reproductive, maternal, newborn, child, and adolescent health services. Components Table Name Improving Primary Health Care Results:(Cost $150.00 M) Strengthening Institutional Capacity:(Cost $15.10 M) Cross-county and Intergovernmental Collaboration, and Project Management:(Cost $26.00 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Unsatisfactory Overall Risk Rating Substantial Substantial Implementation Status and Key Decisions The Transforming Health Systems for Universal Care Project (THS-UCP) aims to improve utilization and quality of primary healthcare services with a focus on reproductive, maternal, newborn, child, and adolescent health services. 6/23/2019 Page 1 of 7 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) A Mid-Term Review (MTR) of the Project conducted during March 25-April 5, 2019 showed implementation progress with 3 out of the 4 PDO-level indicators and 6 out of the 8 intermediate results indicators (IRIs) achieved or surpassed Year 2 targets. Under Component 1, procurement of family planning commodities is on track and the Kenya Medical Supply Authority continues to distribute these commodities to the counties according to guidance from the Division of Family Health and County Governments. All 47 counties are implementing activities prioritized in their sector annual work plans. Eight hundred Enrolled Community Health Nurses are being trained at the Kenya Medical Training College and preparations are ongoing to facilitate roll out of the Joint Health Inspection Checklist in all 47 counties in FY 2019/20. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance High High High Macroeconomic Moderate Moderate Moderate Sector Strategies and Policies Moderate Moderate Substantial Technical Design of Project or Program Substantial Substantial Substantial Institutional Capacity for Implementation and Sustainability High High High Fiduciary Substantial Substantial Substantial Environment and Social Low Moderate Substantial Stakeholders Substantial Substantial Substantial Other -- -- -- Overall Substantial Substantial Substantial Results PDO Indicators by Objectives / Outcomes Improved utilization and quality of primary health care services with focus on RMNCAH services IN00686601 ►Children younger than 1 year who were fully immunized (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 73.00 75.00 82.00 76.00 Date 31-Dec-2015 29-Jun-2018 31-Mar-2019 30-Jun-2021 The data reflected in this ISR cover the period from January 2019 until March 2019. Comments: IN00686602 ►Pregnant women attending at least four ANC visits (Percentage, Custom) 6/23/2019 Page 2 of 7 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) Baseline Actual (Previous) Actual (Current) End Target Value 40.00 48.00 48.40 46.00 Date 31-Dec-2015 29-Jun-2018 31-Mar-2019 30-Jun-2021 The data reflected in this ISR cover the period from January 2019 until March 2019. Comments: IN00686603 ►Births attended by skilled health personnel (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 57.00 63.00 63.40 64.00 Date 31-Dec-2015 29-Jun-2018 31-Mar-2019 30-Jun-2021 The data reflected in this ISR cover the period from January 2019 until March 2019. Comments: IN00686604 ►Women between the ages of 15-49 years currently using a modern FP method (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 41.00 49.00 47.10 45.00 Date 31-Dec-2015 29-Jun-2018 31-Mar-2019 30-Jun-2021 The data reflected in this ISR cover the period from January 2019 until March 2019. Comments: IN00686605 ►Inspected facilities meeting safety standards (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 50.00 Date 31-Dec-2015 29-Jun-2018 31-Mar-2019 30-Jun-2021 No data is available. There has been a delay in inspections as the pilot in three counties has come to an end. It is expected that the inspections will resume and be scaled up to the remaining counties next fiscal Comments: year. Overall Comments PDO The results framework will be revised based on the findings from the Mid-Term Review as part of the upcoming restructuring paper to address data quality issues and reflect changes in implementation. Intermediate Results Indicators by Components Component 1: Improved primary health care results IN00686606 ►Health facilities providing BEmOC (Percentage, Custom) 6/23/2019 Page 3 of 7 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) Baseline Actual (Previous) Actual (Current) End Target Value 39.00 38.00 28.00 60.00 Date 11-Mar-2016 29-Jun-2018 31-Mar-2019 30-Jun-2021 The data reflected in this ISR cover the period from January 2019 until March 2019. Due to data quality Comments: issues, this indicator is proposed to be dropped as part of the upcoming restructuring. IN00686609 ►Pregnant women attending ANC supplemented with IFA (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 31.00 66.50 69.90 40.00 Date 31-Dec-2015 29-Jun-2018 31-Mar-2019 30-Jun-2021 The data reflected in this ISR cover the period from January 2019 until March 2019. Comments: IN00686616 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 3,596,557.00 5,377,636.00 10,060,000.00 Date 29-Sep-2016 29-Jun-2018 31-Mar-2019 30-Jun-2021 The baseline date corresponds the date at which the Project became effective. This is a corporate indicator capturing the cumulative number of people receiving essential health services over the Project Comments: lifecycle (# deliveries attended by skilled personnel and # children aged 0 to 5 who were immunized). No Nutrition services are supported by the Project. IN00686617 Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,921,376.00 2,852,896.00 5,400,000.00 Date 29-Sep-2016 29-Jun-2018 31-Mar-2019 30-Jun-2021 IN00686618 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,675,181.00 2,524,740.00 4,660,000.00 Date 29-Sep-2016 29-Jun-2018 31-Mar-2019 30-Jun-2021 Component 2: Strengthened institutional capacity IN00686607 ►Facilities inspected for safety standards (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 70.00 6/23/2019 Page 4 of 7 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) Date 11-Mar-2016 29-Jun-2018 31-Mar-2019 30-Jun-2021 There is no data available for this indicator. There has been a delay in inspections as the pilot in three counties has come to an ed. It is expected that the inspections will resume and be scaled up to the Comments: remaining counties the next financial year. IN00686610 ►Facilities submitting complete DHIS data in a timely manner (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 76.00 84.00 82.00 85.00 Date 31-Dec-2015 29-Jun-2018 31-Mar-2019 30-Jun-2021 The data reflected in this ISR cover the period from January 2019 until March 2019. Comments: IN00686612 ►Registration of births (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 67.80 60.90 70.00 80.00 Date 31-Dec-2015 29-Jun-2018 31-Mar-2019 30-Jun-2021 Data for this indicator is still preliminary and is subject to the final verification report. Comments: IN00686614 ►RMNCAH related operations research completed to inform policy/strategy (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 3.00 Date 11-Mar-2016 29-Jun-2018 31-Mar-2019 30-Jun-2021 IN00686615 ►A benefit package developed, costed, and disseminated (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 1.00 Date 11-Mar-2016 29-Jun-2018 31-Mar-2019 30-Jun-2021 This value for this indicator is still 0 because the benefit package has not yet been disseminated publicly. Comments: Component 3: Cross-county/intergovernmental collaboration and project management IN00686608 ►Functional community units (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1,549.00 2,926.00 3,145.00 2,400.00 Date 31-Dec-2015 29-Jun-2018 31-Mar-2019 30-Jun-2021 IN00686611 6/23/2019 Page 5 of 7 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) ►Grievances registered related to delivery of project benefits that are addressed (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 80.00 Date 31-Dec-2015 29-Jun-2018 31-Mar-2019 30-Jun-2021 While the instruments and guidance were developed, there have been delays in rolling them out. Comments: IN00686613 ►Implementing entities submitting the annual FM and technical report on time (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 80.00 Date 11-Mar-2016 29-Jun-2018 31-Mar-2019 30-Jun-2021 Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P152394 IDA-58360 Effective USD 150.00 150.00 0.00 39.16 106.90 27% P152394 TF-A2561 Effective USD 40.00 40.00 0.00 17.83 22.17 45% P152394 TF-A2792 Effective USD 1.10 1.10 0.00 0.44 0.66 40% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P152394 IDA-58360 Effective 15-Jun-2016 04-Jul-2016 29-Sep-2016 30-Sep-2021 30-Sep-2021 P152394 TF-A2561 Effective 15-Jun-2016 04-Jul-2016 29-Sep-2016 30-Sep-2021 30-Sep-2021 P152394 TF-A2792 Effective 15-Jun-2016 04-Jul-2016 04-Jul-2016 30-Jun-2020 30-Jun-2020 Cumulative Disbursements 6/23/2019 Page 6 of 7 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 6/23/2019 Page 7 of 7