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: 6 | ARCHIVED on 20-Dec-2018 | ISR35149 | 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: -- 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 Satisfactory Overall Risk Rating Substantial Substantial Implementation Status and Key Decisions Transforming Health Systems for Universal Care Project aims to improve the utilization and quality of primary health care services with a focus on reproductive, maternal, newborn, child, and adolescent health services. 12/20/2018 Page 1 of 7 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) The dedicated project management team (PMT) has been working with the implementing entities to accelerate implementation and the following have been achieved:  Counties have developed sector annual work plans (AWPs) incorporating on-budget support and will initiate the planned activities support by the Project.  The Kenya Medical Supplies Authority has begun distribution of family planning commodities to counties based on guidance from the Division of Family Health and county governments.  The Kenya Medical Training College admitted 400 students into the Community Enrolled Health Nurse program of which 153 were students from vulnerable and marginalized groups. This is in addition to 402 students admitted in 2017.  In July 2018, all 47 county accountants were trained on county return preparations as well as the provisions of the financial management manual. 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 Moderate 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 Moderate 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 IN00651171 ►Children younger than 1 year who were fully immunized (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 73.00 75.00 75.00 76.00 Date 31-Dec-2015 29-Jun-2018 29-Jun-2018 30-Jun-2021 IN00651172 12/20/2018 Page 2 of 7 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) ►Pregnant women attending at least four ANC visits (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 40.00 48.00 48.00 46.00 Date 31-Dec-2015 29-Jun-2018 29-Jun-2018 30-Jun-2021 IN00651173 ►Births attended by skilled health personnel (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 57.00 63.00 63.00 64.00 Date 31-Dec-2015 29-Jun-2018 29-Jun-2018 30-Jun-2021 IN00651174 ►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 49.00 45.00 Date 31-Dec-2015 29-Jun-2018 29-Jun-2018 30-Jun-2021 IN00651175 ►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 29-Jun-2018 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 this Comments: financial year. Overall Comments PDO This is an interim ISR to add the corporate indicators. The data will be updated for the next ISR, which is due in March 2019 and will concise with the MTR. Intermediate Results Indicators by Components Component 1: Improved primary health care results IN00651176 ►Health facilities providing BEmOC (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 39.00 38.00 38.00 60.00 12/20/2018 Page 3 of 7 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) Date 11-Mar-2016 29-Jun-2018 29-Jun-2018 30-Jun-2021 IN00651179 ►Pregnant women attending ANC supplemented with IFA (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 31.00 66.50 66.50 40.00 Date 31-Dec-2015 29-Jun-2018 29-Jun-2018 30-Jun-2021 IN00654242 ►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 10,060,000.00 Date 29-Sep-2016 -- 29-Jun-2018 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. IN00654244 Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 1,921,376.00 5,400,000.00 Date 29-Sep-2016 -- 29-Jun-2018 30-Jun-2021 IN00654246 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 4,660,000.00 Date 29-Sep-2016 -- 29-Jun-2018 30-Jun-2021 Component 2: Strengthened institutional capacity IN00651177 ►Facilities inspected for safety standards (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 70.00 Date 11-Mar-2016 29-Jun-2018 29-Jun-2018 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 this financial year. IN00651180 ►Facilities submitting complete DHIS data in a timely manner (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target 12/20/2018 Page 4 of 7 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) Value 76.00 84.00 84.00 85.00 Date 31-Dec-2015 29-Jun-2018 29-Jun-2018 30-Jun-2021 IN00651182 ►Registration of births (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 67.80 60.90 60.90 80.00 Date 31-Dec-2015 29-Jun-2018 29-Jun-2018 30-Jun-2021 The implementing partner is reviewing the data to identify a clear explanation for the decline in birth registration from last year. The task team, PMT and implementing partner will review this during the Comments: November mission. IN00651184 ►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 29-Jun-2018 30-Jun-2021 IN00651185 ►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 29-Jun-2018 30-Jun-2021 Component 3: Cross-county/intergovernmental collaboration and project management IN00651178 ►Functional community units (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1,549.00 2,926.00 2,926.00 2,400.00 Date 31-Dec-2015 29-Jun-2018 29-Jun-2018 30-Jun-2021 IN00651181 ►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 29-Jun-2018 30-Jun-2021 The procurement of consultants to develop a GRM system has been delayed and is still in process. Meanwhile current systems and options are being explored. Initial awareness and Comments: strengthening the current system will be carried out before December 2018. Hence there is no evidence that the GRM is receiving and processing complaints. IN00651183 12/20/2018 Page 5 of 7 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) ►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 29-Jun-2018 30-Jun-2021 Overall Comments IR Note: this is an interim ISR to include corporate indicators in the system. All data will be updated at the next ISR which is due in March 2019 and will coincide to the MTR. 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 27.42 120.22 19% P152394 TF-A2561 Effective USD 40.00 40.00 0.00 11.80 28.20 30% P152394 TF-A2792 Effective USD 1.10 1.10 0.00 0.37 0.73 33% 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 12/20/2018 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. 12/20/2018 Page 7 of 7