The World Bank Report No: ISR8889 Implementation Status & Results Kazakhstan Health Sector Technology Transfer and Institutional Reform (P101928) Public Disclosure Copy Operation Name: Health Sector Technology Transfer and Institutional Reform Project Stage: Implementation Seq.No: 8 Status: ARCHIVED Archive Date: 03-Jan-2013 (P101928) Country: Kazakhstan Approval FY: 2008 Product Line: IBRD/IDA Region: EUROPE AND CENTRAL ASIA Lending Instrument: Specific Investment Loan Implementing Agency(ies): Key Dates Board Approval Date 15-Jan-2008 Original Closing Date 30-Jun-2013 Planned Mid Term Review Date 31-Oct-2011 Last Archived ISR Date 26-Jun-2012 Effectiveness Date 15-Dec-2008 Revised Closing Date 31-Dec-2015 Actual Mid Term Review Date 31-Oct-2011 Project Development Objectives Project Development Objective (from Project Appraisal Document) To introduce international standards and build long-term institutional capacity in MOH and related healthcare institutions in support of key health sector reforms pursued by the Government of Kazakhstan in the context of the State Health Care Reform and Development Program. Has the Project Development Objective been changed since Board Approval of the Project? Yes No Component(s) Component Name Component Cost Component A: Health Financing and Management 20.20 Component B: Health Care Quality Improvement 59.90 Component C: Reform of Medical Education and Medical Science 9.40 Component D: Health Information System Development 188.60 Component E: Pharmaceutical Policy Reform 4.20 Public Disclosure Copy Component F: Food Safety and WTO Accession 8.70 Component G: Project Management 4.60 Overall Ratings Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Satisfactory Overall Risk Rating Substantial Page 1 of 7 The World Bank Report No: ISR8889 Implementation Status Overview Overall implementation progress is satisfactory. - The Project has been restructured, including: (1) a revision of the results framework; and (2) an extension of the closing date to December 31, 2015. Public Disclosure Copy - As part of an implementation support mission that took place between November 12-15, 2012, the Bank and the Ministry of Health conducted a series of multi-stakeholder round table sessions and coordination meetings to review the implementation status of the project and overall health sector reforms as well as review and discuss implementation plan for activities planned up to 2015 with emphasis on disease management programs. A round table conducted on November 15 and chaired by the Minister of Health confirmed that the project is providing strong support to the health sector reforms implemented in the framework of the State Health Care Development Program “Salamatty Kazakhstan�. Also noted was the strong synergy between the State Program and the project and the plans of the Ministry to benefit from project support to the full extent given the extension of its closing date. Major highlights of the conference include Kazakhstan’s achievements in the healthcare sector, the strong commitment of the country leadership to healthcare development and the emphasis on the importance of striking a right balance between the provision of health care at the primary and tertiary levels. Locations Country First Administrative Division Location Planned Actual Kazakhstan Not Entered Shyghys Qazaqstan Oblysy Kazakhstan Not Entered Pavlodar Oblysy Kazakhstan Not Entered Qaraghandy Oblysy Kazakhstan Not Entered Astana Results Project Development Objective Indicators Indicator Name Core Unit of Measure Baseline Current End Target Increased funding for Primary Health Care Percentage Value 16.00 19.00 30.00 Date 31-Dec-2011 10-Dec-2012 31-Dec-2015 Comments On track (to be re-confirmed based on year-end value). Public Disclosure Copy Improved financial risk protection as defined by Percentage Value 32.90 29.00 30.00 reduced share of household health spending in Date 31-Dec-2010 10-Dec-2012 31-Dec-2015 total health expenditures Comments Based on draft NHA 2011; to be re-confirmed based on findings of Household Survey in Q1-2 of 2013. Page 2 of 7 The World Bank Report No: ISR8889 Master plans for capital investments, Number Value 0.00 0.00 4.00 developed based on international best practice, Date 31-Dec-2011 10-Dec-2012 31-Dec-2015 used as a basis for capital investment Comments allocations in at least 4 oblasts Public Disclosure Copy At least two evidence-based disease Number Value 0.00 0.00 2.00 management programs, which include Date 31-Dec-2011 10-Dec-2012 31-Dec-2015 incentives for health care providers and Comments patients, developedand endorsed by the Ministry of Health Number of public health facilities accredited by Number Value 20.00 25.00 40.00 national accreditation body in accordance with Date 31-Dec-2011 10-Dec-2012 31-Dec-2015 international standards Comments On track. ICT standards, which conform with Text Value No standards The work on development of TBD international standards and include standards started interoperability standards, are endorsed by Date 31-Dec-2011 10-Dec-2012 31-Dec-2015 Health ICT Regulatory Body and published Comments Slightly delayed due to Target values to be unsuccessful contract determined based on negotiations with first-ranked international expert's candidate. Contract has been recommendations to be concluded with next-in- received by the end of 2012. ranking candidate and work started. Intermediate Results Indicators Indicator Name Core Unit of Measure Baseline Current End Target Increased capacity for health policy analysis Number Value 0.00 0.00 4.00 (as measured by number of national analytical Date 31-Dec-2011 10-Dec-2012 31-Dec-2015 reports produced annually) Comments Delayed: health system review will be finalized in the 1st half of 2013 Public Disclosure Copy NHA reports produced annually, disaggregated Yes/No Value Yes Yes Yes by national and sub-national levels, and Date 31-Dec-2011 10-Dec-2012 31-Dec-2015 disseminated among key stakeholders Comments NHA 2010 aggregated at On track: NHA 2011 Four NHA reports to be national level aggregated at national level; prepared by 2015. disaggregation by sub- national levels to be done starting with NHA 2012. Page 3 of 7 The World Bank Report No: ISR8889 New network planning tools and new facility Text Value New hospital planning tools Delayed: new hospital New tools and standards for standards formally adopted by the Ministry of and standards developed planning tools and standards planning hospitals, laboratory Health will be submitted to MOH for and PHC facilities formally approval in 1st half of 2013 adopted Public Disclosure Copy Date 31-Dec-2011 10-Dec-2012 31-Dec-2015 Comments Delayed. Master plans for capital investments developed Number Value 5.00 14.00 16.00 for 16 regions based on international best Date 31-Dec-2011 10-Dec-2012 31-Dec-2015 practice Comments On track. Oblast-level health network master plans Number Value 0.00 0.00 4.00 endorsed for at least 4 oblasts Date 31-Dec-2011 10-Dec-2012 31-Dec-2015 Comments On track. First oblast level master plan adopted in November 2012 (East- Kazakhstan oblast). Evidence-based incentives for providers in Text Value No evidence-based incentives International experience being Optimized set of evidence- disease management programs implemented for providers reviewed based incentives and pay-for- performance mechanisms for providers implemented Date 31-Dec-2011 10-Dec-2012 31-Dec-2015 Comments On track. Incentives introduced, including revision of co- Text Value No incentives for patients International experience being Optimized set of incentives for payments, for patients to comply with diseases reviewed patients implemented management programs Date 31-Dec-2011 10-Dec-2012 31-Dec-2015 Comments On track. Criteria, procedures and standards for Text Value Health facility accreditation Kazakhstan's upgraded Accreditation criteria, accreditation of health facilities developed, standards developed inpatient accreditation procedures and standards adopted and implemented in line with standards accredited by renewed international practice ISQua for the period 2012-2016. Public Disclosure Copy Date 31-Dec-2011 10-Dec-2012 31-Dec-2015 Comments On track. Evidence-based CPGs for selected disease Text Value No CPGs for disease International experience being CPGs for disease management programs developed management programs reviewed management programs implemented Date 31-Dec-2011 10-Dec-2012 31-Dec-2015 Comments On track. Page 4 of 7 The World Bank Report No: ISR8889 Increase in share of voluntary blood donations Percentage Value 83.00 84.00 88.00 by 2015 Date 31-Dec-2011 10-Dec-2012 31-Dec-2015 Comments On track. Public Disclosure Copy Decrease in absolute number of paid donations Number Value 38800.00 34074.00 33400.00 by 2015 Date 31-Dec-2011 10-Dec-2012 31-Dec-2015 Comments Year-end value to be confirmed in Q1 2013. Criteria, procedures and standards for Text Value No educational programs Institutional accreditation Educational programs for accreditation of basic medical education accredited standards revised. “General Medicine� of two programs developed, adopted and medical universities implemented in linewith international practice accredited Date 31-Dec-2011 10-Dec-2012 31-Dec-2015 Comments On track. IT-infrastructure for deployment of UHMIS in Text Value IT infrastructure developed in IT infrastructure developed in IT infrastructure developed in selected oblasts developed by the Ministry of 140 health organizations 290 health organizations 2,000 health organizations Health Date 31-Dec-2011 10-Dec-2012 31-Dec-2015 Comments On track (Akmola: 123, Astana: 17, Karaganda: 150). Functional ICT standards in line with major Text Value No functional ICT standards The work on development of TBD international functional standards developed by standards started Health ICT Regulatory Body Date 31-Dec-2011 10-Dec-2012 31-Dec-2015 Comments Slightly delayed due to Target values to be unsuccessful contract determined based on negotiations with first-ranked international expert’s candidate. Contract has been recommendations to be concluded with next-in- provided by the end of 2012. ranking candidate and work started. Drug price reference system for drugs included Text Value Ceiling prices for drugs set Methodology for estimation of Reference drug prices refined in the National Formulary Book developed and threshold reference drug based on implementation Public Disclosure Copy adopted by the Ministry of Health prices developed experience Date 31-Dec-2011 10-Dec-2012 31-Dec-2015 Comments On track. Legal and regulatory documents related to Text Value Recommendations on 26 food safety norms and HACCP system post-processing food standards revised in revision of 26 food safety rules and 25 technical implementation in food accordance with international standards norms and rules, 25 technical regulations revised industry expanded regulations, and on amendments to the Law on Food Safety developed Page 5 of 7 The World Bank Report No: ISR8889 Date 31-Dec-2011 10-Dec-2012 31-Dec-2015 Comments On track. Project work plans, procurement plans, and Yes/No Value Yes Yes Yes Public Disclosure Copy budget produced and approved on an annual Date 31-Dec-2011 10-Dec-2012 31-Dec-2015 basis as described in the Project Operational Comments Achieved. Manual Health personnel receiving training (number) Number Value 10720.00 47594.00 63066.00 Date 31-Dec-2011 10-Dec-2012 31-Dec-2015 Comments On track. Health facilities constructed, renovated, and/or Number Value 160.00 312.00 2058.00 equipped (number) Date 31-Dec-2011 10-Dec-2012 31-Dec-2015 Comments On track. Data on Financial Performance (as of 05-Dec-2012) Financial Agreement(s) Key Dates Project Ln/Cr/Tf Status Approval Date Signing Date Effectiveness Date Original Closing Date Revised Closing Date P101928 IBRD-48830 Effective 15-Jan-2008 02-Feb-2008 15-Dec-2008 30-Jun-2013 31-Dec-2015 Disbursements (in Millions) Project Ln/Cr/Tf Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P101928 IBRD-48830 Effective USD 117.70 117.70 0.00 41.56 76.14 35.00 Disbursement Graph Public Disclosure Copy Page 6 of 7 The World Bank Report No: ISR8889 Public Disclosure Copy Key Decisions Regarding Implementation N/A Restructuring History Level two Approved on 12-Oct-2012 Related Projects There are no related projects. Public Disclosure Copy Page 7 of 7