The World Bank Report No: ISR11879 Implementation Status & Results India India: Karnataka Health Systems (P071160) Public Disclosure Copy Operation Name: India: Karnataka Health Systems (P071160) Project Stage: Implementation Seq.No: 14 Status: ARCHIVED Archive Date: 20-Oct-2013 Country: India Approval FY: 2007 Product Line: IBRD/IDA Region: SOUTH ASIA Lending Instrument: Specific Investment Loan Implementing Agency(ies): Key Dates Board Approval Date 22-Aug-2006 Original Closing Date 31-Mar-2012 Planned Mid Term Review Date 01-Dec-2008 Last Archived ISR Date 16-May-2013 Effectiveness Date 11-Jan-2007 Revised Closing Date 31-Mar-2016 Actual Mid Term Review Date 16-Jul-2010 Project Development Objectives Project Development Objective (from Project Appraisal Document) To improve health service delivery, public-private collaboration, and financing, particularly for the benefit of underserved and vulnerable groups in Karnataka. Has the Project Development Objective been changed since Board Approval of the Project? Yes No Component(s) Component Name Component Cost Component I: Strengthening existing government health programs 115.07 Component II: Innovations in service delivery and health financing 110.00 Component III: Project Management, Monitoring and Evaluation 15.16 Overall Ratings Previous Rating Current Rating Satisfactory Moderately Satisfactory Public Disclosure Copy Progress towards achievement of PDO Overall Implementation Progress (IP) Satisfactory Moderately Satisfactory Overall Risk Rating Moderate Moderate Implementation Status Overview There has been progress in institutional and capacity development of the state government's scheme financing hospital care for the poor, benefiting a cumulative total of 36,664 patients since the start of the program in 2010. Technical design work has proceeded for new pilot activities, notably for non-communicable disease control and road safety, although start-up of implementation has been delayed, leading to mixed progressed towards achieving project objectives. Ongoing activities supported by the project are proceeding, including investment in Primary Health Centers (PHCs) providing round-the-clock services; 48% of PHCs in the state now provide 24/7 services. The project has supported training for over 9,500 health staff as well as construction and renovation of 321 health facilities and other infrastructure. Page 1 of 5 The World Bank Report No: ISR11879 Locations Country First Administrative Division Location Planned Actual India State of Karnataka State of Karnataka Public Disclosure Copy Results Project Development Objective Indicators Indicator Name Core Unit of Measure Baseline Current End Target Percent of births/deliveries occuring in a health Percentage Value 65.00 86.00 90.00 facility Date 31-Mar-2006 31-Mar-2009 31-Mar-2016 Comments NFHS III (2005-06) UNICEF Coverage Evaluation planned DLHS IV (expected Survey, 2009 2014-15) In 2011-12, 788,701 deliveries in health facilities were recorded in the state (590,283 ingovernment facilities and 198,418 in private facilities). In 2012-13, a total of 837,276 deliveries in health facilities were reported (616,727 in government facilities and 220,549 in private facilities). Percent of birth/deliveries occuring in a health Percentage Value 37.00 45.00 55.00 facility among the poor Date 31-Mar-2004 31-Mar-2008 31-Mar-2016 Comments DLHS II (2002-04) DLHS III (2007-08) planned DLHS IV In 2011-12, 219,591 deliveries in health facilities were reported, while in 2012-13, this figure was Public Disclosure Copy 214,752. Percent of population receiving outpatient care Percentage Value 46.00 81.00 78.00 in government facilities in 7 less-developed Date 31-Mar-2006 31-Mar-2013 31-Mar-2016 districts Comments HMIS HMIS HMIS Number of health claims paid by health Number Value 0.00 36664.00 45000.00 insurance pilot program benefitting Below Date 31-Mar-2006 31-Aug-2013 31-Mar-2016 Poverty Line (BPL) households Comments Page 2 of 5 The World Bank Report No: ISR11879 Number of women screened for cervical cancer Number Value 0.00 0.00 60000.00 in pilot districts Date 31-Mar-2006 30-Nov-2012 31-Mar-2016 Comments Not Applicable Screening not initiated Public Disclosure Copy Percent change in number of road traffic Percentage Value 0.00 0.00 10.00 accident patients transported by 108 Date 31-Mar-2006 30-Nov-2012 31-Mar-2016 ambulance system who receive emergency Comments Not Available Injury tracking system not yet care at government health facilities in pilot districts in place. Direct project beneficiaries Number Value 0.00 225000000.00 306000000.00 Date 31-Mar-2006 31-Mar-2013 31-Mar-2016 Comments cumulative number (since project start) of outpatients in government health facilities in the state (from HMIS) Female beneficiaries Percentage Value 0.00 53.00 50.00 Sub Type Supplemental Intermediate Results Indicators Indicator Name Core Unit of Measure Baseline Current End Target Health personnel receiving training (number) Number Value 0.00 9546.00 25500.00 Date 22-Aug-2006 31-Aug-2013 31-Mar-2016 Comments Births (deliveries) attended by skilled health Number Value 0.00 4100000.00 5200000.00 personnel (number) Date 31-Mar-2005 31-Mar-2013 31-Mar-2016 Comments cumulative from baseline cumulative from baseline (from HMIS). (from HMIS). Health facilities constructed, renovated, and/or Number Value 0.00 321.00 375.00 Public Disclosure Copy equipped (number) Date 31-Mar-2006 31-Aug-2013 31-Mar-2016 Comments Number of mobile health clinics operational Number Value 0.00 111.00 125.00 Date 31-Mar-2006 31-Aug-2013 31-Mar-2016 Comments Percent of government Primary Health Centers Percentage Value 0.00 48.00 47.00 (PHCs) providing round-the-clock services Date 31-Mar-2006 31-Aug-2013 31-Mar-2016 Page 3 of 5 The World Bank Report No: ISR11879 Comments 1,018 PHCs are 24/7 out of a total of 2,138 PHCs. Training materials on non-communicable Yes/No Value No No Yes Public Disclosure Copy disease activities for clinical staff are developed Date 31-Mar-2006 31-Mar-2012 31-Mar-2016 Comments Not Available Guidelines and standards for trauma care Yes/No Value No No Yes services are developed Date 31-Mar-2006 30-Nov-2012 31-Mar-2016 Comments Not Available Information and communication technology Yes/No Value No No Yes (ICT) pilot starts implementation Date 31-Mar-2006 30-Nov-2012 31-Mar-2016 Comments Not Available Data on Financial Performance (as of 23-Sep-2013) Financial Agreement(s) Key Dates Project Ln/Cr/Tf Status Approval Date Signing Date Effectiveness Date Original Closing Date Revised Closing Date P071160 IDA-42290 Effective 22-Aug-2006 16-Oct-2006 11-Jan-2007 31-Mar-2012 31-Mar-2016 P071160 IDA-51610 Effective 27-Sep-2012 21-Nov-2012 22-Jan-2013 31-Mar-2016 31-Mar-2016 P071160 TF-99435 Closed 07-Oct-2011 14-Oct-2011 14-Oct-2011 31-Aug-2013 31-Aug-2013 Disbursements (in Millions) Project Ln/Cr/Tf Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P071160 IDA-42290 Effective USD 141.83 141.83 0.00 132.74 16.32 94.00 P071160 IDA-51610 Effective USD 70.00 70.00 0.00 0.02 70.86 0.00 P071160 TF-99435 Closed USD 0.40 0.40 0.00 0.04 0.36 10.00 Disbursement Graph Public Disclosure Copy Page 4 of 5 The World Bank Report No: ISR11879 Public Disclosure Copy Key Decisions Regarding Implementation No decisions for disclosure Restructuring History Level two Approved on 08-Dec-2010, Level two Approved on 28-Feb-2012, Level two Approved on 07-Aug-2012, Level two Approved on 28-Dec-2012 Related Projects P126846-India: Karnataka Health - Additional Financing, P130395-India: Karnataka Health Systems Additional Financing Public Disclosure Copy Page 5 of 5