The World Bank Report No: ISR10692 Implementation Status & Results Cameroon Cameroon Health Sector Support Investment (SWAP) (P104525) Public Disclosure Copy Operation Name: Cameroon Health Sector Support Investment (SWAP) Project Stage: Implementation Seq.No: 11 Status: ARCHIVED Archive Date: 12-Jun-2013 (P104525) Country: Cameroon Approval FY: 2008 Product Line: IBRD/IDA Region: AFRICA Lending Instrument: Specific Investment Loan Implementing Agency(ies): Key Dates Board Approval Date 24-Jun-2008 Original Closing Date 31-Mar-2014 Planned Mid Term Review Date 30-Mar-2012 Last Archived ISR Date 10-Dec-2012 Effectiveness Date 03-Mar-2009 Revised Closing Date 31-Mar-2014 Actual Mid Term Review Date 06-May-2013 Project Development Objectives Project Development Objective (from Project Appraisal Document) To increase utilization and improve the quality of health services with a particular focus on child and maternal health and communicable diseases. Has the Project Development Objective been changed since Board Approval of the Project? Yes No Component(s) Component Name Component Cost District Service Delivery 20.00 Institutional Strengthening 5.00 Overall Ratings Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Satisfactory Public Disclosure Copy Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating Implementation Status Overview The World Bank team and the Government have completed the Mid Term Review (MTR) of the Project. The four regions were visited by multi-disciplinary teams included members from the World Bank and Ministry of Public Health and a workshop was held to analyze the progress of the project. MTR field visits in the four regions identified that the project is operating successfully in the four regions. Feedback from both health care providers and clients of health services is overwhelmingly positive and enthusiastic about the project performance. Out of the 13 indicators of the project, 7 exceed 70% of end of project target including 2 surpassing that target, 4 indicators are at 40% to 57% of end of project target and one indicator is at 20% and a last indicator is lagging behind at 9% of end of project target. The MTR concluded that: Page 1 of 6 The World Bank Report No: ISR10692 1) the overall trend of the project indicators shows that the project is likely to achieve its development objectives provided that additional time is granted for implementation; 2) the Project Development Objectives (PDO) and the project institutional arrangements to support project implementation are still relevant; 3) the project's legal covenants are implemented as expected; and 4) the MTR has found that the performance of both government and Bank is satisfactory. Public Disclosure Copy Locations Country First Administrative Division Location Planned Actual Cameroon South-West Province South-West Region Cameroon North-West Province North-West Region Cameroon Littoral Province Littoral Region Cameroon Not Entered Republic of Cameroon Results Project Development Objective Indicators Indicator Name Core Unit of Measure Baseline Current End Target People with access to a basic package of Number Value 0.00 622807.00 750000.00 health, nutrition, or reproductive health services Date 30-Apr-2009 20-May-2013 31-Mar-2014 (number) Comments 83% of end of project target is achieved - Total number of new consultations provided to the population for health, nutrition and population service needs in the targeted areas. Source: reports from health centers verified by the PPA verification teams Public Disclosure Copy Children immunized (number) Text Value 72% (2006 MICS) 56895 100000 Date 01-Jan-2006 20-May-2013 31-Mar-2014 Comments to be updated once the 2009 56% of end of project target is combined DHS/MICS is achieved - Source: reports available from health center, verified by the PPA verification teams Percentage of births attended by skilled Text Value 63% 35287 30000 professional Date 01-Jan-2006 20-May-2013 31-Mar-2014 Page 2 of 6 The World Bank Report No: ISR10692 Comments Source: (2005 DHS) 116% achieved- End of project target surpassed - Source: reports from health centers - Verified by the PPA Public Disclosure Copy verification teams. New cases of TB detected and treated in Number Value 2044.00 5000.00 targeted areas Date 20-May-2013 31-Mar-2014 Comments 40.9% of end of project target is achieved - Source: reports from health centers. Verified by the PPA verification teams. Direct project beneficiaries Number Value 0.00 714024.00 885000.00 Date 02-Mar-2009 20-May-2013 31-Mar-2014 Comments 80.6% of end of project target is achieved - Source: reports from health centers. Verified by the PPA verification teams. Female beneficiaries Percentage Value 0.00 363815.00 443000.00 Sub Type Supplemental Intermediate Results Indicators Indicator Name Core Unit of Measure Baseline Current End Target Pregnant women receiving antenatal care Number Value 117643.00 100000.00 during a visit to a health provider (number) Date 20-May-2013 31-Mar-2014 Comments 117% - End of project target is surpassed - Source: reports from health centers. verified by PPA verification teams. New acceptors of modern contraceptive Number Value 11247.00 20000.00 Public Disclosure Copy methods in targeted areas Date 20-May-2013 31-Mar-2014 Comments 56% of end of project target is achieved - Source: reports from health centers. verified by PPA verification teams. Page 3 of 6 The World Bank Report No: ISR10692 Children by the first anniversary who have Number Value 84625.00 100000.00 received one dose of Vit. A in the last six Date 20-May-2013 31-Mar-2014 months in targeted areas Comments 84.6% of end of project target Public Disclosure Copy is achieved - Source: reports from health centers. Verified by PPA verification teams. Patients treated for TB (number) Text Value Littoral: 51% 56.5% 80% N-West: 66% S-West: 50% East: 38% ( % for each region) Date 30-Apr-2009 20-May-2013 31-Mar-2014 Comments 1207 patients cured over over 2137 patients = . 70.6% of end of project target (which is 80%) is achieved - Source: reports from health centers. Data verified by the PPA verification teams. Tracer drugs available in targeted health Percentage Value 0.00 37.20 75.00 facilities on the day of the visit Date 31-Mar-2009 20-May-2013 31-Mar-2014 Comments 37.2 % - 142 health facilities have 100% of tracer drugs available the day of the last visit, over 382 total number of PBF health facilities. Source: reports from PPAs Health facilities achieving an average score of Percentage Value 0.00 12.00 60.00 75% of the quality index of services as Date 31-Mar-2009 20-May-2013 31-Mar-2014 measured in RBF in the targeted areas Comments 12% - There is a total of 46 health facilities that achieved Public Disclosure Copy 75% over 382 facilities source: reports from PPAs Health facilities reporting monthly activities Number Value 0.00 72.80 75.00 using standard report form in targeted areas Date 31-Mar-2009 20-May-2013 31-Mar-2014 Comments 72.8 % for a target of 75% - The end target is 75% of all There are 286 health facilities facilities that will be involved using the standard report form in RBF. Total expected from a total of 393 involved in number will be available by December 2012 whenall Page 4 of 6 The World Bank Report No: ISR10692 the reporting facilities. contracts with health facilities Source: reports from PPAs are signed. Consultations provided to people from the Percentage Value 0.00 6780.00 75000.00 poorest quintile as measured by asset index in Public Disclosure Copy Date 20-May-2013 31-Mar-2014 targeted areas Comments 09% of end of project target The end target is 10% of all achieved - Source: reports new consultations in the from health centers. Verified targeted areas. by the PPA verification teams. Data on Financial Performance (as of 11-Apr-2013) Financial Agreement(s) Key Dates Project Ln/Cr/Tf Status Approval Date Signing Date Effectiveness Date Original Closing Date Revised Closing Date P104525 IDA-44780 Effective 24-Jun-2008 30-Oct-2008 03-Mar-2009 31-Mar-2014 31-Mar-2014 P104525 TF-58012 Closed 28-Feb-2007 28-Feb-2007 28-Feb-2007 07-Dec-2007 07-Jun-2008 Disbursements (in Millions) Project Ln/Cr/Tf Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P104525 IDA-44780 Effective USD 25.00 25.00 0.00 10.35 12.93 41.00 P104525 TF-58012 Closed USD 0.50 0.24 0.26 0.24 0.00 100.00 Disbursement Graph Public Disclosure Copy Page 5 of 6 The World Bank Report No: ISR10692 Key Decisions Regarding Implementation The following decisions were agreed between the Government and the World Bank: - The Government will finance at least 50% of the implementation cost of Performance Based Financing (PBF) in the Littoral region, using its own budget in the 2014 calendar year. - The closing date of the project would be extended for up to 24 months to allow the project to: (i) to achieve the PDO indicators; (ii) complete the impact evaluation in order to inform Public Disclosure Copy the decision on scaling up PBF to the national level; (iii) to allow the Government to implement its strategy to tap into the national budget to support the implementation of PBF in Cameroon, in addition to World Bank and other donors financial support. - An additional financing (around US $ 10 to 15 million) to the project will be sought where resources area available. Restructuring History Level two Approved on 13-Jun-2011 Related Projects There are no related projects. Public Disclosure Copy Page 6 of 6