The World Bank Report No: ISR15874 Implementation Status & Results Afghanistan Afghanistan: System Enhancement for Health Action in Transition Project (P129663) Public Disclosure Copy Operation Name: Afghanistan: System Enhancement for Health Action in Project Stage: Implementation Seq.No: 4 Status: ARCHIVED Archive Date: 09-Nov-2014 Transition Project (P129663) Country: Afghanistan Approval FY: 2013 Product Line: IBRD/IDA Region: SOUTH ASIA Lending Instrument: Emergency Recovery Loan Implementing Agency(ies): Key Dates Board Approval Date 28-Feb-2013 Original Closing Date 30-Jun-2018 Planned Mid Term Review Date 25-Mar-2016 Last Archived ISR Date 31-May-2014 Effectiveness Date 20-Jun-2013 Revised Closing Date 30-Jun-2018 Actual Mid Term Review Date Project Development Objectives Project Development Objective (from Project Appraisal Document) The project development objectives are to expand the scope, quality and coverage of health services provided to the population, particularly for the poor, in the project areas, and to enhance the stewardship functions of the Ministry of Public Health. Has the Project Development Objective been changed since Board Approval of the Project? Yes No Component(s) Component Name Component Cost Sustaining and improving BPHS and EPHS services 307.00 Building the stewardship capacity of MOPH and system development 90.00 Strengthening program management 10.00 Overall Ratings Public Disclosure Copy Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Satisfactory Overall Risk Rating Substantial Substantial Implementation Status Overview Overall progress towards achieving the project development objectives is rated as moderately satisfactory. Despite security challenges and political uncertainty in the country, HMIS data show an increase in the utilization of key maternal and child health services during the first 6 months of 2014 as compared to the same period of 2013. To further address geographic access barriers, 35 new health facilities have been established, 14 health facilities have been upgraded and around 1,000 health facilities have been equipped with Page 1 of 6 The World Bank Report No: ISR15874 necessary inputs to provide health services in the project area. Implementation performance remains moderately satisfactory due to continued delays in the hiring of the third party monitoring and evaluation firm which will be responsible for the verification of health facility data to assess the performance of contracted NGOs. Locations Public Disclosure Copy Country First Administrative Division Location Planned Actual Afghanistan Not Entered Wilāyat-e Zābul Afghanistan Not Entered Wardak Afghanistan Not Entered Sar-e Pul Afghanistan Not Entered Samangān Afghanistan Not Entered Parwān Afghanistan Not Entered Uruzgān Afghanistan Not Entered Wilāyat-e Nīmrōz Afghanistan Not Entered Nangarhār Afghanistan Not Entered Wilāyat-e Lōgar Afghanistan Not Entered Wilāyat-e Laghmān Afghanistan Not Entered Kunduz Afghanistan Not Entered Wilāyat-e Kunaṟ Afghanistan Not Entered Wilāyat-e Kāpīsā Afghanistan Not Entered Helmand Afghanistan Not Entered Wilāyat-e Ghōr Afghanistan Not Entered Farāh Public Disclosure Copy Afghanistan Not Entered Balkh Afghanistan Not Entered Bādghīs Afghanistan Not Entered Velāyat-e Nūrestān Afghanistan Not Entered Daykundi Province Afghanistan Not Entered Panjshir Results Page 2 of 6 The World Bank Report No: ISR15874 Project Development Objective Indicators Indicator Name Core Unit of Measure Baseline Current End Target Births attended by skilled health personnel Percentage Value 15.60 35.00 Public Disclosure Copy among lowest income quintile Date 09-Oct-2014 Comments Update will be available by December 2015. The hiring of a consulting firm to conduct household surveys and HFA is in process PENTA3 coverage among children aged Percentage Value 28.90 60.00 between 12 -23 months in lowest income Date 09-Oct-2014 quintile Comments Update will be available by December 2015. The hiring of a consulting firm to conduct household surveys and HFA is in process Contraceptive prevalence rate (any modern Percentage Value 19.50 30.00 method) Date 09-Oct-2014 Comments Update will be available by December 2015. The hiring of a consulting firm to conduct household surveys and HFA is in process Proportion of children under five years with Percentage Value 37.00 55.00 severe acute malnutrition who are treated Date 09-Oct-2014 Comments TBD: baseline and target will TBD: update to be provided in TBD be set after having results of January 2015. the nutrition household survey in December 2013 Score on the balanced scorecard examining Percentage Value 61.00 70.00 Public Disclosure Copy quality of care in SCs, BHCs and CHCs Date 09-Oct-2014 Comments Updated upon recruitment of 3rd Party and completion of health facilities assessment expected in June 2015. The accreditation for procurement of goods Yes/No Value No Yes and works achieved and maintained Date 09-Oct-2014 Comments N/A A plan for the accreditation of Maintained the MOPH procurement Page 3 of 6 The World Bank Report No: ISR15874 department will be provided by the relevant thematic group (improving fiduciary systems) under Component 2. Public Disclosure Copy Proposal is expected by end of November 2014. Intermediate Results Indicators Indicator Name Core Unit of Measure Baseline Current End Target Health Facility Utilization Rate: consultation per Percentage Value 1.60 1.80 2.00 person per year Date 11-May-2014 Comments Score on the hospital balanced scorecard that Percentage Value 69.00 77.00 examines quality of care in public hospitals Date 09-Oct-2014 delivering EPHS Comments Update will be available by June 2015. The hiring of a consultant firm to conduct household surveys and HFA under SEHAT is in process Antenatal care coverage- at least one visit Percentage Value 26.00 40.00 among lowest income quintile Date 09-Oct-2014 Comments Update will be available by December 2015. The hiring of a consultant firm to conduct household surveys under SEHAT is in process. Percentage of pregnant and lactating women Percentage Value 0.00 50.00 who received counseling on infant and young Date 09-Oct-2014 child feeding (IYCF) Comments Afghanistan did not have this Update will be available by type of counseling services. December 2015. The hiring Public Disclosure Copy This is the first time. of a consulting firm to conduct household surveys and HFA is in process. NGO contracts for BPHS/EPHS service Number Value 27.00 27.00 27.00 delivery signed and properly managed as per Date 06-Nov-2013 agreed timeline Comments TB treatment success rate Percentage Value 89.00 89.00 90.00 Date 11-May-2014 Comments 90 maintained Page 4 of 6 The World Bank Report No: ISR15874 Percentage of IDUs reached by Needle Percentage Value 27.00 50.00 Syringe Program Date 09-Oct-2014 Comments Update will be available by Public Disclosure Copy June 2016. The hiring of a consultant firm to conduct IBBC under SEHAT is in process. Number of national hospitals with full Number Value 0.00 0.00 15.00 budgetary autonomy Date 11-May-2014 Comments 15 national hospitals with partial budgetary autonomy. Proportion of budget from the Provincial Percentage Value 0.00 0.00 70.00 Budgeting Initiative executed Date 09-Oct-2014 Comments It is in the planning process. Capacity of drug quality control lab developed Yes/No Value No No Yes Date 11-May-2014 Comments N/A Assessment of existing infrastructure completed. MOPH is in the process of developing proposals for strengthening of the QC laboratory. It is expected to be completed by December 31, 2014. We will further discuss with the MOPH on refining this indicator. Proportion of MOPH core development budget Percentage Value 54.00 68.00 75.00 executed Date 11-May-2014 Comments MOPH core development budget execution rate in 2013 Public Disclosure Copy was 68%. HIS annual report prepared and disseminated Yes/No Value No Yes Yes Date 09-Oct-2014 Comments The report was released in June 2014. Data on Financial Performance (as of 20-Oct-2014) Financial Agreement(s) Key Dates Page 5 of 6 The World Bank Report No: ISR15874 Project Ln/Cr/Tf Status Approval Date Signing Date Effectiveness Date Original Closing Date Revised Closing Date P129663 IDA-H8290 Effective 28-Feb-2013 06-May-2013 20-Jun-2013 30-Jun-2018 30-Jun-2018 P129663 TF-15005 Effective 27-Aug-2013 27-Aug-2013 06-Oct-2013 30-Jun-2018 30-Jun-2018 Public Disclosure Copy P129663 TF-95691 Effective 20-Dec-2009 20-Dec-2009 20-Dec-2009 30-Sep-2013 30-Jun-2018 Disbursements (in Millions) Project Ln/Cr/Tf Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P129663 IDA-H8290 Effective USD 100.00 100.00 0.00 38.60 59.86 39.00 P129663 TF-15005 Effective USD 100.00 100.00 0.00 50.67 49.33 51.00 P129663 TF-95691 Effective USD 12.00 12.00 0.00 7.35 4.65 61.00 Disbursement Graph Public Disclosure Copy Key Decisions Regarding Implementation There are no key decisions for disclosure. Restructuring History Level 2 RVP Decision on 29-May-2013 Related Projects P152122-SEHAT Additional Financing Page 6 of 6