The World Bank Implementation Status & Results Report Uttarakhand Health Systems Development Project (P148531) Uttarakhand Health Systems Development Project (P148531) SOUTH ASIA | India | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2017 | Seq No: 6 | ARCHIVED on 01-Oct-2019 | ISR38426 | Implementing Agencies: Government of India, Department of Medical Health and Family Welfare, Government of Uttarakhand Key Dates Key Project Dates Bank Approval Date: 26-Jan-2017 Effectiveness Date: 23-May-2017 Planned Mid Term Review Date: 29-May-2020 Actual Mid-Term Review Date: Original Closing Date: 30-Sep-2023 Revised Closing Date: 30-Sep-2023 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The Project Development Objective (PDO) is to improve access to quality health services, particularly in the hilly districts of thestate, and to expand health financial risk protection for the residents of Uttarakhand Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Innovations in engaging the private sector:(Cost $80.00 M) Stewardship and system improvement component:(Cost $45.00 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO ►Moderately Unsatisfactory ►Moderately Satisfactory Overall Implementation Progress (IP) ►Moderately Unsatisfactory ►Moderately Satisfactory Overall Risk Rating ►Substantial ►Substantial Implementation Status and Key Decisions After two years of minimal progress, the mission was pleased to note that implementation has finally started to make headway. Implementation of the Tehri cluster public- private partnership (PPP) for service delivery has been progressing well with nearly all actions detailed in the Tehri Handover Roadmap completed in a timely manner. Moreover, not only are there tangible results on the ground – Caesarean-section deliveries have already begun at the district hospital Baurari – but this will be 10/1/2019 Page 1 of 7 The World Bank Implementation Status & Results Report Uttarakhand Health Systems Development Project (P148531) reflected in more rapid increases in disbursements in the upcoming months. Implementation of environmental and social safeguards activities has progressed with both a communications strategy and an environmental action plan developed and outreach activities begun. It is evident from the progress of the last few months that there is greater ownership of and commitment to the Uttarakhand Health Systems Development Project by the state government, including strengthening of institutional arrangements and implementation of core activities. Furthermore, some of the progress made indicates that future implementation and disbursements are indeed feasible even if challenging Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance -- ►Moderate ►Moderate Macroeconomic -- ►Moderate ►Moderate Sector Strategies and Policies -- ►Moderate ►Moderate Technical Design of Project or Program -- ►Substantial ►Substantial Institutional Capacity for Implementation and Sustainability -- ►Substantial ►Substantial Fiduciary -- ►Substantial ►Substantial Environment and Social -- ►Moderate ►Moderate Stakeholders -- ►Substantial ►Substantial Other -- -- -- Overall -- ►Substantial ►Substantial Results PDO Indicators by Objectives / Outcomes Innovations in engaging the private sector IN00739985 ►Number of outpatient visits to Primary Health Centers (PHCs), CHCs, and mobile vans per year, disaggregated by districts (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 774,926.00 774,926.00 3,024,917.00 1,150,000.00 Date 31-Mar-2016 31-Mar-2016 31-Jul-2019 31-Mar-2023 Data for FY will be reported at the end of March 2020 Comments: IN00740007 10/1/2019 Page 2 of 7 The World Bank Implementation Status & Results Report Uttarakhand Health Systems Development Project (P148531) ►Number of hospital admissions and outpatient consultations covered by any form of health insurance supported by the project (RSBY and MSBY), disaggregated by gender (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 46,040.00 46,040.00 74,747.00 100,000.00 Date 29-Jul-2016 29-Jul-2016 31-Jul-2019 31-Mar-2023 Data for FY will be reported at the end of March 2020 Comments: Stewardship and system improvement component IN00740006 ►Number of persons who used the Health Helpline to receive information or lodge grievances, disaggregated by gender (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 81,192.00 81,192.00 461,850.00 160,000.00 Date 25-Nov-2016 25-Nov-2016 31-Jul-2019 31-Mar-2023 Data for FY will be reported at the end of March 2020 Comments: IN00740008 ►Patients contacted by the Health Helpline that are satisfied with the health services provided to them (per year, disaggregated by gender) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 1.31 70.00 Date 25-Nov-2016 25-Nov-2016 31-Jul-2019 31-Mar-2023 Data for FY will be reported at the end of March 2020 Comments: IN00740009 ►Number of government and non-government healthcare facilities in the state issued with an entry (or higher) level certification by the National Accreditation Board for Hospitals (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 2.00 2.00 0.00 8.00 Date 25-Nov-2016 25-Nov-2016 31-Jul-2019 31-Mar-2023 Intermediate Results Indicators by Components Innovations in engaging the private sector IN00740010 ►People with access to any form of health insurance in the state during the year, disaggregated by gender (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target 10/1/2019 Page 3 of 7 The World Bank Implementation Status & Results Report Uttarakhand Health Systems Development Project (P148531) Value 921,584.00 921,584.00 10,085,000.00 3,000,000.00 Date 31-Dec-2014 31-Dec-2014 31-Jul-2019 31-Mar-2023 Data for FY will be reported at the end of March 2020 Comments: IN00740012 ►Number of children covered under the expanded health insurance program who received an annual health assessment during the year, disaggregated by gender (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 200,000.00 Date 25-Nov-2016 25-Nov-2016 31-Jul-2019 31-Mar-2023 Data for FY will be reported at the end of March 2020 Comments: IN00740014 ►Number of patients who use the services provided by the mobile health vans, disaggregated by gender (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 104,122.00 104,122.00 0.00 300,000.00 Date 25-Nov-2016 25-Nov-2016 31-Jul-2019 31-Mar-2023 Data for FY will be reported at the end of March 2020 Comments: IN00740015 ►Number of mobile medical units complying with the requirement of having at least one female doctor with sonology certification (>90% compliance on a day-to-day basis) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 9.00 Date 25-Nov-2016 25-Nov-2016 31-Jul-2019 31-Mar-2023 Data for FY will be reported at the end of March 2020 Comments: IN00740016 ►Number of outsourced CHCs with utilization of emergency services reported during each month (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 2.00 8.00 Date 25-Nov-2016 25-Nov-2016 31-Jul-2019 31-Mar-2023 Data for FY will be reported at the end of March 2020 Comments: IN00740017 ►Number of outsourced CHCs where at least one emergency caesarean section was reported during each quarter (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 6.00 10/1/2019 Page 4 of 7 The World Bank Implementation Status & Results Report Uttarakhand Health Systems Development Project (P148531) Date 25-Nov-2016 25-Nov-2016 31-Jul-2019 31-Mar-2023 Data for FY will be reported at the end of March 2020 Comments: IN00740018 ►Benefit package of child health services finalized and piloted (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 No 'yes' from year 2 Date 25-Nov-2016 25-Nov-2016 31-Jul-2019 31-Mar-2023 IN00740019 ►Benefit package of NCDs services finalized and piloted (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target "no" for the first three Value 0.00 0.00 No years and "yes" from year 4. Date 25-Nov-2016 25-Nov-2016 31-Jul-2019 31-Mar-2023 IN00740020 ►Share of eligible households successfully enrolled under RSBY/MSBY during the year (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 45.70 45.70 100.00 50.00 Date 31-Dec-2014 31-Dec-2014 31-Jul-2019 31-Mar-2023 IN00740021 ►Number of specialists working in the outsourced health facilities (and augmenting the positions functionally vacant in the public system) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 25.00 25.00 15.00 50.00 Date 25-Nov-2016 25-Nov-2016 31-Jul-2019 31-Mar-2023 Data for FY will be reported at the end of March 2020 Comments: IN00740022 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 140,631.00 140,631.00 70,276.00 180,000.00 Date 31-Mar-2016 31-Mar-2016 31-Jul-2019 31-Mar-2023 Number of children immunized. Comments: Data for FY will be reported at the end of March 2020 IN00740023 ►Number of children immunized (Number, Corporate Breakdown) 10/1/2019 Page 5 of 7 The World Bank Implementation Status & Results Report Uttarakhand Health Systems Development Project (P148531) Baseline Actual (Previous) Actual (Current) End Target Value 140,631.00 140,631.00 70,276.00 180,000.00 Date 31-Mar-2016 31-Mar-2016 31-Jul-2019 31-Mar-2023 Stewardship and system improvement component IN00740011 ►Health personnel receiving training financed by the project- cumulative (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 5,000.00 Date 25-Nov-2016 25-Nov-2016 31-Jul-2019 31-Mar-2023 Data for FY will be reported at the end of March 2020 Comments: IN00740013 ►Development and periodical update of a comprehensive disaster response plan at the state level (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Done by year 2, updated Value 0.00 0.00 No by year revised by year 6. Date 25-Nov-2016 25-Nov-2016 31-Jul-2019 31-Mar-2023 Progress for FY will be reported at the end of March 2020 Comments: Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P148531 IDA-59480 Effective USD 100.00 100.00 0.00 1.27 98.73 1.3% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P148531 IDA-59480 Effective 26-Jan-2017 23-Mar-2017 23-May-2017 30-Sep-2023 30-Sep-2023 Cumulative Disbursements 10/1/2019 Page 6 of 7 The World Bank Implementation Status & Results Report Uttarakhand Health Systems Development Project (P148531) Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 10/1/2019 Page 7 of 7