The World Bank Implementation Status & Results Report Sri Lanka: Primary Health Care System Strengthening Project (P163721) Sri Lanka: Primary Health Care System Strengthening Project (P163721) SOUTH ASIA | Sri Lanka | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2018 | Seq No: 2 | ARCHIVED on 25-Mar-2019 | ISR34888 | Implementing Agencies: Ministry of Health, Nutrition and Indigenous Medicine, Democratic Socialist Republic of Sri Lanka Key Dates Key Project Dates Bank Approval Date: 27-Jun-2018 Effectiveness Date: -- Planned Mid Term Review Date: 17-May-2021 Actual Mid-Term Review Date: -- Original Closing Date: 31-Dec-2023 Revised Closing Date: 31-Dec-2023 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The project development objective is to increase the utilization and quality of primary health care services, with an emphasis on detection and management of non-communicable diseases in high-risk population groups, in selected areas of the country. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Implementation of the PHC System Reorganization and Strengthening Strategies:(Cost $4404.00 M) Project Implementation Support and Innovation Grants:(Cost $14.22 M) Contingent Emergency Response Component Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating Substantial Substantial Implementation Status and Key Decisions The Loan Agreement for the Project was signed and made effective on January 23, 2019. The Project was launched with health stakeholders and detailed implementation plans are being discussed for each of the provinces and districts. The Ministry of Health and provinces are working towards the successful completion of the first year expected disbursement-linked results towards the implementation of the Ministry of Health's strategy towards strengthening and reorganizing the primary health care system. Given the early stage of project implementation and the level of commitment by the Ministry of Health and other stakeholders, the progress towards achieving the project development objective is satisfactory. 3/25/2019 Page 1 of 8 The World Bank Implementation Status & Results Report Sri Lanka: Primary Health Care System Strengthening Project (P163721) Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Substantial Substantial Substantial Macroeconomic Moderate Moderate Moderate Sector Strategies and Policies Moderate Moderate Moderate Technical Design of Project or Program Substantial Substantial Substantial Institutional Capacity for Implementation and Sustainability Moderate Moderate Moderate Fiduciary Moderate Moderate Moderate Environment and Social Low Low Low Stakeholders Substantial Substantial Substantial Other -- -- -- Overall Substantial Substantial Substantial Results PDO Indicators by Objectives / Outcomes Increase utlization of PHC services, particularly prevention/management of NCDs in high-risk groups IN00647967 ►Number of women at age 35 and at age 45 years who are screened for cervical cancer at a network of public health facilities (DLI 8) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 107,551.00 107,551.00 161,344.00 213,000.00 Date 31-Dec-2017 31-Dec-2017 31-Dec-2018 31-Dec-2022 IN00647969 ►Percentage of screened adults with high risk for non-communicable diseases who are registered and actively followed-up at primary medical care institutions (DLI 9) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 25.00 Date 29-Dec-2017 31-Dec-2017 31-Dec-2018 31-Dec-2022 IN00647970 Male (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 25.00 3/25/2019 Page 2 of 8 The World Bank Implementation Status & Results Report Sri Lanka: Primary Health Care System Strengthening Project (P163721) Date 31-Dec-2017 31-Dec-2017 31-Dec-2018 31-Dec-2022 IN00647971 Female (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 25.00 Date 31-Dec-2017 31-Dec-2017 31-Dec-2018 30-Dec-2022 Increase in the quality of PHC services, in selected areas of the country IN00647968 ►The number of primary medical care institutions that have the required capabilities for providing comprehensive and quality care. (DLI 3) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 550.00 Date 31-Dec-2017 31-Dec-2017 31-Dec-2018 31-Dec-2022 Intermediate Results Indicators by Components Implementation of the PHC System Reorganization and Strengthening Strategies IN00647973 ►MoH and Provinces endorse policies and standards for reorganizing PHC (DLI 1) (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target MoH and Provinces Policies and standards endorse the package sufficient to guide PHC of circulars and Value -- Same as baseline. Reorganization do not guidelines necessary exist for PHC model implementation Date 03-Sep-2018 16-Aug-2018 28-Feb-2019 30-Jun-2019 IN00647975 ►MoH adopts and updates clinical protocols for selected health conditions (DLI 2) (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target No clinical protocols Package of protocols targeted for the PHC adopted for defined Value -- Same as baseline. level exist for the defined selected health tracer conditions conditions Date 03-Sep-2018 16-Aug-2018 28-Feb-2019 23-Jun-2023 IN00647976 ►Number of annual progress reviews on MoH Action Plan, including Project Results Indicators at the central MoH (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 3.00 Date 03-Sep-2018 16-Aug-2018 28-Feb-2019 31-Dec-2022 3/25/2019 Page 3 of 8 The World Bank Implementation Status & Results Report Sri Lanka: Primary Health Care System Strengthening Project (P163721) IN00647977 ►Number of patient-friendly services provided on the basis of 4 types of services at the PMCIs (DLI 4) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 550.00 Date 03-Sep-2018 16-Aug-2018 31-Dec-2018 31-Dec-2022 IN00647978 ►Percentage of Medical Officers (both Medical Officers of Health in the Public Health stream and Medical Officers at PMCIs) trained on essential service package on NCDs (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 70.00 Date 01-Jul-2018 16-Aug-2018 31-Dec-2018 31-Dec-2022 IN00647979 ►Percentage of PMCIs with transport facilities for dispatching the samples for investigations to apex laboratories (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 55.00 Date 03-Sep-2018 16-Aug-2018 31-Dec-2018 31-Dec-2022 IN00647980 ►Percentage of PMCIs with capability for primary detection and management of dengue (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 55.00 Date 31-Dec-2017 16-Aug-2018 31-Dec-2018 31-Dec-2022 IN00647981 ►Percentage of PMCIs providing a standard primary oral health care package (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 55.00 Date 03-Sep-2018 16-Aug-2018 31-Dec-2018 31-Dec-2022 IN00647982 ►Percentages of PMCIs with basic emergency care facilities (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 10.00 0.00 0.00 50.00 Date 03-Sep-2018 16-Aug-2018 31-Dec-2018 30-Dec-2022 IN00647983 ►Percentage of Medical Officer of Health areas offering mental health services in at least one PMCI (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 35.00 3/25/2019 Page 4 of 8 The World Bank Implementation Status & Results Report Sri Lanka: Primary Health Care System Strengthening Project (P163721) Date 03-Sep-2018 16-Aug-2018 31-Dec-2018 31-Dec-2022 IN00647984 ►Percentage of PMCIs with capability for TB screening and referral (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 45.00 Date 03-Sep-2018 16-Aug-2018 31-Dec-2018 31-Dec-2022 IN00647985 ►Percentage of Medical Officer of Health areas with at least one PMCI providing routine nutrition counseling services, particularly for identified high-risk population, by qualified nutritionist (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 35.00 Date 03-Sep-2018 16-Aug-2018 31-Dec-2018 31-Dec-2022 IN00647986 ►Percentage of public sector schools implementing health promoting programs (health promoting schools) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 31.00 31.00 31.00 45.00 Date 31-Dec-2017 31-Dec-2017 31-Dec-2018 30-Dec-2022 IN00647987 ►Percentage of food business operators inspected and classified as satisfactory according to the healthy food standard (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 51.00 51.00 51.00 75.00 Date 29-Dec-2017 31-Dec-2017 31-Dec-2018 31-Dec-2022 IN00647988 ►Number of PMCIs that use personal health records to coordinate patient care over time and through the referral chain (DLI 5) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 550.00 Date 03-Sep-2018 16-Aug-2018 31-Dec-2018 31-Dec-2022 IN00647989 ►Number of PMCIs connected to and using the Medical Supplies Management Information System (DLR 6.1) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 550.00 Date 03-Sep-2018 16-Aug-2018 31-Dec-2018 31-Dec-2022 IN00647990 ►Percentage of annual procurement by MSD that is less than or equal to defined performance benchmarks (DLR 6.3) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target 3/25/2019 Page 5 of 8 The World Bank Implementation Status & Results Report Sri Lanka: Primary Health Care System Strengthening Project (P163721) Value 50.00 50.00 50.00 70.00 Date 31-Dec-2016 31-Dec-2016 31-Dec-2018 31-Dec-2022 IN00647991 ►The use of the urgent procurement procedure as a percent of total medical supplies procurement that is reduced from the established baseline (DLR 6.5) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 40.00 Date 31-Dec-2017 31-Dec-2017 31-Dec-2018 31-Dec-2022 IN00647992 ►Community Engagement Mechanism for health sector operational, including grievance redressal mechanism (DLI 7) (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target An operational community There is no operational engagement and community engagement Value -- Same as baseline. citizen feedback and grievance redressal mechanism in place, mechanism especially for users of PMCIs. Date 03-Sep-2018 16-Aug-2018 28-Feb-2019 30-Jun-2023 IN00647993 ►Number of PMCIs with active community engagement committees (DLR 7.5) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 550.00 Date 03-Sep-2018 16-Aug-2018 31-Dec-2018 30-Dec-2022 IN00647994 ►Adequate and timely release of treasury funds requested to health sector program (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 75.00 75.00 75.00 85.00 Date 31-Dec-2017 31-Dec-2017 31-Dec-2018 31-Dec-2022 Project Implementation Support and Innovation Grants IN00647972 ►Percentage of MoH and district training/capacity building plans developed and monitored (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 100.00 Date 03-Sep-2018 16-Aug-2018 31-Dec-2018 31-Dec-2022 IN00647974 ►Number of innovative subprojects supported, evaluated and disseminated (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target 3/25/2019 Page 6 of 8 The World Bank Implementation Status & Results Report Sri Lanka: Primary Health Care System Strengthening Project (P163721) Value 0.00 0.00 0.00 50.00 Date 03-Sep-2018 16-Aug-2018 31-Dec-2018 31-Dec-2023 Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed Not P163721 IBRD-88780 USD 200.00 200.00 0.00 0.00 200.00 0% Effective Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date Not P163721 IBRD-88780 27-Jun-2018 23-Jan-2019 -- 31-Dec-2023 31-Dec-2023 Effective Cumulative Disbursements 3/25/2019 Page 7 of 8 The World Bank Implementation Status & Results Report Sri Lanka: Primary Health Care System Strengthening Project (P163721) Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 3/25/2019 Page 8 of 8