The World Bank Report No: ISR9840 Implementation Status & Results India India: Karnataka Health Systems (P071160) Public Disclosure Copy Operation Name: India: Karnataka Health Systems (P071160) Project Stage: Implementation Seq.No: 13 Status: ARCHIVED Archive Date: 16-May-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 14-Dec-2012 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 Satisfactory Public Disclosure Copy Progress towards achievement of PDO Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating Moderate Moderate Implementation Status Overview Additional Financing of US$70 million to the original project became effective on January 22, 2013. Ongoing project activities continue, such as mobile health clinics and citizen help desks in hospitals, while needs assessments and technical design work are proceeding for new activities, notably for pilots for non-communicable disease control and road safety. The state government scheme purchasing tertiary hospital care for poor patients has expanded to the entire state and is meeting institutional development milestones. Almost 30,000 below-poverty-line (BPL) patients have benefited from the scheme. 48% of the state's Primary Health Centers (PHCs) are providing round the clock services, 111 mobile health clinics are providing outreach services to under-served populations and 305 health care facilities have been renovated/refurbished and equipped to provide quality health care. Page 1 of 4 The World Bank Report No: ISR9840 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 by 2014) 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 Percent of population receiving outpatient care Percentage Value 46.00 75.00 78.00 in government facilities in 7 less-developed Date 31-Mar-2006 31-Mar-2012 31-Mar-2016 districts Comments HMIS HMIS HMIS Number of health claims paid by health Number Value 0.00 29346.00 45000.00 insurance pilot program benefitting Below Date 31-Mar-2006 30-Nov-2012 31-Mar-2016 Poverty Line (BPL) households Comments 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 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 Public Disclosure Copy 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 207815932.00 306000000.00 Date 31-Mar-2006 30-Nov-2012 31-Mar-2016 Comments Female beneficiaries Percentage Value 0.00 50.00 50.00 Sub Type Supplemental Page 2 of 4 The World Bank Report No: ISR9840 Intermediate Results Indicators Indicator Name Core Unit of Measure Baseline Current End Target Health personnel receiving training (number) Number Value 0.00 3813.00 25500.00 Public Disclosure Copy Date 22-Aug-2006 30-Nov-2012 31-Mar-2016 Comments Births (deliveries) attended by skilled health Number Value 0.00 4100000.00 5200000.00 personnel (number) Date 31-Mar-2005 30-Nov-2012 31-Mar-2016 Comments cumulative from baseline cumulative from baseline (from HMIS). (from HMIS). Health facilities constructed, renovated, and/or Number Value 0.00 305.00 375.00 equipped (number) Date 31-Mar-2006 30-Nov-2012 31-Mar-2016 Comments Number of mobile health clinics operational Number Value 0.00 111.00 125.00 Date 31-Mar-2006 30-Nov-2012 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 30-Nov-2012 31-Mar-2016 Comments Training materials on non-communicable Yes/No Value No No Yes 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 Public Disclosure Copy Data on Financial Performance (as of 02-Apr-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 Effective 07-Oct-2011 14-Oct-2011 14-Oct-2011 31-Aug-2013 31-Aug-2013 Page 3 of 4 The World Bank Report No: ISR9840 Disbursements (in Millions) Project Ln/Cr/Tf Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P071160 IDA-42290 Effective USD 141.83 141.83 0.00 129.57 19.12 91.00 P071160 IDA-51610 Effective USD 70.00 70.00 0.00 0.00 71.53 0.00 Public Disclosure Copy P071160 TF-99435 Effective USD 0.40 0.40 0.00 0.04 0.36 10.00 Disbursement Graph Key Decisions Regarding Implementation No decisions for disclosure Restructuring History Public Disclosure Copy 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 Page 4 of 4