The World Bank Report No: ISR5842 Implementation Status & Results Samoa SAMOA HEALTH SECTOR MANAGEMENT PROGRAM SUPPORT PROJECT (P086313) Public Disclosure Copy Operation Name: SAMOA HEALTH SECTOR MANAGEMENT PROGRAM Project Stage: Implementation Seq.No: 6 Status: ARCHIVED Archive Date: 20-Feb-2011 SUPPORT PROJECT (P086313) Country: Samoa Approval FY: 2008 Product Line: IBRD/IDA Region: EAST ASIA AND PACIFIC Lending Instrument: Specific Investment Loan Implementing Agency(ies): Ministry of Health Key Dates Board Approval Date 19-Jun-2008 Original Closing Date 31-Dec-2013 Planned Mid Term Review Date 06-Apr-2011 Last Archived ISR Date 20-Feb-2011 Effectiveness Date 21-Oct-2008 Revised Closing Date 31-Dec-2013 Actual Mid Term Review Date 14-Dec-2011 Project Development Objectives Project Development Objective (from Project Appraisal Document) The objective of the Project is to improve the Recipient's effectiveness in managing and implementing the Program based on the use of results from sector performance monitoring. The Program's aim in the medium-term (FY2009-2013) is to improve accesst to, and utilization of effective, efficient and quality health services to improve the health status of the Samoan population. Health SWAP development objectives: To improve the effectiveness of the Government of Samoa in managing and implementing the HSP, based on the use of results from sector performance monitoring Has the Project Development Objective been changed since Board Approval of the Project? Yes No Component(s) Component Name Component Cost Health Promotion and Prevention 4.58 Enhancement of Quality Health Care Service Delivery 15.42 Strengthening Policy, Monitoring and Regulatory Oversight of the Health System 4.10 Public Disclosure Copy Overall Ratings Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Satisfactory Overall Risk Rating Implementation Status Overview The Implementation Review Mission took place as a follow up to the Redevelopment Mission held in April 2011. Both the Government of Samoa and the development partners Page 1 of 6 The World Bank Report No: ISR5842 reaffirmed their commitment to the redevelopment process and the importance of the Redevelopment Position Paper (RPP) in providing strategy and direction for the program going forward. The final draft RPP confirmed the findings for the first Redevelopment mission that the development objectives of the program, performance indicators and the architecture of the implementation arrangements of the Program will remain unchanged. Public Disclosure Copy It was agreed that the RPP would be finalized, on the basis of agreements reached during the mission. To facilitate improved connections between activities approved (and to be approved in the future) and program and whole of sector outcomes, a new format will incorporate direct linkages to all sources of financing available to the sector and the M&E framework which will also reduce the need to report on inputs and activities. The new (revised) POW in the revised format/template will be submitted to the Development Partners by the Ministry of Health by end February, 2012. Implementation progress was and remains moderately satisfactory: the mission came to the conclusion that implementation was moderately satisfactory on the basis that very recent work to get the program back on track – particularly for a few major contracts – signaled a turn-around from the last mission. Expenditure still lags but is expected to pick up given the work achieved in the last month following the last mission. Locations Country First Administrative Division Location Planned Actual Samoa Not Entered Independent State of Samoa Samoa Not Entered Savai'i Samoa Tuamasaga Apia Results Project Development Objective Indicators Indicator Name Core Unit of Measure Baseline Current End Target Share of annual outpatient visits by poorest Text Value To be determined by HIES quintile of population survey Date 31-Dec-2008 23-Dec-2010 Comments These data from a household survey, which has not been analysed yet. MOH has not obtained these results yet. Public Disclosure Copy The status of these results will be examined during the formal supervision mission in March 2011 % of health sector budgets and disbursements Text Value SWAP will introduce a Needs to be confirmed but conform to policy objectives and HSP priority mechanism for better aligning draft estimate for FY11 is 14% areas. resources with priorities. Date 31-Mar-2008 23-Dec-2010 27-Apr-2012 Page 2 of 6 The World Bank Report No: ISR5842 Comments These data from a household survey which has not yet been analyzed. The status of these results will be examined Public Disclosure Copy during formal supervision mission in March 2012. Data not available in December 2011 Intermediate Results Indicators Indicator Name Core Unit of Measure Baseline Current End Target Children receiving a dose of vitamin A Number Value 0.00 0.00 Date 31-Mar-2010 31-Dec-2013 Comments The DHS 2009 report has Baseline data will be available been released and does have April 2011 information on Vitamin A RATES. It is not possible to get data on the NUMBER from this data source. People with access to a basic package of Number Value 0.00 0.00 health, nutrition, or population services Date 31-Mar-2010 31-Dec-2013 Comments There is no such thing as a Baseline data will be available basic package in Samoa. April 2011 Pregnant women receiving antenatal care Number Value 0.00 0.00 during a visit to a health provider Date 31-Mar-2010 31-Dec-2013 Comments The DHS 2009 report has Baseline data will be available been released and does have April 2011 information on antenatal utilisation RATES. It is not possible to get data on the NUMBER from this data Public Disclosure Copy source. Children immunized Number Value 0.00 0.00 Date 31-Mar-2010 31-Dec-2013 Comments The DHS 2009 report has Baseline data will be available been released and does have April 2011 information on immunisation RATES. It is not possible to get data on the NUMBERof Page 3 of 6 The World Bank Report No: ISR5842 immunisations from this data source. Health facilities constructed, renovated, and/or Number Value 0.00 0.00 equipped Public Disclosure Copy Date 31-Mar-2010 31-Dec-2013 Comments This mission did not assess Baseline data will be available this. April 2011 Health personnel receiving training Number Value 40.00 0.00 Date 31-Mar-2010 31-Dec-2013 Comments The actual number may be Baseline data will be available even higher as there was April 2011 some on-going training when this mission was completed. MOH Financial Audits are submitted on timie Text Value No DHS available at baseline and action plan agreed on for resolving Date 25-Sep-2008 23-Dec-2010 outstanding issues. Comments DHS and other statisticalreports completed within stated timeframe and made public Planning of health service is enhanced through Text Value No disaggregated data by use of disaggregated data by age, sex, and age, sex and domicile used in domicile program planningat present Date 25-Sep-2008 31-Mar-2010 Comments The DHS is being used in policy and planning Health expenditures as a percentage of Text Value Health allocation is 15% of government expenditures increases total government Stakeholders' participation in program planning expenditures Stakeholders' and implementation reviews improves participation in programme planning: none Date 25-Sep-2008 28-Dec-2012 Comments Stakeholders' participation in Public Disclosure Copy program planing remains limited except for health lifestyle programs Percentage of SWAp program funds released Text Value To be measured once All funds required under according to agreed schedule. implementation begins agreements made availale. Number of reported drug stock-outs by facility this will be reviewed in April 2012 as par of revisions of program budgets and its financing. Date 25-Sep-2008 27-Apr-2012 Page 4 of 6 The World Bank Report No: ISR5842 Comments Data on drug stockouts will be available by June 2012. System will be strengthened through new HMIS being Public Disclosure Copy developed under project. MTEF and related procurement plan updated Text Value Work program and Second MTEF completed in MTF regularly updated. and adjusted based on recommendations from procurement plan completed first quarter 2011. Loose sector reviews for Year 1 of program connection in last POW or implementation procurement plan to MTEF results. The revised POW/ procurement plan for review in first quarter 2012 should improve the link. Date 25-Sep-2008 23-Dec-2010 Comments The MTEF Advisor has been hired and a new round of the MTEF is underway. Data on Financial Performance (as of 27-Jan-2012) Financial Agreement(s) Key Dates Project Loan No. Status Approval Date Signing Date Effectiveness Date Closing Date P086313 IDA-44320 Effective 19-Jun-2008 23-Jul-2008 21-Oct-2008 31-Dec-2013 P086313 IDA-47210 Effective 04-May-2010 20-May-2010 26-Jul-2010 31-Dec-2013 Disbursements (in Millions) Project Loan No. Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P086313 IDA-44320 Effective XDR 1.90 1.90 0.00 1.41 0.49 74.00 P086313 IDA-47210 Effective XDR 2.00 2.00 0.00 0.00 2.00 0.00 Public Disclosure Copy Disbursement Graph Page 5 of 6 The World Bank Report No: ISR5842 Public Disclosure Copy Key Decisions Regarding Implementation Through the Redevelopment process it has been concluded that the development objectives and monitoring indicators in the PAD remain valid and there is no need to alter the implementation arrangements for the project – although decisions have been made to strengthen implementation capacity – particularly within Component 2 which is located within the National Health Services (NHS) and relatively small but important changes to the terms of reference of the SWAp Coordination Unit. The actions taken with respect to Component 2 have included the recruitment of a senior person to assist the Component focal point and initiation of procurement/recruitment actions to strengthen procurement and asset management and design capacity with the NHS. Consequently, the MTR has concluded that no formal modification of the Financing Agreement is needed. The MOH has made proposals regarding the review of the thresholds for procurement. GoS will provide a report on how procurement performance and compliance would be monitored, to ensure the risks do not escalate with the enhanced thresholds. It is expected that a response will be provided to GoS by February 29, 2012. Agreement has now been reached on the revised terms s of reference for the SWAp Coordination Unit. These proposed changes are expected to be completed by February 29, 2012. Restructuring History There has been no restructuring to date. Public Disclosure Copy Related Projects P120832-ADD'L Financing - SAMOA HEALTH SECTOR MANAGEMENT PROGRAM SUPPORT PROJECT Page 6 of 6