The World Bank Report No: ISR11555 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: 10 Status: ARCHIVED Archive Date: 19-Oct-2013 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): 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 23-Jun-2013 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 Moderately Unsatisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Satisfactory Overall Risk Rating Moderate Moderate Implementation Status Overview Subsequent to the approval of the final Program of Works (PoW) in April 2013, the Ministry of Health (MOH) has been completing all remaining activities for the current closing date of Page 1 of 6 The World Bank Report No: ISR11555 December 31, 2013. The only outstanding activities relate to infrastructure requirements under the SWAp, which were approved for financing by NzAid, and are being launched. These will be completed over a 1.5 year period (the works comprise a pharmaceutical warehouse and associated key equipment, a Primary Health Care Center, Orthotics and Prosthetics Workshop, and renovations and extensions of MT2 hospital, Savaii and the emergency generator). Associated equipment for the pharmaceutical warehouse in particular will also be undertaken during the 1.5 year period. Both Phase A and Phase B medical equipment bids have been launched for delivery by December 31, 2013. Public Disclosure Copy The MOH has received Part One of an HIS proposal, and this, in conjunction with the recommendations provided from the monitoring and evaluation assessment carried out in April 2013, are under review. The M&E was also a topic raised at the Ministers of Health Meeting in Samoa in July 2013 which heightened the importance of M&E. In addition, during this event, the MOH presented two sites where the NCD best buys are being implemented: Lufilufi and Lalomanu Rural District Hospitals who are implementing the WHO Package of Essentials Noncommunicable (PEN) Disease. The PEN program has been extended to another six sites. In addition, the MOH is launching efforts at Tobacco Control and discussing mechanisms related to taxes on tobacco products. The NHS has established a Primary Healthcare Division, and is also working on Human Resources needs. Much work has been undertaken to increase General Practitioners visits to rural areas, supplementing the nursing workforce with Auxiliary Nurses, reinforcing training of nurses, and training for health personnel management level. Good supervision, training, and mentoring continue to be required so that all of these efforts are fully implemented. 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 % of health sector budgets and disbursements Text Value SWAP will introduce a >90% 90% conform to policy objectives and HSP priority mechanism for better aligning areas. resources with priorities. Date 31-Mar-2008 30-Sep-2013 31-Dec-2013 Public Disclosure Copy Comments This indicator refers to the proportion of budget expenditure on public health, primary care, hospital services and administration Share of annual outpatient visits by poorest Text Value The 2009 survey does not DHS 2009 survey underlines quintile of population have specific data for this the following by quintile: indicator. % receiving antenatal care from a hlth provider: 1: 86.5; 2: 91.6; 3: 95.1; 4: 93.9; 5: Page 2 of 6 The World Bank Report No: ISR11555 99.1 Public health facility delivery: 1: 65.9; 2: 79.9; 3: 79.8; 4: Public Disclosure Copy 81.7; 5: 88.7 All child receiving basic vaccinations: 1: 20.0; 2: 15.1; 3: 29.3; 4: 31.2; 5: 29.5 Date 31-Dec-2008 30-Sep-2013 31-Dec-2013 Comments Intermediate Results Indicators Indicator Name Core Unit of Measure Baseline Current End Target MTEF and related procurement plan updated Text Value Work program and Done MTEF regularly updated. and adjusted based on recommendations from procurement plan completed sector reviews for Year 1 of program implementation Date 25-Sep-2008 30-Sep-2013 31-Dec-2013 Comments Percentage of SWAp program funds released Text Value None. Funds released on schedule. 100% funds released SWAp according to agreed schedule. Construction of pharma <10% of baseline. Number of reported drug stock-outs by facility warehouse to be launched in next six months (under proposed no cost extension). Date 25-Sep-2008 30-Sep-2013 31-Dec-2013 Comments There was no data for stock- Stock management will be out. improved with the construction of the Pharmaceutical warehouse and stock management Public Disclosure Copy systems. Health expenditures as a percentage of Text Value 15% 15% > 15% government expenditures increases Program planning has been Stakeholders' participation in program planning set and all activities will end and implementation reviews improves (except infrastructure) by December 31, 2013. Date 25-Sep-2008 30-Sep-2013 31-Dec-2013 Comments Stakeholders' participation in Stakeholder participation has programme planning: none been made under the SWAp. Page 3 of 6 The World Bank Report No: ISR11555 Planning of health service is enhanced through Text Value No disaggregated data by Surveys disaggregated use of disaggregated data by age, sex, and age, sex and domicile used in domicile program planning at present. Public Disclosure Copy Date 25-Sep-2008 30-Sep-2013 31-Dec-2013 Comments Surveys and other data beginning to be used in policy discussions. MOH Financial Audits are submitted on timie Text Value No DHS available at baseline Audit report received and and action plan agreed on for resolving unqualified. outstanding issues. Date 25-Sep-2008 30-Sep-2013 31-Dec-2013 DHS and other statisticalreports completed Comments DHS Report completed and within stated timeframe and made public officially launched in August 2010. The DHS is carried out every 5 years. Next one due CY 2014/15. Health personnel receiving training (number) Number Value 1995.00 0.00 Date 30-Sep-2013 31-Dec-2013 Comments Data from budget reports. Health facilities constructed, renovated, and/or Number Value 0.00 10.00 0.00 equipped (number) Date 31-May-2008 30-Sep-2013 31-Dec-2013 Comments 1 Nurses Bldg; 1 Nurses Hostel; 3 dental units in primary schools; Medical equipment; Environmental health protection equipment; 2 Healthcare waste truck; equipment for mobile clinic. Children immunized (number) Number Value 25108.00 40357.00 0.00 Date 31-May-2008 30-Sep-2013 31-Dec-2013 Comments Data received from UNICEF Data provided from MOH for Public Disclosure Copy converting percentages and 2012 (EPI - NHS). using denominator from Stats Office. Data collection was done by percentages. Pregnant women receiving antenatal care Number Value 0.00 4460.00 0.00 during a visit to a health provider (number) Date 31-May-2008 30-Sep-2013 31-Dec-2013 Comments Data collection is not done by Adjustments, provided by numbers but by percentages. MOH. Total Number of Antenatal Mothers Booked Page 4 of 6 The World Bank Report No: ISR11555 and Delivered at All Public Health Facilities for the Year 2011. Public Disclosure Copy Data on Financial Performance (as of 11-Jul-2013) Financial Agreement(s) Key Dates Project Ln/Cr/Tf Status Approval Date Signing Date Effectiveness Date Original Closing Date Revised Closing Date P086313 IDA-44320 Effective 19-Jun-2008 23-Jul-2008 21-Oct-2008 31-Dec-2013 31-Dec-2013 P086313 IDA-47210 Effective 04-May-2010 20-May-2010 26-Jul-2010 31-Dec-2013 31-Dec-2013 Disbursements (in Millions) Project Ln/Cr/Tf Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P086313 IDA-44320 Effective XDR 1.90 1.90 0.00 1.90 0.00 100.00 P086313 IDA-47210 Effective XDR 2.00 2.00 0.00 0.00 2.00 0.00 Disbursement Graph Public Disclosure Copy Key Decisions Regarding Implementation The PEN program will be assessed during the next mission. Restructuring History Page 5 of 6 The World Bank Report No: ISR11555 There has been no restructuring to date. Related Projects Public Disclosure Copy P120832-ADD'L Financing - SAMOA HEALTH SECTOR MANAGEMENT PROGRAM SUPPORT PROJECT Public Disclosure Copy Page 6 of 6