Implementation Status & Results Swaziland Swaziland Health, HIV/AIDS and TB Project (P110156)

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1 Public Disclosure Authorized Public Disclosure Authorized The World Bank Implementation Status & Results Swaziland Swaziland Health, HIV/AIDS and TB Project (P110156) Operation Name: Swaziland Health, HIV/AIDS and TB Project (P110156) Project Stage: Implementation Seq.No: 6 Status: ARCHIVED Archive : 22-Jun-2014 Country: Swaziland Approval FY: 2011 Product Line: IBRD/IDA Region: AFRICA Lending Instrument: Specific Investment Loan Implementing Agency(ies): Ministry of Health, Deputy Prime Minister's Office Key s Board Approval 10-Mar-2011 Original Closing Planned Mid Term Review 30-Apr-2015 Last Archived ISR 30-Dec-2013 Effectiveness 09-May-2012 Revised Closing Actual Mid Term Review Project Development Objectives Project Development Objective (from Project Appraisal Document) The project development objectives (PDOs) are: (i) to improve access to and quality of health services in Swaziland with a particular focus on primary health care, maternal health and TB, and (ii) to increase social safety net access for OVC. Has the Project Development Objective been changed since Board Approval of the Project? Yes No Component(s) losure Authorized Public Disclosure Authorized Component Name Component Cost Strengthening the Capacity of the Health Sector 3.90 Facility-level Support to Improve Access, Quality and Efficiency of Services Strengthening of the Orphans and Vulnerable Children (OVC) Safety Net 6.71 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 Highlights of recent progress include: (i) final costing and implementation plan for the essential health care package (EHCP), (ii) final report for the Service Availability Mapping (SAM); (iii) finalization of the list of health facilities for rehabilitation and development of drawings, (iv) capacity building of the MOH Biomedical Engineering Department for health facility maintenance, (v) development of a TB infections, prevention and control (IPC) workplan, (vi) training of TB Screening Officers and training of nurses on MDR-TB, and (vii) finalization of the design features for the orphans and vulnerable children (OVC) cash transfer program. To date, this co-financed World Bank loan and European Union grant has disbursed a combined US$ million or 10% of the total project funds. Page 1 of 6

2 The two project implementing teams in the Ministry of Health (MOH) and the Deputy Prime Minister's Office (DPM's Office) have made significant strides in overcoming capacity constraints and implementation challenges. The AWP for the third year of implementation ( ) is currently under finalization. Locations Country First Administrative Division Location Planned Actual Swaziland Not Entered Sitobela Swaziland Not Entered Siteki Swaziland Not Entered Shiselweni District Swaziland Not Entered Mbabane Swaziland Not Entered Manzini District Swaziland Not Entered Manzini Swaziland Not Entered Lubombo District Swaziland Not Entered Hhohho District Results Project Development Objective Indicators Indicator Name Core Unit of Measure Baseline Current End Target Health facilities that provide at least five public Percentage Value health services 25-Nov-2013 Source:SAM 2010 Service Availability Mapping (SAM) report 2013 Births delivered by a skilled attendant at a Percentage Value health facility 14-May-2013 Source: DHS 2007 Source: MICS The next survey data will be available in TB case notification rate Number Value Dec-2010 Source: NTCP quarterly report 25-Nov-2013 No new data available Note: This target is the Ministry's own target for its program, as defined in the TB Page 2 of 6

3 OVC beneficiaries that receive cash transfers regularly (as defined in the Implementation Manual) M&E Performance Framework Percentage Value Jan-2011 The OVC cash transfer pilot has not yet been established. The first phase of component 3 will involve capacity building and system strengtheningthis will involve the design of the pilot. The pilot will be gradually scaled-up in four constituencies (regions) in Swaziland. It is not expected that grants will be paid until year 3. This activity has not yet started Intermediate Results Indicators Indicator Name Core Unit of Measure Baseline Current End Target People Living with HIV who are screened for Percentage Value TB Source: HMIS, 2010 ART and TB Program database - HMIS. Source: Semi Annual progress report, April Targeted health facilities with TB infection Percentage Value control measures in place Although renovations supported by the project have not yet started, the National TB Control Program database (1 Jan Dec 2013) reported 63.8% of ALL facilities have at least one of four IC measures in place. Targeted health facilities with health care waste Percentage Value management facilities in place 31-Dec-2010 The baseline is an estimate and will be finalized following determination of the target 25-Nov-2013 HCWM activities are in progress, and no data yet available on targeted facilities. However, 77% of ALL Page 3 of 6

4 Clinics that have had at least 6 supervision visits in the last 12 months OVC directly supported through this cash transfer pilot Health facilities constructed, renovated, and/or equipped (number) Quarterly progress reports produced by the Management Information System, according to agreed reporting standards facilities. Source: HMIS, 2010 facilities nationwide reported having at least one of four HCW measures in place. National TB Control Program database (1 Jan Dec 2013) Service Availability Mapping (SAM) report, Percentage Value Dec-2010 Source: HMIS, Dec-2013 HMIS database and SAM 2013 Number Value Jan-2011 Note: The baseline is zero This activity has not yet because the OVC cash started. transfer pilot has not yet been established. The pilot will be gradually scaled-up in four constituencies (regions) in Swaziland. It is not expected that grants will be paid until year 3. Number Value Jan-2011 Note: The associated target and progress data only refer to the number of health facilities to be renovated and equipped. Results are cumulative. Renovations have not yet started. Percentage Value Jan-2011 Note: The MIS system will be built under the project. It is expected that this will be operational by year 2 of the project The MIS development is underway. The first phase comprising five modules have been developed, deployed, tested and implemented with the support of an MIS lead Consultant. The necessary trainings have been completed. Currently, Page 4 of 6

5 Health facilities that submit HMIS reports on time arrangements for data entry set up are being made. Percentage Value Source: HMIS, 2010 HMIS has 287 facilities reporting. Of these, 203 are government and mission facilities. The balance of 84 facilities are private & industry/company facilities. They all reported on time for FY2013. Source: Semi Annual report, April Women who deliver at target health facilities Number Value Jan-2011 Source: HMIS, 2011 Data not yet reported on targeted facilities only recently identified. However, the national figure reported by HMIS, January - December 2013 is 10,252. Health centers that provide Basic EmONC Number Value services 01-Jan-2011 Renovations and training have not yet started. Students who are trained under the newly Number Value developed guidelines for mentorship & 01-Jan-2011 preceptorship Pre-service training curriculum has been developed and preceptorship is happening informally, as the program is being piloted. The project is considering removing this indicator at the MTR stage. Data on Financial Performance (as of 28-May-2014) Financial Agreement(s) Key s Project Ln/Cr/Tf Status Approval Signing Effectiveness Original Closing Revised Closing P IBRD Effective 10-Mar Dec May-2012 Page 5 of 6

6 Project Ln/Cr/Tf Status Approval Signing Effectiveness Original Closing Revised Closing P TF Effective 04-Apr Apr May-2012 Disbursements (in Millions) Project Ln/Cr/Tf Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P IBRD Effective USD P TF Effective USD Disbursement Graph Key Decisions Regarding Implementation N/A Restructuring History There has been no restructuring to date. Related Projects There are no related projects. Page 6 of 6