The World Bank Social Accountability Knowledge, Skills, Action and Networking (P147835)
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- Megan Wilkinson
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1 Public Disclosure Authorized AFRICA Mozambique Governance Global Practice Recipient Executed Activities Investment Project Financing FY 2014 Seq No: 2 ARCHIVED on 12-Jan-2018 ISR29464 Implementing Agencies: Concern Universal, Fonagni - Provincial Forum of Organizations from Niassa, Nafeza - Famale Association from Zambezia Public Disclosure Authorized Key Dates Key Project Dates Bank Approval Date:20-Dec-2013 Original Closing Date:20-Dec-2018 Project Development Objectives Effectiveness Date:20-Dec-2013 Revised Closing Date:20-Dec-2018 Public Disclosure Authorized Project Development Objective (from Project Appraisal Document) The objective is to improve quality of life of the most vulnerable (women, persons with disability, people with HIV etc.) in Niassa and Zambézia Provinces through enhanced social accountability and responsiveness to social needs of service delivery in the health sector. Has the Project Development Objective been changed since Board Approval of the Project Objective? No PHRPDODEL Components Name Public Disclosure Authorized Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Satisfactory Implementation Status and Key Decisions The overall project progress has been satisfactory. Social accountability, combined with advocacy at the provincial and national level, is bringing significant impacts to target districts. The project is contributing to improve maternal and reproductive health and HIV treatment. The social accountability experience is highly welcome by the government and early 2017, the Minister of Health visited the grantee in Lichinga (Niassa) to learn about social accountability. The Minister congratulated both the grantee and the local CBOs for their contribution through innovative approach to improve service delivery in the health sector. 1/12/2018 Page 1 of 9
2 Provincial Governors of the target Provinces (Zambezia and Niassa) have verbally stated that project activities should cover other currently nontargeted districts in their Provinces. Furthermore, the Niassa Provincial Directorate of Health has sent a statement to Concern Universal (grantee) recognizing the contribution of the project in improving access to and quality of the health services in the province as well as requesting Concern Universal to scale-up the project to other districts. Additionally, the civic health group of Muembe district received a diploma of honor from the district government for ensuring better transmission of information on rights and duties of users, universal access to general health services and reporting on monitoring findings in the health units of this district. Moreover, this group has partnered with the health sector at the district level and started to disseminate good nutrition practices to groups of mothers, children and people living with HIV. Drawing from the pilots in the use of social audits and community consultations to strengthen accountability in improving access to and quality of the health services in six districts of Niassa and Zambezia, the Mozambique Primary Healthcare Strengthening Program has Disbursement Linked indicator (DLI-9) to incentivize improved health center performance in priority districts through scorecard assessments with community consultations. 1/12/2018 Page 2 of 9
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6 Risks Overall Risk Rating Risk Category Rating at Approval Previous Rating Current Rating Overall Moderate Moderate Moderate Comments The overall risk rating remains moderate. Results Project Development Objective Indicators PHINDPDOTBL Number of CBOs/CSOs representing vulnerable groups trained in and using SA tools around target health services delivery (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value Date 04-May Sep Dec-2017 PHINDPDOTBL Increasing engagement between supply and demand side actors on the quality of health service delivery (Number, Custom) (Number, Custom) 1/12/2018 Page 6 of 9
7 Baseline Actual (Previous) Actual (Current) End Target Value Date 04-May Aug Dec-2017 Overall Comments The project met the targets in both indicators: (i) Number of CBOs/CSOs representing vulnerable groups trained in and using SA tools around target health services delivery and (ii) Increasing engagement between supply and demand side actors on the quality of health service delivery. Alignment of the Project with Government Polices/Strategies The project is aligned with the National Strategy for Quality and Humanization of the Ministry of Health mainly on promotion of constructive engagement between the demand and supply side around quality and humanization of health services (Maternal and Child Health-MCH and Universal Access to Antiretroviral Therapy - ART) in 6 districts of Niassa and Zambezia Province. Project actions have resulted in increased capacity of grassroots and civil society organizations - local CBOs / CSOs for engaging in social accountability and responsiveness to social needs on service delivery in the health sector, increased interaction between service providers and users on the quality of services provided, and in promoting more spaces for dialogue and evidence-based engagement between civic groups and government around health issues. Positive Contribution of the Project to Service Delivery in the Health Sector The project has contributed to improvements in the health sector in general with focus on MCH services and universal access to ART: (i) Improved citizens' awareness as health care users about their rights and duties translated into increased numbers of citizens using existing beneficiary feedback mechanisms to address their concerns such as public health auditoriums, green line, etc; (ii) Increased openness of health system managers on the questions raised by the users and subsequent accountability; (iii) Increased attention from the government, especially at district level, which translates into allocation of additional resources, for example, to build the health infrastructures and housing for health professionals. The health center of Itepia and the maternity in the district of Maúa, built in 2016 at the request of the communities during the Public Health auditorium are examples of this; (iv) The allocation of female midwives (at the request of communities) and the improvement of parturient privacy through the construction of new maternity units. As the result, the rate of institutional births increased from 2 average deliveries per month to 42 monthly deliveries in the center of Maiaca, Maúa district. In recognition of the contribution of the project to Humanization of the health care through improved engagement between government and communities, the project was awarded a Diploma of Honour by the Government of Niassa. The Minister of Health visited Concern Universal in Niassa early 2017 to learn about the SAKSAN project and acknowledged the importance of the lessons be replicated at the national level. Niassa Provincial Directorate of Health has sent written statement to Concern Universal recognizing the contribution of the SAKSAN project in improving access to and quality of the health services in the province as well as requesting Concern Universal to scale-up the project to other districts. Intermediate Results Indicators 1/12/2018 Page 7 of 9
8 PHINDIRITBL Generate knowledge and sharing learning on social accountability (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value Date 04-May Aug Sep Dec-2017 Overall Comments Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed Disbursed P TF Effective USD % Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P TF Effective 20-Dec Dec Dec Dec Dec-2018 Cumulative Disbursements 1/12/2018 Page 8 of 9
9 Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 1/12/2018 Page 9 of 9
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