Public Disclosure Authorized AFRICA Swaziland Health, Nutrition & Population Global Practice IBRD/IDA Specific Investment Loan FY 2011 Seq No: 10 ARCHIVED on 27-Jun-2016 ISR24063 Implementing Agencies: Ministry of Health, Deputy Prime Minister's Office Public Disclosure Authorized Key Dates Key Project Dates Bank Approval Date:10-Mar-2011 Planned Mid Term Review Date:30-Apr-2015 Original Closing Date:31-May-2016 Project Development Objectives Effectiveness Date:09-May-2012 Actual Mid-Term Review Date:24-Oct-2014 Revised Closing Date:31-Mar-2018 Public Disclosure Authorized 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 Objective? No PHRPDODEL Components Name Strengthening the Capacity of the Health Sector:(Cost $3.90 M) Public Disclosure Authorized Facility-level Support to Improve Access, Quality and Efficiency of Services:(Cost $24.38 M) Strengthening of the Orphans and Vulnerable Children (OVC) Safety Net:(Cost $6.71 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Unsatisfactory Moderately Satisfactory Overall Risk Rating Substantial Substantial 6/27/2016 Page 1 of 7
Implementation Status and Key Decisions The project s closing date has been extended to March 31, 2018. To date, 38.5 percent of the consolidated World Bank loan (US$ 20 million) and European Union grant (14.5 million Euros) funds have disbursed. Highlights of recent progress include: Component 1: (i) Finalization of first draft essential health care package, development of facility equipment and staffing, and costing; (ii) Capacity building provided for professional regulatory bodies, such as the Swaziland Nursing Council (SNC); and (iii) Health planning and coordination capacity building to the Health Planning Unit and technical assistance provided to support the development of the Second National Health Sector Strategic Plan 2014-2018 and the National Health Financing Policy 2015-2022. Component 2: (i) Renovations of the maternity ward at the Mbabane Government Hospital; Health Centres at Mkhuzweni, Nhlangano and Matsanjeni; School of Nursing; Maternity Waiting Home at Good Shepherd Hospital and RFM Hospital; TB Centre, Manzini; (ii) Procurement of ambulances and communication equipment for Emergency Medical Services, as well as a communications campaign to increase community awareness of the Emergency Preparedness and Response Program; (iii) Emergency Obstetric and Neonatal Care trainings based on the protocol and guidelines developed; (iv) Support to the country s response to the HIV/TB co-epidemic through training provided to twenty TB cough monitors to conduct HIV screenings for TB patients at the clinic level; (v) Health care waste management training manuals for tertiary, in-service and community levels were completed and 38 TOTs were trained. Component 3: Provision of the first payment of the OVC Cash Transfer Pilot in May 2016. The first payment reached 1,312 households and 5,518 OVCs. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance -- Substantial Substantial Macroeconomic -- Moderate Moderate Sector Strategies and Policies -- Moderate Moderate Technical Design of Project or Program -- Moderate Moderate Institutional Capacity for Implementation and Sustainability -- Substantial Substantial Fiduciary -- Substantial Substantial Environment and Social -- Moderate Moderate Stakeholders -- Moderate Moderate Other -- -- -- Overall -- Substantial Substantial 6/27/2016 Page 2 of 7
Results Project Development Objective Indicators Health facilities that provide at least five public health services: (i) family planning (modern methods);(ii) postnatal care, (iii) management of STI/HIV, (iv)immunization; and (iv) growth monitoring (Percentage, Custom) Value 56.30 68.28 68.28 75.00 Date 31-Dec-2010 31-Mar-2016 31-Mar-2016 31-Mar-2018 Caesarean deliveries as a percentage of institutional deliveries at health facilities (Percentage, Custom) Value 10.15 9.44 10.00 12.00 Date 31-Dec-2011 31-Mar-2016 10-Jun-2016 31-Mar-2018 TB treatment success rate among bacteriologically confirmed cases (Percentage, Custom) Value 71.00 80.70 80.70 85.00 Date 31-Dec-2011 31-Dec-2015 31-Dec-2015 31-Mar-2018 OVC beneficiaries that receive cash transfers quarterly (as defined in the Implementation Manual) (Percentage, Custom) Value 0.00 0.00 0.00 75.00 Date 01-Jan-2011 30-May-2014 30-May-2014 31-Mar-2018 Overall Comments 6/27/2016 Page 3 of 7
Intermediate Results Indicators Nurses or midwives enrolled at nursing training institutions supported by the project (Number, Custom) Value 581.00 707.00 707.00 518.00 Date 31-Dec-2011 31-Mar-2016 31-Mar-2016 31-Mar-2018 Comments Actual and target to be revised to reflect cumulative health personnel that received training. Pregnant women receiving antenatal care during a visit to a health provider (number) (Number, Core) Value 13963.00 29489.00 30751.00 24323.00 Date 31-Dec-2012 31-Mar-2016 10-Jun-2016 31-Mar-2018 Number of deliveries at health facilities (Number, Custom) Value 25400.00 20040.00 24961.00 24490.00 Date 31-Dec-2011 31-Mar-2016 10-Jun-2016 31-Mar-2018 People receiving tuberculosis treatment in accordance with the WHO-recommended Directly Observed Treatment Strategy (DOTS) (number) (Number, Core) Value 9180.00 4567.00 4567.00 6100.00 Date 31-Dec-2011 31-Dec-2015 31-Dec-2015 31-Mar-2018 6/27/2016 Page 4 of 7
Health personnel receiving training (number) (Number, Core) Value 22.00 295.00 295.00 65.00 Date -- 31-Mar-2016 31-Mar-2016 31-Mar-2018 Comments Actual and target to be revised to reflect cumulative health personnel that received training. HIV Positive TB Patients (adults and children) who are initiated on antiretroviral therapy (Percentage, Custom) Value 50.70 93.00 93.00 90.00 Date 31-Dec-2011 31-Dec-2015 31-Dec-2015 31-Mar-2018 Health facilities constructed, renovated, and/or equipped (number) (Number, Core) Value 0.00 12.00 12.00 15.00 Date 01-Jan-2011 31-Mar-2016 31-Mar-2016 31-Mar-2018 Health facilities that submit HMIS reports on time (Percentage, Custom) Value 77.00 60.00 69.14 85.00 Date 31-Dec-2010 31-Mar-2015 10-Jun-2016 31-Mar-2018 6/27/2016 Page 5 of 7
OVC directly supported through this cash transfer pilot (Number, Custom) Value 0.00 0.00 5518.00 8000.00 Date 01-Jan-2011 30-May-2014 10-Jun-2016 31-Mar-2018 Quarterly progress reports produced by the Management Information System, according to agreed reporting standards (Percentage, Custom) Value 0.00 0.00 0.00 75.00 Date 01-Jan-2011 30-May-2014 30-May-2014 31-Mar-2018 Overall Comments Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed Disbursed P110156 IBRD-80190 Effective USD 20.00 20.00 0.00 7.73 12.27 39% P110156 TF-11740 Effective USD 8.55 8.55 0.00 7.29 1.26 85% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P110156 IBRD-80190 Effective 10-Mar-2011 14-Dec-2011 09-May-2012 31-May-2016 31-Mar-2018 P110156 TF-11740 Effective 04-Apr-2012 04-Apr-2012 09-May-2012 31-May-2016 31-Mar-2018 Cumulative Disbursements 6/27/2016 Page 6 of 7
Restructuring History Level 2 Approved on 26-May-2016 Related Project(s) There are no related projects. 6/27/2016 Page 7 of 7