Public Disclosure Authorized Public Disclosure Authorized The World Bank Implementation Status & Results Sri Lanka Sri Lanka - Second Health Sector Development Project (P118806) Operation Name: Sri Lanka - Second Health Sector Development Project Project Stage: Implementation Seq.No: 3 Status: ARCHIVED Archive : 09-Jul-2014 (P118806) Country: Sri Lanka Approval FY: 2013 Product Line: IBRD/IDA Region: SOUTH ASIA Lending Instrument: Sector Investment and Maintenance Loan Implementing Agency(ies): Ministry of Health, Ministry of Local Government and Provinical Councils, Provincial Ministries of Health Key s Board Approval 27-Mar-2013 Original Closing 30-Sep-2018 Planned Mid Term Review 14-Mar-2016 Last Archived ISR 15-Jan-2014 Effectiveness 12-Sep-2013 Revised Closing 30-Sep-2018 Actual Mid Term Review Project Development Objectives Project Development Objective (from Project Appraisal Document) The project development objective (PDO) is to upgrade the standards of performance of the public health system and enable it to better respond to the challenges of malnutrition and non-communicable diseases. 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 Support to priority areas under the National Health Development Plan 190.00 Innovation, results monitoring and capacity building fund 10.00 Overall Ratings Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating Moderate Moderate Implementation Status Overview The US$ 200 million Second Health Sector Development Project (SHSDP) became effective in September 2013 and will be implemented over the next five years. A World Bank team conducted an implementation support visit in May 2014, the first such visit since the project became effective. The objective of the project is to upgrade the performance of the state health system and enable it to better respond to the challenges of non-communicable diseases and malnutrition. The project has two components: Component 1: Support to priority areas under the National Health Development Plan (US$ 190 million) and Component 2: Innovation, results monitoring and capacity-building fund (US$ 10 million). Component 1 is linked to the achievement of results specified for nine Disbursement Linked Indicators (DLIs) and Component 2 will finance capacity building initiatives, training, surveys, monitoring Page 1 of 7
results, and activities to improve equality of health services in Sri Lanka. So far, in the first year of implementation the six Project Development Objective (PDO) Indicators all met or surpassed their targets for 2013 and progress against the Intermediate Results Indicators is also positive. Locations Country First Administrative Division Location Planned Actual Sri Lanka Western Province Western Province Sri Lanka Province of Uva Province of Uva Sri Lanka Southern Province Southern Province Sri Lanka Province of Sabaragamuwa Province of Sabaragamuwa Sri Lanka North Western Province North Western Province Sri Lanka North Central Province North Central Province Sri Lanka Central Province Central Province Sri Lanka Northern Province Northern Province Sri Lanka Eastern Province Eastern Province Results Project Development Objective Indicators Indicator Name Core Unit of Measure Baseline Current End Target % of persons (over 40 years) screened for Percentage Value 3.00 6.83 12.00 selected NCDs (Diabetes, hypertension, cancer breast and oral) at healthy lifestyle centers 340,344 out of 4,980,413 Data will be reported annually. population were tested at the end of 2013. Management andmonitoring % of pregnant women with anaemia after the Percentage Value 34.00 34.00 20.00 second trimester Page 2 of 7
% of centrally managed health facilities with ETUs for that level of facility based on standard guidelines (DLI 1) % of provincially managed health facilities with ETUs for that level of facility based on standard guidelines (DLI 2) % of MOH managed health facilities sending indoor morbidity data through e-immr (DLI 3) % of provincially managed health facilities sending indoor morbidity data through e-immr (DLI 4) Department (PMM) and Ministry of health (MOH). Percentage Value 0.00 0.00 40.00 A draft of the Accident and Emergency Care Policy and Guidelines were developed which was the end of 2013 target for this result. mission. First year target: Develop and finalize the policy and guidelines for Accident and Emergency services Percentage Value 0.00 0.00 50.00 A draft of the Accident and Emergency Care Policy and Guidelines were developed which was the end of 2013 target for this result. First year target: Develop and finalize the policy and guidelines for Accident and Emergency services Percentage Value 2.00 26.50 80.00 Percentage Value 1.00 14.46 70.00 Intermediate Results Indicators Indicator Name Core Unit of Measure Baseline Current End Target % of MCH clinics that have an agreed package Percentage Value 20.00 19.95 95.00 of equipment and supplies for the provision of care for pregnant women and children under five years. (DLI 5) Data will be reported annually. Page 3 of 7
% of Medical Officer of Health areas with at least three health and nutrition community support groups % of CEMOC facilities providing 24x7 CEMOC services. % of Medical Officer of Health areas with at least two healthy lifestyle centers (DLI 6) No. of provinces with at least one health facility providing rehabilitation services % of primary health care institutions having one month s buffer stock for 16 selected NCD drugs % of training institutes managed by the Ministry of Health meeting national standards Percentage Value 10.00 55.00 90.00 Less than 10% Data will be reported annually. Percentage Value 45.00 70.00 75.00 Data will be reported annually. Percentage Value 10.00 25.30 90.00 Data will be reported annually. Number Value 1.00 1.00 7.00 The target was to develop and finalize the guidelines for rehabilitation services and disability by the end of 2013. The guidelineswere in draft stage at the end of 2013, slightly behind schedule. Percentage Value 2.00 2.00 60.00 Action started to improve Data will be reported annually. capacity for drug logistics management system started. Percentage Value 0.00 0.00 40.00 Not Available Target for 2013 was to have Data will be reported annually. national standards developed for accreditation and they are currently under development. Page 4 of 7
% of laboratories in health facilities (base hospitals and above) participating in the external quality assurance program for selected tests conducted by the Medical Research Institute Percentage Value 10.00 45.87 80.00 50 out of 109 laboratories reached the required quality standards in 2013. First year: 20% of the laboratories participating in external quality assurance program for selected tests conducted by MRI Case detection rate for Tuberculosis Percentage Value 69.00 74.00 78.00 To be reported annually. % of hospitals (base hospitals and above) that Percentage Value 5.00 5.00 40.00 have obtained EPL and HWL Less than 5% The goal for 2013 was to review the existing situation based on the HCWM guidelines and framework. This is currently being carried out and is, therefore, slightly delayed. First year target: Review existing situation based on the HCWM guidelines and framework. Data will be reported annually. % of fully functioning quality management Units (QMUs) in MOH managed base hospitals and above (DLI 7) % of fully functioning quality management Units (QMUs) in provincially managed base hospitals and above (DLI 8) Percentage Value 9.00 9.00 95.00 Guidelines for the quality management units (QMU) have been prepared and training for administration of the guidelines has been completed by MoH. Data will be reported annually. Percentage Value 6.00 6.00 90.00 Guidelines for the quality Data will be reported annually. management units (QMU) Page 5 of 7
% of National Competitive Bidding (NCB) contracts awarded within the first nine months of the previous calendar year from 2014 onwards % of the six-monthly cash forecast (for nonsalary recurring and capital expenditures) released (DLI 9) have been prepared and training for administration of the guidelines has been completed by MoH. Percentage Value 0.00 0.00 80.00 Not available and will be reported from 2014 onwards. Not Available and will be reported from 2014 onwards. Percentage Value 81.00 83.00 90.00 Equal to or more than 90% First year target: 83% Data on Financial Performance (as of 27-May-2014) Financial Agreement(s) Key s Project Ln/Cr/Tf Status Approval Signing Effectiveness Original Closing Revised Closing P118806 IDA-52280 Effective 27-Mar-2013 19-Aug-2013 12-Sep-2013 30-Sep-2018 30-Sep-2018 P118806 TF-98721 Effective 12-Dec-2011 20-Dec-2011 20-Dec-2011 30-Sep-2013 30-Sep-2013 Disbursements (in Millions) Project Ln/Cr/Tf Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P118806 IDA-52280 Effective XDR 129.80 129.80 0.00 22.77 107.03 18.00 P118806 TF-98721 Effective USD 0.40 0.40 0.00 0.40 0.00 100.00 Disbursement Graph Page 6 of 7
Key Decisions Regarding Implementation It was agreed between the GoSL and the World Bank that the final joint results validation report for 2013 will be completed and available before July 30, 2014. Restructuring History There has been no restructuring to date. Related Projects There are no related projects. Page 7 of 7