The World Bank Sri Lanka - Second Health Sector Development Project (P118806)

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1 Public Disclosure Authorized SOUTH ASIA Sri Lanka Health, Nutrition and Population Global Practice IBRD/IDA Sector Investment and Maintenance Loan FY 2013 Seq No: 5 ARCHIVED on 22-Jun-2015 ISR19359 Implementing Agencies: Ministry of Health, Ministry of Local Government and Provinical Councils Public Disclosure Authorized Key Dates Key Project Dates Board Approval date:27-mar-2013 Planned Mid Term Review Date:14-Mar-2016 Original Closing Date:30-Sep-2018 Project Development Objectives Effectiveness Date:12-Sep-2013 Actual Mid-Term Review Date:-- Revised Closing Date:30-Sep-2018 Public Disclosure Authorized 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 Objective? No PHRPDODEL Components Name Support to priority areas under the National Health Development Plan:(Cost $ M) Public Disclosure Authorized Innovation, results monitoring and capacity building fund:(cost $10.00 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating Moderate Moderate Implementation Status and Key Decisions 6/22/2015 Page 1 of 11

2 An implementation support mission took place from May 5-15, The objective of the mission was to review implementation progress of the US$ 200 million Second Health Sector Development Project (SHSDP). Overall, the mission noted strong implementation progress and the project remains on track with strong likelihood of achieving the Project Development Objective. The Project Management and Monitoring Department of the Ministry of Policy Planning (earlier under the Ministry of Finance) produced a progress and results report for calendar year Commitment for achievement of the agreed targets by the implementing teams in the Ministry of Health and the nine Provinces is high as indicated by the progress against targets for most of the 20 indicators. A mid-term review of the project is tentatively planned for around March /22/2015 Page 2 of 11

3 Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance -- Moderate Moderate Macroeconomic -- Moderate Moderate Sector Strategies and Policies -- Moderate Moderate Technical Design of Project or Program -- Moderate Moderate Institutional Capacity for Implementation and Sustainability -- Moderate Moderate Fiduciary -- Moderate Moderate Environment and Social -- Moderate Moderate Stakeholders -- Moderate Moderate Other Overall -- Moderate Moderate 6/22/2015 Page 3 of 11

4 Results Project Development Objective Indicators % of persons (over 40 years) screened for selected NCDs (Diabetes, hypertension, cancer breast and oral) at healthy lifestyle centers (Percentage, Custom) Value ,054,831 persons out of 5,305,576 persons over 40 years of age (target) were screened. Results are as of December 31, % of pregnant women with anaemia after the second trimester (Percentage, Custom) Value Results will be reported from CY2015 onwards. As such there is no new data. % of centrally managed health facilities with ETUs for that level of facility based on standard guidelines (DLI 1) (Percentage, Custom) Value /28 hospitals. Denominator is 28 as there are only 28 centrally managed hospitals which require ETU services. Results are as of December 31, /22/2015 Page 4 of 11

5 % of provincially managed health facilities with ETUs for that level of facility based on standard guidelines (DLI 2) (Percentage, Custom) Value Date 30-Sep Dec Dec Dec /545 hospitals. The denominator is 545 hospitals - which is the total number of provinces managed hospitals requiring ETU services. Results are as of December 31, 2014 % of MOH managed health facilities sending indoor morbidity data through e-immr (DLI 3) (Percentage, Custom) Value /47 hospitals. The denominator is the number of centrally managed hospitals that require an electronic indoor patient information system. Results are as of December 31, % of provincially managed health facilities sending indoor morbidity data through e-immr (DLI 4) (Percentage, Custom) Value /525 hospitals. The denominator is the number of provincially managed hospitals that require an electronic indoor patient information system. Results are as of December 31, Overall Five of the six PDO level indicator targets for 2014 have been achieved or surpassed (GoSL officially reports results once per year for the previous calendar year). The PDO indicator for "% of pregnant women with anemia after the second trimester" will only be reported on from 2015 and, as such, there is no new data for the 2014 results year. 6/22/2015 Page 5 of 11

6 Intermediate Results Indicators % of MCH clinics that have an agreed package of equipment and supplies for the provision of care for pregnant women and children under five years. (DLI 5) (Percentage, Custom) Value /3883 MCH clinics. The denominator is the number of maternal and child health field clinics in Sri Lanka. Results are as of December 31, % of Medical Officer of Health areas with at least three health and nutrition community support groups (Percentage, Custom) Value /330. The denominator is the number of Medical officer of health areas (preventive health areas) in Sri Lanka. Results are as of December 31, Please note that the December 15, 2014 (ISR 4) inadvertently reported the achievement as 75% when it should have been reported as 55%. % of CEMOC facilities providing 24x7 CEMOC services. (Percentage, Custom) Value /73. The denominator is the number of central and province managed secondary and tertiary care hospitals that are providing Comprehensive Emergency Obstetric services in Sri Lanka. Results are as of December 31, /22/2015 Page 6 of 11

7 % of Medical Officer of Health areas with at least two healthy lifestyle centers (DLI 6) (Percentage, Custom) Value /324. The denominator is the number of Medical officer of health areas (preventive health areas) relevant to providing Healthy Life Style centres in Sri Lanka. Results are as of December 31, No. of provinces with at least one health facility providing rehabilitation services (Number, Custom) Value The denominator is the number of Medical officer of health areas (preventive health areas) in Sri Lanka. Results are as of December 31, % of primary health care institutions having one month s buffer stock for 16 selected NCD drugs (Percentage, Custom) Value /855. The denominator is the number of Hospitals that are defined as Primary Health care institutions in Sri Lanka. Results are as of December 31, Please note that the reported results in December 2014 was provisional and is corrected down as of December 2014 data in this ISR. 6/22/2015 Page 7 of 11

8 % of training institutes managed by the Ministry of Health meeting national standards (Percentage, Custom) Value There are 32 Ministry of Health managed health training schools in Sri Lanka. The 2013 result was achieved by completing the National Standards. Currently, 4 training schools have taken initiatives to meet the national standards. Results are as of December 31, % 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, Custom) Value /69 eligible hospitals. The denominator is the number of secondary care hospitals in Sri Lanka that have Laboratories to provide selected tests. Results are as of December 31, Case detection rate for Tuberculosis (Percentage, Custom) Value The TB case detection rate achievement is not on track to targets expected. Results are as of December 31, /22/2015 Page 8 of 11

9 % of hospitals (base hospitals and above) that have obtained EPL and HWL (Percentage, Custom) Value /69 base hospitals-a and above. The denominator is the number of Base Hospitals A and above (secondary care hospitals) in Sri Lanka. Results are as of December 31, % of fully functioning quality management Units (QMUs) in MOH managed base hospitals and above (DLI 7) (Percentage, Custom) Value Results are as of December 31, % of fully functioning quality management Units (QMUs) in provincially managed base hospitals and above (DLI 8) (Percentage, Custom) Value The denominator is the number of Medical officer of health areas (preventive health areas) in Sri Lanka. Results are as of December 31, /22/2015 Page 9 of 11

10 % of National Competitive Bidding (NCB) contracts awarded within the first nine months of the previous calendar year from 2014 onwards (Percentage, Custom) Value /296. The denominator is the number of total National Competitive Bidding Contracts awarded in 2014 by the Ministry of Health in Results are as of December 31, % of the six-monthly cash forecast (for non-salary recurring and capital expenditures) released (DLI 9) (Percentage, Custom) Value Results are as of December 31, Overall Most recent data for this ISR is from the GoSL progress and results report for the calendar year It is noted that 10 of the 14 Intermediate level indicators have been achieved while 5 of the 6 PDO level indicators have also been achieved. Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed Disbursed P IDA Effective XDR % Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P IDA Effective 27-Mar Aug Sep Sep Sep-2018 Cumulative Disbursements 6/22/2015 Page 10 of 11

11 Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 6/22/2015 Page 11 of 11