Implementation Status & Results Samoa SAMOA HEALTH SECTOR MANAGEMENT PROGRAM SUPPORT PROJECT (P086313)

Transcription

1 Public Disclosure Authorized Public Disclosure Authorized The World Bank Implementation Status & Results Samoa SAMOA HEALTH SECTOR MANAGEMENT PROGRAM SUPPORT PROJECT (P086313) Operation Name: SAMOA HEALTH SECTOR MANAGEMENT PROGRAM Project Stage: Implementation Seq.No: 7 Status: ARCHIVED Archive : 22-Jul-2012 SUPPORT PROJECT (P086313) Country: Samoa Approval FY: 2008 Product Line: IBRD/IDA Region: EAST ASIA AND PACIFIC Lending Instrument: Specific Investment Loan Implementing Agency(ies): Ministry of Health Key s Board Approval 19-Jun-2008 Original Closing Planned Mid Term Review 06-Apr-2011 Last Archived ISR 03-Mar-2012 Effectiveness 21-Oct-2008 Revised Closing Actual Mid Term Review 14-Dec-2011 Project Development Objectives Project Development Objective (from Project Appraisal Document) The objective of the Project is to improve the Recipient's effectiveness in managing and implementing the Program based on the use of results from sector performance monitoring. The Program's aim in the medium-term (FY ) is to improve accesst to, and utilization of effective, efficient and quality health services to improve the health status of the Samoan population. Health SWAP development objectives: To improve the effectiveness of the Government of Samoa in managing and implementing the HSP, based on the use of results from sector performance monitoring losure Authorized Public Disclosure Authorized Has the Project Development Objective been changed since Board Approval of the Project? Yes No Component(s) Component Name Component Cost Health Promotion and Prevention 4.58 Enhancement of Quality Health Care Service Delivery Strengthening Policy, Monitoring and Regulatory Oversight of the Health System 4.10 Overall Ratings Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Satisfactory Overall Risk Rating Implementation Status Overview Implementation of the SWAP has picked up in a very positive way since last December. Page 1 of 8

2 At the strategic level, the GoS has revised the Program of Works (POW) using a format agreed on with the DPs. The revised POW presents the linkages with the GoS strategies and the M&E plan. It also includes contributions to the Sector from additional donors. The Health Advisory Committee with revised membership and role is now up and running. The Government has held the Annual Health Sector Forum, reporting on key health issues to sector stakeholders and building a forum for domestic accountability for health results and policy discussion. At the same time, the GoS has provided the 6-monthly narrative report to December 2011 which is linked to the PAD indicators and revised procurement and financial plans. All those reports show good progress in launching or implementing the large and urgent procurement items. While it can be potentially improved, the MTEF has reviewed expenditures pattern in the Sector and has given a picture of staffing and operations as well as the envelope of resources available. On the M&E front, up to this mission, it has been difficult to track progress towards achieving the PDOs because the indicators for the SWAp were not clearly tracked and the results matrix was not completed. However, the mission is happy to note that the GoS has now completed to a large extent, the results matrix and that much progress in the indicators is noted. The results matrix which is annexed to the Aide-MémoireI reports on a number of health sector program indicators in the area of control of NCDs, maternal and child health, access to reproductive health services, control of communicable diseases and injury prevention indicators. If implementation continues at the pace witnessed since last December, the GOS is likely to achieve the PDOs. Finally, the Sector has come together in a productive way. The new NHS GM has taken the lead in preparing the NHS Corporate Business Plan which provides clear financial information regarding Capital and Operating Costs. The mission is pleased with the planning instruments used to monitor progress and bottlenecks. Several TAs are now either in place or being recruited to support the process, namely a Procurement Specialist, a Bio-medical specialist, and an Asset Manager, among others. It is hoped that these appointments will allow the Sector to meet the tight deadlines on civil works and goods as outlined in the procurement plan. In addition, due to the dedicated work of the SCU team, the Mission was able to clear requests for the award of contracts for the Supervision of construction of three buildings to house the Primary Health Care, warehouse and Orthotics facilities, the construction of three dental clinics as well as the Information Specialist to carry out the initial scoping for the Health Information System to be installed. These contracts have a total value of approximately US$1.6 million. Locations Country First Administrative Division Location Planned Actual Samoa Not Entered Independent State of Samoa Samoa Not Entered Savai'i Samoa Tuamasaga Apia Results Project Development Objective Indicators Page 2 of 8

3 Indicator Name Core Unit of Measure Baseline Current End Target Share of annual outpatient visits by poorest quintile of population % of health sector budgets and disbursements conform to policy objectives and HSP priority areas. Text Value To be determined by HIES survey 31-Dec-2008 Text Value SWAP will introduce a mechanism for better aligning resources with priorities. Data from PATIS not complete to provide a full analysis for this indicator. However, findings of the DHS 2009 shows that 9% of households in the lowest wealth quintile have a member aged 25 or older diagnosed with diabetes compared with 29% of households in the highest wealth quintile. Similarly, 12% of the poorest households reported having at least one member aged 25 or older ever diagnosed with hypertension compared with 25% of those in the wealthiest households. During next mission, the Team will explore the possibility of obtaining data that would help to measure this indicator more accurately. Yr 2 = 70% 90 % Yr 4 = 90% Intermediate Results Indicators All activities funded under SWAP follow the health sector priorities as articulated in the HSP. 31-Mar May Apr-2012 Page 3 of 8

4 Indicator Name Core Unit of Measure Baseline Current End Target People with access to a basic package of Number Value health, nutrition, or reproductive health services (number) There is no such thing as a basic package in Samoa. Will explore a way to measure this indicator during next mission. Pregnant women receiving antenatal care Number Value during a visit to a health provider (number) 31-Mar-2010 The DHS 2009 report has been released and does have Baseline data will be available April 2011 information on antenatal utilization RATES. The Results matrix in the AM reports an antenatal care coverage for at least 3 visits to be 58% Children immunized (number) Number Value Mar-2010 Health facilities constructed, renovated, and/or equipped (number) The DHS 2009 report has been released and does have information on immunisation RATES. The AM results matrix reports that the % of children under 1 year who have received at least one dose of measles vaccine is 48% compared to 45% in the baseline. Baseline data will be available April 2011 Number Value Mar-2010 This mission did not assess this. Baseline data will be available April 2011 Health personnel receiving training (number) Number Value The actual number may be even higher as there was some on-going training when this mission was completed. Baseline data will be available April 2011 Page 4 of 8

5 MOH Financial Audits are submitted on timie and action plan agreed on for resolving outstanding issues. DHS and other statisticalreports completed within stated timeframe and made public Planning of health service is enhanced through use of disaggregated data by age, sex, and domicile Health expenditures as a percentage of government expenditures increases Stakeholders' participation in program planning and implementation reviews improves Text Value No DHS available at baseline Yr 1, 2, and 3 completed 25-Sep-2008 Text Value No disaggregated data by age, sex and domicile used in program planningat present 25-Sep-2008 Text Value Health allocation is 15% of total government expenditures Stakeholders' participation in programme planning: none 25-Sep-2008 Submitted unqualified report with few minor management and administrative outstanding issues. 09-May-2012 DHS Report completed and officially launched in August The DHS is carried out every 5 years. The Village Health Fair (NCD Screening) Report is also completed and was officially launched in Dec 2011 during the Annual Health Forum. MOH Annual Report for FY09/10 has been submitted to Parliament and the FY 2010/2011 is near completion. Data from existing HIS PATIS and CHNIS are disaggregated by sex, age and region. Same for data from STEPS, DHS and second generation survey for STIs. 09-May-2012 The DHS iand other data beginning to be used in policy discussions FY 12.4% % Participation of Health Sector partners and stakeholders in program and planning as well as implementation has very much improved over the Page 5 of 8

6 years since the launching of the Health Sector Plan The Ministry of Health has been conducting an Annual Health Forum since 2008 where all health sector partners actively participate in discussing and presenting their views on the various themes for the annual forum. The Year 2011 experienced a huge change in the way the forum is conducted, in that the MOH prepares papers on different health issues and each health partner or organization provides interventions in relation to the papers provided. The Ministry of Health continues to develop policies and plans using a consultative approach, where all health partners and stakeholders participate. The Ministry of Health also coordinates monthly public health sector management meetings. All key allocations have been agreed with SWAp partners and assessed as consistent with health priorities. March % stock out from rural facilities Percentage of SWAp program funds released according to agreed schedule. Number of reported drug stock-outs by facility Text Value To be measured once implementation begins 25-Sep % availability of essential medicines at all public health facilities at any onetime 100% 10% of baseline Page 6 of 8

7 MTEF and related procurement plan updated and adjusted based on recommendations from sector reviews Text Value Work program and procurement plan completed for Year 1 of program implementation 25-Sep-2008 Currently putting in place strategies in order to efficiently track stock outages as part of our key performances indicatorsfor stock management The Second MTEF is completed and was launched together with the M&E Operational Manual in Dec Dec-2010 The MTEF Advisor has been hired and a new round of the MTEF is underway. MTEF regularly updated. Data on Financial Performance (as of 27-Jan-2012) Financial Agreement(s) Key s Project Ln/Cr/Tf Status Approval Signing Effectiveness Original Closing Revised Closing P IDA Effective 19-Jun Jul Oct-2008 P IDA Effective 04-May May Jul-2010 Disbursements (in Millions) Project Ln/Cr/Tf Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P IDA Effective XDR P IDA Effective XDR Disbursement Graph Page 7 of 8

8 Key Decisions Regarding Implementation The mission appreciates the revised program of work which, as requested, includes the programs that are funded outside of the SWAp. This enables the program to be assessed in a broader context. The mission was pleased with the significant progress in procurement since the last mission in December It noted, however, that the completion of all planned projects by December 2013 is still challenging, with potential significant financial risks to the GoS in embarking on infrastructure projects that may not be completed. Restructuring History There has been no restructuring to date. Related Projects P ADD'L Financing - SAMOA HEALTH SECTOR MANAGEMENT PROGRAM SUPPORT PROJECT Page 8 of 8