LATIN AMERICA AND CARIBBEAN St. Lucia Health, Nutrition & Population Global Practice IBRD/IDA Investment Project Financing FY 2019 Seq No: 1 ARCHIVED on 26-Dec-2018 ISR35158 Implementing Agencies: Ministry of Finance, Economic Growth, Job Creation, External Affairs and Public Service, Ministry of Health and Wellness, Saint Lucia Key Dates Key Project Dates Bank Approval Date: 28-Sep-2018 Effectiveness Date: -- Planned Mid Term Review Date: 30-Apr-2021 Actual Mid-Term Review Date: -- Original Closing Date: 31-Oct-2023 pdotable Project Development Objectives Project Development Objective (from Project Appraisal Document) Revised Closing Date: 31-Oct-2023 The development objective is to improve the accessibility, efficiency, and responsiveness of key health services. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Component 1: Design and Implementation of an Essential Benefits Package:(Cost $5.50 M) Component 2: Strengthening Service Delivery in Support of the Essential Benefits Package:(Cost $13.00 M) Component 3: Institutional Capacity Building, Project Management and Coordination:(Cost $1.50 M) Component 4: Contingent Emergency Response Component Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO -- Satisfactory Overall Implementation Progress (IP) -- Satisfactory Overall Risk Rating -- Substantial Implementation Status and Key Decisions The Project was approved on September 28, 2018 by the World Bank Board of Directors and the Financing Agreement was signed on November 27, 2018 in a ceremony held in Washington DC. The issuance of the legal opinion is required for the project to be declared effective. The Legal Opinion is expected to be received by the World Bank by no later than December 31, 2018, after which, the project can be declared effective. The Government proactively requested a Project Preparation Advance (PPA). The PPA was approved on July 20, 2018 and allows the Government team to begin using the project funds despite the project not yet being effective. Under the PPA, the Government team identified key preparation activities that would help strengthen capacity for implementation and would inform the larger investments to be financed under the project. These activities include the staffing of a project implementation unit based in the Ministry of Health and Wellness (MOHW) and undertaking 12/26/2018 Page 1 of 7
IN00651332 IN00651335 key technical consultancies such as the assessment and costing of the Essential Benefits Package (EBP) of health services and finalizing the implementation arrangements for the Performance Based Financing (PBF) scheme. Other key activities to be financed under the PPA include a public expenditure review of the Saint Lucia health sector; an assessment of the public health facility network (existing infrastructure, inventory of equipment and supplies); and carrying out a baseline study for the results framework. Terms of Reference for these three activities are underway. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Substantial -- Substantial Macroeconomic Substantial -- Substantial Sector Strategies and Policies Moderate -- Moderate Technical Design of Project or Program Substantial -- Substantial Institutional Capacity for Implementation and Sustainability High -- High Fiduciary Substantial -- Moderate Environment and Social Substantial -- Moderate Stakeholders Moderate -- Moderate Other Moderate -- -- Overall Substantial -- Substantial Results PDO Indicators by Objectives / Outcomes The development objective is to improve the accessibility of key health services Number of people registered under the National Health Scheme (Number, Custom) Value 0.00 -- 0.00 100,000.00 The number of people formally registered in the National Health Scheme. The scheme will be developed under Component 1 of the Project. As such, the baseline is 0. Number of people registered under the National Health Scheme (women) (Number, Custom Breakdown) Value 0.00 -- 0.00 50,000.00 12/26/2018 Page 2 of 7
IN00651341 IN00651343 Date 25-Jun-2018 -- 10-Dec-2018 31-Oct-2023 The development objective is to improve the efficiency of key health services IN00651333 Percent of diabetic patients > 18 years at public primary health facilities managed according to national protocols (Percentage, Custom) The share of people > 18 years at public primary health facilities with diabetes managed according to national protocols. These protocols will be developed under the Project. As such, the baseline is 0. Percent of diabetic patients > 18 years at public primary health facilities managed according to national protocols (women) (Percentage, Custom Supplement) IN00651342 Percent of hypertensive patients > 18 years at public primary health facilities managed according to national protocols (Percentage, Custom) The share of people > 18 years at public primary health facilities with hypertension managed according to national protocols. These protocols will be developed under the Project. As such, the baseline is 0. Percent of hypertensive patients > 18 years at public primary health facilities managed according to national protocols (women) (Percentage, Custom Supplement) The development objective is to improve the responsiveness of key health services IN00651334 Compliance with 2005 International Health Regulations (IHR) by maintaining a trained Rapid Response Team (RRT) to respond to events that may constitute a public health emergency (Yes/No, Custom) Value Yes -- Yes Yes Date 22-Jun-2018 -- 10-Dec-2018 31-Oct-2023 This is one of the key actions which the Government is asked to comply with on a yearly basis by the World Health Organization (WHO) as a critical activity under the 13 core capacity areas of the 2005 International Health Regulations (IHR). Intermediate Results Indicators by Components 12/26/2018 Page 3 of 7
IN00651344 IN00651346 IN00651352 IN00651349 IN00651355 Component 1. Design and Implementation of an Essential Benefits Package Essential package of benefits formally adopted and reviewed on an annual basis (Yes/No, Custom) Value No -- No Yes This indicator reflects whether a formal review of the essential benefits package was conducted and agreed upon by the Ministry of Health and Wellness. Primary care service utilization rates (public health sector) (Number, Custom) Value 37,320.00 -- 37,320.00 55,000.00 Date 06-Jul-2018 -- 10-Dec-2018 31-Oct-2023 The number of visits to public primary health facilities during one year relative to the total population in the same geographic area. Rates are reported per 100,000 population. Primary care service utilization rates (public health sector) (women) (Number, Custom Breakdown) Value 44,447.00 -- 44,447.00 60,000.00 Date 26-Jun-2018 -- 10-Dec-2018 31-Oct-2023 IN00651351 Percentage of Primary Health Care (PHC) facilities that have implemented exit surveys with service users in a one-year period and presenting results to the MOHW (Percentage, Custom) Date 22-Jun-2018 -- 10-Dec-2018 31-Oct-2023 This indicator will measure the number of public PHC facilities implementing exit surveys. The numerator will consist of the number of PHC facilities implementing exit surveys over the denominator which is the total number of PHC facilities. These exit surveys will be developed during the project. As such, the baseline is 0. People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Value 60,420.00 -- 60,420.00 100,000.00 Date 06-Jul-2018 -- 10-Dec-2018 31-Oct-2023 People who have received essential health, nutrition, and population (HNP) services - Female (RMS requirement) (Number, Corporate Supplement) 12/26/2018 Page 4 of 7
IN00651345 IN00651347 IN00651350 IN00651354 Value 35,368.00 -- 35,368.00 60,000.00 Component 2. Strengthening Service Delivery in Support of the Essential Benefits Package Number of public primary care health facilities equipped for NCD management (Number, Custom) Value 0.00 -- 0.00 30.00 The number of primary care facilities in the public sector equipped with medicines, equipment and basic technologies according to national guidelines. Equipping of these facilities will be conducted under the project. As such, the baseline is 0. Number of public sector providers registered under the PBF scheme (Number, Custom) Value 0.00 -- 0.00 25.00 Date 18-Jun-2018 -- 10-Dec-2018 31-Oct-2023 This indicates the number of public sector primary care facilities registered to participate in the PBF scheme. Providers are considered registered if they have signed an agreement with the MOHW to participate in the PBF. The PBF scheme will be developed under the Project. As such, the baseline is 0. IN00651348 Number of patients > 18 years screened for diabetes at public primary health facilities based on national protocols (Number, Custom) Value 0.00 -- 0.00 20,000.00 Date 18-Jun-2018 -- 10-Dec-2018 31-Oct-2023 The number of people from the at-risk population aged > 18 years screened for diabetes at public primary health facilities based on national protocols. These protocols will be developed under the Project. As such, the baseline is 0. Number of patients > 18 years screened for diabetes at public primary health facilities based on national protocols (women) (Number, Custom Supplement) Value 0.00 -- 0.00 10,000.00 IN00651353 Number of patients > 18 years screened for hypertension at public primary health facilities based on national protocols (Number, Custom) Value 0.00 -- 0.00 20,000.00 Date 18-Jun-2018 -- 10-Dec-2018 31-Oct-2023 The number of people from the at-risk population aged > 18 years screened for hypertension at public primary health facilities based on national protocols. These protocols will be developed under the Project. As such, the baseline is 0. 12/26/2018 Page 5 of 7
IN00656082 IN00656083 Number of patients > 18 years screened for hypertension at public primary health facilities based on national protocols (women) (Number, Custom Supplement) Value 0.00 -- 0.00 10,000.00 IN00651356 Percentage of Primary Health Care facilities participating in the Performance Based Financing (PBF) scheme that have developed an action plan based on the results of the quarterly satisfaction surveys (Percentage, Custom) Date 22-Jun-2018 -- 10-Dec-2018 31-Oct-2023 This indicator will measure the numerator as the number of PHC facilities participating in the PBF scheme that have developed an action plan based on the quarterly satisfaction surveys and the denominator as the total number of PHC facilities participating in the PBF scheme. The PBF scheme will be developed under the Project. As such, the baseline is 0. People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Value 60,420.00 -- 60,420.00 100,000.00 Date 06-Jul-2018 -- 06-Jul-2018 31-Oct-2023 This indicator already appears under Component 1. It is being repeated here due to the requirement of adding a corporate breakdown indicator which can only be added by first adding the main corporate indicator. The only applicable corporate breakdown indicator applies to Component 2, "deliveries attended by skilled personnel". The main corporate indicator is being repeated across Component 1 and 2 to be able to add the corporate breakdown indicator under Component 2. Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) Value 5,000.00 -- 0.00 10,000.00 Date 13-Dec-2018 -- 13-Dec-2018 31-Oct-2023 Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P166783 IDA-63160 Not Effective USD 20.00 20.00 0.00 0.00 20.00 0% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date 12/26/2018 Page 6 of 7
P166783 IDA-63160 Not Effective 28-Sep-2018 -- -- 31-Oct-2023 31-Oct-2023 Cumulative Disbursements Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 12/26/2018 Page 7 of 7