LATIN AMERICA AND CARIBBEAN Brazil Health, Nutrition and Population Global Practice IBRD/IDA Adaptable Program Loan FY 2009 Seq No: 11 ARCHIVED on 21-Jan-2015 ISR17508 Implementing Agencies: Ministry of Health Key Dates Key Project Dates Board Approval date:29-jan-2009 Planned Mid Term Review Date:31-May-2012 Original Closing Date:30-Jun-2014 Project Development Objectives Effectiveness Date:19-Feb-2010 Actual Mid-Term Review Date:28-May-2012 Revised Closing Date:31-Dec-2015 Project Development Objective (from Project Appraisal Document) (a) Improve the quality and efficiency of SUS# Regional Health Care Networks (RHCN) with emphasis on secondary-level health care, specialty, diagnostic and emergency centers, and logistical systems serving the Project#s targeted regions and populations. (b) Improve the effectiveness of the SUS# RHCNs delivery system to prevent, detect and treat priority health conditions in the Project#s targeted regions and populations. Has the Project Development Objective been changed since Board Approval of the Project Objective? No PHRPDODEL Components Name A. Development of Regional Healthcare Networks and strengthening of health care facilities:(cost $205.00 M) B. System Development for Performance Enhancement:(Cost $26.30 M) C. Project Management:(Cost $3.10 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Satisfactory Overall Risk Rating -- Moderate 1/21/2015 Page 1 of 5
Implementation Status and Key Decisions The MOH is working closely with the states to advance implementation of the 15 sub-projects (Component A). As formally agreed with the participant states and Bank, this decentralized component will be finalized by April, 2015 and the Project will implement exclusively activities supported by Component B (studies and systemic interventions) until the closing date. The current legal agreements signed between MOH and selected states will be reviewed and extended from December 31, 2014 to April 30, 2015 according to the following criteria: (i) supplier contracts signed and formally presented to the MOH by January 31, 2015; and (ii) implementation schedule by April 30, 2015. The MOH and Bank team has agreed to review the Project experience in having implemented Regional Healthcare Network Sub-Projects. The review will be carried out as part of the Project closing and will include assessing the results achieved and the processes related to implementing healthcare network schemes to identify good practices and lessons learned that can be useful to future interventions in the Brazilian public health sector. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance -- -- Low Macroeconomic -- -- Moderate Sector Strategies and Policies -- -- Moderate Technical Design of Project or Program -- -- Moderate Institutional Capacity for Implementation and Sustainability -- -- Moderate Fiduciary -- -- Low Environment and Social -- -- Low Stakeholders -- -- Low Other -- -- -- Overall -- -- Moderate Results Project Development Objective Indicators Number of RHCNs with at least 20% of population identified with a targeted priority condition registered by risk classification andreceiving preventive and treatment care. (Text, Custom) 1/21/2015 Page 2 of 5
Number of RHCNs with an increase of at least 10% of hospitals which have achieved at least level 1 accreditation from a MOH recognized accreditation organization. (Text, Custom) Number RHCNs subprojects with 50% of emergency departments and call centers that are operating with a risk classification system. (Text, Custom) Overall Intermediate Results Indicators 1/21/2015 Page 3 of 5
PHINDIRITBL PHINDIRITBL PHINDIRITBL Number of RNCNs with all municipalities integrated into Regional Governance/Management structures and planning instruments (Text, Custom) Number of RHCNs with at least 60% of the SUS user population (usuarios do SUS) which have digital unique patient identification card linked to clinical activities in the regional network (Text, Custom) Number of RHCNs with 60% of municipalities covered by an organized transport system for patients, links with Referral and support for emergency and elective patients. (Text, Custom) Overall Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed Disbursed P088716 IBRD-76320 Effective USD 235.00 170.00 65.00 65.79 104.21 39% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P088716 IBRD-76320 Effective 29-Jan-2009 22-Dec-2009 19-Feb-2010 30-Jun-2014 31-Dec-2015 1/21/2015 Page 4 of 5
Cumulative Disbursements Restructuring History Level 2 Approved on 20-Jun-2014 Related Project(s) There are no related projects. 1/21/2015 Page 5 of 5