Public Disclosure Authorized @ The World Bank Implementation Status & Results Ghana Health Insurance Project (P11852) o o Operation Name: Health Insurance Project (P11852) Project Stage: Implementation Seq.No: 12 Status: ARCHIVED Archive Date: 24-Dec-211 Country: Ghana Approval FY: 28 6 Product Line: IBRD/IDA Region: AFRICA Lending Instrument: Specific Investment Loan.U) Implementing Agency(ies): National Health Insurance Secretariat Public Disclosure Authorized O Key Dates Board Approval Date 3-Jul-27 Original Closing Date 31-Dec-212 Planned Mid Term Review Date Last Archived ISR Date 24-Dec-21 1 Effectiveness Date 1-Dec-27 Revised Closing Date 31-Dec-212 Actual Mid Term Review Date Project Development Objectives Project Development Objective (from Project Appraisal Document) The Project Development Objective is to strengthen the financial and operational management of the National Health Insurance Scheme by improving: (i) the policy adaptation and implementation capacity of the National Health Insurance Council in addressing ongoing core policy issues related to contribution collection, risk equalization, and provider payment mechanisms; and (ii) the purchasing function of the District Mutual Health Insurance Schemes, and the billing function of the Providers. Has the Project Development Objective been changed since Board Approval of the Project? O Yes i No Public Disclosure Authorized Component(s) Component Name Component Cost Streamlined Purchasing Policies and Mechanisms 2.5 Strengthening Integrated Claims Management Systems 8.6 Project Management. a Overall Ratings Previous Rating Current Rating 2 Progress towards achievement of PDO Moderately Satisfactory Moderately Satisfactory o Overall Implementation Progress (IP) Moderately Unsatisfactory Moderately Satisfactory -5-.U Overall Risk Rating losure Authorized - Implementation Status Overview.. This is an update on project implementation based on the conclusions and recommendations of a mini country portfolio performance review (CPPR) of problem projects that took place on January 26, 212. Page 1 of 5
@ The World Bank The mini CPPR concluded that enough progress is being made on the project and therefore recommended that the Implementation Progress be upgraded to Moderately Satisfactory. It was also recommended to maintain the Project Development Objective rating as Moderately Satisfactory. Since the resolution of outstanding challenges the speed of implementation of all project activities has increased. A common targeting of the poor strategy has been completed for O implementation by all stakeholders. This is a collaborative effort of the Ministries of Health and Employment and Social Welfare as well as the National Health Insurance Authority. 2 The questionaires for the national health account are ready to start field work in two weeks. -6 The upgrade of the Claims Processing Center is on course to be completed and for the National Health Insurance Authority to begin receiving electronic claims by end of March, U 212 to cover nearly 2 million claims, increasing in the following months. Disbursement has started to improve with $2.9 million disbursed to date (22% of the IDA credit), a withdrawal application for $1. million currently being processed by the Bank and $6. million committed. Project management continues to improve and the Bank team continues to provide day to day support to the implementation team. Locations Country First Administrative Division Location Planned Actual Ghana Ashanti Region Ashanti Region Results Project Development Objective Indicators Indicator Name Core Unit of Measure Baseline Current End Target % of population in the lowest quintile (2% of Percentage Value 14. 14. 4. the index of socio-economic status) registered Date 31-Dec-28 31-Dec-28 31-Dec-212 under the NHIS with a valid card Comments Source: 28 Ghana DHS Source: 28 DHS. Data will be updated in March, 212 % of total "clean" claims that are reimbursed by Percentage Value.3 65. 7. payers (NHIS) to providers within 6 days of Date 31-Dec-21 31-Oct-21 1 31-Dec-212 >1 claims receipt Comments NHIC M&E system Source: NHIC M&E system. o The indicator will be updated in March, 212 U) % of total claims submitted by providers to Percentage Value 45. 45. 59. -Z NHIS (DMHIS or CPC) for processing that Date 31-Dec-21 31-Oct-21 1 31-Dec-212 C, passed the initial screening (i.e. not rejectedby Comments NHIC M&E system Source NHIC M&E system. first electronic/manual review) This indicator will be updated in February, 212 Page 2 of 5
The World Bank # of total claims received electronically by Number Value 19537. 19537. 25. processors (NHIS) from provider Date 31 -Dec-21 3-Nov-211 31 -Dec-212 Comments NHIC M&E system Source: NHIC M&E system. CL an update will be provided in cn Intermediate Results Indicators Indicator Name Core Unit of Measure Baseline Current End Target % of total claims that are submitted by Percentage Value 64. 68. 75. providers to NHIS (CPC or DMHIS) within 6 Date 31-Dec-21 31-Oct-211 31-Dec-212 days of service provision Cm Comments t HIP Implementation m Unit Source HIP Implementation Unit. Indicator will be updated in March, 212. First call received through the NHIA call Center Text Value No No Yes and successfully responded Date 31 -Dec-21 31 -Oct-21 1 31 -Dec-212 Comments NHIC Source NHIC Strategy Department NHIA is funding this activity from own source. CPC has "gone live" with its first electronic Text Value No No Yes claim automatically vetted and paid Date 31 -Dec-21 31-Oct-21 1 31 -Dec-212 Justification was approved in Dec 211 and work is underway. It is expected to go live by end March, 212. >1 HMIS Master Plan for 211-216 (including Text Value No No Yes - implementation plan and cost estimates for Date 31-Dec-21 31-Oct-211 31-Dec-212 ) hardware, software, training and maintenance) 2 approved by Management (MoH/IASC) Work is in progress. -Z Health Data Dictionary approved Text Value No No Yes.U, Date 31 -Dec-21 1 31 -Oct-21 1 31 -Dec-212 L) Work is in progress. Health personnel receiving training x Number Value 6. 1142. 1486. Page 3 of 5
The World Bank Date 31 -Dec-21 31-Oct-21 1 31 -Dec-212 An update will be provided in o March, 212. a Financial sustainability strategy for NHIS Text Value No Yes Yes o approved by Management (MoH/iasc/NHIC) Date 31-Dec-21 31-Oct-211 31-Dec-212 o) Target has been met. Provider payment policy, implementation Text Value No Yes Yes : strategy, guidelines and tools for NHIS Date 31 -Dec-21 31 -Oct-21 1 31 -Dec-21 approved by Management (MoH/IASC/NHIC Comments NHIC Board) CmetNHCSource: NHIC Target has been met. NHIS population exemption policy (with Text Value No No Yes implementation plan and cost projections) for Date 31-Dec-21 31-Dec-21 1 31-Dec-212 the enrollment of the poor approved by Management (MoH/IASC/NHIC Board) Common targeting mechanism completed. Bu implementation plan and cost projections are still being prepared. HR Strategy approved by Management (MoH/ Text Value None Yes Yes IASC/NHIC Board) Date 31 -Dec-21 31 -Oct-21 1 31 -Dec-212 Target has been met. HMIS Master Plan for 211-216 (including Text Value No No Yes implementation plan and cost estimates for Sub Type hardware, software, training and maintenance) Supplemental approved by Management (MoH/lASC) Data on Financial Performance (as of 5-Jan-212) U Financial Agreement(s) Key Dates 3 Project Loan No. Status Approval Date Signing Date Effectiveness Date Closing Date P11852 IDA-4345 Effective 3-Jul-27 8-Aug-27 1-Dec-27 31-Dec-212 - Disbursements (in Millions) Project Loan No. Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P11852 IDA-4345 Effective XDR 1. 1.. 2.12 7.88 21. Page 4 of 5
) The World Bank Disbursement Graph O U) 12-1- - Original ---- Formally Revised -- Actual r) CY CY C Y C YC W n, C, Il l l l l Key Decisions Regarding Implementation Project implementation is intensifying and it was agreed that the project ratings will be further reviewed by end of March, 212. Restructuring History Level two Approved on 25-Apr-21 1, Level two Approved on 24-Jun-21 1 Related Projects There are no related projects. C-).U Page 5 of 5