Public Disclosure Authorized SOUTH ASIA Sri Lanka Health, Nutrition & Population Global Practice IBRD/IDA Sector Investment and Maintenance Loan FY 2013 Seq No: 6 ARCHIVED on 15-Dec-2015 ISR21541 Implementing Agencies: Ministry of Health, Ministry of Local Government and Provinical Councils Public Disclosure Authorized Key Dates Key Project Dates Bank Approval Date:27-Mar-2013 Planned Mid Term Review Date:25-Jan-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 $190.00 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 12/15/2015 Page 1 of 12
The project continues to make strong implementation progress and commitment for achievement of the agreed targets by the implementing teams in the Ministry of Health and the nine Provinces remains high based on regular project implementation reviews. The project remains on track with strong likelihood of achieving the Project Development Objective. A.mid-term review of the project is expected to take place from January 25 to February 3 2016. The objective of the mission will be to review implementation progress and adjust the project design, if considered necessary, to further improve results achievement in the health sector. 12/15/2015 Page 2 of 12
12/15/2015 Page 3 of 12
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 Results Project Development Objective Indicators PHINDPDOTBL % of persons (over 40 years) screened for selected NCDs (Diabetes, hypertension, cancer breast and oral) at healthy lifestyle centers (Percentage, Custom) Value 3.00 19.90 19.90 12.00 This indicator is updated annually and the 2015 data will be available in January 2016. 12/15/2015 Page 4 of 12
PHINDPDOTBL % of pregnant women with anaemia after the second trimester (Percentage, Custom) Value 34.00 34.00 34.00 20.00 This indicator is updated annually and the 2015 data will be available in January 2016. PHINDPDOTBL % of centrally managed health facilities with ETUs for that level of facility based on standard guidelines (DLI 1) (Percentage, Custom) Value 0.00 14.30 14.30 40.00 The data is the status as of end of June 2015. PHINDPDOTBL % of provincially managed health facilities with ETUs for that level of facility based on standard guidelines (DLI 2) (Percentage, Custom) Value 0.00 28.80 32.30 50.00 Date 30-Sep-2012 31-Dec-2014 12-Dec-2015 31-Dec-2017 Out of the 545 hospitals at the primary and secondary care levels under the management of the provinces 176 hospitals report to having an ETU as of June 30 2015. PHINDPDOTBL % of MOH managed health facilities sending indoor morbidity data through e-immr (DLI 3) (Percentage, Custom) Value 2.00 49.00 53.20 80.00 12/15/2015 Page 5 of 12
The data is the status as of end of June 2015. 25 of the 47 hospitals (53.2%) are reporting patient information using the eimmr. PHINDPDOTBL % of provincially managed health facilities sending indoor morbidity data through e-immr (DLI 4) (Percentage, Custom) Value 1.00 33.00 40.00 70.00 The data is the status as of end of June 2015. 218 of the 545 divisional hospitals and above (40%) are reporting patient information using the eimmr. Overall 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 20.00 41.90 46.00 95.00 The data is the status as of end of June 2015. 1781 of the 3883 MCH field clinics (46%) have the agreed package required for MCH services. 12/15/2015 Page 6 of 12
% of Medical Officer of Health areas with at least three health and nutrition community support groups (Percentage, Custom) Value 10.00 65.50 69.70 90.00 The data is the status as of end of June 2015. 230 of the 330 Medical Officer of Health areas (69.7%) have at least 3 health and nutrition community groups. % of CEMOC facilities providing 24x7 CEMOC services. (Percentage, Custom) Value 45.00 75.30 75.30 75.00 The data will be reported annually and will be available in January 2016. % of Medical Officer of Health areas with at least two healthy lifestyle centers (DLI 6) (Percentage, Custom) Value 10.00 49.30 64.50 90.00 The data is the status as of end of June 2015. 213 of the 330 Medical Officer of Health areas (64.5%) have at least 2 HLCs. 12/15/2015 Page 7 of 12
No. of provinces with at least one health facility providing rehabilitation services (Number, Custom) Value 1.00 3.00 4.00 7.00 The data is the status as of end of June 2015. 4 of the 9 provinces provide rehabilitation services. % of primary health care institutions having one month s buffer stock for 16 selected NCD drugs (Percentage, Custom) Value 2.00 43.40 57.50 60.00 The data is the status as of end of June 2015. 492 of the 855 primary health care institutions (57.5%) have the essential NCD drugs are available in their stores. % of training institutes managed by the Ministry of Health meeting national standards (Percentage, Custom) Value 0.00 5.00 11.80 40.00 The data is the status as of end of June 2015. 4 of the 34 health training institutes (11.82%) are improved to meet national standards. 12/15/2015 Page 8 of 12
% 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 10.00 94.20 94.20 80.00 Data for this indicator will be reported by January 2016.. Case detection rate for Tuberculosis (Percentage, Custom) Value 69.00 66.10 66.10 78.00 Data for this indicator will be reported by January 2016.. % of hospitals (base hospitals and above) that have obtained EPL and HWL (Percentage, Custom) Value 5.00 6.00 6.00 40.00 The data will be reported in January 2016. 12/15/2015 Page 9 of 12
% of fully functioning quality management Units (QMUs) in MOH managed base hospitals and above (DLI 7) (Percentage, Custom) Value 9.00 38.10 73.80 95.00 The data is the status as of end of June 2015. 31 of the 42 MOH managed hospitals which require a QMU have functional QMUs. % of fully functioning quality management Units (QMUs) in provincially managed base hospitals and above (DLI 8) (Percentage, Custom) Value 6.00 43.70 56.30 90.00 The data is the status as of end of June 2015. 40 of the 69 health facilities (Base and above) (58%) have functional QMUs. % of National Competitive Bidding (NCB) contracts awarded within the first nine months of the previous calendar year from 2014 onwards (Percentage, Custom) Value 0.00 73.60 73.60 80.00 The data will be reported after January 2016. 12/15/2015 Page 10 of 12
% of the six-monthly cash forecast (for non-salary recurring and capital expenditures) released (DLI 9) (Percentage, Custom) Value 81.00 92.00 92.00 90.00 The data will be reported after Janaury 2016. Overall Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed Disbursed P118806 IDA-52280 Effective XDR 129.80 129.80 0.00 52.59 77.21 41% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P118806 IDA-52280 Effective 27-Mar-2013 19-Aug-2013 12-Sep-2013 30-Sep-2018 30-Sep-2018 Cumulative Disbursements 12/15/2015 Page 11 of 12
Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 12/15/2015 Page 12 of 12