The World Bank Implementation Status & Results Report Emergency Tuberculosis Project (P160947)

Emergency Tuberculosis Project (P160947)

EAST ASIA AND PACIFIC | Papua New Guinea | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2017 | Seq No: 8 | ARCHIVED on 03-Feb-2021 | ISR45080 | Public Disclosure Authorized

Implementing Agencies: Department of Treasury, National Department of Health

Key Dates

Key Project Dates

Bank Approval Date: 31-May-2017 Effectiveness Date: 25-Sep-2017 Planned Mid Term Review Date: 12-Apr-2021 Actual Mid-Term Review Date: Original Closing Date: 30-Jun-2022 Revised Closing Date: 30-Jun-2022 pdoTable

Project Development Objectives Public Disclosure Authorized Project Development Objective (from Project Appraisal Document) To Improve the quality and expand the coverage and utilization of health services to control the spread of tuberculosis in targeted areas of Papua New Guinea by strengthening programmatic management of tuberculosis.

Has the Project Development Objective been changed since Board Approval of the Project Objective? No

Components Table

Name Early detection of active tuberculosis patients:(Cost $3.55 M) Effective treatment of drug-susceptible and drug-resistant tuberculosis patients:(Cost $7.70 M) Strengthening government systems for managing its health services delivery and tuberculosis Public Disclosure Authorized response:(Cost $3.75 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 High Substantial

Implementation Status and Key Decisions

Papua New Guinea continues to be affected by COVID-19, although the number of recorded COVID-19 cases and COVID-19 related deaths in PNG remains low compared with other countries. Essential health services have been affected including tuberculosis control generally, as well as implementation of some Project activities, as human resources are redirected to contribute to the COVID-19 response and as some international Public Disclosure Authorized technical workers have been withdrawn from their functions, particularly in Daru Island and Western Province.

During the period covered by this report (July to December 2020), travel and pandemic-control restrictions have meant that the World Bank team has not been able to undertake in-person implementation support missions. In the absence of in-person implementation support, the World Bank and National Department of Health Project implementation teams, as well as key stakeholders (the World Health Organization, United Nations Office for Project Services, and World Vision Australia), have been in regular contact through virtual meetings and email correspondence. However,

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it has not been possible to verify the latest project results and the results included in this report are those verified up to December 2019. Although preliminary indications are that results related to service delivery and treatment outcomes have been maintained, despite the challenges related to COVID-19. Maintenance of these results in service delivery and improved treatment outcomes for patients is in part due to the ongoing and successful implementation of community-based treatment support activities in the National Capital District.

The World Bank and National Department of Health intend to hold a mid-term review of the project before June 2021 at which time project results and performance will be assessed, the project design and implementation approach will be reviewed, and any necessary adjustments to the project will be made.

Risks

Systematic Operations Risk-rating Tool

Risk Category Rating at Approval Previous Rating Current Rating

Political and Governance High High High Macroeconomic Substantial High Substantial Sector Strategies and Policies Substantial Substantial Substantial Technical Design of Project or Program Low Low Low Institutional Capacity for Implementation and High High Substantial Sustainability Fiduciary High High High Environment and Social Low Moderate Moderate Stakeholders Substantial Substantial Substantial Other -- -- Substantial Overall High High Substantial

Results

PDO Indicators by Objectives / Outcomes

To Improve the quality and expand the coverage and utilization of health services to control the spr

IN00939595 ►Number of people receiving tuberculosis treatment in accordance with the national guidelines (NCD) (Number, Custom)

Baseline Actual (Previous) Actual (Current) End Target

Value 6,169.00 6,800.00 6,800.00 7,100.00

Date 31-Aug-2016 31-Dec-2019 31-Dec-2019 30-Jun-2022

IN00939856

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►Number of people receiving tuberculosis treatment in accordance with the national guidelines (Daru/South Fly District, Western Province) (Number, Custom)

Baseline Actual (Previous) Actual (Current) End Target

Value 1,659.00 593.00 593.00 1,900.00

Date 31-Aug-2016 31-Dec-2019 31-Dec-2019 30-Jun-2022

IN00939857 ►The proportion of TB patients who have received drug-sensitivity testing (DST) (NCD) for Longer regime (LR) (Percentage, Custom)

Baseline Actual (Previous) Actual (Current) End Target

Value 20.00 45.00 45.00 80.00

Date 31-Aug-2016 31-Dec-2019 31-Dec-2019 30-Jun-2022

Comments:

IN00939858 ►The proportion of TB patients who have received DST (Daru/South Fly District,Western Province) for Shorter regime (SR) (Percentage, Custom)

Baseline Actual (Previous) Actual (Current) End Target

Value 41.00 40.00 40.00 80.00

Date 31-Aug-2016 31-Dec-2019 31-Dec-2019 30-Jun-2022

IN00939859 ►TB treatment success rate for DS TB (NCD) (Percentage, Custom)

Baseline Actual (Previous) Actual (Current) End Target

Value 56.00 87.00 87.00 85.00

Date 31-Aug-2016 31-Dec-2019 31-Dec-2019 30-Jun-2022

IN00939860 ►TB treatment success rate for DS TB (Daru/South Fly District,Western Province) (Percentage, Custom)

Baseline Actual (Previous) Actual (Current) End Target

Value 71.00 85.00 84.00 85.00

Date 31-Aug-2016 31-Dec-2019 31-Dec-2019 30-Jun-2022

IN00939861 ►TB treatment success rate for DR TB (NCD) for Shorter regime ( SR) (Percentage, Custom)

Baseline Actual (Previous) Actual (Current) End Target

Value 44.00 54.00 54.00 75.00

Date 31-Aug-2016 31-Dec-2019 31-Dec-2019 30-Jun-2022

IN00939862

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►TB treatment success rate for DR TB for females (NCD) (Percentage, Custom)

Baseline Actual (Previous) Actual (Current) End Target

Value 0.00 58.00 58.00 75.00

Date 31-Aug-2016 31-Dec-2019 31-Dec-2019 30-Jun-2022

IN00939863 ►TB treatment success rate for DR TB (Daru/South Fly District,Western Province) (Percentage, Custom)

Baseline Actual (Previous) Actual (Current) End Target

Value 49.00 88.00 88.00 75.00

Date 31-Aug-2016 31-Dec-2019 31-Dec-2019 30-Jun-2022

IN00939864 ►TB treatment success rate for DR TB for females (Daru/South Fly District,Western Province) (Percentage, Custom)

Baseline Actual (Previous) Actual (Current) End Target

Value 71.40 93.00 93.00 75.00

Date 31-Aug-2016 31-Dec-2019 31-Dec-2019 30-Jun-2022

IN00939865 ►Number of BMUs where all clinical staff have been trained/ retrained on TB and DR TB (NCD & Western Province) (Number, Custom)

Baseline Actual (Previous) Actual (Current) End Target

Value 0.00 14.00 14.00 20.00

Date 31-Aug-2016 31-Dec-2019 31-Dec-2019 30-Jun-2022

Comments:

Overall Comments PDO

As indicated above, while preliminary data on some of the indicators have been collected, these have yet to be verified and submitted officially to NDOH. Therefore, the data presented here is the same as the last Report and will be updated once the data covering the follow-on period has been verified and provided.

Intermediate Results Indicators by Components

Early detection of active tuberculosis patients

IN00939866 ►Population-based screening in Daru is complete (Yes/No, Custom)

Baseline Actual (Previous) Actual (Current) End Target

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Value No Yes Yes Yes

Date 31-Aug-2016 31-Dec-2019 31-Dec-2019 30-Jun-2022

IN00939869 ►Number of BMUs with functioning TB Smear microscopy (NCD) (Number, Custom)

Baseline Actual (Previous) Actual (Current) End Target

Value 7.00 7.00 7.00 14.00

Date 31-Aug-2016 31-Dec-2019 31-Dec-2019 30-Jun-2022

IN00939872 ►Number of BMUs with functioning Xpert MTB/Rif (NCD) (Number, Custom)

Baseline Actual (Previous) Actual (Current) End Target

Value 3.00 4.00 4.00 14.00

Date 31-Aug-2016 31-Dec-2019 31-Dec-2019 30-Jun-2022

IN00939875 ►Number of BMUs with functioning TB Smear microscopy (Daru/ South Fly District, Western Province) (Number, Custom)

Baseline Actual (Previous) Actual (Current) End Target

Value 1.00 1.00 1.00 2.00

Date 31-Aug-2016 31-Dec-2019 31-Dec-2019 30-Jun-2022

IN00939877 ►Number of BMUs with functioning Xpert MTB/Rif (Daru/ South Fly District, Western Province) (Number, Custom)

Baseline Actual (Previous) Actual (Current) End Target

Value 1.00 1.00 1.00 2.00

Date 31-Aug-2016 31-Dec-2019 31-Dec-2019 30-Jun-2022 Daru General Hospital is the only BMU with a functioning GeneXpert machine (4-modules) in the South Fly District of Western Province. Comments: .

Effective treatment of drug-susceptible and drug-resistant tuberculosis patients

IN00939867 ►Smear conversion rate among DS TB cases (by 2 months for new cases and 3 months for retreatment cases) (NCD) (Percentage, Custom)

Baseline Actual (Previous) Actual (Current) End Target

Value 73.00 88.00 88.00 85.00

Date 31-Aug-2016 31-Dec-2019 31-Dec-2019 30-Jun-2022

IN00939870

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►Smear conversion rate among DS TB cases (by 2 months for new cases and 3 months for retreatment cases) (Daru/South Fly District,Western Province) (Percentage, Custom)

Baseline Actual (Previous) Actual (Current) End Target

Value 78.00 70.00 70.00 85.00

Date 31-Aug-2016 31-Dec-2019 31-Dec-2019 30-Jun-2022

IN00939873 ►Culture conversion rate among DR TB cases ( 4 months for shorter course) (NCD) for Shorter Regime (SR) (Percentage, Custom)

Baseline Actual (Previous) Actual (Current) End Target

Value 0.00 43.00 43.00 75.00

Date 31-Aug-2016 31-Dec-2019 31-Dec-2019 30-Jun-2022

IN00939878 ►Culture conversion rate among DR TB cases (At 6 months for normal course and 4 months for shorter course) (Daru/South Fly District,Western Province) (Percentage, Custom)

Baseline Actual (Previous) Actual (Current) End Target

Value 65.00 83.00 83.00 75.00

Date 31-Aug-2016 31-Dec-2019 31-Dec-2019 30-Jun-2022

IN00939879 ►Percentage of Lost to follow up of DS TB patients (Daru/South Fly District,Western Province) (Percentage, Custom)

Baseline Actual (Previous) Actual (Current) End Target

Value 15.00 2.70 2.70 6.00

Date 31-Aug-2016 31-Dec-2019 31-Dec-2019 30-Jun-2022

IN00939880 ►Percentage of Lost to follow up of DR TB patients (NCD) (Percentage, Custom)

Baseline Actual (Previous) Actual (Current) End Target

Value 12.00 14.00 14.00 5.00

Date 31-Aug-2016 31-Dec-2019 31-Dec-2019 30-Jun-2022

IN00939881 ►A reduction in lost to follow up of DS TB patients (NCD) (Percentage, Custom)

Baseline Actual (Previous) Actual (Current) End Target

Value 10.00 7.00 7.00 4.00

Date 31-Aug-2016 31-Dec-2019 31-Dec-2019 30-Jun-2022

IN00939882 ►Number (cumulative) of DR TB patients on shorter regimen (NCD & Western Province) (Number, Custom)

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Baseline Actual (Previous) Actual (Current) End Target

Value 0.00 222.00 222.00 400.00

Date 31-Aug-2016 31-Dec-2019 31-Dec-2019 30-Jun-2022

Strengthening government systems for managing its health services delivery and tuberculosis response

IN00939868 ►The conduction of semi-annual review meeting which involves TB development partners and government agencies to review the progress and make the consolidated, integrated work plan and budget (Yes/No, Custom)

Baseline Actual (Previous) Actual (Current) End Target

Value No Yes Yes Yes

Date 31-Aug-2016 31-Dec-2019 31-Dec-2019 30-Jun-2022

IN00939871 ►Citizens and/or communities involved in planning/implementation/evaluation of development programs (Yes/No, Custom)

Baseline Actual (Previous) Actual (Current) End Target

Value No Yes Yes Yes

Date 31-Aug-2016 31-Dec-2019 31-Dec-2019 30-Jun-2022

IN00939874 ►Project-supported organization(s) publishing reports containing information on feedback received from citizens and/or communities and if/how this feedback has been used (Yes/No, Custom)

Baseline Actual (Previous) Actual (Current) End Target

Value No No No Yes

Date 31-Aug-2016 31-Dec-2019 31-Dec-2019 30-Jun-2022

IN00939876 ►Timely delivery of annual report compiled by NTP (Yes/No, Custom)

Baseline Actual (Previous) Actual (Current) End Target

Value No No No Yes

Date 31-Aug-2016 31-Dec-2019 31-Dec-2019 30-Jun-2022

Overall Comments IR

As indicated above, while preliminary data on some of the indicators have been collected, these have yet to be verified and submitted officially to NDOH. Therefore, the data presented here is the same as the last Report and will be updated once the data covering the follow-on period has been verified and provided.

Performance-Based Conditions

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Data on Financial Performance

Disbursements (by loan)

Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed

P160947 IDA-60670 Effective USD 15.00 15.00 0.00 4.57 11.23 29%

Key Dates (by loan)

Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date

P160947 IDA-60670 Effective 31-May-2017 19-Jul-2017 25-Sep-2017 30-Jun-2022 30-Jun-2022

Cumulative Disbursements

PBC Disbursement

Achievement Disbursed amount in Disbursement % PBC ID PBC Type Description Coc PBC Amount Status Coc for PBC

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Restructuring History

There has been no restructuring to date.

Related Project(s)

There are no related projects.

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