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The World Bank Document of The World Bank Public Disclosure Authorized Report No: ICR00003211 IMPLEMENTATION COMPLETION AND RESULTS REPORT (TF-92182) Public Disclosure Authorized ON A GRANT IN THE AMOUNT OF US$ 6.02 MILLION TO Health Insurance Fund FOR A Public Disclosure Authorized Pre-paid Health Scheme Pilot in Nigeria (P104405) January 30, 2015 Health, Nutrition and Population Global Practice Africa Region This document is being made publicly available after Bank approval. This does not imply a presumed Public Disclosure Authorized outcome. This document may be updated following Bank approval and the updated document will be made publicly available in accordance with the Bank’s policy on Access to Information. ABBREVIATIONS AND ACRONYMS ANC Antenatal care CAPDAN Computer and Allied Products Distribution Association of Nigeria CBHIS Community-based health insurance schemes CHAT Choosing Health Plans All Together COHSAS The Council for Health Service Accreditation of Southern Africa CPS Country Partnership Strategy FFS Fee-For-Service FIRR Financial Internal Rate of Return GPOBA Global Partnership on Output-based Aid HBL Hygeia Better Life HCHC Hygeia Community Health Care HIF Stichting Health Insurance Fund HMB Hospital Management Board HNP Health, Nutrition and Population HWs Health workers ICR Implementation Completion and Results report IEC Information, education and communication IFC International Finance Corporation ILI Intensive learning ICR ILO International Labour Organization ISR Implementation Status and Results Report JCI Joint Commission International LHFMAA Lagos Health Facility Monitoring and Accreditation Agency LMW Lagos Market Women M&E Monitoring and Evaluation MDD Medical Due Diligence MDG Millennium Development Goal MILK Microinsurance Learning and Knowledge MRC Market Research Consultancy NPV Net present value NGN Nigerian Naira NGOs Non-governmental organizations NHIS National Health Insurance Scheme NSHDP National Strategic Health Development Plan OBA Output-Based Aid PAF PharmAccess Foundation PDO Project Development Objective PPF Project Preparation Facility ii PSS Price Sensitivity Study QEA Quality at Entry QSA Quality of Supervision SOPs Standard Operating Procedures SPN Service provider network UHC Universal Health Coverage HNP Senior Director: Timothy Evans Practice Manager: Trina Haque Project Team Leader: Chris Atim ICR Team Leader: Samuel Mills ICR Author: Samuel Mills iii CURRENCY EQUIVALENTS Exchange Rate Effective November 19, 2008 Currency Unit = Naira Euro 1.00 = US$ 1.34 US$ 1.00 = 128.00 FISCAL YEAR January 1 – December 31 iv NIGERIA Pre-paid Health Scheme Pilot in Nigeria (P104405) CONTENTS Data sheet A. BASIC INFORMATION......................................................................................................................................................... VII B. KEY DATES ....................................................................................................................................................................... VII C. RATINGS SUMMARY .......................................................................................................................................................... VII D. SECTOR AND THEME CODES ............................................................................................................................................. VIII E. BANK STAFF ...................................................................................................................................................................... VIII F. RESULTS FRAMEWORK ANALYSIS ..................................................................................................................................... VIII G. RATINGS OF PROJECT PERFORMANCE IN ISRS ...................................................................................................................XII H. RESTRUCTURING (IF ANY) ..................................................................................................................................................XII I. DISBURSEMENT PROFILE ....................................................................................................................................................XII 1. PROJECT CONTEXT, DEVELOPMENT OBJECTIVES AND DESIGN .................................................................. 1 1.1 Context at Appraisal ................................................................................................................................................. 1 1.2 Original Project Development Objectives (PDO) and Key Indicators ..................................................................... 3 1.3 Revised PDO and Key Indicators ............................................................................................................................. 3 1.4 Main Beneficiaries .................................................................................................................................................... 3 1.5 Original Components................................................................................................................................................ 4 1.6 Revised Components ............................................................................................................................................ 5 1.7 Other significant changes ......................................................................................................................................... 5 2. KEY FACTORS AFFECTING IMPLEMENTATION AND OUTCOMES ............................................................... 5 2.1 Project Preparation, Design, and Quality ................................................................................................................ 5 2.2 Implementation ......................................................................................................................................................... 7 2.3 Monitoring and Evaluation (M&E) Design, Implementation and Utilization .......................................................... 9 2.4 Safeguard and Fiduciary Compliance: ................................................................................................................... 11 2.5 Post-completion Operation/Next Phase .................................................................................................................. 12 3. ASSESSMENT OF OUTCOMES ............................................................................................................................... 12 3.1 Relevance of Objectives and Design ....................................................................................................................... 12 3.2 Achievement of Project Development Objectives (efficacy) ................................................................................... 14 3.3 Efficiency ................................................................................................................................................................ 19 3.4 Justification of Overall Outcome Rating ................................................................................................................ 19 3.5 Overarching Themes, Other Outcomes and Impacts .............................................................................................. 20 3.6 Summary of Findings of Beneficiary Survey and/or Stakeholder Workshops: ....................................................... 20 4. ASSESSMENT OF RISK TO DEVELOPMENT OUTCOME ................................................................................... 21 5. ASSESSMENT OF BANK AND BORROWER PERFORMANCE ........................................................................... 21 5.1 Bank Performance .................................................................................................................................................. 21 5.2 Borrower Performance ........................................................................................................................................... 23 6. LESSONS LEARNED .................................................................................................................................................. 24 v ANNEXES ........................................................................................................................................................................ 27 ANNEX 1. PROJECT COSTS AND FINANCING ................................................................................................................... 27 ANNEX 2. OUTPUTS BY COMPONENT ............................................................................................................................. 28 ANNEX 3. ECONOMIC AND FINANCIAL ANALYSIS (INCLUDING ASSUMPTIONS IN THE ANALYSIS) .................................. 39 ANNEX 4. BANK LENDING AND IMPLEMENTATION SUPPORT/SUPERVISION PROCESSES ................................................ 43 ANNEX 5. BENEFICIARY SURVEY RESULTS .................................................................................................................... 45 ANNEX 6. STAKEHOLDER WORKSHOP REPORT AND RESULTS ....................................................................................... 51 ANNEX 7. SUMMARY OF BORROWER’S ICR AND/OR COMMENTS ON DRAFT ICR .......................................................... 55 ANNEX 8. LIST OF SUPPORTING DOCUMENTS................................................................................................................
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