The World Bank Report No: ISR4739

Implementation Status & Results Djibouti Health Sector Development Project (P071062)

Operation Name: Health Sector Development Project (P071062) Project Stage: Implementation Seq.No: 23 Status: ARCHIVED Archive Date: Country: Djibouti Approval FY: 2002

Public Disclosure Authorized Product Line:IBRD/IDA Region: MIDDLE EAST AND NORTH AFRICA Lending Instrument: Adaptable Program Loan Implementing Agency(ies): Unite de Gestion des Projets (UGP) Key Dates Board Approval Date 04-Jun-2002 Original Closing Date 30-Jun-2008 Planned Mid Term Review Date 14-Jan-2007 Last Archived ISR Date 03-Apr-2011 Public Disclosure Copy Effectiveness Date 11-Nov-2002 Revised Closing Date 30-Jun-2012 Actual Mid Term Review Date 14-Jan-2007

Project Development Objectives Project Development Objective (from Project Appraisal Document) The revised Project Development Objective is to improve the quality of health services in a sustainable manner in order to contribute to the progress towards achieving the health-related Millennium Development Goals (MDGs) of reducing child and maternal mortality and combating communicable diseases. Has the Project Development Objective been changed since Board Approval of the Project?

● Yes No Public Disclosure Authorized Component(s)

Component Name Component Cost IMPROVE HEALTH SERVICES 5.00 IMPROVE AVAILABILITY AND QUALITY OF TRAINED PERSONNEL 2.20 IMPROVE DRUG SUPPLY 5.80 IMPROVE SECTOR MANAGEMENT 2.00 Improving the Health Service Delivery Performance 3.60 Strengthening of Health Systems 3.40

Overall Ratings

Public Disclosure Authorized Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating Public Disclosure Copy Implementation Status Overview The Project is moving forward towards achieving its Development Objectives. In terms of maternal and child health, child mortality rate was reduced from 103 deaths per 1000 live

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births in 2002 to 67 deaths per 1000 live births in 2006. Medically assisted deliveryreached 58 percent in 2010 compared to 44 percent in 2002. Moreover, the proportion of children 12-23 months of age who are vaccinated with DPT3 before 12 months of age has increased from 45 percent in 2002 to 90 percent in 2010. In terms of combating communicable diseases, HIV/AIDS prevalence among young pregnant women (15 to 24 years old) has decreased to 1.4 percent in 2010, compared to 2.1percent in 2007 and 2.9 percent in 2002. In addition, the total number of students enrolled in the High Institute of Health Sciences (HIHS) has increased to 948 students in 2011 compared to 515 students in 2008. The total number of insecticide treated bed nets distributed to households in high transmission areas has increased to 432,500 bed nets in 2010 compared to 138,000 bed nets in 2008.

Locations Country First Administrative Division Location Planned Actual Djibouti Region de Dikhil Yoboki

Djibouti Region de Tadjourah Tadjoura

Public Disclosure Copy Djibouti Region de Tadjourah Randa

Djibouti Region d' Obock Obock

Djibouti Not Entered Mouloud

Djibouti Region d' Obock Medeho

Djibouti Region d' Obock Khor `Angar

Djibouti Ville de Djibouti Ambouli

Djibouti Region d' Ali Sabieh Holhol

Djibouti Region de Tadjourah Dorra

Djibouti Ville de Djibouti Dorale

Djibouti Ville de Djibouti Djibouti

Djibouti Region de Dikhil Dikhil

Djibouti Not Entered Da`asbiyo

Djibouti Region de Dikhil `As `Ela

Djibouti Not Entered `Asamo

Djibouti Region d' Arta `Arta

Djibouti Region d' Ali Sabieh `Ali Sabieh

Djibouti Region d' Ali Sabieh `Ali `Adde

Public Disclosure Copy Djibouti Not Entered `Adaylou

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Country First Administrative Division Location Planned Actual Djibouti Region d' Obock Alaili Dadda`

Djibouti Ville de Djibouti Damerdjog

Djibouti Region d' Ali Sabieh Goubetto

Djibouti Region de Tadjourah `Assa Gaila

Results

Public Disclosure Copy Project Development Objective Indicators Indicator Name Core Unit of Measure Baseline Current End Target Reduced Maternal Mortality Rate Text Value 546 deaths per 100,000 live The MMR will be conducted 350 deaths per 100,000 live births in 2002 (source: as an element of the births in 2011. PAPFAM) PAPFAM survey in 2012. Date 01-May-2002 31-Mar-2011 30-Jun-2012 Comments

Reduced Child Mortality Rate Text Value 124 deaths per 1000 live 67 deaths per 1000 live births 80 deaths per 1,000 live births births in 2002. (source: in 2006. (Source: EDIM 2006 in 2011. PAPFAM). final results). The end-of-project target has been achieved. Date 01-May-2002 31-Mar-2011 30-Jun-2012 Comments Will be updated based on the results of PAPFAM survey in 2012 HIV/AIDS prevalence among young pregnant Text Value Above 2.9% in 2002 1.4% (Source: MOH Annual 1.8% women (15 # 24 years old) Report 2010) Date 01-May-2002 31-Mar-2011 30-Jun-2012 Comments Will be updated based on the results of PAPAFAM survey in 2012

Intermediate Results Indicators Public Disclosure Copy

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Indicator Name Core Unit of Measure Baseline Current End Target Increase from 40% (2002) to 90% (2011) the Text Value 44% 58% (Source: MOH Annual 90% in 2011 proportion of births occurring in health facilities. Report 2010) Date 01-May-2002 31-Mar-2011 30-Jun-2012 Comments Will be updated based on the results of EDIM and PAPFAM surveys in 2012 Increase from 45% to 85% the proportion of Text Value 45% 90% (Source: Report on 85% in 2011 children 12-23 months of age who are routine immunization for vaccinated with DPT3 before 12 months of age. 2010) Date 01-May-2002 31-Mar-2011 30-Jun-2012 Public Disclosure Copy Comments

Health personnel receiving training Number Value 0.00 948.00 705.00

Date 31-Dec-2002 31-Mar-2011 30-Jun-2012 Comments Total number of students enrolled in the High Institute of Health Sciences (HIHS) Long-lasting insecticide-treated malaria nets Number Value 0.00 432500.00 298000.00 purchased and/or distributed Date 31-Dec-2002 31-Mar-2011 30-Jun-2012 Comments Number of insecticide treated bed nets distributed to households in high transmission areas Health facilities constructed, renovated, and/or Number Value 0.00 7.00 7.00 equipped Date 31-Dec-2002 31-Mar-2011 30-Jun-2012 Comments Number of health facilities Number of health facilities constructed, renovated, and/ constructed, renovated, and/ or equipped or equipped Children immunized Number Value 0.00 17500.00 18600.00

Date 31-Dec-2002 31-Mar-2011 30-Jun-2012 Comments Number of children aged 12-24 months completely immunized before their first birthday Public Disclosure Copy Data on Financial Performance (as of 03-Oct-2011)

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Financial Agreement(s) Key Dates Project Loan No. Status Approval Date Signing Date Effectiveness Date Closing Date P071062 IDA-36500 Effective 04-Jun-2002 12-Aug-2002 11-Nov-2002 30-Jun-2012 P071062 IDA-H4950 Effective 26-May-2009 22-Jun-2009 15-Oct-2009 30-Jun-2012

Disbursements (in Millions) Project Loan No. Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P071062 IDA-36500 Effective XDR 12.00 12.00 0.00 11.99 0.01 100.00 P071062 IDA-H4950 Effective XDR 4.70 4.70 0.00 1.41 3.29 30.00 Public Disclosure Copy Disbursement Graph

Key Decisions Regarding Implementation -

Restructuring History Board Approved on 26-May-2009

Related Projects Public Disclosure Copy P107395-Improving Health Sector Performance

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