Implementation Status & Results

The World Bank Report No: ISR12786

Implementation Status & Results Uganda Uganda Health Systems Strengthening Project (P115563)

Operation Name: Uganda Health Systems Strengthening Project (P115563) Project Stage: Implementation Seq.No: 8 Status: ARCHIVED Archive Date: 26-Dec-2013 Country: Uganda Approval FY: 2010

Public Disclosure Authorized Product Line:IBRD/IDA Region: AFRICA Lending Instrument: Specific Investment Loan Implementing Agency(ies): Key Dates Board Approval Date 25-May-2010 Original Closing Date 31-Jul-2015 Planned Mid Term Review Date 14-Apr-2013 Last Archived ISR Date 22-Jun-2013 Public Disclosure Copy Effectiveness Date 10-Feb-2011 Revised Closing Date 31-Jul-2015 Actual Mid Term Review Date 02-Apr-2013

Project Development Objectives Project Development Objective (from Project Appraisal Document) The project development objective (PDO) is to deliver the Uganda National Minimum Health Care Package (UNMHCP) to Ugandans, with a focus on maternal health, newborn care and family planning. This will be through improving human resources for health, physical health infrastructure, and management, leadership and accountability for health service delivery. Has the Project Development Objective been changed since Board Approval of the Project?

Public Disclosure Authorized Yes No

Component(s)

Component Name Component Cost Improved health workforce 5.00 Improved health infrastructure of existing facilities. 85.00 Improved management and leadership 10.00 Improved maternal, newborn and family planning services. 30.00

Overall Ratings Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Public Disclosure Authorized Overall Implementation Progress (IP) Moderately Satisfactory Moderately Satisfactory Overall Risk Rating Substantial Substantial

Implementation Status Overview Public Disclosure Copy The pace of implementation remains robust with the project making generally satisfactory progress towards the development objectives. Four out of five outcome indicators have been achieved and several of the intermediate outcome indicators met.

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The major activity in the last six months was the selection of contractors for phase one of the renovation of hospitals. The contracts for the civil works were signed and sites handed over to the contractors in preparation for commencement of the works.

Major procurements under the project are almost complete and the distribution of critical equipment to 230 facilities countrywide is underway and should boost their technical capacity and performance.

The team is working on a package for additional financing in the amount of US$ 90 million which is scheduled for Board approval on February 28, 2014.

Locations Country First Administrative Division Location Planned Actual Uganda Ntungamo District Rubaare Public Disclosure Copy Uganda Ntungamo District Rubaare

Uganda Pallisa District Pallisa

Uganda Arua District Pakwach

Uganda Kitgum District Padibe

Uganda Adjumani District Obongi

Uganda Luwero District Ntenjeru

Uganda Mukono District Ntenjeru

Uganda Nakaseke District Ngoma

Uganda Nebbi District Nebbi

Uganda Not Entered Nankoma

Uganda Not Entered Nankoma Public Disclosure Copy Uganda Nakaseke District Nakaseke

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Country First Administrative Division Location Planned Actual Uganda Nakaseke District Nakaseke

Uganda Not Entered Mwizi

Uganda Not Entered Mwera

Uganda Mityana District Mwera

Public Disclosure Copy Uganda Mubende District Mubende

Uganda Mubende District Mubende

Uganda Moyo District Moyo

Uganda Moroto District Moroto

Uganda Mubende District Mityana

Uganda Masindi District Masindi

Uganda Kamuli District Kiyunga

Uganda Not Entered Kiyunga

Uganda Not Entered Kitwe

Uganda Kitgum District Kitgum

Public Disclosure Copy Uganda Masindi District Kiryandongo

Uganda Masindi District Kiryandongo

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Uganda Not Entered Kikamulo

Uganda Kaliro District Kiganda

Uganda Not Entered Kiganda

Uganda Pallisa District Kibuku

Uganda Not Entered Kawolo Station Public Disclosure Copy Uganda Mubende District Kasanda

Uganda Mubende District Kasanda

Uganda Kiruhura District Kabuyanda

Uganda Iganga District Iganga

Uganda Wakiso District Entebbe

Uganda Ntungamo District Chitwe

Uganda Masindi District Bwijanga

Uganda Not Entered Buyinja

Uganda Jinja District Buwenge

Uganda Mukono District Buvuma Island

Uganda Masindi District Bulisa Public Disclosure Copy Uganda Masindi District Bulisa

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Uganda Bukwa District Bukwa

Uganda Not Entered Bugongo

Uganda Bugiri District Bugiri

Uganda Not Entered Budondo Public Disclosure Copy Uganda Not Entered Budondo

Uganda Pallisa District Budaka

Uganda Nebbi District Atyak

Uganda Gulu District Atiak

Uganda Apac District Apac

Uganda Gulu District Anaka

Uganda Apac District Aduku

Uganda Apac District Aboke

Uganda Ntungamo District Ntungamo District

Uganda Isingiro District Isingiro District

Uganda Mityana District Mityana District

Public Disclosure Copy Results

Project Development Objective Indicators

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Indicator Name Core Unit of Measure Baseline Current End Target People with access to a basic package of Number Value 0.00 626876.00 70000.00 health, nutrition, or reproductive health services Date 04-Oct-2009 30-Apr-2013 31-Jul-2015 (number) Comments Shall use proxy indicator: UHSSP Report. Target has patient visits in renovated been exceeded. Target will be health facilities - in and out revised during the additional patients financing. Deliveries taking place in Government and Percentage Value 34.00 40.00 45.00 PNFP Health Facilities (%) Date 30-Oct-2009 30-Apr-2013 31-Jul-2015 Comments Baseline 2011/2012 HMIS/AHSPR.

Public Disclosure Copy Mothers attending at least 4 antenatal care Percentage Value 50.00 35.00 65.00 (ANC) visits (%) Date 29-Dec-2006 30-Apr-2013 31-Jul-2015 Comments Baseline Based on the HMIS. It under- reports the actual value compared to the DHS Contraceptive Prevalence Rate Percentage Value 24.00 34.00 35.00 Date 29-Dec-2006 30-Jun-2013 31-Jul-2015 Comments From DHS. Based on the 2012 Panel Survey. Direct project beneficiaries Number Value 0.00 113803.00 70000.00 Date 31-Dec-2009 30-Jun-2013 31-Jul-2015 Comments UHSSP Health Facilities Shall use proxy indicator: Records 58% were women. patient visits in renovated target surpassed. health facilities - in and out patients

Intermediate Results Indicators Indicator Name Core Unit of Measure Baseline Current End Target Health personnel receiving training (number) Number Value 0.00 350.00 75.00 Date 04-Oct-2009 30-Jun-2013 31-Jul-2015 Comments Baseline Training in Nkozi University. Target surpassed and will be revised during the AF. Health facilities constructed, renovated, and/or Number Value 0.00 0.00 46.00 equipped (number) Date 04-Oct-2009 30-Apr-2013 31-Jul-2015 Public Disclosure Copy

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Comments Baseline Equipment procured and being distributed. Renovations not yet started. Approved positions filled by qualified health Percentage Value 56.00 58.00 80.00 workers Date 30-Oct-2009 30-Jun-2013 31-Jul-2015 Comments Baseline Source: 2012/2013 AHSPR. No new update as yet Health workers receiving a salary within two Percentage Value 0.00 46.00 30.00 months from reporting to work Date 04-Oct-2009 30-Jun-2013 31-Jul-2015 Comments MoPS Survey.

Public Disclosure Copy HC IVs and Hospitals with functioning minimum Number Value 0.00 0.00 58.00 Essential Equipment Date 04-Oct-2009 31-Oct-2012 31-Jul-2015 Comments This is a complex indicator, which duplicates other indicator on equipment. Shall be dropped during the AF. Hospitals and HC IVs offering comprehensive Percentage Value 20.00 33.00 50.00 emergency obstetric care Date 04-Oct-2009 30-Apr-2013 31-Jul-2015 Comments Source: Resource Center HC IV facilities conducting maternal and Percentage Value 5.00 31.00 40.00 perinatal death audits Date 04-Oct-2009 30-Jun-2013 31-Jul-2015 Comments Report of National Committee on MPDR Committee 2012. No Change Health facilities with Client Charters Percentage Value 0.00 9.00 100.00 Date 04-Oct-2009 30-Apr-2013 31-Jul-2015 Comments UHSSP Progress Report. Please note that the figure for the previous year was spurious. Upon validation the correct figure is 9% Health facilities without stock-outs of tracer Percentage Value 26.00 53.00 55.00 medicines and supplies Date 04-Oct-2009 30-Jun-2013 31-Jul-2015 Comments Source: 2012/2013 AHSPR. Please note that the target in 2011/12 was 48% and not

Public Disclosure Copy 70%.

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Hospitals with medical superintendents trained Percentage Value 0.00 70.00 100.00 in health management/hospital administration Date 04-Oct-2009 30-Jun-2013 31-Jul-2015 Comments Drug Orders processed timely by National Percentage Value 55.00 100.00 80.00 Medical Stores Date 04-Oct-2009 31-Oct-2012 31-Jul-2015 Comments Source: NMS. This indicator is to be dropped as NMS has changed to a push from a pull system. Pregnant women receiving antenatal care Number Value 1200000.00 353518.00 1400000.00

Public Disclosure Copy during a visit to a health provider (number) Date 30-Oct-2009 31-Oct-2012 31-Jul-2015 Comments Source: UHSSP Reports Targets revised to UHSSP Supported Facilities Couple years of protection Number Value 549594.00 3275400.00 1000000.00 Date 30-Oct-2009 30-Jun-2013 31-Jul-2015 Comments Source: 2012/2013 AHSPR The targets were surpassed and will be revised during the AF. Health Center IV Performing Caesarian Percentage Value 14.00 33.00 50.00 Sections Date 30-Oct-2009 30-Jun-2013 31-Jul-2015 Comments Source: MoH RH Division Report Health Center IV and Hospitals Renovated Number Value 0.00 0.00 46.00 according to agreed standards Date 30-Oct-2009 30-Apr-2013 31-Jul-2015 Comments Activity not started yet.

Data on Financial Performance (as of 04-Sep-2013)

Financial Agreement(s) Key Dates Project Ln/Cr/Tf Status Approval Date Signing Date Effectiveness Date Original Closing Date Revised Closing Date P115563 IDA-47420 Effective 25-May-2010 12-Aug-2010 10-Feb-2011 31-Jul-2015 31-Jul-2015

Disbursements (in Millions) Project Ln/Cr/Tf Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed

Public Disclosure Copy P115563 IDA-47420 Effective XDR 85.70 85.70 0.00 27.36 58.34 32.00

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Disbursement Graph Public Disclosure Copy

Key Decisions Regarding Implementation N/A

Restructuring History There has been no restructuring to date.

Related Projects P145280-Uganda Health Systems Strengthening Project Public Disclosure Copy

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