World Bank Document

The World Bank Report No: ISR7023

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

Operation Name: Uganda Health Systems Strengthening Project (P115563) Project Stage: Implementation Seq.No: 5 Status: ARCHIVED Archive Date: 12-Dec-2011 Country: Uganda Approval FY: 2010

Public Disclosure Authorized Product Line:IBRD/IDA Region: AFRICA Lending Instrument: Specific Investment Loan Implementing Agency(ies): Ministry of Health 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 12-Dec-2011 Public Disclosure Copy Effectiveness Date 10-Feb-2011 Revised Closing Date 31-Jul-2015 Actual Mid Term Review Date

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) Satisfactory Moderately Satisfactory Overall Risk Rating Substantial Substantial

Implementation Status Overview Public Disclosure Copy Project implementation continues to pick up. All key consultants including the project coordinator have been recruited. As a result implementation is anticipated to accelerate.

The project was launched early this year in February in a ceremony attended by the Deputy Prime Minister who represented H.E. the President.

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Implementation of the health infrastructure and maternal, newborn and family planning services components are satisfactory. Implementation of other components (improved health workforce management and improved leadership and management) remains moderately satisfactory.

Overall, execution of procurement activities is progressing relatively well. As of March 31, 2012 a total of US$ 9.6 million had been disbursed to the project Special Account representing 7.2% of the project proceeds. To-date, US$ 11 million is fully committed. In addition, the Ministry of Health is in the advanced stages of processing tenders worth US$ 27 million; the majority of them are expected to be concluded by end of June 2012.

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 Direct project beneficiaries Number Value 0.00 70000.00 Date 31-Dec-2009 30-Oct-2011 31-Jul-2015 Comments Awaiting confirmation of Shall use proxy indicator: findings patient visits in renovated health facilities - in and out patients Contraceptive Prevalence Rate Percentage Value 24.00 33.00 45.00 Date 29-Dec-2006 30-Oct-2011 31-Jul-2015 Comments From DHS. Based on the panel survey

Public Disclosure Copy findings of 09/10. The data here will require verification after the DHS underway. Mothers attending at least 4 antenatal care Percentage Value 50.00 32.00 65.00 (ANC) visits (%) Date 29-Dec-2006 30-Oct-2011 31-Jul-2015 Comments Baseline 2010/2011 AHSPR. There has been a marked drop. It is not clear, but it is believed that giving of delivery kits is encouraging mothers to come for the first visit only. Deliveries taking place in Government and Percentage Value 34.00 46.00 45.00 PNFP Health Facilities (%) Date 30-Oct-2009 30-Oct-2011 31-Jul-2015 Comments Baseline 2010/2011 AHSPR. The marked increase witnessed is a reflection of increased attention given to deliveries by govt and partners. People with access to a basic package of Number Value 0.00 1600000.00 70000.00 health, nutrition, or reproductive health services Date 04-Oct-2009 30-Oct-2011 31-Jul-2015 (number) Comments Shall use proxy indicator: 2010/2011 AHSPR. The data patient visits in renovated is based on national figures. health facilities - in and out Data for UHSSP facilities is patients being computed

Intermediate Results Indicators Public Disclosure Copy

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Indicator Name Core Unit of Measure Baseline Current End Target Health Center IV and Hospitals Renovated Number Value 0.00 0.00 46.00 according to agreed standards Date 30-Oct-2009 30-Oct-2011 31-Jul-2015 Comments Activity not started yet. Health Center IV Performing Caesarian Percentage Value 14.00 24.00 50.00 Sections Date 30-Oct-2009 30-Oct-2011 31-Jul-2015 Comments Source: MoH RH Division Report Couple years of protection Number Value 549594.00 787390.00 1000000.00 Date 30-Oct-2009 30-Oct-2011 31-Jul-2015 Public Disclosure Copy Comments Source: 2010/2011 AHSPR Pregnant women receiving antenatal care Number Value 1200000.00 1327296.00 1400000.00 during a visit to a health provider (number) Date 30-Oct-2009 30-Oct-2011 31-Jul-2015 Comments Source: 2010/2011 AHSPR Drug Orders processed timely by National Percentage Value 55.00 70.00 80.00 Medical Stores Date 04-Oct-2009 30-Oct-2011 31-Jul-2015 Comments Source: NMS Hospitals with medical superintendents trained Percentage Value 0.00 0.00 100.00 in health management/hospital administration Date 04-Oct-2009 30-Oct-2011 31-Jul-2015 Comments Not Available Health facilities without stock-outs of tracer Percentage Value 26.00 43.00 55.00 medicines and supplies Date 04-Oct-2009 30-Oct-2011 31-Jul-2015 Comments Source: 2010/2011 AHSPR Health facilities with Client Charters Percentage Value 0.00 0.00 100.00 Date 04-Oct-2009 30-Oct-2011 31-Jul-2015 Comments HC IV facilities conducting maternal and Percentage Value 5.00 17.00 40.00 perinatal death audits Date 04-Oct-2009 30-Oct-2011 31-Jul-2015 Comments MoH Report, RH Division Hospitals and HC IVs offering comprehensive Percentage Value 20.00 24.00 50.00 emergency obstetric care Date 04-Oct-2009 30-Oct-2011 31-Jul-2015 Comments Source: 2010/2011 AHSPR Public Disclosure Copy

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HC IVs and Hospitals with functioning minimum Number Value 0.00 0.00 58.00 Essentail Equipment Date 04-Oct-2009 30-Oct-2011 31-Jul-2015 Comments Pending Assessment Health workers receiving a salary within two Percentage Value 0.00 0.00 30.00 months from reporting to work Date 04-Oct-2009 30-Oct-2010 31-Jul-2015 Comments Still awaiting collection of data Approved positions filled by qualified health Percentage Value 56.00 56.00 80.00 workers Date 30-Oct-2009 30-Oct-2011 31-Jul-2015 Comments Baseline Source: 2010/2011 AHSPR. There has been no change as Public Disclosure Copy the wage budget was not increased. Health facilities constructed, renovated, and/or Number Value 0.00 0.00 46.00 equipped (number) Date 04-Oct-2009 30-Oct-2011 31-Jul-2015 Comments Baseline Equipment under procurement and renovations not yet started. Health personnel receiving training (number) Number Value 0.00 50.00 75.00 Date 04-Oct-2009 30-Oct-2011 31-Jul-2015 Comments Baseline Training in Nkozi University.

Data on Financial Performance (as of 16-Mar-2012)

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 P115563 IDA-47420 Effective XDR 85.70 85.70 0.00 6.22 79.48 7.00

Disbursement Graph Public Disclosure Copy

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Key Decisions Regarding Implementation N/A

Restructuring History There has been no restructuring to date.

Related Projects There are no related projects. Public Disclosure Copy

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