The World Bank Report No: ISR15055 Implementation Status & Results Uganda Uganda Health Systems Strengthening Project (P115563) Operation Name: Uganda Health Systems Strengthening Project (P115563) Project Stage: Implementation Seq.No: 9 Status: ARCHIVED Archive Date: 21-Jun-2014 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 26-Dec-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 Satisfactory Overall Risk Rating Substantial Substantial Implementation Status Overview Public Disclosure Copy 1. Project implementation over the last six months was on track. The project has consistently achieved annual targets for four of the five PDO indicators and is making satisfactory progress towards achievement of its development objective. Page 1 of 9 Public Disclosure Authorized The World Bank Report No: ISR15055 2. The contracts for the renovation of the nine hospitals under Phase I were signed and civil works started and medical equipment procured by the project were distributed to a total of 230 health facilities. The implementation of the scholarship program and training of hospital managers is progressing well, and the training and mentorship of front-line health workers in provision of emergency obstetric care and long term permanent methods of family planning as well as the roll-out of maternal and peri-natal death reviews have picked up pace. The negotiations for the Additional Financing (US$ 90 million) were successfully concluded in January 2014. With the passing of the Anti-homosexuality Act in February 2014, the World Bank postponed the approval of the AF pending due diligence to assess impact of the new law on the achievement of the project development objectives. Locations Country First Administrative Division Location Planned Actual Uganda Ntungamo District Rubaare Public Disclosure Copy Uganda Ntungamo District Rubaare Uganda Pallisa District Pallisa Uganda Pallisa District Pallisa Uganda Arua District Pakwach Uganda Arua District Pakwach Uganda Kitgum District Padibe Uganda Kitgum District Padibe Uganda Adjumani District Obongi Uganda Adjumani District Obongi Uganda Luwero District Ntenjeru Uganda Mukono District Ntenjeru Uganda Nakaseke District Ngoma Uganda Nakaseke District Ngoma Uganda Nebbi District Nebbi Uganda Nebbi District Nebbi Uganda Not Entered Nankoma Uganda Not Entered Nankoma Public Disclosure Copy Uganda Nakaseke District Nakaseke Page 2 of 9 The World Bank Report No: ISR15055 Country First Administrative Division Location Planned Actual Uganda Nakaseke District Nakaseke Uganda Not Entered Mwizi Uganda Not Entered Mwizi Uganda Not Entered Mwera Uganda Mityana District Mwera Uganda Mityana District Mwera Public Disclosure Copy Uganda Mubende District Mubende Uganda Mubende District Mubende Uganda Moyo District Moyo Uganda Moyo District Moyo Uganda Moroto District Moroto Uganda Moroto District Moroto Uganda Mubende District Mityana Uganda Mubende District Mityana Uganda Masindi District Masindi Uganda Masindi District Masindi Uganda Kamuli District Kiyunga Uganda Kamuli District Kiyunga Uganda Not Entered Kiyunga Uganda Not Entered Kitwe Uganda Not Entered Kitwe Uganda Kitgum District Kitgum Uganda Kitgum District Kitgum Public Disclosure Copy Uganda Masindi District Kiryandongo Uganda Masindi District Kiryandongo Page 3 of 9 The World Bank Report No: ISR15055 Uganda Not Entered Kikamulo Uganda Kaliro District Kiganda Uganda Not Entered Kiganda Uganda Not Entered Kiganda Uganda Pallisa District Kibuku 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 Iganga District Iganga Uganda Wakiso District Entebbe Uganda Wakiso District Entebbe Uganda Ntungamo District Chitwe Uganda Masindi District Bwijanga Uganda Masindi District Bwijanga Uganda Not Entered Buyinja Uganda Not Entered Buyinja Uganda Jinja District Buwenge Uganda Jinja District Buwenge Uganda Mukono District Buvuma Island Uganda Mukono District Buvuma Island Uganda Masindi District Bulisa Public Disclosure Copy Uganda Masindi District Bulisa Page 4 of 9 The World Bank Report No: ISR15055 Uganda Bukwa District Bukwa Uganda Bukwa District Bukwa Uganda Not Entered Bugongo Uganda Not Entered Bugongo Uganda Bugiri District Bugiri Uganda Bugiri District Bugiri Uganda Not Entered Budondo Public Disclosure Copy Uganda Not Entered Budondo Uganda Pallisa District Budaka Uganda Pallisa District Budaka Uganda Nebbi District Atyak Uganda Gulu District Atiak Uganda Apac District Apac Uganda Apac District Apac Uganda Gulu District Anaka Uganda Gulu District Anaka Uganda Apac District Aduku Uganda Apac District Aduku Uganda Apac District Aboke 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 Page 5 of 9 The World Bank Report No: ISR15055 Indicator Name Core Unit of Measure Baseline Current End Target People with access to a basic package of Number Value 0.00 274900.00 70000.00 health, nutrition, or reproductive health services Date 04-Oct-2009 30-Apr-2014 31-Jul-2015 (number) Comments Shall use proxy indicator: Target will be revised during patient visits in renovated the additional financing. The health facilities - in and out data are from project patients supported hospitals only unlike the previous year. Deliveries taking place in Government and Percentage Value 34.00 41.00 45.00 PNFP Health Facilities (%) Date 30-Oct-2009 30-Apr-2014 31-Jul-2015 Comments Public Disclosure Copy Baseline 2012/13 Mothers attending at least 4 antenatal care Percentage Value 50.00 31.00 65.00 (ANC) visits (%) Date 29-Dec-2006 30-Apr-2014 31-Jul-2015 Comments Baseline Based on the HMIS. It under- reports the actual value compared to the DHS. As part of the Additional Financing, this indicator will be dropped due to measurement challenges. Contraceptive Prevalence Rate Percentage Value 24.00 30.00 35.00 Date 29-Dec-2006 30-Jun-2014 31-Jul-2015 Comments From DHS. Direct project beneficiaries Number Value 0.00 137458.00 70000.00 Date 31-Dec-2009 30-Apr-2014 31-Jul-2015 Comments Shall use proxy indicator: patient visits in renovated 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 0.00 821.00 75.00 Date 04-Oct-2009 30-Apr-2014 31-Jul-2015 Comments Baseline Health facilities constructed, renovated, and/or Number Value 0.00 219.00 46.00 Public Disclosure Copy equipped (number) Date 04-Oct-2009 30-Apr-2014 31-Jul-2015 Page 6 of 9 The World Bank Report No: ISR15055 Comments Baseline The contracts for the renovation of the nine hospitals under Phase I were signed and civil works started. Distribution of medical equipment procured by the project is complete. Approved positions filled by qualified health Percentage Value 56.00 63.00 80.00 workers Date 30-Oct-2009 30-Apr-2014 31-Jul-2015 Comments Baseline Health workers receiving a salary within two Percentage Value 0.00 46.00 30.00 Public Disclosure Copy months from reporting to work Date 04-Oct-2009 30-Apr-2014 31-Jul-2015 Comments HC IVs and Hospitals with functioning minimum Number Value 0.00 0.00 58.00 Essential Equipment Date 04-Oct-2009 30-Apr-2014 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 30.00 50.00 emergency obstetric care Date 04-Oct-2009 30-Apr-2014 31-Jul-2015 Comments Source: Resource Center HC IV facilities conducting maternal and Percentage Value 5.00 0.00 40.00 perinatal death audits Date 04-Oct-2009 30-Apr-2014 31-Jul-2015 Comments Data Not Available Health facilities with Client Charters Percentage Value 0.00 23.00 100.00 Date 04-Oct-2009 30-Apr-2014 31-Jul-2015 Comments Health facilities without stock-outs of tracer Percentage Value 26.00 53.00 55.00 medicines and supplies Date 04-Oct-2009 30-Apr-2014 31-Jul-2015 Comments Source: