Public Disclosure Authorized Public Disclosure Authorized The World Bank Implementation Status & Results Argentina Essential Public Health Functions Programs II Project (P110599) Operation Name: Essential Public Health Functions Programs II Project Project Stage: Implementation Seq.No: 7 Status: ARCHIVED Archive : 12-Jul-2014 (P110599) Country: Argentina Approval FY: 2011 Product Line: IBRD/IDA Region: LATIN AMERICA AND CARIBBEAN Lending Instrument: Specific Investment Loan Implementing Agency(ies): Key s Board Approval Original Closing Planned Mid Term Review 04-Aug-2014 Last Archived ISR 19-Jan-2014 Effectiveness 03-Aug-2011 Revised Closing Actual Mid Term Review 15-Aug-2014 Project Development Objectives Project Development Objective (from Project Appraisal Document) The PDOs are to: (i) improve the stewardship role of the federal public health system, through the strengthening of Essential Public Health Functions; and (ii) increase the coverage and clinical governance of Priority Public Health Programs Has the Project Development Objective been changed since Board Approval of the Project? Yes No Component(s) losure Authorized Public Disclosure Authorized Component Name Component Cost Strengthen the Ministry of Health's (MSN) and Provincial Ministries' Stewardship Capacities and 123.20 Improve the Public Health Infrastruc ture. Improve Results of Public Health Priority Programs and the Provincial Level 322.00 Administration, Monitoring, and Evaluation 14.50 Overall Ratings Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating Substantial Implementation Status Overview The Project was approved by the board on December 20, 2010, and the loan was signed on April 11, 2011. Project became effective on August 3, 2011. The Project shows a positive trend towards achieving the Project Development Objectives (PDO), as demonstrated by the progress in the PDO indicators and several intermediate Page 1 of 8
indicators. While one of the 5 PDO indicators surpassed the end target two years in advance (blood program), other 3 PDOs show positive trends (reduction of tobacco consumption, increased percentage of epidemiological surveillance nodes, and increased percentage of children vaccinated with pentavalent vaccine). The PDO indicator 3 (at least 200 out of the 700 participating municipalities certified as Health Responsible Municipalities) is lagging behind original estimates. Pilot projects on Non Communicable Diseases (NCDs) in Tucuman and Misiones Provinces are already being implemented. As of June 13th 2014, 71% of loan proceeds had been disbursed. Locations Country First Administrative Division Location Planned Actual Argentina Not Entered Provincia de Misiones Not Entered Not Entered Provincia de Misiones Argentina Not Entered Provincia de Formosa Not Entered Not Entered Provincia de Formosa Argentina Not Entered Ciudad Autónoma de Buenos Aires Argentina Not Entered Provincia de Entre Ríos Not Entered Not Entered Provincia de Entre Ríos Argentina Not Entered Provincia de Corrientes Not Entered Not Entered Provincia de Corrientes Argentina Not Entered Provincia de Buenos Aires Not Entered Not Entered Provincia de Buenos Aires Argentina Not Entered Provincia de Tucumán Not Entered Not Entered Provincia de Tucumán Not Entered Not Entered Provincia de Tucumán Argentina Not Entered Provincia de Tierra del Fuego, Antártida e Islas del Atlántico Sur Not Entered Not Entered Provincia de Tierra del Fuego, Antártida e Islas del Atlántico Sur Argentina Not Entered Provincia de Santiago del Estero Not Entered Not Entered Provincia de Santiago del Estero Argentina Not Entered Provincia de Santa Fe Not Entered Not Entered Provincia de Santa Fe Page 2 of 8
Country First Administrative Division Location Planned Actual Argentina Not Entered Provincia de Santa Cruz Not Entered Not Entered Provincia de Santa Cruz Argentina Not Entered Provincia de San Luis Not Entered Not Entered Provincia de San Luis Argentina Not Entered Provincia de San Juan Not Entered Not Entered Provincia de San Juan Argentina Not Entered Provincia de Salta Not Entered Not Entered Provincia de Salta Argentina Not Entered Provincia de Río Negro Not Entered Not Entered Provincia de Río Negro Argentina Not Entered Provincia del Neuquén Not Entered Not Entered Provincia del Neuquén Argentina Not Entered Provincia de Mendoza Not Entered Not Entered Provincia de Mendoza Argentina Not Entered Provincia de La Rioja Not Entered Not Entered Provincia de La Rioja Argentina Not Entered Provincia de La Pampa Not Entered Not Entered Provincia de La Pampa Argentina Not Entered Provincia de Jujuy Not Entered Not Entered Provincia de Jujuy Argentina Not Entered Provincia de Córdoba Not Entered Not Entered Provincia de Córdoba Argentina Not Entered Provincia del Chubut Not Entered Not Entered Provincia del Chubut Argentina Not Entered Provincia del Chaco Page 3 of 8
Not Entered Not Entered Provincia del Chaco Argentina Not Entered Provincia de Catamarca Not Entered Not Entered Provincia de Catamarca Results Project Development Objective Indicators Indicator Name Core Unit of Measure Baseline Current End Target Increased kilograms of blood-plasma produced Number Value 33000.00 45402.00 40000.00 by MSN and provincial labs End target surpassed. Reduction of the tobacco consumption Percentage Value 30.00 30.00 27.00 prevalence in adults 18-64 Results of the third Risk Factor survey (2014) are not available yet. GATS 2013 showed prevalence at 22.1% in 2012. At least 200 out of the 700 participating Number Value 0.00 6.00 200.00 municipalities certified as Health Responsible Municipalities Slow progress. Indicator to be discussed during the upcoming MTR. Increased percentage of certified departments Percentage Value 0.00 43.70 80.00 or local territories with satisfactory or highly satisfactory epidemiological surveillance nodes (C2). The MSN is proposing to use a new methodology to measure this indicator, which would give a result of 40.8. Indicator to be discussed during the MTR. Increased percentage of children under one Percentage Value 93.60 93.30 95.00 year of age vaccinated with pentavalent vaccine. The MSN is proposing to use a new methodology (number of children vaccinated) to measure this indicator, which Page 4 of 8
would give a result of 87.1%. Indicator to be discussed during the MTR. Intermediate Results Indicators Indicator Name Core Unit of Measure Baseline Current End Target Increased participation of provinces in training Number Value 0.00 24.00 24.00 of health personnel in public health 31-May-2013 Indicator has been achieved two years in advance. Number of pilot studies with nutritional Number Value 0.00 0.00 2.00 sprinkles component (to reduce iron deficiency anemia) No progress. Indicator to be discussed during the upcoming MTR. Health personnel receiving training (number) Number Value 0.00 519.00 800.00 31-Mar-2011 Health personnel from the MSN and Provinces receiving training in public health labs, blood banks, and vaccination for more than 40hours. The indicator shows a positive Annually. trend but the indicator will be discussed during MTR. Percentage of women between 35 and 64 years old in the two pilot provinces benefiting from at least one HPV and/or cutology test provided by the health system. Percentage of women between 35 and 64 in Misiones benefiting from at least one PHV and/ or citology test provided by the health system Percentage of women between 35 and 64 in Tucuman benefiting from at least one PHV and/or citology test provided by the health system Increased number of PROFE population from Tucuman and Misiones enrolled in a clinical governance program for kidney disease prevention and control. Percentage Value 10.00 41.00 60.00 20-Dec-2010 31-May-2013 This indicator has been split by province. Percentage Value 10.00 48.10 60.00 Sub Type 01-Nov-2010 Breakdown Indicator is progressing. Percentage Value 10.00 34.60 60.00 Sub Type 01-Nov-2010 Breakdown Indicator is progressing. Number Value 0.00 1113.00 4000.00 20-Dec-2010 Program under implementation. Page 5 of 8
Number of intensive health care units Number Value 0.00 178.00 400.00 evaluated and properly registered in the system. Certification is underway. Blood donations per 1000 inhabitants over 18 Percentage Value 25.60 28.30 30.60 years old Ratio Although results are lower than previous ISR, the trend is positive and end target is expected to be achieved. Percentage of operational HIV/AIDS Percentage Value 0.00 78.50 70.00 Counseling and Testing Centers. 31-May-2013 Target was achieved two years in advance. Percentage of PROFE beneficiaries with low Percentage Value 0.00 37.00 50.00 incidence high cost diseases included in the 12-Dec-2011 PROFE health care chain. 0 out of 2.132 No additional progress since last ISR. Percentage of PROFE newly diagnosed Percentage Value 0.00 40.00 80.00 patients with renal chronic dialysis evaluated 30-Jun-2015 within six months of beginning dialysis. Slow progress. Indicator to be discussed during MTR. Percentage of PROFE renal chronic dialysis Percentage Value 0.00 15.00 80.00 patients evaluated and included in SINTRA. No progress. Delays in reporting are evident. Number of PROFE women with more than 7 Number Value 0.00 8477.00 40000.00 children having signed their letter of rights. Slow progress. Indicator to be discussed during MTR. Number of tobacco free municipalities. Number Value 0.00 22.00 140.00 20-Dec-2010 Updated results to be available for the MTR. A recent survey (2013) found that 225 municipalities have legislation to promote tobacco free environment. Page 6 of 8
Number of technical audits on clinical effectiveness of the diseases of low incidence and higher cost, renal disease and haemophilia. Health facilities constructed, renovated, and/or equipped (number) Percentage of women betweeen 40 and 69 years old in the two pilot provinces benefitting from at least one mammography provided by the health system Percentage of women in the province of Misiones between 40 y 70 years benefiting from at least one mammography provided by the health system Number Value 0.00 1.00 2.00 Indicator is progressing. Number Value 0.00 0.00 12.00 20-Dec-2010 Indicator to be discussed during MTR. Percentage Value 0.00 45.50 60.00 Average results in Misiones and Tucuman. Percentage Value 10.00 29.20 60.00 Sub Type 01-Nov-2010 Breakdown Slow progress Percentage of women betweeen 40 and 69 years old in Tucuman benefitting from at least one mammography provided by the health system Percentage Sub Type Breakdown Value 10.00 62.40 60.00 01-Nov-2010 End target achieved one year in advance. Data on Financial Performance (as of 12-Jun-2014) Financial Agreement(s) Key s Project Ln/Cr/Tf Status Approval Signing Effectiveness Original Closing Revised Closing P110599 IBRD-79930 Effective 20-Dec-2010 11-Apr-2011 03-Aug-2011 Disbursements (in Millions) Project Ln/Cr/Tf Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P110599 IBRD-79930 Effective USD 461.00 461.00 0.00 329.18 131.82 71.00 Disbursement Graph Page 7 of 8
Key Decisions Regarding Implementation A Mid-Term Review (MTR) is expected to take place in August in 2014. The Project s results framework (RF) will be discussed to assess the need of changes in indicators, targets and source and methods for calculating the achievement of results. Restructuring History There has been no restructuring to date. Related Projects There are no related projects. Page 8 of 8