Nicaragua Strengthening the Public Health Care System

Abstract*

The objectives of the Strengthening the Public Health Care System Project for Nicaragua are to: (a) strengthen quality and access to health services; (b) contribute to adapting the public health system to the country’s changing epidemiological profile; and (c) secure financial support in case of Public Health Alert or Public Health Emergency. There are four components to the project, the first component being strengthening the quality and access to... Show More

Development Objective

The Project Development Objectives (PDO) are to: (a) strengthen quality and access to health services; (b) contribute to adapting the public health system to the country’s changing epidemiological profile; and (c) secure financial support in case of Public HealthAlert or Public Health Emergency.

Key Details

Project Details

Project ID
P152136
Status
Closed
Team Leader
Amparo Gordillo-Tobar
Borrower 2
Ministry of Finance

Country
Nicaragua
Disclosure Date
December 29, 2014
Approval Date
(as of board presentation)
June 4, 2015
Effective Date
September 17, 2015

Total Project Cost 1
US$ 60.00 million
Implementing Agency
Ministry of Health
Region
Latin America and Caribbean
Fiscal Year 3
2015

Commitment Amount
US$ 60.00 million
Environmental Category
B
Environmental and Social Risk
Not Applicable
Closing Date
September 30, 2020

Consultant Services required
Yes
Last Stage Reached
BANK APPROVED
Last Update Date
April 25, 2024

Notes
1. Total project cost includes funding from World Bank and non-bank sources in US$ millions. Active and Closed projects show current commitments. Proposed (pipeline) and dropped projects show the forecast amount. The commitment amount for projects in the pipeline is indicative and may be modified during the project preparation.
2. Borrower refers to the Borrower of a Loan or Recipient of a Grant.
3. ”Fiscal Year” is the fiscal year in which the project was approved (or dropped if the status is dropped). The World Bank's fiscal year is from July 1 - June 30. For example, a fiscal year of 1996 corresponds to July 1, 1995 - June 30, 1996.

Sectors

Themes

FY17 - Human Development and Gender

FY17 - Disease Control40%
- FY17 - Non-communicable diseases40%
FY17 - Health Systems and Policies60%
- FY17 - Child Health10%
- FY17 - Health System Strengthening40%
- FY17 - Reproductive and Maternal Health10%

Project Map

Interactive Map

Finances

Financing Plan (US$ Millions)

Financier	Commitments
IDA Grant	60.00

Total Project Financing (US$ Millions)

Product Line	IBRD/IDA
IBRD Commitment	N/A
IDA Commitment	60.00
IBRD + IDA Commitment	60.00

Lending Instrument
Grant Amount	N/A
Total Project Cost**	60.00

Summary Status of World Bank Financing (US$ Millions) as of March 31, 2025

No data available.

Detailed Financial Activity as of March 31, 2025

Download:

Period	Financier	Transaction Type	Amount (US$)
Jun 30, 2016	IDA-D0720	Loan Disb	1,000,000.00
Dec 16, 2016	IDA-D0720	Loan Disb	384,847.50
Sep 12, 2016	IDA-D0720	Loan Disb	3,000,000.00
Jun 7, 2016	IDA-D0720	Loan Disb	1,489,341.00
Jan 27, 2017	IDA-D0720	Loan Disb	3,000,000.00
Apr 26, 2017	IDA-D0720	Loan Disb	444,733.12
Jun 27, 2017	IDA-D0720	Loan Disb	67,698.68
Mar 30, 2017	IDA-D0720	Loan Disb	1,076,392.10
Mar 24, 2017	IDA-D0720	Loan Disb	624,669.30
Dec 22, 2016	IDA-D0720	Loan Disb	334,611.10
Dec 22, 2016	IDA-D0720	Loan Disb	597,716.00
Aug 22, 2016	IDA-D0720	Loan Disb	911,280.20
Apr 28, 2017	IDA-D0720	Loan Disb	10,000,000.00
Jun 19, 2017	IDA-D0720	Loan Disb	918,978.25
Jun 21, 2017	IDA-D0720	Loan Disb	1,453,098.40
Oct 17, 2017	IDA-D0720	Loan Disb	350,000.00
Oct 17, 2017	IDA-D0720	Loan Disb	1,131,349.40
Nov 27, 2017	IDA-D0720	Loan Disb	62,880.01
Aug 16, 2017	IDA-D0720	Loan Disb	2,997,853.80
Jul 17, 2017	IDA-D0720	Loan Disb	565,116.90
Dec 26, 2017	IDA-D0720	Loan Disb	2,000,000.00
Jun 4, 2015	IDA-D0720	Loan Commitment	60,000,000.00
Feb 9, 2021	IDA-D0720	Loan Cancel	141.34
Dec 31, 2019	IDA-D0720	Loan Disb	105,666.51
May 6, 2020	IDA-D0720	Loan Disb	259,660.02
Apr 21, 2020	IDA-D0720	Loan Disb	84,833.75
Apr 24, 2020	IDA-D0720	Loan Disb	72,060.56
Aug 28, 2020	IDA-D0720	Loan Disb	5,040.66
Jun 15, 2020	IDA-D0720	Loan Disb	1,837,857.00
Oct 6, 2020	IDA-D0720	Loan Disb	355,815.72
Oct 7, 2020	IDA-D0720	Loan Disb	326,193.53
Aug 20, 2020	IDA-D0720	Loan Disb	122,239.43
Dec 4, 2020	IDA-D0720	Loan Disb	5,411.67
Nov 30, 2020	IDA-D0720	Loan Disb	34,965.31
Jan 14, 2021	IDA-D0720	Loan Disb	100.81
Oct 22, 2018	IDA-D0720	Loan Disb	10,000.00
Feb 14, 2019	IDA-D0720	Loan Disb	545,111.44
Oct 22, 2018	IDA-D0720	Loan Disb	15,720.01
Mar 19, 2019	IDA-D0720	Loan Disb	309,979.03
Apr 2, 2019	IDA-D0720	Loan Disb	1,475,795.20
Apr 15, 2019	IDA-D0720	Loan Disb	74,168.55
Apr 25, 2019	IDA-D0720	Loan Disb	980,615.75
Jun 24, 2019	IDA-D0720	Loan Disb	3,200,000.00
May 24, 2019	IDA-D0720	Loan Disb	119,150.75
May 28, 2019	IDA-D0720	Loan Disb	471,958.38
Jul 24, 2019	IDA-D0720	Loan Disb	136,277.86
Oct 1, 2019	IDA-D0720	Loan Disb	697,780.75
Aug 1, 2019	IDA-D0720	Loan Disb	2,151.41
Aug 1, 2019	IDA-D0720	Loan Disb	169,419.34
Sep 30, 2019	IDA-D0720	Loan Disb	451,640.00
Oct 31, 2019	IDA-D0720	Loan Disb	364,965.34
Sep 18, 2019	IDA-D0720	Loan Disb	143,999.98
Feb 7, 2020	IDA-D0720	Loan Disb	-47,560.04
Mar 18, 2020	IDA-D0720	Loan Disb	750,240.25
Aug 7, 2017	IDA-D0720	Loan Disb	514,334.97
Mar 30, 2018	IDA-D0720	Loan Disb	407,959.38
Jun 13, 2018	IDA-D0720	Loan Disb	570,397.20
Jun 11, 2018	IDA-D0720	Loan Disb	286,965.75
Jun 29, 2018	IDA-D0720	Loan Disb	1,453,098.40
Jun 29, 2018	IDA-D0720	Loan Disb	575,246.56
Jun 14, 2018	IDA-D0720	Loan Disb	592,040.60
Jun 27, 2018	IDA-D0720	Loan Disb	3,000,000.00
Dec 13, 2018	IDA-D0720	Loan Disb	452,603.00
Dec 20, 2018	IDA-D0720	Loan Disb	380,358.72
Dec 20, 2018	IDA-D0720	Loan Disb	2,000,000.00
Dec 20, 2018	IDA-D0720	Loan Disb	199,999.02
Oct 22, 2018	IDA-D0720	Loan Disb	73,114.57
Aug 8, 2016	IDA-D0720	Loan Disb	40,000.00
Feb 3, 2016	IDA-D0720	Loan Disb	2,000,000.00
Nov 2, 2015	IDA-D0720	Loan Disb	200,000.02
Oct 26, 2015	IDA-D0720	Loan Disb	500,000.00
Sep 28, 2015	IDA-D0720	Loan Disb	21,099.99
Oct 26, 2016	IDA-D0720	Loan Disb	465,323.00

Footnotes

Ratings

IMPLEMENTATION RATINGS

Name	Review	Date
Progress towards achievement of PDO	Satisfactory	2020-06-15
Monitoring and Evaluation	Satisfactory	2020-06-15
Overall Implementation Progress (IP)	Satisfactory	2020-06-15
Project Management	Satisfactory	2020-06-15
Procurement	Satisfactory	2020-06-15
Financial Management	Satisfactory	2020-06-15

COMPLETION RATINGS

INDICATOR	IMPLEMENTATION COMPLETION & RESULTS REPORT: 03-30-2021
Outcomes	Substantial
Risk to Development Outcome
Bank Performance	Substantial
Borrower Performance
Government Performance
Implementing Agency

INDEPENDENT EVALUATION RATINGS

INDICATOR	ICR REVIEW: 06-18-2021	PROJECT PERFORMANCE ASSESSMENT REPORT:
Outcome Rating	Satisfactory	N/a
Risk To Development Outcome		N/a
Bank Performance	Satisfactory	N/a
Borrower Performance		N/a
Government Performance	Not Rated	N/a
Implementing Agency		N/a
Icr Quality	Substantial	N/a
M&e Quality	Substantial	N/a

Results Framework

PROJECT DEVELOPMENT OBJECTIVE INDICATORS

INDICATOR		BASELINE	CURRENT	TARGET

1. Percentage of women receiving prenatal care coverage (at least four visits) (Percentage. List of municipalities in Annex 2 of the PAD)	Value	G1: 53%G2: 71%G3: 83%	G1:70%;G2:80%;G3:85%	Group 1: 60%Group 2: 75%Group 3: 85%
	Date	December 31, 2014	December 31, 2019
	Comment

4. Number of health centers certified on hypertension screening. Value 0.00 40.00 25.00
Date December 31, 2014 December 31, 2019
Comment

2. Percentage of children under 1 year of age receiving three doses of pentavalent vaccine.(List of municipalities in An nex 2).	Value	G1: 94 %G2: 96%G3: 96%	G1:97%; G2:98%; G3:98%	Group 1: 95%Group 2: 97%Group 3: 97%
	Date	December 31, 2014	December 31, 2019
	Comment

3. Municipalities that have more than 50 percent compliance with their quality health care plan Value 0.00 66.00 46.00
Date December 31, 2014 December 31, 2019
Comment
People who have received essential health, nutrition, and population (HNP) services Value 0.00 0.00 0.00
Date December 31, 2014 December 31, 2019
Comment
Number of children immunized Value 0.00 0.00 0.00
Date December 31, 2014 December 31, 2019
Comment

INTERMEDIATE RESULTS INDICATORS

INDICATOR		BASELINE	CURRENT	TARGET

Percentage of cold chain networks rehabilitated at the primary health care level Value 88.00 93.00 0.00
Date December 31, 2014 September 30, 2020
Comment
Number of home visits to promote awareness on prevention of vector borne diseases Value 5000000.00 8200500.00 7000000.00
Date December 31, 2014 December 31, 2019
Comment

Percentage of women receiving postpartum care within 2 to 10 days of delivery (List of municipalities in Annex 2).	Value	G1: 37%G2: 58%G3: 73%	G1:55%; G2:70%; G3:82%	G1: 45%G2: 63%G3: 77%
	Date	December 31, 2014	December 31, 2019
	Comment

Health facilities constructed, renovated, and/or equipped (number) Value 0.00 44.00 22.00
Date December 31, 2014 September 30, 2020
Comment
Percentage of reference hospitals with updated and implemented waste management plans Value 11.00 83.00 0.00
Date December 31, 2014 September 30, 2020
Comment
Number of municipalities with signed annual performance agreements (acuerdos sociales) with SILAIS Value 66.00 66.00 66.00
Date December 31, 2014 December 31, 2019
Comment
Number of reference centers with capacity to treat cervical cancer ( infrastructure, equipment, and qualified human resources) Value 0.00 10.00 5.00
Date December 31, 2014 December 31, 2019
Comment
Percentage of health centers certified on quality of care. Value 0.00 33.00 16.00
Date December 31, 2014 December 31, 2019
Comment
Health personnel receiving training (number) Value 0.00 1000.00 500.00
Date December 31, 2014 September 30, 2020
Comment
Number of municipal health units implementing traditional medicine. Value 0.00 12.00 1.00
Date December 31, 2014 September 30, 2020
Comment
Number of schools participating in the children fluoridation program. Value 0.00 4040.00 3000.00
Date December 31, 2014 September 30, 2020
Comment

4. Number of health centers certified on hypertension screening.	Value	0.00	40.00	25.00
	Date	December 31, 2014	December 31, 2019
	Comment

Number of children immunized	Value	0.00	0.00	0.00
	Date	December 31, 2014	December 31, 2019
	Comment

Percentage of cold chain networks rehabilitated at the primary health care level	Value	88.00	93.00	0.00
	Date	December 31, 2014	September 30, 2020
	Comment

Number of home visits to promote awareness on prevention of vector borne diseases	Value	5000000.00	8200500.00	7000000.00
	Date	December 31, 2014	December 31, 2019
	Comment

Percentage of reference hospitals with updated and implemented waste management plans	Value	11.00	83.00	0.00
	Date	December 31, 2014	September 30, 2020
	Comment

Number of municipalities with signed annual performance agreements (acuerdos sociales) with SILAIS	Value	66.00	66.00	66.00
	Date	December 31, 2014	December 31, 2019
	Comment