Rural Health Project

Abstract*

The objective of the Rural Health Project for China is to provide increased and more equitable access to quality health services, improved financial protection, and better management of public health threats in pilot provinces and counties, with lessons to support reforms in non-project areas. There are two components to the project. The first component is the health reform innovations supported via block grants. It will support innovations that can... Show More

Development Objective

The main project objective is increased and more equitable access to quality health services, improved financial protection, and better management of public health threats in pilot provinces and counties, with lessons to support reforms in non-project areas.

Key Details

Project Details

Project ID
P084437
Status
Closed
Team Leader
Shuo Zhang
Borrower 2
N/A

Country
China
Disclosure Date
March 6, 2006
Approval Date
(as of board presentation)
June 24, 2008
Effective Date
December 31, 2008

Total Project Cost 1
US$ 110.00 million
Implementing Agency
Ministry of Health
Region
East Asia and Pacific
Fiscal Year 3
2008

Commitment Amount
US$ 60.00 million
Environmental Category
B
Last Update Date
January 15, 2013
Closing Date
December 31, 2014

Last Stage Reached
BANK APPROVED

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 - Health Systems and Policies67%
- FY17 - Health System Strengthening67%

FY17 - Urban and Rural Development

FY17 - Rural Development33%
- FY17 - Rural Infrastructure and service delivery33%

Project Map

Interactive Map

Finances

Financing Plan (US$ Millions)

Financier	Commitments
International Bank for Reconstruction and Development	50.00
Borrower/Recipient	50.00
UK: British Department for International Development (DFID)	10.00

Total Project Financing (US$ Millions)

Product Line	IBRD/IDA
IBRD Commitment	50.00
IDA Commitment	N/A
IBRD + IDA Commitment	50.00

Lending Instrument
Grant Amount	10.00
Total Project Cost**	110.00

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$)
Mar 7, 2014	IBRD-75510	Loan Disb	407,379.03
Mar 6, 2014	IBRD-75510	Loan Disb	-285,075.44
Nov 18, 2013	IBRD-75510	Loan Disb	132,321.02
Nov 14, 2013	IBRD-75510	Loan Disb	102,567.02
Oct 25, 2013	IBRD-75510	Loan Disb	202,694.84
Nov 12, 2013	IBRD-75510	Loan Disb	528,944.90
Dec 15, 2013	IBRD-75510	Int Charges	1,360.00
Dec 15, 2013	IBRD-75510	Int Charges	102,481.38
Jan 6, 2014	IBRD-75510	Loan Disb	210,326.02
Feb 10, 2014	IBRD-75510	Loan Disb	967,365.40
Jan 10, 2014	IBRD-75510	Loan Disb	-123,447.47
Dec 10, 2013	IBRD-75510	Loan Disb	546,176.00
Nov 22, 2013	IBRD-75510	Loan Disb	465,254.40
Aug 9, 2013	IBRD-75510	Loan Disb	403,798.70
Aug 21, 2013	IBRD-75510	Loan Disb	652,550.90
Aug 21, 2013	IBRD-75510	Loan Disb	224,591.53
Aug 28, 2013	IBRD-75510	Loan Disb	486,928.60
Sep 3, 2013	IBRD-75510	Loan Disb	330,702.00
Dec 17, 2014	IBRD-75510	Loan Disb	50,000.00
Dec 8, 2014	IBRD-75510	Loan Disb	109,369.57
Jan 23, 2015	IBRD-75510	Loan Disb	120,743.96
Nov 18, 2014	IBRD-75510	Loan Disb	252,498.31
Nov 4, 2014	IBRD-75510	Loan Disb	310,768.62
Dec 10, 2014	IBRD-75510	Loan Disb	60,000.00
Nov 5, 2014	IBRD-75510	Loan Disb	336,363.88
Dec 15, 2017	IBRD-75510	Int Charges	286,582.20
Dec 15, 2017	IBRD-75510	Loan Repay	1,665,262.40
Jun 15, 2017	IBRD-75510	Int Charges	97.57
Jun 15, 2017	IBRD-75510	Loan Repay	1,665,262.40
Jun 15, 2017	IBRD-75510	Int Charges	273,017.38
Dec 15, 2016	IBRD-75510	Int Charges	210,039.62
Dec 15, 2016	IBRD-75510	Loan Repay	1,668,215.40
Oct 26, 2016	IBRD-75510	Loan Disb	-70,962.74
Oct 26, 2016	IBRD-75510	Loan Cancel	70,962.74
Jun 15, 2016	IBRD-75510	Int Charges	176,591.90
Jun 15, 2016	IBRD-75510	Loan Repay	1,668,215.40
Dec 15, 2015	IBRD-75510	Int Charges	112,317.78
Dec 15, 2015	IBRD-75510	Loan Repay	1,668,215.40
Jun 15, 2015	IBRD-75510	Int Charges	350.26
Jun 15, 2015	IBRD-75510	Int Charges	92,144.35
Jun 15, 2015	IBRD-75510	Loan Repay	1,668,215.40
Jun 15, 2021	IBRD-75510	Int Charges	40,487.03
Jun 15, 2021	IBRD-75510	Loan Repay	1,665,262.40
Dec 15, 2020	IBRD-75510	Loan Repay	1,665,262.40
Dec 15, 2020	IBRD-75510	Int Charges	67,756.80
Jun 15, 2020	IBRD-75510	Int Charges	296,099.22
Jun 15, 2020	IBRD-75510	Loan Repay	1,665,262.40
Dec 15, 2019	IBRD-75510	Int Charges	381,791.72
Dec 15, 2019	IBRD-75510	Loan Repay	1,665,262.40
Jun 15, 2019	IBRD-75510	Int Charges	497,464.62
Jun 15, 2019	IBRD-75510	Loan Repay	1,665,262.40
Dec 15, 2018	IBRD-75510	Int Charges	453,960.47
Dec 15, 2018	IBRD-75510	Loan Repay	1,665,262.40
Jun 15, 2018	IBRD-75510	Loan Repay	1,665,262.40
Jun 15, 2018	IBRD-75510	Int Charges	335,700.22
Jun 24, 2008	IBRD-75510	Loan Commitment	50,000,000.00
Jun 15, 2024	IBRD-75510	Int Charges	495,208.94
Jun 15, 2024	IBRD-75510	Loan Repay	1,665,262.40
Dec 15, 2023	IBRD-75510	Int Charges	532,225.40
Dec 15, 2023	IBRD-75510	Loan Repay	1,665,262.40
Jun 15, 2023	IBRD-75510	Int Charges	532,740.50
Jun 15, 2023	IBRD-75510	Loan Repay	1,665,262.40
Dec 15, 2022	IBRD-75510	Int Charges	282,375.78
Dec 15, 2022	IBRD-75510	Loan Repay	1,665,262.40
Dec 15, 2021	IBRD-75510	Int Charges	25,446.64
Dec 15, 2021	IBRD-75510	Loan Repay	1,665,262.40
Jun 15, 2022	IBRD-75510	Int Charges	41,341.70
Jun 15, 2022	IBRD-75510	Loan Repay	1,665,262.40
Aug 13, 2014	IBRD-75510	Loan Disb	100,000.00
Dec 15, 2014	IBRD-75510	Int Charges	88,384.76
Dec 15, 2014	IBRD-75510	Loan Repay	1,623,956.50
Dec 15, 2014	IBRD-75510	Int Charges	237.14
Jul 29, 2014	IBRD-75510	Loan Disb	500,325.44
Jun 15, 2014	IBRD-75510	Int Charges	613.05
Jun 15, 2014	IBRD-75510	Int Charges	93,783.64
Jun 15, 2014	IBRD-75510	Loan Repay	1,589,360.80
Apr 22, 2014	IBRD-75510	Loan Disb	405,365.56
Mar 26, 2014	IBRD-75510	Loan Disb	-820,122.06
Jan 27, 2014	IBRD-75510	Loan Disb	338,854.62
Mar 5, 2014	IBRD-75510	Loan Disb	387,909.70

Footnotes

Ratings

IMPLEMENTATION RATINGS

Name	Review	Date
Project Management	Satisfactory	2014-12-24
Progress towards achievement of PDO	Satisfactory	2014-12-24
Procurement	Satisfactory	2014-12-24
Overall Safeguards Rating	Satisfactory	2014-12-24
Counterpart Funding	Satisfactory	2014-12-24
Monitoring and Evaluation	Satisfactory	2014-12-24
Overall Implementation Progress (IP)	Satisfactory	2014-12-24
Financial Management	Moderately Satisfactory	2014-12-24
Overall Safeguards Rating	Satisfactory	2014-12-24

COMPLETION RATINGS

INDICATOR	IMPLEMENTATION COMPLETION & RESULTS REPORT: 06-22-2015
Outcomes	Substantial
Risk to Development Outcome	Negligible
Bank Performance	Moderately Satisfactory
Borrower Performance	Substantial
Government Performance	Substantial
Implementing Agency	Substantial

INDEPENDENT EVALUATION RATINGS

INDICATOR	ICR REVIEW: 10-19-2015	PROJECT PERFORMANCE ASSESSMENT REPORT:
Outcome Rating	Satisfactory	N/a
Risk To Development Outcome	Negligible To Low	N/a
Bank Performance	Moderately Satisfactory	N/a
Borrower Performance	Satisfactory	N/a
Government Performance	Satisfactory	N/a
Implementing Agency	Satisfactory	N/a
Icr Quality	Satisfactory	N/a
M&e Quality	Substantial	N/a

Results Framework

PROJECT DEVELOPMENT OBJECTIVE INDICATORS

INDICATOR		BASELINE	CURRENT	TARGET

Innovation accepted and rolled out at provincial or regional level Value 0 199 Positive trend
Date May 31, 2008 October 31, 2014 December 31, 2014
Comment
% households with annual health expenditures in excess of 20% of total income Value 19.20 13.20 14.20
Date December 31, 2008 October 31, 2014 December 31, 2014
Comment
Rate of overall satisfaction with rural health services among men Value 63.80 85.40 67.80
Date December 31, 2008 October 31, 2014 December 31, 2014
Comment
Rate of overall satisfaction with rural health services among women Value 66.60 85.50 70.60
Date December 31, 2008 October 31, 2014 December 31, 2014
Comment
Public health system scorecard rating Value 61.78 90.22 80.00
Date December 31, 2008 October 31, 2014 December 31, 2014
Comment

Ratio of outpatient visit rate of the bottom 20% vs. the top 40% in the income distribution in the previous year	Value	Average 1.1; 18 counties<1; 14 counties 1-1.5;	1.2	# of counties with a ratio lower than 1 reduced to
	Date	December 31, 2008	December 31, 2013	December 31, 2014
	Comment

Ratio of hospitalization rate of MA (Medical Assistance scheme) vs. non-MA beneficiaries	Value	Average 1.5;12 counties<1; 29 counties 1-2; 9 c	2.1	Positive trend
	Date	December 31, 2008	October 31, 2014	December 31, 2014
	Comment

INTERMEDIATE RESULTS INDICATORS

INDICATOR		BASELINE	CURRENT	TARGET

% of total annual (individual) inpatient expenses financed through out-of-pocket payments for NCMS members Value 74.7 48.4 67.7
Date December 31, 2008 October 31, 2014 December 31, 2014
Comment
Total annual NCMS expenditures as % of total annual NCMS funds Value 72.7 98.6 >85
Date December 31, 2008 October 31, 2014 December 31, 2014
Comment
Average number of outpatient visits per health professional per day over last year at THC Value 3.9 4 Positive trend
Date December 31, 2008 October 31, 2014 December 31, 2014
Comment
% of women who have access to a female qualified worker Value 28 Counties >90%12 Counties <90% 95.9 32 Counties >90%
Date December 31, 2008 October 31, 2014 December 31, 2014
Comment
Annual per capita government expenditures on county level public health institutions and programs Value 14.6 yuan 56 Yuan 20.9 yuan
Date December 31, 2008 October 31, 2014 December 31, 2014
Comment

Project lessons and experiences are documented and disseminated (Qualitative)	Value	0	All 40 project counties carried out summarization	100% of project counties have implemented
	Date	December 31, 2008	October 31, 2014	December 31, 2014
	Comment

Health facilities constructed, renovated, and/or equipped (number) Value 0.00 1755.00 0.00
Date December 31, 2008 June 30, 2014
Comment
Health personnel receiving training (number) Value 0.00 180728.00 0.00
Date December 31, 2008 June 30, 2014
Comment

% of total annual (individual) inpatient expenses financed through out-of-pocket payments for MA beneficiaries covered by the NCMS	Value	72.30	35.60	65.30
	Date	December 31, 2008	October 31, 2014	December 31, 2014
	Comment

% NCMS enrollment rate Value 93.90 97.30 0.00
Date December 31, 2008 October 31, 2014 December 31, 2014
Comment
% of villages that meet 'healthy village' standards Value 0.00 0.00 0.00
Date December 31, 2008 December 31, 2013 December 31, 2013
Comment

Project experiences are extended or adopted outside project areas (Qualitative)	Value	0	All 8 project provinces had carried out promotion	60% of the project provinces disseminate experienc
	Date	December 31, 2008	October 31, 2014	December 31, 2014
	Comment

% of outpatients at township health centers and village clinics that receive two or more antibiotics	Value	18.9% township health centers and 19.8% village cl	4.8% township health centers and 6.5% village clin	4% reduction from baseline
	Date	December 31, 2008	October 31, 2014	December 31, 2014
	Comment

% of deliveries by caesarean section Value 28.90 28.5 # of counties moving towards WHO standard which is
Date December 31, 2008 October 31, 2014 December 31, 2014
Comment
% of women between age 15 and 49 who undergo gynecological check-up in last year Value 44.10(with big disparities across provinces) 66.3 54.10
Date December 31, 2008 October 31, 2014 December 31, 2014
Comment
% of individuals over 35 with hypertension who have been followed-up in the last three months Value 66.20 89.4 >80%
Date December 31, 2008 October 31, 2014 December 31, 2014
Comment
Rate of change in average cost per inpatient case in county hospitals Value 7.70 7.5% Project counties should be lower than provincial a
Date December 31, 2009 October 31, 2014 December 31, 2014
Comment

Number of administrative villages that have initiated the implementation of 'healthy village'	Value	0	35 out of total 40 project counties(87.5%) launche	50% of the project counties have initiated the imp
	Date	December 31, 2008	October 31, 2014	December 31, 2014
	Comment

% households with annual health expenditures in excess of 20% of total income	Value	19.20	13.20	14.20
	Date	December 31, 2008	October 31, 2014	December 31, 2014
	Comment

Rate of overall satisfaction with rural health services among men	Value	63.80	85.40	67.80
	Date	December 31, 2008	October 31, 2014	December 31, 2014
	Comment

Rate of overall satisfaction with rural health services among women	Value	66.60	85.50	70.60
	Date	December 31, 2008	October 31, 2014	December 31, 2014
	Comment

Public health system scorecard rating	Value	61.78	90.22	80.00
	Date	December 31, 2008	October 31, 2014	December 31, 2014
	Comment

% of total annual (individual) inpatient expenses financed through out-of-pocket payments for NCMS members	Value	74.7	48.4	67.7
	Date	December 31, 2008	October 31, 2014	December 31, 2014
	Comment

Total annual NCMS expenditures as % of total annual NCMS funds	Value	72.7	98.6	>85
	Date	December 31, 2008	October 31, 2014	December 31, 2014
	Comment

% of women who have access to a female qualified worker	Value	28 Counties >90%12 Counties <90%	95.9	32 Counties >90%
	Date	December 31, 2008	October 31, 2014	December 31, 2014
	Comment

Annual per capita government expenditures on county level public health institutions and programs	Value	14.6 yuan	56 Yuan	20.9 yuan
	Date	December 31, 2008	October 31, 2014	December 31, 2014
	Comment

Health facilities constructed, renovated, and/or equipped (number)	Value	0.00	1755.00	0.00
	Date	December 31, 2008	June 30, 2014
	Comment

% NCMS enrollment rate	Value	93.90	97.30	0.00
	Date	December 31, 2008	October 31, 2014	December 31, 2014
	Comment

% of deliveries by caesarean section	Value	28.90	28.5	# of counties moving towards WHO standard which is
	Date	December 31, 2008	October 31, 2014	December 31, 2014
	Comment

% of women between age 15 and 49 who undergo gynecological check-up in last year	Value	44.10(with big disparities across provinces)	66.3	54.10
	Date	December 31, 2008	October 31, 2014	December 31, 2014
	Comment

% of individuals over 35 with hypertension who have been followed-up in the last three months	Value	66.20	89.4	>80%
	Date	December 31, 2008	October 31, 2014	December 31, 2014
	Comment

Rate of change in average cost per inpatient case in county hospitals	Value	7.70	7.5%	Project counties should be lower than provincial a
	Date	December 31, 2009	October 31, 2014	December 31, 2014
	Comment