1. What We Do

Health System Modernization Project (APL2) in Support of the Second Phase of the Health Sector Reform Program

Abstract*

The Health System Modernization Project (APL2) is the second phase of a two-phase Adaptable Lending Program (APL) to support Armenia's health sector reform program. The objective is to improve the organization of the health care system in order to provide more accessible, quality and sustainable health care services to the population, in particular to the most vulnerable groups, and to better manage public health threats. The project goals are: increasing...

* The project abstract is drawn from the PAD, SAR or PGD and may not accurately reflect the project's current nature

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Development Objective

The overall objective of the HSRP Program remains unchanged: to improve the organization of the health care system in order to provide more accessible, quality and sustainable health care services to the population, in particular to the most vulnerable groups, and to better manage public health threats. This Project aims at: (i) scaling up family medicine based primary health care reform by expanding the renovation of primary health care facilities and upgrading of the medical equipment in the remaining marzes; (ii) optimizing and upgrading hospital networks in the remaining marzes; (iii) strengthening Government's capacity to develop and monitor effective health sector policies in the area of health financing, resource allocation and provider payments; and (iii) expanding investment in human resources to include formal and continuous education in health (medical, nursing, auxiliary health professionals).

Key Details

Project Details

  • P104467

  • Closed

  • Susanna Hayrapetyan

  • Ministry of Finance

  • Armenia

  • January 17, 2007

  • (as of board presentation)

    March 8, 2007

  • June 6, 2007

  • US$ 30.42 million

  • Ministry of Health, HSMP-PIU

  • Europe and Central Asia

  • 2007

  • US$ 22.80 million

  • B

  • March 28, 2024

  • February 29, 2016

  • BANK APPROVED

  • Notes

Sectors

Created with Highstock 5.0.14FY17 - Central Government(Central Agencies)FY17 - Central Government (Central Agencies)FY17 - Tertiary EducationFY17 - Health

Themes

Project Map

Interactive Map

Finances

Financing Plan (US$ Millions)

No data available.
Financier Commitments
Local Communities 0.15
IDA Credit 22.80
Local Sources of Borrowing Country 0.30
Borrower/Recipient 7.17

Total Project Financing (US$ Millions)

Product Line IBRD/IDA
IBRD Commitment N/A
IDA Commitment 22.80
IBRD + IDA Commitment 22.80
Lending Instrument
Grant Amount N/A
Total Project Cost** 30.42

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

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No data available.
Financier Approval Date Closing Date Principal Disbursed Repayments Interest, Charges & Fees

Detailed Financial Activity as of March 31, 2025

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No data available.
Period Financier Transaction Type Amount (US$)
Oct 15, 2014 IDA-42670 Int Charges 82,218.33
Aug 15, 2013 IBRD-79870 Int Charges 1,096.02
Aug 15, 2013 IBRD-79870 Int Charges 45,457.65
Aug 22, 2013 IBRD-79870 Loan Disb 1,124,704.80
Dec 9, 2014 IBRD-79870 Loan Disb 619,428.80
Oct 15, 2013 IDA-42670 Int Charges 1,089.34
Oct 15, 2013 IDA-42670 Int Charges 1,089.34
Apr 15, 2022 IDA-42670 Loan Repay 1,002,627.90
Apr 15, 2022 IDA-42670 Int Charges 37,842.83
Apr 15, 2022 IDA-42670 Int Charges 37,842.83
Apr 15, 2022 IDA-42670 Loan Repay 6,513.46
Aug 15, 2022 IBRD-79870 Int Charges 117,965.74
Aug 15, 2022 IBRD-79870 Loan Repay 514,224.40
Apr 15, 2018 IDA-42670 Loan Repay 72,730.26
Apr 15, 2018 IDA-42670 Loan Repay 1,001,417.40
Apr 15, 2018 IDA-42670 Int Charges 6,065.44
Apr 15, 2018 IDA-42670 Int Charges 6,065.44
Apr 15, 2018 IDA-42670 Int Charges 72,504.99
Apr 15, 2018 IDA-42670 Int Charges 72,504.99
Feb 15, 2018 IBRD-79870 Int Charges 204,739.31
Aug 15, 2018 IBRD-79870 Int Charges 259,626.16
Oct 15, 2018 IDA-42670 Loan Repay 3,304.99
Oct 15, 2018 IDA-42670 Loan Repay 1,029,063.44
Oct 15, 2018 IDA-42670 Int Charges 54,445.54
Oct 15, 2018 IDA-42670 Int Charges 54,445.54
Feb 15, 2019 IBRD-79870 Int Charges 309,534.80
Apr 15, 2019 IDA-42670 Int Charges 58,500.35
Apr 15, 2019 IDA-42670 Int Charges 58,500.35
Apr 15, 2019 IDA-42670 Int Charges 11,308.25
Apr 15, 2019 IDA-42670 Int Charges 11,308.25
Apr 15, 2019 IDA-42670 Loan Repay 61,410.21
Apr 15, 2019 IDA-42670 Loan Repay 965,537.40
Aug 15, 2019 IBRD-79870 Int Charges 328,350.78
Oct 15, 2019 IDA-42670 Int Charges 3,072.15
Oct 15, 2019 IDA-42670 Int Charges 3,072.15
Oct 15, 2019 IDA-42670 Loan Repay 1,012,339.25
Oct 15, 2019 IDA-42670 Int Charges 56,944.04
Oct 15, 2019 IDA-42670 Int Charges 56,944.04
Apr 15, 2017 IDA-42670 Loan Repay 937.77
Oct 15, 2020 IDA-42670 Loan Repay 1,041,764.70
Feb 15, 2021 IBRD-79870 Int Charges 100,914.16
Feb 15, 2021 IBRD-79870 Loan Repay 531,276.00
Feb 15, 2021 IBRD-79870 Loan Repay 100,914.16
Apr 15, 2021 IDA-42670 Int Charges 1,442.41
Apr 15, 2021 IDA-42670 Loan Repay 47,894.60
Apr 15, 2021 IDA-42670 Loan Repay 1,007,183.94
Apr 15, 2021 IDA-42670 Int Charges 0.01
Apr 15, 2021 IDA-42670 Int Charges 0.01
Apr 15, 2021 IDA-42670 Int Charges 47,478.52
Apr 15, 2021 IDA-42670 Int Charges 47,478.52
Aug 15, 2021 IBRD-79870 Loan Repay 632,190.20
Aug 15, 2021 IBRD-79870 Int Charges 85,813.23
Oct 15, 2021 IDA-42670 Loan Repay 1,033,340.80
Oct 15, 2021 IDA-42670 Int Charges 43,012.59
Oct 15, 2021 IDA-42670 Int Charges 43,012.59
Oct 15, 2021 IDA-42670 Loan Repay 9,389.34
Apr 15, 2021 IDA-42670 Int Charges 1,442.41
Apr 15, 2017 IDA-42670 Loan Repay 1,002,435.56
Apr 15, 2017 IDA-42670 Int Charges 68,361.65
Apr 15, 2017 IDA-42670 Int Charges 68,361.65
Oct 15, 2017 IDA-42670 Loan Repay 12,648.88
Oct 15, 2017 IDA-42670 Int Charges 68,546.53
Oct 15, 2017 IDA-42670 Int Charges 68,546.53
Oct 15, 2017 IDA-42670 Loan Repay 1,032,215.70
Oct 15, 2017 IDA-42670 Int Charges 7,176.29
Oct 15, 2017 IDA-42670 Int Charges 7,176.29
Aug 15, 2017 IBRD-79870 Int Charges 188,992.60
Feb 15, 2017 IBRD-79870 Int Charges 175,629.48
Jun 30, 2016 IBRD-79870 Loan Cancel 15,310.00
May 2, 2016 IBRD-79870 Loan Disb -15,310.00
Aug 15, 2016 IBRD-79870 Int Charges 137,295.60
Feb 15, 2016 IBRD-79870 Int Charges 1,598.69
Feb 15, 2016 IBRD-79870 Int Charges 103,368.29
Apr 15, 2016 IDA-42670 Int Charges 77,856.33
Apr 15, 2016 IDA-42670 Int Charges 784.11
Apr 15, 2016 IDA-42670 Int Charges 784.11
Apr 15, 2016 IDA-42670 Int Charges 77,856.33
Oct 15, 2016 IDA-42670 Int Charges 12.88
Oct 15, 2016 IDA-42670 Int Charges 12.88
Oct 15, 2016 IDA-42670 Int Charges 76,350.68
Oct 15, 2016 IDA-42670 Int Charges 76,350.68
Mar 16, 2015 IBRD-79870 Loan Disb 771,685.60
Aug 15, 2015 IBRD-79870 Int Charges 76,086.81
Jun 16, 2015 IBRD-79870 Loan Disb 708,322.40
Jul 22, 2015 IBRD-79870 Loan Disb 864,391.94
Apr 15, 2015 IDA-42670 Int Charges 2,482.85
Apr 15, 2015 IDA-42670 Int Charges 2,482.85
Apr 15, 2015 IDA-42670 Int Charges 73,546.71
Apr 15, 2015 IDA-42670 Int Charges 73,546.71
Dec 20, 2010 IBRD-79870 Loan Commitment 19,000,000.00
Mar 8, 2007 IDA-42670 Loan Commitment 22,000,000.00
Aug 15, 2022 IBRD-79870 Loan Repay 117,965.74
Feb 15, 2022 IBRD-79870 Int Charges 80,607.72
Feb 15, 2022 IBRD-79870 Loan Repay 551,582.44
Feb 15, 2022 IBRD-79870 Loan Repay 80,607.72
Oct 15, 2022 IDA-42670 Loan Repay 26,389.15
Oct 15, 2022 IDA-42670 Loan Repay 916,357.44
Oct 15, 2022 IDA-42670 Int Charges 31,817.71
Oct 15, 2022 IDA-42670 Int Charges 31,817.71
Feb 15, 2023 IBRD-79870 Int Charges 27,595.16
Feb 15, 2023 IBRD-79870 Int Charges 379,470.44
Feb 15, 2023 IBRD-79870 Loan Repay 632,190.20
Apr 15, 2023 IDA-42670 Loan Repay 966,910.70
Apr 15, 2023 IDA-42670 Int Charges 16,920.98
Apr 15, 2023 IDA-42670 Int Charges 16,920.98
Apr 15, 2023 IDA-42670 Loan Repay 33,508.51
Aug 15, 2023 IBRD-79870 Int Charges 17,255.24
Aug 15, 2023 IBRD-79870 Int Charges 447,765.60
Aug 15, 2023 IBRD-79870 Loan Repay 632,190.20
Apr 15, 2024 IDA-42670 Loan Repay 954,975.10
Apr 15, 2024 IDA-42670 Int Charges 21,874.36
Apr 15, 2024 IDA-42670 Int Charges 21,874.36
Apr 15, 2024 IDA-42670 Loan Repay 17,217.07
Aug 15, 2024 IBRD-79870 Int Charges 2,791.87
Aug 15, 2024 IBRD-79870 Int Charges 477,886.40
Aug 15, 2024 IBRD-79870 Loan Repay 632,190.20
Oct 15, 2023 IDA-42670 Int Charges 21,489.39
Oct 15, 2023 IDA-42670 Int Charges 21,489.39
Oct 15, 2023 IDA-42670 Int Charges 12,659.87
Oct 15, 2023 IDA-42670 Int Charges 12,659.87
Oct 15, 2023 IDA-42670 Loan Repay 967,428.60
Oct 15, 2023 IDA-42670 Int Charges 3,905.58
Oct 15, 2023 IDA-42670 Int Charges 3,905.58
Feb 15, 2024 IBRD-79870 Int Charges 4,601.39
Feb 15, 2024 IBRD-79870 Int Charges 497,150.72
Feb 15, 2024 IBRD-79870 Loan Repay 632,190.20
Feb 15, 2020 IBRD-79870 Int Charges 263,929.38
Oct 15, 2020 IDA-42670 Int Charges 49,394.97
Oct 15, 2020 IDA-42670 Int Charges 49,394.97
Apr 15, 2020 IDA-42670 Int Charges 52,988.09
Apr 15, 2020 IDA-42670 Int Charges 52,988.09
Apr 15, 2020 IDA-42670 Loan Repay 2,863.31
Apr 15, 2020 IDA-42670 Loan Repay 1,006,433.10
Aug 15, 2020 IBRD-79870 Int Charges 229,387.80
Oct 15, 2020 IDA-42670 Loan Repay 699.59
Sep 11, 2015 IBRD-79870 Loan Disb 673,654.50
Oct 15, 2015 IDA-42670 Int Charges 2,375.70
Oct 15, 2015 IDA-42670 Int Charges 2,375.70
Oct 15, 2015 IDA-42670 Int Charges 75,372.61
Oct 15, 2015 IDA-42670 Int Charges 75,372.61
Oct 15, 2013 IDA-42670 Int Charges 83,001.31
Oct 15, 2013 IDA-42670 Int Charges 83,001.31
Nov 1, 2013 IBRD-79870 Loan Disb 568,784.10
Feb 5, 2014 IBRD-79870 Loan Disb 633,258.10
Dec 12, 2013 IBRD-79870 Loan Disb 393,243.34
Feb 15, 2014 IBRD-79870 Int Charges 55,853.80
Feb 15, 2014 IBRD-79870 Int Charges 609.76
Apr 15, 2014 IDA-42670 Int Charges 665.22
Apr 15, 2014 IDA-42670 Int Charges 665.22
Apr 15, 2014 IDA-42670 Int Charges 85,527.34
Apr 15, 2014 IDA-42670 Int Charges 85,527.34
Jun 3, 2014 IBRD-79870 Loan Disb 825,702.10
Feb 15, 2015 IBRD-79870 Int Charges 65,622.98
Sep 12, 2014 IBRD-79870 Loan Disb 804,502.20
Aug 15, 2014 IBRD-79870 Int Charges 153.03
Aug 15, 2014 IBRD-79870 Int Charges 56,573.87
Oct 15, 2014 IDA-42670 Int Charges 210.35
Oct 15, 2014 IDA-42670 Int Charges 210.35
Oct 15, 2014 IDA-42670 Int Charges 82,218.33
Footnotes

Ratings

IMPLEMENTATION RATINGS

Name Review Date
Procurement Satisfactory 2016-02-12
Project Management Satisfactory 2016-02-12
Financial Management Satisfactory 2016-02-12
Counterpart Funding Satisfactory 2016-02-12
Monitoring and Evaluation Satisfactory 2016-02-12
Overall Implementation Progress (IP) Satisfactory 2016-02-12
Progress towards achievement of PDO Moderately Satisfactory 2016-02-12

COMPLETION RATINGS

INDICATORIMPLEMENTATION COMPLETION & RESULTS REPORT: 08-17-2016
Outcomes
Risk to Development OutcomeSubstantial
Bank Performance
Borrower Performance
Government Performance
Implementing Agency

INDEPENDENT EVALUATION RATINGS

INDICATORICR REVIEW: 05-24-2017PROJECT PERFORMANCE ASSESSMENT REPORT: 03-20-2019
Outcome RatingSatisfactory Satisfactory
Risk To Development OutcomeNegligibleModest
Bank PerformanceSatisfactorySatisfactory
Borrower PerformanceSatisfactorySatisfactory
Government PerformanceSatisfactoryNot Rated
Implementing AgencySatisfactorySatisfactory
Icr QualitySubstantialNot Rated
M&e QualitySubstantialSubstantial

Results Framework

PROJECT DEVELOPMENT OBJECTIVE INDICATORS

INDICATORBASELINECURRENTTARGET
  • Proportion of Armenian Population covered by qualified family medicine practicesValue47%91%95%
    DateDecember 31, 2006February 18, 2016February 29, 2016
    Comment
  • Increased utilization of a) out-patient services; and b) in-patient services by the poorest income quintileValuea) 3.9%; b) 3.1%a) 5.3%; b) 9.7%Increased Utilization
    DateNovember 22, 2011February 18, 2016February 29, 2016
    Comment
  • Health Sector Performance Report issued once every two yearsValueHSPA for 2006 year publishedHSPA 2014 developed and in the process of being puHSPA published every two year
    DateSeptember 1, 2007February 18, 2016February 29, 2016
    Comment
  • Perceived quality of care in marzes increasedValue64.3%not available75%
    DateDecember 30, 2007February 18, 2016February 29, 2016
    Comment
  • ALOS in marz hospitals decreased close to OECD averageValue7.75.86.5
    DateDecember 1, 2006February 18, 2016February 29, 2016
    Comment
  • National Health Accounts report published annuallyValue2006 NHA report distributed 2007NHA 2014 in process of being publishedAnnual
    DateDecember 31, 2006February 18, 2016February 29, 2016
    Comment
  • Public hospitals in project sites that have published financial audit reports from independent auditsValue0713
    DateDecember 31, 2006February 18, 2016February 29, 2016
    Comment
  • Proportion of patients with a) hypertension who had at least one ECG annually; b) ischemic heart disease who had at least one totalcholesterol test annuallyValuea) 42%; b) 33%a) 55.2%; b) 53.7%Increased
    DateDecember 31, 2006July 9, 2015February 29, 2016
    Comment
  • Project beneficiariesValue550,000 population served by renovated/constructed627,709 (ambulatories); 2,026,803 (hospitals)590,000 (ambulatories); 2,000,000 (hospitals)
    DateDecember 31, 2006February 18, 2016February 29, 2016
    Comment

INTERMEDIATE RESULTS INDICATORS

INDICATORBASELINECURRENTTARGET
  • Number of certified FDs trainedValue63316951750
    DateDecember 31, 2006February 18, 2016February 29, 2016
    Comment
  • Number of certified FNs trainedValue56818361950
    DateDecember 1, 2006February 18, 2016February 29, 2016
    Comment
  • Reduction of sq. meters of hospital space (percent of original) in all marzesValue0%85%85%
    DateDecember 31, 2006February 18, 2016February 29, 2016
    Comment
  • Health personnel receiving training (number)Value1201.004118.003700.00
    DateJanuary 1, 2009February 18, 2016February 29, 2016
    Comment
  • Health facilities constructed, renovated, and/or equipped (number)Value0.00112.00100.00
    DateJanuary 1, 2008February 18, 2016February 29, 2016
    Comment
  • Proportion of health budget allocated to PHCValue35.5037.2043.00
    DateDecember 31, 2006February 18, 2016February 29, 2016
    Comment
  • All project hospitals apply updated environmental management guidelinesValueNoYesYes
    DateJanuary 1, 2007February 18, 2016February 29, 2016
    Comment
  • State Medical University has a revised students examination system in line with EU countriesValueNo revision has been doneNoYes
    DateDecember 31, 2006February 18, 2016February 29, 2016
    Comment
  • Increased number of admission in project hospitalsValue29,66849,12140,000
    DateMay 1, 2009February 18, 2016February 29, 2016
    Comment
  • Proportion of key management staff in project hospitals trained on financial management after the results of performed independent auditsValue03:39 key management staff39 key management staff or 100%
    DateDecember 31, 2006February 18, 2016February 29, 2016
    Comment
  • Reduction in out-of-pocket payments for essential health servicesValuea) 35.4% (out-patient); b) 47.1% (in-patient)a) 20.6% (out-patient); b) 42.8% (in-patient) (201Reduction
    DateDecember 31, 2009February 18, 2016February 29, 2016
    Comment