Health Services Improvement Project

Abstract*

The development objective of the Health Services Improvement Project for Zambia is to improve health delivery systems and utilization of maternal, newborn, and child health (MNCH) and nutrition services in project areas. The project has three components. The first component, strengthening capacity for primary and community level MNCH and nutrition services objective is to strengthen health systems in project areas through: (i) enhanced training capacity... Show More

Development Objective

The project development objective is 'to improve health delivery systems and utilization of maternal, newborn and child health and nutrition services in project areas, and to prepare for and provide an immediate and effective response to the EVD emergency.

Key Details

Project Details

Project ID
P145335
Status
Closed
Team Leader
Musonda Rosemary Sunkutu , John Makumba
Borrower 2
Ministry of Finance (Republic of Zambia)

Country
Zambia
Disclosure Date
August 21, 2013
Approval Date
(as of board presentation)
March 21, 2014
Effective Date
March 31, 2015

Total Project Cost 1
US$ 67.00 million
Implementing Agency
Ministry of Health
Region
Eastern and Southern Africa
Fiscal Year 3
2014

Commitment Amount
US$ 67.00 million
Environmental Category
B
Environmental and Social Risk
N/A
Closing Date
December 31, 2020

Consultant Services required
Yes
Last Stage Reached
BANK APPROVED
Last Update Date
September 8, 2023

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 Control0%
- FY17 - Malaria15%
- FY17 - Pandemic Response1%
FY17 - Health Systems and Policies30%
- FY17 - Child Health20%
- FY17 - Health System Strengthening30%
- FY17 - Reproductive and Maternal Health20%
FY17 - Nutrition and Food Security26%
- FY17 - Food Security13%
- FY17 - Nutrition13%

FY17 - Private Sector Development

FY17 - Public Private Partnerships10%

FY17 - Public Sector Management

FY17 - Public Administration10%
- FY17 - Administrative and Civil Service Reform10%

FY17 - Social Development and Protection

FY17 - Social Inclusion20%
- FY17 - Participation and Civic Engagement20%

Project Map

Interactive Map

Finances

Financing Plan (US$ Millions)

Financier	Commitments
IDA Credit	52.00
Health Results-based Financing	15.00

Total Project Financing (US$ Millions)

Product Line	IBRD/IDA
IBRD Commitment	N/A
IDA Commitment	52.00
IBRD + IDA Commitment	52.00

Lending Instrument
Grant Amount	15.00
Total Project Cost**	67.00

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 29, 2017	IDA-53940	Loan Disb	1,961,092.80
Jul 7, 2017	IDA-53940	Loan Disb	309,268.56
Mar 22, 2017	IDA-53940	Loan Disb	476,612.50
May 16, 2017	IDA-53940	Loan Disb	1,510,586.00
Mar 6, 2017	IDA-53940	Loan Disb	254,202.50
Nov 17, 2017	IDA-53940	Loan Disb	580,360.70
Oct 25, 2017	IDA-53940	Loan Disb	268,121.50
Oct 20, 2017	IDA-53940	Loan Disb	230,438.77
Jul 16, 2017	IDA-53940	Loan Disb	-33,702.36
Jul 16, 2017	IDA-53940	Loan Disb	33,702.36
Aug 8, 2017	IDA-53940	Loan Disb	683,566.94
Sep 15, 2017	IDA-53940	Int Charges	108.57
Sep 15, 2017	IDA-53940	Int Charges	108.57
Sep 15, 2017	IDA-53940	Int Charges	44,783.48
Sep 15, 2017	IDA-53940	Int Charges	44,783.48
Mar 15, 2018	IDA-53940	Int Charges	31,154.05
Apr 4, 2018	IDA-53940	Loan Disb	682,999.75
Apr 13, 2018	IDA-53940	Int Charges	33,069.32
Apr 13, 2018	IDA-53940	Int Charges	33,069.32
Apr 6, 2018	IDA-53940	Loan Disb	878,488.44
Dec 28, 2017	IDA-53940	Loan Disb	593,833.75
May 29, 2018	IDA-53940	Loan Disb	469,021.16
Jul 24, 2018	IDA-53940	Loan Disb	421,500.00
Aug 6, 2018	IDA-53940	Loan Disb	194,351.22
Sep 4, 2018	IDA-53940	Loan Disb	793,902.00
Jun 14, 2018	IDA-53940	Loan Disb	908,893.50
Jun 28, 2018	IDA-53940	Loan Disb	450,519.56
Jun 28, 2018	IDA-53940	Loan Disb	234,618.80
Dec 3, 2018	IDA-53940	Loan Disb	518,054.06
Nov 2, 2018	IDA-53940	Loan Disb	339,993.80
Dec 26, 2018	IDA-53940	Loan Disb	2,365,465.80
Feb 8, 2019	IDA-53940	Loan Disb	354,429.25
Dec 7, 2018	IDA-53940	Loan Disb	950,410.50
Dec 27, 2018	IDA-53940	Loan Disb	1,089,206.60
Dec 5, 2018	IDA-53940	Loan Disb	715,525.30
Oct 16, 2018	IDA-53940	Int Charges	923.57
Oct 16, 2018	IDA-53940	Int Charges	923.57
Oct 16, 2018	IDA-53940	Int Charges	82,229.90
Oct 16, 2018	IDA-53940	Int Charges	82,229.90
Sep 25, 2018	IDA-53940	Loan Disb	292,330.06
Mar 1, 2019	IDA-53940	Loan Disb	137,107.88
Feb 22, 2019	IDA-53940	Loan Disb	593,036.94
Jun 27, 2019	IDA-53940	Loan Disb	178,286.38
Mar 6, 2019	IDA-53940	Loan Disb	557,170.56
Jun 17, 2019	IDA-53940	Loan Disb	994,212.00
Apr 12, 2019	IDA-53940	Loan Disb	137,567.20
Jun 7, 2019	IDA-53940	Loan Disb	613,961.20
Jun 18, 2019	IDA-53940	Loan Disb	123,223.31
May 28, 2019	IDA-53940	Loan Disb	875,293.90
Aug 6, 2015	IDA-53940	Loan Disb	1,000,000.00
Sep 9, 2015	IDA-53940	Loan Disb	1,000,000.00
Apr 11, 2016	IDA-53940	Int Charges	950.22
Apr 11, 2016	IDA-53940	Int Charges	950.22
Apr 11, 2016	IDA-53940	Int Charges	7,409.69
Apr 11, 2016	IDA-53940	Int Charges	7,409.69
Mar 30, 2016	IDA-53940	Loan Disb	165,807.12
Sep 15, 2016	IDA-53940	Int Charges	168.54
Sep 15, 2016	IDA-53940	Int Charges	168.54
Sep 15, 2016	IDA-53940	Int Charges	12,493.52
Sep 15, 2016	IDA-53940	Int Charges	12,493.52
May 3, 2016	IDA-53940	Loan Disb	306,239.84
May 11, 2016	IDA-53940	Loan Disb	282,674.00
Apr 14, 2021	IDA-53940	Int Charges	2,896.88
Apr 29, 2021	IDA-53940	Loan Disb	-1,671,565.60
Sep 21, 2021	IDA-53940	Int Charges	170,677.81
Sep 21, 2021	IDA-53940	Int Charges	170,677.81
Sep 15, 2021	IDA-53940	Int Charges	1,544.24
Sep 15, 2021	IDA-53940	Int Charges	1,544.24
Mar 15, 2022	IDA-53940	Int Charges	587.54
Mar 15, 2022	IDA-53940	Int Charges	587.54
Mar 24, 2022	IDA-53940	Int Charges	165,861.75
Mar 24, 2022	IDA-53940	Int Charges	165,861.75
Sep 16, 2022	IDA-53940	Int Charges	-152,715.48
Sep 16, 2022	IDA-53940	Int Charges	-152,715.48
Oct 26, 2022	IDA-53940	Int Charges	152,294.20
Oct 26, 2022	IDA-53940	Int Charges	152,294.20
Mar 29, 2019	IDA-53940	Int Charges	501.38
Mar 29, 2019	IDA-53940	Int Charges	501.38
Mar 29, 2019	IDA-53940	Int Charges	103,810.34
Mar 29, 2019	IDA-53940	Int Charges	103,810.34
Aug 30, 2019	IDA-53940	Loan Disb	571,776.50
Jun 5, 2019	IDA-53940	Loan Disb	276,213.12
Oct 7, 2019	IDA-53940	Int Charges	169.14
Oct 7, 2019	IDA-53940	Int Charges	169.14
Oct 7, 2019	IDA-53940	Int Charges	125,595.11
Oct 7, 2019	IDA-53940	Int Charges	125,595.11
Feb 27, 2020	IDA-53940	Loan Disb	3,788,317.00
Dec 18, 2019	IDA-53940	Loan Disb	-6,536.14
Mar 15, 2020	IDA-53940	Int Charges	1,450.35
Mar 15, 2020	IDA-53940	Int Charges	1,450.35
Mar 13, 2020	IDA-53940	Loan Disb	530,425.56
Dec 19, 2019	IDA-53940	Loan Disb	305,997.60
Apr 14, 2020	IDA-53940	Int Charges	133,444.20
Apr 14, 2020	IDA-53940	Int Charges	133,444.20
May 12, 2020	IDA-53940	Loan Disb	4,332,112.00
Oct 13, 2020	IDA-53940	Int Charges	176.14
Oct 13, 2020	IDA-53940	Int Charges	176.14
Oct 13, 2020	IDA-53940	Int Charges	164,103.80
Oct 13, 2020	IDA-53940	Int Charges	164,103.80
Jan 8, 2018	IDA-53940	Loan Disb	2,962,377.50
Dec 29, 2017	IDA-53940	Loan Disb	589,747.25
Mar 15, 2018	IDA-53940	Int Charges	1,641.43
Mar 15, 2018	IDA-53940	Int Charges	1,641.43
Mar 15, 2018	IDA-53940	Int Charges	31,154.05
Jun 20, 2016	IDA-53940	Loan Disb	1,452,197.50
Nov 14, 2016	IDA-53940	Loan Disb	1,776,047.00
Oct 19, 2016	IDA-53940	Loan Disb	152,392.80
Jun 29, 2016	IDA-53940	Loan Disb	234,016.84
Oct 28, 2016	IDA-53940	Loan Disb	219,637.98
Apr 10, 2017	IDA-53940	Int Charges	6,844.20
Apr 10, 2017	IDA-53940	Int Charges	6,844.20
Mar 15, 2017	IDA-53940	Int Charges	7,165.16
Mar 15, 2017	IDA-53940	Int Charges	7,165.16
Mar 16, 2017	IDA-53940	Loan Disb	615,792.06
Mar 22, 2017	IDA-53940	Int Charges	7,488.75
Mar 22, 2017	IDA-53940	Int Charges	7,488.75
Mar 15, 2017	IDA-53940	Int Charges	55.94
Mar 15, 2017	IDA-53940	Int Charges	55.94
May 17, 2017	IDA-53940	Loan Disb	566,082.20
Jun 7, 2017	IDA-53940	Loan Disb	1,749,345.20
May 30, 2017	IDA-53940	Loan Disb	-499,889.84
Mar 21, 2014	IDA-53940	Loan Commitment	52,000,000.00
Sep 16, 2022	IDA-53940	Int Charges	152,715.48
Sep 16, 2022	IDA-53940	Int Charges	152,715.48
Sep 15, 2022	IDA-53940	Int Charges	3,591.38
Sep 15, 2022	IDA-53940	Int Charges	3,591.38
Mar 24, 2023	IDA-53940	Int Charges	159,766.77
Mar 24, 2023	IDA-53940	Int Charges	159,766.77
Mar 15, 2023	IDA-53940	Int Charges	2,247.76
Mar 15, 2023	IDA-53940	Int Charges	2,247.76
Sep 19, 2023	IDA-53940	Int Charges	158,587.27
Sep 19, 2023	IDA-53940	Int Charges	158,587.27
Sep 15, 2023	IDA-53940	Int Charges	841.17
Sep 15, 2023	IDA-53940	Int Charges	841.17
Mar 15, 2024	IDA-53940	Int Charges	4,164.01
Mar 15, 2024	IDA-53940	Int Charges	4,164.01
Mar 18, 2024	IDA-53940	Int Charges	156,663.80
Mar 18, 2024	IDA-53940	Int Charges	156,663.80
Apr 30, 2021	IDA-53940	Loan Cancel	2,431,188.20
Apr 14, 2021	IDA-53940	Loan Disb	1,267,287.90
Apr 14, 2021	IDA-53940	Int Charges	173,933.06
Apr 14, 2021	IDA-53940	Int Charges	173,933.06
Apr 14, 2021	IDA-53940	Int Charges	2,896.88

Footnotes

Ratings

IMPLEMENTATION RATINGS

Name	Review	Date
Monitoring and Evaluation	Moderately Unsatisfactory	2022-06-22
Project Management	Moderately Satisfactory	2022-06-22
Financial Management	Satisfactory	2022-06-22
Progress towards achievement of PDO	Moderately Satisfactory	2022-06-22
Procurement	Moderately Satisfactory	2022-06-22
Overall Implementation Progress (IP)	Moderately Satisfactory	2022-06-22

COMPLETION RATINGS

INDICATOR	IMPLEMENTATION COMPLETION & RESULTS REPORT: 06-30-2022
Outcomes	Moderately Satisfactory
Risk to Development Outcome
Bank Performance	Moderately Unsatisfactory
Borrower Performance
Government Performance
Implementing Agency

INDEPENDENT EVALUATION RATINGS

INDICATOR	ICR REVIEW:	PROJECT PERFORMANCE ASSESSMENT REPORT:
Outcome Rating	Moderately Satisfactory	N/a
Risk To Development Outcome		N/a
Bank Performance	Moderately Unsatisfactory	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

Deliveries by skilled health providers in the project areas Value 27.00 63.00 80.00
Date December 31, 2012 December 31, 2020 December 31, 2020
Comment

Under-2 children received monthly growth monitoring and promotion (GMP) based on new standard guidelines in the project. areas (Custom).	Value	0.00	45.00	25.00
	Date	December 31, 2013	December 31, 2020	December 31, 2019
	Comment

High risk districts with strengthened surveillance for rapid detection and isolation of EVD cases. Value 0.00 50.00 35.00
Date December 31, 2018 December 31, 2020 September 30, 2020
Comment
Fully immunized children at 12 months of age in the project areas. Value 80.00 99.80 95.00
Date December 31, 2012 December 31, 2020 December 31, 2020
Comment

Health facilities (health post, health centres and district hospitals) offering integrated management of childhood Illnesses (IMCI)based on new standard guidelines in the project areas	Value	0.00	67.00	65.00
	Date	December 31, 2013	December 31, 2020	December 31, 2020
	Comment

INTERMEDIATE RESULTS INDICATORS

INDICATOR		BASELINE	CURRENT	TARGET

Health workers trained in MNCH and nutrition competencies in the targeted provinces (Cumulative, Custom, DLI) Value 0.00 419.00 400.00
Date December 31, 2013 December 31, 2020 December 31, 2020
Comment

Health facilities (health centers and district hospitals) implementing the RBF approach in Project areas (Cumulative, Custom)	Value	70.00	964.00	900.00
	Date	December 31, 2013	December 31, 2020	December 31, 2020
	Comment

Health policy analysis conducted and results disseminated nationally (Cumulative, Custom) Value 0.00 3.00 3.00
Date December 31, 2013 December 31, 2020 December 31, 2019
Comment
High-risk districts with fully functional event-based surveillance systems in place Value 10.00 40.00 5.00
Date December 31, 2018 December 31, 2020 September 30, 2020
Comment
Regional hubs and staging posts equipped countrywide (Cumulative, Custom, DLI) Value 0.00 7.00 7.00
Date December 31, 2013 December 31, 2020 December 31, 2020
Comment
Protocols and guidelines at community and primary care levels updated and disseminated (Cumulative, Custom) Value 0.00 6.00 6.00
Date December 31, 2013 December 31, 2020 December 31, 2020
Comment
Districts with community information system integrated DHIS-2 in project areas (Cumulative, Custom) Value 0.00 40.00 45.00
Date December 31, 2013 December 31, 2020 December 31, 2020
Comment
Staff trained in field epidemiology training program (FETP), surveillance and response Value 10.00 30.00 20.00
Date December 31, 2018 December 31, 2020 September 30, 2020
Comment
People who have received essential health, nutrition, and population (HNP) services Value 931505.00 3404047.00 3000000.00
Date December 31, 2013 December 31, 2020 December 31, 2020
Comment
NHCs implementing community health management information system (CHMIS) in targeted in the project areas Value 0.00 2091.00 2200.00
Date December 31, 2013 December 31, 2020 December 31, 2020
Comment
Personnel (including community volunteers) trained in risk communication Value 40.00 150.00 100.00
Date December 31, 2018 December 31, 2020 September 30, 2020
Comment

Nurses and midwives trained in MNCH and nutrition competencies based on enhanced pre-service & in-service training and CPD in project areas (Cumulative, Custom, DLI)	Value	0.00	15000.00	2000.00
	Date	December 31, 2013	December 31, 2020	December 31, 2019
	Comment

Rural health facilities (health post, health centers and district hospitals) with at least one qualified health worker in the project areas (Custom)	Value	19.00	98.00	95.00
	Date	December 31, 2013	December 31, 2020	December 31, 2020
	Comment

People who have received essential health, nutrition, and population (HNP) services - Female (RMS requirement) Value 851721.00 1485141.00 967796.00
Date
Comment

Health facilities (health post, health centers and district hospitals) conducting GMP based on new standard guidelines in the project areas (Custom)	Value	0.00	30.00	30.00
	Date	December 31, 2013	December 31, 2020	December 31, 2019
	Comment

Number of children immunized Value 156439.00 240162.00 170881.00
Date December 31, 2013 December 31, 2020 December 31, 2019
Comment
Outreach sites in targeted provinces conducting GMP based on new standard guidelines in the project areas Value 0.00 1000.00 800.00
Date December 31, 2013 December 31, 2020 December 31, 2019
Comment
Number of women and children who have received basic nutrition services Value 683030.00 2969000.00 1857200.00
Date December 31, 2013 December 31, 2020 December 31, 2019
Comment
Health facilities (health centers and hospitals) conducting cervical cancer screening in project areas (Custom) Value 0.00 8.00 6.00
Date December 31, 2013 December 31, 2020 December 31, 2019
Comment
Number of deliveries attended by skilled health personnel Value 92036.00 194885.00 298079.00
Date December 31, 2013 December 31, 2020 December 31, 2019
Comment
Structures protected by indoor residual spraying in project areas (Custom) Value 1050000.00 1100000.00 1100000.00
Date December 31, 2013 December 31, 2020 December 31, 2019
Comment
Women attending ANC within the first three months of Pregnancy in the project areas (Custom, DLI) Value 9.00 50.00 45.00
Date December 31, 2013 December 31, 2020 December 31, 2019
Comment

Health care providers and tutors Trained in essential newborn care (ENC) competency-based training (Cumulative, Custom)	Value	0.00	200.00	130.00
	Date	December 31, 2013	December 31, 2020	December 31, 2019
	Comment

Lactating women accessing post-natal care within six days in the project areas Value 37.00 73.90 85.00
Date December 31, 2013 December 31, 2020 December 31, 2020
Comment
Neighborhood health committees (NHCs) implementing the RBF approach in the project areas (Cumulative, Custom) Value 0.00 3000.00 2500.00
Date December 31, 2013 December 31, 2020 December 31, 2019
Comment

Deliveries by skilled health providers in the project areas	Value	27.00	63.00	80.00
	Date	December 31, 2012	December 31, 2020	December 31, 2020
	Comment

High-risk districts with fully functional event-based surveillance systems in place	Value	10.00	40.00	5.00
	Date	December 31, 2018	December 31, 2020	September 30, 2020
	Comment

People who have received essential health, nutrition, and population (HNP) services	Value	931505.00	3404047.00	3000000.00
	Date	December 31, 2013	December 31, 2020	December 31, 2020
	Comment

People who have received essential health, nutrition, and population (HNP) services - Female (RMS requirement)	Value	851721.00	1485141.00	967796.00
	Date
	Comment

Number of children immunized	Value	156439.00	240162.00	170881.00
	Date	December 31, 2013	December 31, 2020	December 31, 2019
	Comment

Number of women and children who have received basic nutrition services	Value	683030.00	2969000.00	1857200.00
	Date	December 31, 2013	December 31, 2020	December 31, 2019
	Comment

Number of deliveries attended by skilled health personnel	Value	92036.00	194885.00	298079.00
	Date	December 31, 2013	December 31, 2020	December 31, 2019
	Comment

Structures protected by indoor residual spraying in project areas (Custom)	Value	1050000.00	1100000.00	1100000.00
	Date	December 31, 2013	December 31, 2020	December 31, 2019
	Comment

Women attending ANC within the first three months of Pregnancy in the project areas (Custom, DLI)	Value	9.00	50.00	45.00
	Date	December 31, 2013	December 31, 2020	December 31, 2019
	Comment

Lactating women accessing post-natal care within six days in the project areas	Value	37.00	73.90	85.00
	Date	December 31, 2013	December 31, 2020	December 31, 2020
	Comment