Nepal Health Sector Management Reform Program

Abstract*

The development objective of the Health Sector Management Reform Program-for-Results (PforR) Project for Nepal is to improve efficiency in public resource management systems of the health sector in Nepal. The program to be supported by the PforR financing is a subset of the larger Nepal Health Sector Strategy (NHSS) program of the Government of Nepal (GoN) and focuses on specific NHSS outcomes in critical areas of public management reforms. The government’s... Show More

Development Objective

The Program Development Objective is to improve efficiency in the Federal-level public resource management systems of the health sector in Nepal.

Key Details

Project Details

Project ID
P160207
Status
Closed
Team Leader
Sangeeta Pinto
Borrower 2
Ministry of Finance

Country
Nepal
Disclosure Date
September 18, 2016
Approval Date
(as of board presentation)
January 13, 2017
Effective Date
April 13, 2017

Total Project Cost 1
US$ 2881.82 million
Implementing Agency
Ministry of Health and Population
Region
South Asia
Fiscal Year 3
2017

Commitment Amount
US$ 150.00 million
Environmental Category
N/A
Environmental and Social Risk
Not Applicable
Closing Date
July 16, 2022

Last Stage Reached
BANK APPROVED
Last Update Date
February 28, 2023

Associated Projects
P176694

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 Policies100%
- FY17 - Health Service Delivery41%
- FY17 - Health System Strengthening89%

FY17 - Public Sector Management

FY17 - Public Administration10%
- FY17 - E-Government, incl. e-services10%
FY17 - Public Finance Management33%
- FY17 - Public Expenditure Management33%

FY17 - Social Development and Protection

FY17 - Social Inclusion10%
- FY17 - Participation and Civic Engagement10%

Project Map

Interactive Map

Finances

Financing Plan (US$ Millions)

Financier	Commitments
IDA Credit	150.00
Borrower/Recipient	69.82

Total Project Financing (US$ Millions)

Product Line	IBRD/IDA
IBRD Commitment	N/A
IDA Commitment	150.00
IBRD + IDA Commitment	150.00

Lending Instrument
Grant Amount	N/A
Total Project Cost**	2881.82

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$)
Feb 11, 2021	IDA-59130	Loan Disb	8,651,118.00
Feb 11, 2021	IDA-59130	Loan Disb	25,712,504.00
Oct 15, 2020	IDA-59130	Int Charges	157.09
Oct 15, 2020	IDA-59130	Int Charges	157.09
Oct 15, 2020	IDA-59130	Int Charges	357,393.47
Oct 15, 2020	IDA-59130	Int Charges	357,393.47
May 21, 2020	IDA-59130	Loan Disb	24,387,456.00
Dec 13, 2019	IDA-59130	Loan Disb	29,240,034.00
Apr 15, 2020	IDA-59130	Int Charges	496.50
Apr 15, 2020	IDA-59130	Int Charges	496.50
Apr 15, 2020	IDA-59130	Int Charges	238,043.36
Apr 15, 2020	IDA-59130	Int Charges	238,043.36
Apr 15, 2019	IDA-59130	Int Charges	1,095.99
Apr 15, 2019	IDA-59130	Int Charges	1,095.99
Apr 15, 2019	IDA-59130	Int Charges	93,152.46
Apr 15, 2019	IDA-59130	Int Charges	93,152.46
Oct 15, 2019	IDA-59130	Int Charges	20,290.45
Oct 15, 2019	IDA-59130	Int Charges	20,290.45
Oct 15, 2019	IDA-59130	Int Charges	165,657.94
Oct 15, 2019	IDA-59130	Int Charges	165,657.94
Feb 26, 2019	IDA-59130	Loan Disb	19,963,530.00
Oct 15, 2018	IDA-59130	Int Charges	92,811.63
Oct 15, 2018	IDA-59130	Int Charges	92,811.63
Oct 15, 2018	IDA-59130	Int Charges	12,521.79
Oct 15, 2018	IDA-59130	Int Charges	12,521.79
Mar 21, 2018	IDA-59130	Loan Disb	25,991,318.00
Jul 8, 2021	IDA-69110	Loan Commitment	50,000,000.00
Jan 13, 2017	IDA-59130	Loan Commitment	150,000,000.00
Jan 16, 2023	IDA-59130	Loan Cancel	6,742.05
Jan 19, 2023	IDA-69110	Loan Cancel	407,991.75
Apr 15, 2024	IDA-59130	Loan Repay	47,213.20
Apr 15, 2024	IDA-59130	Loan Repay	2,165,933.80
Apr 15, 2024	IDA-69110	Int Charges	167,859.40
Apr 15, 2024	IDA-69110	Int Charges	167,859.40
Apr 15, 2024	IDA-69110	Int Charges	2,927.75
Apr 15, 2024	IDA-69110	Int Charges	2,927.75
Apr 15, 2024	IDA-59130	Int Charges	514,532.03
Apr 15, 2024	IDA-59130	Int Charges	514,532.03
Oct 15, 2023	IDA-69110	Int Charges	1,031.63
Oct 15, 2023	IDA-69110	Int Charges	1,031.63
Oct 15, 2023	IDA-69110	Int Charges	169,950.33
Oct 15, 2023	IDA-69110	Int Charges	169,950.33
Oct 15, 2023	IDA-59130	Loan Repay	2,202,303.00
Oct 15, 2023	IDA-59130	Int Charges	520,269.50
Oct 15, 2023	IDA-59130	Int Charges	520,269.50
Oct 15, 2023	IDA-59130	Int Charges	34,695.08
Oct 15, 2023	IDA-59130	Int Charges	34,695.08
Jan 19, 2023	IDA-69110	Loan Disb	46,677,692.00
Apr 15, 2023	IDA-59130	Loan Repay	17,950.69
Apr 15, 2023	IDA-59130	Loan Repay	2,259,453.80
Apr 15, 2023	IDA-59130	Int Charges	510,673.40
Apr 15, 2023	IDA-59130	Int Charges	510,673.40
Apr 15, 2023	IDA-69110	Int Charges	82,900.66
Apr 15, 2023	IDA-69110	Int Charges	82,900.66
Oct 15, 2022	IDA-59130	Int Charges	509,156.38
Oct 15, 2022	IDA-59130	Int Charges	509,156.38
Oct 15, 2022	IDA-59130	Int Charges	-4,675.05
Oct 15, 2022	IDA-59130	Int Charges	4,675.05
Oct 15, 2022	IDA-59130	Int Charges	12,922.78
Oct 15, 2022	IDA-59130	Int Charges	12,922.78
Jan 3, 2022	IDA-59130	Loan Disb	16,649,705.00
Mar 21, 2018	IDA-59130	Loan Disb	26,016,784.00
May 21, 2020	IDA-59130	Loan Disb	-24,387,456.00
Jan 3, 2022	IDA-59130	Loan Disb	16,666,240.00
Mar 18, 2022	IDA-59130	Loan Disb	396,917.06
May 21, 2020	IDA-59130	Loan Disb	24,504,066.00
Feb 11, 2021	IDA-59130	Loan Disb	-25,712,504.00
Mar 18, 2022	IDA-59130	Loan Disb	-395,994.60
Mar 21, 2018	IDA-59130	Loan Disb	-25,991,318.00
Jan 3, 2022	IDA-59130	Loan Disb	-16,649,705.00
Feb 11, 2021	IDA-59130	Loan Disb	25,876,656.00
Dec 13, 2019	IDA-59130	Loan Disb	-29,240,034.00
Feb 11, 2021	IDA-59130	Loan Disb	-8,651,118.00
Feb 26, 2019	IDA-59130	Loan Disb	20,012,020.00
Dec 13, 2019	IDA-59130	Loan Disb	29,364,144.00
Feb 11, 2021	IDA-59130	Loan Disb	8,706,348.00
Feb 26, 2019	IDA-59130	Loan Disb	-19,963,530.00
Apr 15, 2022	IDA-59130	Int Charges	3,018.45
Apr 15, 2022	IDA-59130	Int Charges	3,018.45
Apr 15, 2022	IDA-59130	Int Charges	518,653.47
Apr 15, 2022	IDA-59130	Int Charges	518,653.47
Mar 18, 2022	IDA-59130	Loan Disb	395,994.60
Oct 15, 2021	IDA-59130	Int Charges	3,634.39
Oct 15, 2021	IDA-59130	Int Charges	3,634.39
Oct 15, 2021	IDA-59130	Int Charges	499,517.53
Oct 15, 2021	IDA-59130	Int Charges	499,517.53
Apr 15, 2021	IDA-59130	Int Charges	472.35
Apr 15, 2021	IDA-59130	Int Charges	472.35
Apr 15, 2021	IDA-59130	Int Charges	426,859.56
Apr 15, 2021	IDA-59130	Int Charges	426,859.56

Footnotes

Ratings

IMPLEMENTATION RATINGS

Name	Review	Date
Overall Implementation Progress (IP)	Satisfactory	2021-10-25
Progress towards achievement of PDO	Satisfactory	2021-10-25
Monitoring and Evaluation	Satisfactory	2021-10-25

COMPLETION RATINGS

INDICATOR	IMPLEMENTATION COMPLETION & RESULTS REPORT: 02-27-2023
Outcomes	Highly Satisfactory
Risk to Development Outcome
Bank Performance	Substantial
Borrower Performance
Government Performance
Implementing Agency

INDEPENDENT EVALUATION RATINGS

INDICATOR	ICR REVIEW: 09-26-2023	PROJECT PERFORMANCE ASSESSMENT REPORT:
Outcome Rating	Highly Satisfactory	N/a
Risk To Development Outcome		N/a
Bank Performance	Satisfactory	N/a
Borrower Performance		N/a
Government Performance		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

Percentage reduction of less than minimum stocks (understock) of tracer health commodities in sub-provincial medical stores (DLI 5)	Value	Baseline to be established in Year 3	40.09% in Gandaki and Madhesh Provinces	35.00
	Date	July 15, 2019	July 16, 2022	July 16, 2022
	Comment

Percentage of the MoHP’s annual spending captured by the TABUCS/CGAS. (DLI 8) Value 70% 99.99% of MoHP spending in Year 6 captured by TABU 95.00
Date January 13, 2017 July 16, 2022 July 16, 2022
Comment

Health facilities reporting annual disaggregated data using District Health Information System (DHIS 2) in a timely manner. (DLI 10)	Value	0%	HMIS/DHIS 2 shows timely reporting from at least 8	70.00
	Date	January 13, 2017	July 16, 2022	July 16, 2022
	Comment

INTERMEDIATE RESULTS INDICATORS

INDICATOR		BASELINE	CURRENT	TARGET

Percentage of contracts managed by the MD through the PPMO’s online procurement portal (DLI 1)	Value	No contract is through online e-procurement develo	99.37% of value of total contracts managed by MD d	95.00
	Date	January 13, 2017	July 16, 2022	July 16, 2022
	Comment

Percentage of the MoHP spending entities submitting annual plan and budget using eAWPB. (DLI 7)	Value	Not all spending units submit their annual plan an	eAWPB/LMBIS used in Year 6 for planning and budget	eAWPB/LMBIS used in Year 6 for planning and budget
	Date	January 13, 2017	July 16, 2022	July 16, 2022
	Comment

Establishment and functioning of web-based grievance redressal mechanism (DLI 2)	Value	Web-based Grievance Redressal Mechanism not establ	MoHP has made available on its website an annual r	MoHP has made available on its website an annual r
	Date	January 13, 2017	July 16, 2022	July 16, 2022
	Comment

Percentage of audited spending units responding to the OAG’s primary audit queries within 35 days. (DLI 9)	Value	Percentage as derived from MoHP inventory of respo	93.33% of the spending units reporting to MOHP tha	80% of the spending units reporting to MOHP that r
	Date	July 17, 2017	July 16, 2022	July 16, 2022
	Comment

MoHP to provide guidance and support to the subnational governments on citizen engagement mechanism (DLI 11)	Value	No formal guidelines for citizen feedback mechanis	MOHP provided onsite support to 11 Local Governmen	MoHP provided on-site support to at least three (3
	Date	January 13, 2017	July 16, 2022	July 16, 2022
	Comment

Percentage of procurements done by Management Division (MD) using standard specifications (DLI 3)	Value	Procurement not based on standard specifications	100% of health commodities; 100% of equipment proc	95% of health commodities; 80% of equipment procur
	Date	January 13, 2017	July 16, 2022	July 16, 2022
	Comment

Central medical stores and medical stores of Provinces report through eLMIS (DLI 4)	Value	eLMIS not in place	eLMIS information for program Year 6 is available	eLMIS information for program Year 6 is available
	Date	January 13, 2017	July 16, 2022	July 16, 2022
	Comment

Percentage improvement in EVM score over 2014 baseline. (DLI 6)	Value	Average EVM Score of 64%, with two attributes achi	Average EVM Score of 70% (based on a survey conduc	DLR 6.2a Average EVM Score of 70% (based on a surv
	Date	January 13, 2017	July 15, 2021	July 15, 2022
	Comment

Percentage of the MoHP’s annual spending captured by the TABUCS/CGAS. (DLI 8)	Value	70%	99.99% of MoHP spending in Year 6 captured by TABU	95.00
	Date	January 13, 2017	July 16, 2022	July 16, 2022
	Comment