Comprehensive Approach to Health System Strengthening

Abstract*

The development objectives of Comprehensive Approach to Health System Strengthening Project for Comoros are: (i) To improve utilization of quality PHC; and (ii) strengthen capacity of institutions which are critical to quality PHC. This project has four components.1) The first component, Improving PHC infrastructure, workforce, and service delivery platforms, has the following subcomponents: (i) Supporting the rehabilitation of PHC facilities (district...

* 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

(i) To improve utilization of quality PHC, (ii) to strengthen capacity of institutions which are critical to quality PHC and (iii) to provide immediate and effective response to an Eligible Crisis or Emergency

Key Details

Project Details

  • P166013

  • Active

  • Cedric Ndizeye

  • UNION OF COMOROS

  • Comoros

  • September 4, 2018

  • (as of board presentation)

    July 2, 2019

  • April 17, 2020

  • US$ 30.00 million

  • MINISTRY OF HEALTH, SOLIDARITY, SOCIAL PROTECTION AND GENDER PROMOTION

  • Eastern and Southern Africa

  • 2020

  • US$ 30.00 million

  • B

  • Not Applicable

  • June 30, 2026

  • Yes

  • Bank Approved

  • May 20, 2024

  • Notes

Finances

Financing Plan (US$ Millions)

No data available.
Financier Commitments
IDA Credit 15.00
IDA Grant 15.00

Total Project Financing (US$ Millions)

Product Line IBRD/IDA
IBRD Commitment N/A
IDA Commitment 30.00
IBRD + IDA Commitment 30.00
Lending Instrument
Grant Amount N/A
Total Project Cost** 30.00

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

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No data available.
Period Financier Transaction Type Amount (US$)

Footnotes

Ratings

IMPLEMENTATION RATINGS

Name Review Date
Financial Management Moderately Satisfactory 2025-10-31
Financial Management Moderately Satisfactory 2025-10-31
Monitoring and Evaluation Satisfactory 2025-10-31
Monitoring and Evaluation Satisfactory 2025-10-31
Overall Implementation Progress (IP) Moderately Satisfactory 2025-10-31
Overall Implementation Progress (IP) Moderately Satisfactory 2025-10-31
Procurement Moderately Satisfactory 2025-10-31
Procurement Moderately Satisfactory 2025-10-31
Progress towards achievement of PDO Satisfactory 2025-10-31
Progress towards achievement of PDO Satisfactory 2025-10-31
Project Management Satisfactory 2025-10-31
Project Management Satisfactory 2025-10-31

COMPLETION RATINGS

No data available.

INDEPENDENT EVALUATION RATINGS

No data available.

Results Framework

PROJECT DEVELOPMENT OBJECTIVE INDICATORS

INDICATORBASELINECURRENTTARGET
  • Functional community health sitesValue69.00173.00172.00
    DateOctober 31, 2019December 1, 2023September 30, 2025
    Comment
  • Number of children immunizedValue0.0051733.0070263.00
    DateDecember 31, 2017December 1, 2023September 30, 2025
    Comment
  • Number of deliveries attended by skilled health personnelValue0.0052016.0070000.00
    DateDecember 31, 2017December 1, 2023September 30, 2025
    Comment
  • Number of women and children who have received basic nutrition servicesValue0.0036370.0059000.00
    DateDecember 31, 2017December 1, 2023September 30, 2025
    Comment
  • Of which femaleValue0.00114481.00161029.00
    DateDecember 31, 2017December 1, 2023September 30, 2025
    Comment
  • PHC facilities participating in the PBF scheme supported by the project which reimburses for both quantity and quality of serviceValue0.0064.0080.00
    DateDecember 31, 2017December 1, 2023September 30, 2025
    Comment
  • PHC facilities with accreditation level 2 above as per the quality assurance programValue0.000.0040.00
    DateDecember 31, 2017December 1, 2023September 30, 2025
    Comment
  • People who have received essential health, nutrition, and population (HNP) servicesValue0.00140119.00199263.00
    DateDecember 31, 2017December 1, 2023September 30, 2025
    Comment
  • Percentage of identified close contacts of confirmed COVID-19 cases investigated based on national guidelinesValue0.00100.0080.00
    DateMay 15, 2020December 1, 2023December 31, 2022
    Comment

INTERMEDIATE RESULTS INDICATORS

INDICATORBASELINECURRENTTARGET
  • Annual District and National Health AssembliesValue0.0050.0086.00
    DateOctober 31, 2019December 1, 2023September 30, 2025
    Comment
  • Community health workers trained to provide health and nutrition servicesValue0.00305.00516.00
    DateDecember 31, 2019December 1, 2023September 30, 2025
    Comment
  • Complaints for grievances timely addressedValue0.00100.0075.00
    DateDecember 31, 2017December 1, 2023September 30, 2025
    Comment
  • Emergency Action Plan validatedValueEmergency Action Plan preparedYesYes
    DateDecember 31, 2019May 11, 2022June 30, 2020
    Comment
  • Functional Emergency Medical Transportation with a dedicated hotline on each islandValue0.000.005.00
    DateDecember 31, 2017December 1, 2023September 30, 2025
    Comment
  • Membership of health professional associationsValue0.00310.00100.00
    DateDecember 31, 2017December 1, 2023September 30, 2025
    Comment
  • National Health Strategies and Plans adopted (Quality of Care, NCDs, Human Resources for Health) (number)Value0.003.003.00
    DateJune 30, 2019December 1, 2023September 30, 2025
    Comment
  • Nationally representative patient experience surveys conductedValue0.001.002.00
    DateDecember 31, 2019December 1, 2023September 30, 2025
    Comment
  • Number of PHC health workers receiving annual CMEValue0.00244.00500.00
    DateDecember 31, 2019December 1, 2023September 30, 2025
    Comment
  • Number of designated GeneXpert center with SARS-CoV-2 diagnostic capacityValue0.003.002.00
    DateMay 15, 2020May 11, 2022December 31, 2022
    Comment
  • Number of designated health facilities with COVID-19 case management capacityValue0.003.003.00
    DateMay 15, 2020May 11, 2022December 31, 2022
    Comment
  • Of which femaleValue0.00162.00332.00
    DateDecember 31, 2019December 1, 2023September 30, 2025
    Comment
  • Of which femaleValue0.00197.00333.00
    DateDecember 31, 2019December 1, 2023September 30, 2025
    Comment
  • Operational hotline for patient complaints and feedbacksValueNoYesYes
    DateDecember 31, 2019December 1, 2023September 30, 2025
    Comment
  • PHC facilities renovated (minor renovations) and/or equipped among the PHC structures in need of these renovations and/or equipment (percentage)Value0.0090.00100.00
    DateDecember 31, 2019December 1, 2023September 30, 2025
    Comment
  • PHC facilities self-monitoring a set of quality of care indicator quarterly for quality improvementValue0.000.0050.00
    DateDecember 31, 2019December 1, 2023September 30, 2025
    Comment
  • PHC facilities with at least one quality improvement initiative with the team based problem solving approachValue0.000.0060.00
    DateDecember 31, 2019December 1, 2023September 30, 2025
    Comment
  • PHC health workers benefiting from annual clinical mentorship and/or coachingValue53.0064.00100.00
    DateDecember 31, 2019December 1, 2023September 30, 2025
    Comment
  • Patient associations/support groups established (diabetes, hypertension, chronic lung diseases, cancer)Value0.001.004.00
    DateDecember 31, 2019December 1, 2023September 30, 2025
    Comment
  • Primary health care facilities submitting monthly report according to national guidelinesValue0.0042.0070.00
    DateDecember 31, 2019December 1, 2023September 30, 2025
    Comment
  • Recipients of scholarships for pre-service training in selected clinical disciplines, public health and health managementValue0.0033.0035.00
    DateDecember 31, 2019December 1, 2023September 30, 2025
    Comment
  • Revision of the pre-service nurse training curriculum to make it competency-basedValueNoNoYes
    DateDecember 31, 2019December 1, 2023September 30, 2025
    Comment