Ghana - Health Sector Support Project

Document of The World Bank FOR OFFICIAL USE ONLY Report No: 25543 IMPLEMENTATION COMPLETION REPORT (TF-21578; TF-29254; IDA-29940) ON A LOAN/CREDIT/GRANT IN THE AMOUNT OF US$ MILLION TO THE GHANA FOR A HEALTH SECTOR SUPPORT PROJECT 06/04/2003 Human Development 2 Africa Region This document has a restricted distribution and may be used by recipients only in the performance of their official duties. Its contents may not otherwise be disclosed without World Bank authorization.  CURRENCY EQUIVALENTS (Exchange Rate Effective ) Currency Unit = Cedi Cedi 1 million = US$ 140 US$ 1 = Cedi 7150 SDR I =US$1.35 FISCAL YEAR ABBREVIATIONS AND ACRONYMS BMC Budget and Management Center CBO Community-based Organization CHAG Christian Health Association of Ghana CMA Common Management Arrangements CPPR Country Portfolio Performance Review DANIDADanish Agency for Development Assistance DFID Department for International Development DHS Demographic and Health Survey GAC Ghana AIDS Commission GAVI Global Alliance for Vaccines and Immunization GFAMT Global Fund against AIDS, Malaria, and Tuberculosis GHS Ghana Health Service GLSS Ghana Living Standard Survey GOG Government of Ghana GPRS Ghana Poverty Reduction Strategy GNI Gross National Income HIPC Highly Indebted Poor Countries HSSP Health Sector Support Project ICB International Competitive Bidding IGF Internally Generated Funds IMCI Integrated Management of Child Illness MCH Maternal and Child Health MOF Ministry of Finance MOH Ministry of Health MOU Memorandum of Understanding MTHS Medium-term Health Strategy NBC National Competitive Bidding NGO Non-Governmental Organization POW Program of Work PSR Project Supervision Report RBM Roll-back Malaria ROC Regional Operations Committee SIL Specific Investment Loan SWAp Sector-wide Approach TB Tuberculosis QAG Quality Assessment Group Vice President: Callisto E. Madavo Country Manager/Director: Mats Karlsson Sector Manager/Director: Alexandre V. Abrantes Task Team Leader/Task Manager: Ousmane Bangoura  GHANA HEALTH SECTOR SUPPORT CONTENTS Page No. 1. Project Data 1 2. Principal Performance Ratings 1 3. Assessment of Development Objective and Design, and of Quality at Entry 6 4. Achievement of Objective and Outputs 8 5. Major Factors Affecting Implementation and Outcome 14 6. Sustainability 20 7. Bank and Borrower Performance 22 8. Lessons Learned 24 9. Partner Comments 27 10. Additional Information 30 Annex 1. Key Performance Indicators/Log Frame Matrix 31 Annex 2. Project Costs and Financing 32 Annex 3. Economic Costs and Benefits 35 Annex 4. Bank Inputs 36 Annex 5. Ratings for Achievement of Objectives/Outputs of Components 39 Annex 6. Ratings of Bank and Borrower Performance 40 Annex 7. List of Supporting Documents 41 Annex 8. Borrower's Comments 45  Project ID: P000949 Project Name: HEALTH SECTOR SUPPORT Team Leader: Ousmane Bangoura TL Unit: AFTH2 ICR Type: Core ICR Report Date: June 4, 2003 1. Project Data Name: HEALTH SECTOR SUPPORT L/C/TF Number: TF-21578; TF-29254; IDA-29940 Country/Department: GHANA Region: Africa Regional Office Sector/subsector: Health (96%); Central government administration (4%) Theme: Health system performance (P); Other financial and private sector development (S); Fighting communicable diseases (S) KEY DATES Original Revised/Actual PCD: 10/25/1995 Effective: 06/18/1998 Appraisal: 06/25/1996 MTR: 06/01/2000 Approval: 10/21/1997 Closing: 06/30/2002 06/30/2002 Borrower/Implementing Agency: GOVERNMENT/MINISTRY OF HEALTH Other Partners: 1) Participating in the Health Account: Danida, DFID, Government of the Kingdom of the Netherlands, The Nordic Fund; ii) Not participating in the Health Account: European Commission, JICA, USAID, CIDA, WHO, Unicef, UNFPA, GTZ, AfDB, ABEDA, OPEC Fund, Saudi Fund for Development. STAFF Current At Appraisal Vice President: Callisto E. Madavo Jean-Louis Sarbib Country Director: Mats Karlsson Kazi Matin (Acting) AFC10 Sector Manager: Alexandre V. Abrantes Helena Ribe Team Leader at ICR: Fran