Peru Second Phase of Health Reform Program Implementation Completion and Results Report

Annex 8. Comments of Cofinanciers and Other Partners/Stakeholders

Annex 9. List of Supporting Documents

• 
  Project Appraisal Document, January 22, 2009
  
• 
  Minutes of Concept Note Review Meeting, November 2, 2005
  
• 
  Minutes of Quality Enhancement Review Meeting, May 4, 2006
  
• 
  Minutes of Decision Review Meeting and Matrix of Comments and Team Reponses, December 8, 2008
  
• 
  Loan Agreement between Republic of Peru and International Bank for Reconstruction and Development (7643-PE), signed November 16, 2009
  
• 
  Minutes of Negotiations, December 15, 2008
  
• 
  Implementation Completion Report of Health Reform Program (Programa de Apoyo a la Reforma del Sector Salud - PARSALUD I; First Phase: Mother and Child Insurance and Decentralization of Health Services), dated March 30, 2006 (ICR000073)
  
• 
  Feasibility Study of PARSALUD II (Segunda fase del Programa de Apoyo a la Reforma del Sector Salud - PARSALUD II. Estudio de Factibilidad), November 2008
  
• 
  Restructuring Papers:
  

1. 
   Restructuring Paper (level 2), dated May 17, 2011, approved June 20, 2011
   
2. 
   Restructuring Paper (level 2), dated August 20, 2014, approved August 26, 2014
   

• 
  Implementation Documents:
  

1. 
   Implementation Status and Results Reports
   
2. 
   Aide Memoires
   
3. 
   Mid-Term Review Report (Revisión de Medio Término de la Segunda Fase del Programa de Apoyo a la Reforma del Sector Salud (PARSALUD II) en el Perú, April 2013)
   
4. 
   Financial Audits Reports
   
5. 
   PARSALUD Progress Reports
   
6. 
   Government’s Final Evaluation of PARSALUD (Estudio de Evaluación Final de la Segunda Fase del Programa de Apoyo a la Reforma del Sector Salud ― PARSALUD II, December 2015)
   

• 
  PARSALUD Studies:
  

1. 
   Sistematización de la Estrategia de Promoción de Practica y Entornos Saludables (EPPES) por el PARSALUD II
   
2. 
   Sistematización de la Estrategia de Derecho a la Identidad y Aseguramiento-DIA del PARSALUD II
   
3. 
   Sistematización del Fondo Concursable para la Selección e implementación de las iniciativas en el ámbito de intervención del PARSALUD II
   
4. 
   Sistematización de la Experiencia en Consulta Previa y Diálogos Interculturales, Implementadas por el PARSALUD II
   

Annex 10: Analysis of PDO Achievement

#	Indicator	2005	2009	2014	End target	Average annual growth rate 2005-2009	Average annual growth rate 2009-2014	Ratings	End target met (100% achieved or surpassed)?	In/ before 2009?	Indicator going in desired direction in 2009-2014?	Annual growth rate >=0.5%?
1	Infant mortality rate	42		17	25			Surpassed	Yes		Yes
2	Prevalence of chronic malnutrition in children under 5 years of age	38.20%		23.70%	30.20%			Surpassed	Yes		Yes
3	Increase the proportion of institutional deliveries in rural areas of the nine selected Regions from 44% (2005) to 78% (2014)	44.00%	58.80%	74.20%	78.00%	3.70%	2.20%	Partially achieved	No		Yes	Yes
4	Reduce the prevalence of anemia among children under age in the nine regions from 69.5% (2005) to 60% (2014)	69.50%	58.20%	57.30%	60.00%	-2.83%	-0.13%	Partially achieved	Yes	Yes	Yes	No
5	Increase from 64% to 80% the share of children in the nine selected regions who are exclusively breastfed until 6 months of age	64.00%	82.20%	87.00%	80.00%	4.55%	0.69%	Achieved	Yes	Yes	Yes	Yes
6	Reduce the prevalence of anemia among pregnant women in the nine Regions from 41.5% (2005) to 35% (2014)	41.50%	31.80%	36.40%	35.00%	-2.43%	0.66%	Not Achieved	No		No
7	Reduce the hospital lethality rate among neonates in the nine selected Regions from 9.5% (2005) to 5% (2014)	9.50%	9.50%	5.00%	5.00%	0.00%	-0.64%	Achieved	Yes		Yes	Yes
8	Increase in the proportion of pregnant women of the nine regions with at least 1 prenatal control during the first trimester of pregnancy from 20% (2005) to 45% (2014)	20.00%	63.90%	69.10%	45.00%	10.98%	0.74%	Achieved	Yes	Yes	Yes	Yes
9	Percentage of SIS affiliated children who received growth and development controls (CRED) according to their age	34.00%	28.80%	56.80%	66.00%	-1.30%	4.00%	Partially achieved	No		Yes	Yes
10	Percentage of health facilities with improvement in infrastructure (minor construction, rehabilitation and/or new equipment)	0.00	0.00	103.00	103.00	0.00%	1471.43%	Achieved	Yes	No	Yes	Yes
11	Percentage of SIS affiliated rural pregnant women with laboratory tests on hemoglobin, urine and syphilis	37.00%	42.00%	69.00%	53.50%	1.25%	3.86%	Surpassed	Yes	No	Yes	Yes
12	Percentage of pregnant women under SIS that receive iron and folic acid supplements	37.00%	49.90%	55.00%	60.00%	3.23%	0.73%	Partially achieved	No		Yes	Yes
13	Percentage of women satisfied with the services in selected facilities by confidence index	0.00%	1.00%	74.40%	25.00%	0.25%	10.49%	Surpassed	Yes	No
14	Percentage of cesareans in SIS affiliated pregnant rural women	3.00%	3.50%	9.50%	10.00%	0.13%	0.86%	Partially achieved	No		Yes	Yes
15	Percentage of references among SIS-affiliated women (during pregnancy and puerperium) and neonates	N/A	N/A	Dropped	Dropped	Dropped	Dropped
16	Percentage of SIS affiliated households that make out-of-pocket expenditures in medicines	67.30%	62.00%	56.00%	55.00%	-1.33%	-0.86%	Partially achieved	No		Yes	Yes
17	Number of accredited health establishment by type of resolution	80.00	N/A	Dropped	Dropped	Dropped	Dropped
18	Number of Management Agreements in place	N/A	N/A	Dropped	Dropped	Dropped	Dropped
19	Number of health personnel and community health workers trained within the behavior change campaign (EPPES)	0.00	0.00	1178.00	758.00	0.00%	16828.57%	Surpassed	Yes	No	Yes	Yes
20	Number of health facilities improved	0.00	0.00	69.00	73.00	0.00%	985.71%	Partially achieved	No		Yes	Yes
21	Norms and regulations to improve efficiency and equity of the health delivery system prepared	0.00	0.00	32.00	27.00	0.00%	457.14%	Surpassed	Yes	No	Yes	Yes
22	Clinical pathways and corresponding financing systems designed	0.00	0.00	16.00	11.00	0.00%	228.57%	Surpassed	Yes	No	Yes	Yes
23	Periodic evaluations of the performance of the health networks	0.00	0.00	19.00	17.00	0.00%	271.43%	Surpassed	Yes	No	Yes	Yes

* Explanation of Ratings:

Surpassed: end target achieved/surpassed and indicator value at the start of the project lower than the end target;

Achieved: end target met/surpassed (at any point in time), growth rate during the project going in desired direction and >=0.5%;

Partially Achieved: end target not met, growth rate during the project going in desired direction and >=0.5% OR end target met before 2009, growth rate during the project going in desired direction and <0.5%;

Not Achieved: end target not met and undesired trajectory of indicator