Ratings for the Health Service Delivery Network Project for Bolivia were as follows: outcomes were unsatisfactory, the Bank performance was unsatisfactory, and the monitoring and evaluation quality was modest. Some lessons learned included: strengthening health care networks can enhance the efficacy and efficiency of public health systems. The operation's approach toward improving access and quality of health service delivery from a network perspective was adequate. Specifically, facilitating patients' navigation through the various levels of care can help improve their access to quality health care services. Likewise, improving the articulation of different levels of care within health care networks, with PHC facilities functioning both as points of entry as well as gatekeepers to more complex levels of care can help improve the efficiency of the overall health system, including avoiding duplication of services and ensuring the alignment between the facilities' capacity and the level of care they provide. It is important to match the scope of the operation with the country's institutional capacity and the implementation capacity of the responsible executing agency. The operation's scope was overly ambitious, particularly under component 1 and when taking into consideration the counterpart's limited institutional and implementation capacity. Even before the 2019-2020 political events, the Bank's portfolio as a whole was affected by frequent changes in authorities and implementing entities' staff, impacting institutional capacity for implementation. In addition, the agency responsible for the bulk of the implementation, had been recently created so lacked experience in managing large investments. It is important to ensure that the timeframe of specific investments is aligned with that of the operation. In this case, the implementation period envisioned for the completion of new hospitals was highly underestimated, particularly when taking into consideration the need to conduct feasibility studies and the high level of technical complexity involved in bidding documents and procedures, project design, construction and operation.
Authors
- Disclosure Date
- 2024/08/01
- Disclosure Status
- Disclosed
- Doc Name
- Bolivia - Health Service Delivery Network Project
- Lending Instrument
- Investment Project Financing
- Pages
- 49
- Product Line
- IBRD/IDA
- Published in
- United States of America
- Rel Proj ID
- BO-Health Service Delivery Network Project -- P164453
- TF No/Name
- TF0A9177-GFF Exploratory grant Round 2: Bolivia
- Unit Owning
- Health Nutrition &Population LCR (HLCHN)
- Version Type
- Gray cover
- Volume No
- 1
Table of Contents
- IMPLEMENTATION COMPLETION AND RESULTS REPORT 1
- IBRD-8868 IDA-6248 1
- ON AN IBRD LOAN 1
- IN THE AMOUNT OF US252 MILLION 1
- AND AN IDA CREDIT 1
- IN THE AMOUNT OF US42 MILLION 1
- TO THE PLURINATIONAL STATE OF BOLIVIA 1
- FOR A 1
- HEALTH SERVICE DELIVERY NETWORK PROJECT 1
- August 1 2024 1
- Health Nutrition Population Global Practice Latin America and Caribbean Region 1
- The World Bank 2
- US1.00 BOB 6.91 2
- US1.00 SDR 0.75 2
- The World Bank 3
- The World Bank 4
- DATA SHEET ................................................................................................................................................. i 4
- The World Bank 5
- The World Bank 6
- The World Bank 7
- The World Bank 8
- The World Bank 9
- The World Bank 10
- The World Bank 11
- Hospital infrastructure was old and inadequate 11
- Medical human resources were scarce particularly highly specialized ones . 11
- Further progress was needed to ensure equitable access - 11
- Access to secondary and tertiary care varied widely across the country - 11
- Continuity of care was still a significant issue - 11
- The World Bank 12
- The World Bank 13
- US243.0 million equivalent to 81 13
- The World Bank 14
- Subcomponent 2.2 - Developing updating and dissemination of national clinical care care pathways standards 14
- . First restructuring Second Restructuring 14
- The World Bank 15
- Third Restructuring 15
- Fourth Restructuring 15
- The World Bank 16
- Fifth Restructuring 16
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- Rating 18
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- Rating Rating 32
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- Rating 33
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- Note 44
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- The World Bank 49
