Washington DC, December 20, 2010 – The World Bank Board of Executive Directors has approved an additional grant of US$ 80 million for the Health Sector Rehabilitation Support Project in the Democratic Republic of Congo.
The additional grant will mainly fund a major scale-up of malaria control activities as well as related support to the overall health system. Malaria is the most common cause of illness in the country, contributing to maternal and child mortality. About 97% of the population is at risk of endemic malaria, while 3% are vulnerable to epidemic malaria.
Activities to be covered by the grant include providing approximately 8.4 million long-lasting insecticidal bed nets in Katanga, South Kivu, and North Kivu provinces; and delivering malaria control services (including prevention, diagnosis, and treatment) to pregnant women and infants in health zones supported by the project.
"The grant will help bridge the funding gap in the government’s effort to scale up malaria control and potentially reach universal bed net coverage by the end of 2011,” said Jean Jacques Frere, Senior Health Specialist and Task Team Leader of the project. “The Democratic Republic of Congo and Nigeria are now the two priority countries served by the World Bank’s Malaria Booster Program."
The grant builds on successful large-scale bed net distribution campaigns by the government in six provinces, including the mass distribution in Kinshasa supported by the World Bank in late 2008. The results are impressive: Nationwide bed net ownership has increased from 9.2 percent of households in 2007 to 51% in 2010, and bed net use by young children and pregnant women has increased dramatically in tandem with a decrease in the prevalence of malaria.
The project’s main objective has been to ensure that selected health zones—covering about 18.9 million people—have access to and make use of a well-defined package of quality essential health services.
The original project supported 83 health zones in 10 districts in Bandundu, Equator, Kinshasa, Katanga and Maniema provinces, covering 9.4 million people. It was restructured in April 2010. The geographic scope was expanded to include 70 more health zones earlier supported by the Emergency Multisectoral Reconstruction and Rehabilitation Project which closed at the end of 2009. This increased the beneficiary population from 9.4 million to 18.9 million.
The overall project has four components:
- Expand Access and Utilization of a Proven Package of Essential Health Services to Selected Districts and Health Zones: The project supports implementation of the Ministry of Health’s Package of essential primary health care services through performance-based contracts with non-governmental organizations.
- Boost Malaria Control Interventions: Malaria Control interventions under the original project include: (i) intermittent preventive treatment in pregnant women for pregnant women; (ii) Artemisinin-based Combination therapy for first-line treatment for malaria; and (iii) scaling up coverage of long-lasting insecticidal nets.
- Strengthen capacity for oversight and evidence-based management of the health system: Under this component, there are two essential activities: (i) building capacity for M&E through contracting of a firm as an External Evaluation Agency and (ii) strengthening institutional capacity of provincial and district health administrations through a contract with an international NGO.
- Project Coordination: This component supports a Project Coordination Unit within the Ministry of Health as well as the costs for an annual Project Review Forum. Initially the Bureau Central de Coordination in the Ministry of Finance was responsible for fiduciary management, but with the recent restructuring this responsibility was fully transferred to the Health Sector Rehabilitation project -Project Coordinator Unit.