- Implementation Support Agency (ISA): World Bank
- Total project financing: $187.6 million
- Funding from GCFF: $37.6 million
- GCFF Financing Approval Date: 01/07/2020
- Project Closing Date: 03/31/2023
- % Disbursed: 100%
- Status: Closed
About the project
The program contributes directly to the health sector goals of Colombia’s National Development Plan (PND) and to the strategic vision of the Ministry of Health and Social Protection (MSPS). The goals of the proposed operation of improving quality and efficiency contribute, in the longer term, to strengthening the financial sustainability of the Colombian health system and, in this sense, mirror the title of the government’s health sector program supported by this PforR: Health for all with quality and efficiency, sustainable by all. This Program for Results (PforR) is structured around two results areas: (a) Results area 1: improve the quality of health care services; and (b) Results area 2: improve efficiency in the health system (SGSSS).
Project Development Objective (PDO)
To support improvements in the quality of health care services and in the efficiency of the health system.
Project Implementation Status
The Improving Quality of Health Care Services and Efficiency in Colombia Program (P169866) was approved by the World
Bank Board of Directors on March 19, 2020. The loan became effective on December 1, 2020, following approval by the Congress
of the Republic of Colombia. The Program closed on December 31, 2024. The remaining funds will be disbursed during the grace
period of six months following the administrative closing date of the program on December 31, 2024. All results have been achieved
and therefore both the loan and grant components of the operation will be fully disbursed (100%) by June 30, 2025.
As of December 2024, the Program has disbursed US$154.4 million out of US$187.6 million (82% disbursement rate), with a total
of ten Disbursement Linked Results (DLRs) achieved out of thirteen. The Program Action Plan is being implemented as planned.
Furthermore, as of December 2024, the program has achieved significant results: two out of three Program Development Objectives
(PDOs) have been fully met and even surpassed; the Performance Index for public hospitals reached a score of 76 out of 100 (a
composite index of 17 indicators), and Efficiency Gains resulting from the introduction of new regulations in the pharmaceutical
market has led to efficiency gains of COP 946 billion (around US$227 million). Additionally, eleven out of twelves intermediary
results indicators have been accomplished.
In October 2024, the Government of Colombia (GoC) requested a third restructuring due to: (i) changes in its strategic orientations
for the health sector, which led to a request to replace the DLR related to EPS (Health Insurance Companies -Entidades Promotoras
de Salud) accreditation, as the GoC intends to substantially restructure the role of EPSs; and (ii) the disruption of preventive health
services for women at risk of breast cancer during the COVID-19 pandemic, coupled with the need to adjust the indicator’s baseline,
which was initially based on preliminary data from the National Development Plan. The restructuring was processed and approved
by the World Bank on November 4, 2024, and has been finally countersigned by the Minister of Finance on December 20, 2024. The
proposed changes in the restructuring include: (i) changes to DLR 1.2 related to EPS accreditation; (ii) adjustments to the Results
Framework to reflect the new baseline and targets for PDO1 and its associated DLR 2.3; (iii) the inclusion of a new DLR 2.4 focused
on an accelerated action plan to improve cancer control; (iv) the reallocation of financing between undisbursed DLRs to include the
new DLR 2.4; and (v) minor adjustments to the Financial Agreement. The approved and countersigned restructuring will allow to
complete execution of the Program proceeds and achievement of the PDO.