grant performance report - print version - ccs.gov.egccs.gov.eg/ntp/pdf/2egyt_117_210_gpr.pdf ·...

EGY-202-G01-T-00

EgyptGrant Performance Report

External Print Version

Last Updated on: 14 May 2008

page 1 of 28

General Grant Information

Grant Start Date 01 Jul 2004 Phase 1 End Date 01 Jul 2006 Phase 2 End Date 30.Jun.09

Total Lifetime Budget $ 4,032,014 Phase 1 Grant Amount

$ 2,480,219 Phase 2 Grant Amount

$ 1,551,795

Time Elapse (at the end of the latest reporting period)

42 months % of Grant Duration 70% Proposal Lifetime 60 months

Disbursed Amount $ 3,705,739 % of Grant Amount 92% Latest Rating B1

Grant Number EGY-202-G01-T-00 Component Tuberculosis Round 2

Country Egypt

Principal Recipient National Tuberculosis Control Program, The Ministry of Health and Population of the Government of Egypt

Grant Title Support of National plan for control of Tuberculosis

EGY-202-G01-T-00

Grant Performance ReportExternal Print Version


page 2 of 28

New GPR Report - Table of Contents(For ExternalVersion)

1. Program Description and Contextual Information

2. Key Grant Performance Information

2.1. Program Goals, Impact and Outcome Indicators

2.2. Programmatic Performance

2.3. Financial Performance

2.4. Progress Update and Disbursement Information

2.6. Phase 2 Grant Renewal

2.5. Contextual Information

2.3.5. Summary of Financial Accountability Issues from PR Annual Audit Report

2.2.1. Reporting Periods

2.2.2. Program Objectives, Service Delivery Areas and Indicators

2.2.3. Cumulative Progress To Date

2.3.1. Grant Financial Key Performance Indicators (KPIs)

2.3.2. Program Budget

2.3.3. Program Expenditures

1.4. Initial Assessment of Principal Recipient

1.5. Conditions Precedent

1.3. Comments on Key Discrepancies between Approved Proposal and Grant Agreement

1.1. Program Description Summary

1.2. Country Latest Statistics

2.3.4. Graph - Cumulative Program Budget, Expenditures and Disbursement to Date

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1. Program Description and Contextual Information

Tuberculosis (TB) is considered an important public health problem in Egypt. A tuberculin survey was carried out in 1995-97, which revealed that the size of the TB problem in Egypt was considerably smaller than 45 years before - the annual risk of infection (ARI) was 0.32% (compared to 0.7% in 1982 and 3.7% in 1949-1952), ranking Egypt among the mid-level incidence countries. Despite considerable progress in DOTS expansion, the National Tuberculosis Control Programme (NTP) in Egypt has not yet achieved the global targets for TB control. Latest surveillance data in 2005 revealed a prevalence rate of 35/100,000. It is estimated that (i) 19,600 new cases of TB currently develop in Egypt annually, of which an estimated 19,500 are people suffering from the infectious smear-positive pulmonary form of TB and (ii) 2,299 people die of TB in Egypt every year.The Program will carry out multiple activities in support of Egypt’s National Tuberculosis Control Programme. The NTP provides TB control services through a nation-wide network of chest clinics and chest hospitals, with a mandate to reduce mortality and morbidity of TB until it is no longer a significant health problem. The objectives are (i) to achieve and sustain a 70% case detection rate and an 80% cure rate, using the DOTS strategy (ii) to screen vulnerable populations, namely refugees, prisoners and health service providers (iii) to control multi-drug-resistant TB (MDR-TB), and (iv) to integrate services with other healthcare providers.

1.1. Program Description Summary

The CCM approached the GF with a request to reprogram and use GF funds to purchase MDR drugs instead of upgrading health facilities due to unavailability of local funds to finance MDR drugs. This was done after submitting the proposal and during the negotiations of the grant agreement and approved by the GF.

1.3. Comments on Key Discrepancies between Approved Proposal and Grant

1.4. Initial PR Assessments

Background Analysis x Background analysis was not performed for the Round 2 grants. As this was a PR for the first time, a full assessment was carried out.

Assessment Area Rating Summary of Recommendations/Action Required and Taken

New SS+ TB cases 8,314 2005 WHO. WHO report 2007.Global tuberculosis control: surveillance, planning, financing.

TB mortality 2,144 2005 WHO. WHO report 2007.Global tuberculosis control: surveillance, planning, financing.

TB incidence 18,479 2005 WHO. WHO report 2007.Global tuberculosis control: surveillance, planning, financing.

People with TB 23,420 2005 WHO. WHO report 2007.Global tuberculosis control: surveillance, planning, financing.

Tuberculosis Estimate Year Source

Child mortality rate (per 1000) 36 2004 WHO. The World health report 2006: Working together for health.

Income level Lower middle income

2005 World Bank. World Development Indicators database (http://devdata.worldbank.org/data-

query/) accessed on January 24, 2007

Physicians, Number 38,485 2003 WHO. The World health report 2006: Working together for health.

Total health expenditure per capita (USD) 55 2003 WHO. The World health report 2006: Working together for health.

Nurses, Number 146,761 2004 WHO. The World health report 2006: Working together for health.

Total population (in 1000s) 72,850 2005 United Nations. World Population Prospects: The 2006 Revision.

GNI per capita (USD) 1,250 2005 World Bank. World Development Indicators database (http://devdata.worldbank.org/data-

query/) accessed on January 24, 2007

Pop age 15-49 (in 1000s) 37,844 2005 United Nations. World Population Prospects: The 2006 Revision.

Pop age 0-4 (in 1000s) 8,545 2005 United Nations. World Population Prospects: The 2006 Revision.

Background and Health Spending Estimate Year Source

1.2. Country Latest Statistics

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1.5. Conditions Precedent

Evidence by means of an assessment of the PRs procurement and supply management systems that it can satisfactorily undertake such procurement.

Yes

A detailed, two year budget using budget line items selected by the PR, including planned disbursements to SRs.

Yes

Letter signed by the PR setting forth name of each person authorized to sign disbursement requests

Yes

Statement confirming the bank account into which the Grant funds will be disbursed

Yes

Evidence that the PR has appointed an external auditor to review and validate the expenditure reports and other financial data and reports.

Yes

Evidence of the development of a monitoring and evaluation plan, incl. tools for data collection and reporting, time intervals, responsible persons identified and agreement on a core set of indicators.

Yes

Evidence that the PR has signed has signed an agreement with the SRs that outlines the roles and responsibilities and reporting requirements of each party to the agreement.Not longer applicable. It was agreed that the health units on the governorate and peripheral level that are reporting to the MOHP are not really sub-recipients.

Yes

Evidence of tax exemptionThe PR submitted a letter that the Ministry of Health and Population (MOHP) will absorb taxes from the ministry's budget until the ministry of finance replies to their request for tax exemption.

Yes

Condition Precedent Tied To Terminal Date Is currently met? Comments

Procurement and Supply Management

B1 The assessment has determined that the PR has the capacity to undertake the procurement, it is however recommended that the procurement and supply management plan should be updated to clearly identify the MDR-TB drugs to be procured based on Green Light Committee guidelines.

Monitoring and Evaluation B1 The PR needs to strengthen its M&E activities so as to ensure that information collected meets Global Fund requirements - such as recording and management of programmatic data, stakeholder coordination and decision-making, related M&E with appropriate quality control measures. The M&E plan should reflect specifically the tools which will be used for data collection and reporting.

Overall B1 NULLOREMPTY

Institutional and Programmatic B1 The assessment has determined that the PR can undertake the management of the proposed program by enhancing its institutional and program management capacity by appointing a Program Management Team to manage and monitor activities funded by the Global Fund. Furthermore, the PR should clearly outline roles, responsibilities and reporting requirements of Sub-recipients under this grant and provide capacity building training as necessary.

Financial Management and Systems

B1 Initial assessments have determined that the Principal Recipient can undertake the management of the proposed program provided it enhances its financial management capacity by formally identifying the team responsible for the finance management system under this grant and establishing key policies and procedures to manage funds to assure flexibility and acceleration of disbursement, without violating any government rules. The financial reporting system should be further enhanced throughout using a computerized financial and accounting information system to monitor the cost of each activity in each governance. Further the PR should strengthen its human resource capacity to absorb and manage the additional resources. An external auditor should be appointed to review and validate expenditure reports and any other financial data and reports.

Assessment Area Rating Summary of Recommendations/Action Required and Taken

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Promptly following completion of the next TB prevalence survey in Egypt, the Principal Recipient shall provide to the Global Fund the proposed targets for the Impact/Outcome Indicator “TB Prevalence Rate” contained in Section B (Program Goal, Impact and Outcome Indicators) of Attachment 3&4 to this Annex A. It is understood by the Principal Recipient that, following the agreement by the Global Fund to such targets, such targets will be incorporated into Attachment 3&4 to this Annex A.

No

Without prejudice to any of the Principal Recipient’s other obligations under this Agreement, by the date that falls no later than three (3) months after the effective date of this Agreement, the Principal Recipient shall ensure that it has reached, or exceeded, the targets for the end of Phase 1 for each of the following indicator targets as referred to in Attachment 2 to the Original Grant Agreement (and shall provide to the Global Fund such confirmations or documentation as the Global Fund may request as evidence to demonstrate that such targets have been met): a) Number of TB patients (new smear positive) detected due to the newly established diagnostic unitsb) Number of TB patients receiving treatment for MDR-TB (using second-line anti-TB drugs)c) Number of NGO service deliverers trained on following up defaulters

In Progress

Evidence that procurement of multi-drug-tuberculosis for new patients or the establishment of the four centers to treat MDR-TB cases will be contingent upon approval by the Green Light Committee of the application and of the implementation of other recommendations of the Green Light Committee mission.

Yes

A plan for monitoring the performance and sustainability of procurement and supply management systems (the monitoring plan to include tracking of procurement prices, distribution costs, additionality of GF resources to domestic and other international sources, and other measures of procurement and supply system performance and sustainability).

Yes

Condition Precedent Tied To Terminal Date Is currently met? Comments

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2.1. Program Goals, Impact and Outcome Indicators

Goal 1 To reduce mortality and morbidity of TB until it is no longer a public health problem.

47% 2001

Value Year

BaselinesCase detectionImpact indicator

70% (Year 2007)

Result

Target

Year 10Year 9Year 8Year 7Year 6Year 5Year 4Year 3Year 2Year 1

75% 2001

Value Year

BaselinesCure rateImpact indicator

85% (year 2007)

58%

Result

Target

Year 10Year 9Year 8Year 7Year 6Year 5Year 4Year 3Year 2Year 1

2. Key Grant Performance Information

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2.2.2. Program Objectives, Service Delivery Areas and Indicators

Objective 1 - Promoting strong managerial capacity

01.Apr.1030.Jun.10

01.Jan.1031.Mar.10

01.Oct.0931.Dec.09

01.Jul.0930.Sep.09

01.Apr.0930.Jun.09

01.Jan.0931.Mar.09

01.Oct.0831.Dec.08

01.Jul.0830.Sep.08

N/A

Period 24Period 23Period 22Period 21Period 20Period 19Period 18Period 17

01.Apr.0830.Jun.08

01.Jan.0831.Mar.08

01.Oct.0731.Dec.07

01.Jul.0730.Sep.07

01.Apr.0730.Jun.07

01.Jan.0731.Mar.07

01.Oct.0631.Dec.06

01.Jul.0630.Sep.06

N/A


01.Apr.0630.Jun.06

01.Jan.0631.Mar.06

01.Oct.0531.Dec.05

01.Jul.0530.Sep.05

01.Apr.0530.Jun.05

01.Jan.0531.Mar.05

01.Oct.0431.Dec.04

01.Jul.0430.Sep.04

N/A


2.2.1. Reporting Periods

2.2. Programmatic Performance

EGY-202-G01-T-00



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Pending result441Pending result385Pending resultPending result385

450450450450375375375375

Result

Target


27318511000000

300250200150150100500

Result

Target


YYJul-2004NALevel 1-People trained

Is Training indicator? (Y/N)

Is Top 10 indicator? (Y/N)

YearValue

Baseline

Indicator 1.3 - Number of service deliverers trained in Epidemiology biostatistics and quality assurance

Not in attachment 3

Result

Target


55500000

64433220

Result

Target


YYJul-2004NALevel 0-Process/Activity Indicator



YearValue

Baseline

Indicator 1.2 - Number of central staff attending international conferences e.g. IUATLD


14141212101088

Result

Target


44400000

66522110

Result

Target


YYJul-20040Level 1-People trained



YearValue

Baseline

Indicator 1.1 - Number of center staff trained on program management incl. those attending national/international training courses

SDA - Supportive Environment: Health systems strengthening

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6565655050505050

Result

Target


3515000000

353020202015105

Result

Target


NNJul-20040Level 2-Service Points supported



YearValue

Baseline

Indicator 2.3 - Number of renovated laboratories in the existing chest facilities


10810810810881818181

Result

Target


51515100000

54542727272790

Result

Target


YYJul-20004

50Level 1-People trained



YearValue

Baseline

Indicator 2.1 - Number of lab technicians trained


8080808080808080

Result

Target


5815000000

8060606060402010

Result

Target





YearValue

Baseline

Indicator 2.2 - Number of new health facilities providing lab diagnosis for TB

SDA - Prevention: Identification of Infectious Cases

Objective 2 - Strengthening case detection

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Pending result19,269Pending result16,352Pending resultPending result14,547

23,85622,36520,87419,38317,89216,40114,91014,910

Result

Target


Pending result

11,928

Result

Target


NY20040Level 3-People reached



YearValue

Baseline

Indicator 2.5 - Number of TB patients (new smear positive) detected in the chest facilities within MOPH and the other sectors starting treatment under DOTS (National figure)

Not in attachment 3

Result

Target


00000000

18016014012012060300

Result

Target


NYJul-20040Level 3-People reached



YearValue

Baseline

Indicator 2.4 - Number of TB patients (new smear positive) detected under DOTS due to the newly established diagnostic units

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Not in attachment 3

Result

Target


22,43919,62217,25314,67111,9599,235Pending resultPending result

25,80522,30519,20516,20512,3059,2356,2403,250

Result

Target


NNJul-20042750Level 3-People reached



YearValue

Baseline

Indicator 3.3 - Number of people receiving DOTS treatment

186%1

17340/19260 (89%)

16000/17780 (89%)

14660/16290 (89%)

13320/14800 (89%)

12042/13380 (89%)

11313/12570 (89%)

10584/11760 (89%)

10584/11760 (89%)

Result

Target


2154/2520 (85%)

1983/2267 (87%)

890/1009 (88%)1057/1216 (86.9%)

1032/1178 (87%)

88%Pending resultPending result

1600/1778 (90%)

1550/1741 (89%)

1500/1705 (88%)

2000/2272 (88%)

1022/1144 (89%)

1127/1295 (87%)

1138/1293 (88%)

990/1125 (88%)

Result

Target


NYJul-20041135/1320

(86%)

Level 3-People reached



YearValue

Baseline

Indicator 3.2 - Number and % of smear-positive TB cases registered under DOTS who are successfully treated (figure relates to National Program) (Not cumulative)

Pending result19,314Pending result16,071Pending resultPending result13,705

20,83019,56018,28217,01015,73513,56213,18813,188

Result

Target


11,173

2210 chest facility doctors;

3050 nurses; 1266 peripheral


3050 nurses; 73 peripheral


720 nurses

225 chest facility doctors

225 chest facility doctorsPending resultPending result

1,200 chest facility doctors;

1,440 chest facility nurses;

8,000 peripheral

health staff


1,080 chest facility nurses;

6,000 peripheral

health staff


720 chest facility nurses;

4,000 peripheral

health staff



4,000 peripheral

health staff



4,000 peripheral

health staff



2,666 peripheral

health staff


240 chest facility

nurses;1,333 peripheral

health staff

600 chest facility doctors

Result

Target





YearValue

Baseline

Indicator 3.1 - Number of service deliverers trained in DOTS strategy and proper diagnosis of TB cases (doctors, nurses, peripheral health staff)

SDA - Treatment: Timely detection and quality treatment of cases

Objective 3 - To increase treatment success case

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640640640480480480480480

Result

Target


198198131000Pending resultPending result

3202401601601601208040

Result

Target





YearValue

Baseline

Indicator 3.6 - Number of NGO service deliverers trained on following up defaulters

8

8

Result

Target


87400000

86444440

Result

Target


NNJul-2004NALevel 0-Process/Activity Indicator



YearValue

Baseline

Indicator 3.5 - Number of workshops held with the partners

SDA - Supportive Environment: Coordination and partnership development (national, community, public-private)

N: D:

P: %Pending resultPending resultPending result

N: D:

P: 3%Pending resultPending result0

N: 327D: 19,260

P: 2%

N: 302D: 17,780

P: 2%

N: 277D: 16,290

P: 2%

N: 252D: 14,800

P: 2%

N: 230D: 13,380

P: 2%

N: 215D: 12,570

P: 2%

N: 200D: 11,760

P: 2%

N: 200D: 11,760

P: 2%

Result

Target


41/2520 (1.62%)

37/2267 (1.6%)28/1009 (2.8%)32/1216 (2%)27/1178 (2%)Pending resultPending resultPending result

N: D:

P: %

N: 17D: 1,741

P: 1%

N: 17D: 1,705

P: 1%

N: 23D: 2,272

P: 1%

N: 20D: 1,000

P: 2%

N: 19D: 950P: 2%

N: 15D: 1,510

P: 1%

N: 28D: 1,400

P: 2%

Result

Target


NNJul-20043%Level 3-People reached



YearValue

Baseline

Indicator 3.4 - New smear positive cases registered under DOTS who fail treatment (number and %)

SDA - Treatment: Control of drug resistance

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300280261243225206187187

Result

Target


1500000Pending resultPending result

1501251007575543618

Result

Target


NYJul-20040Level 3-People reached



YearValue

Baseline

Indicator 4.3 - Number of TB patients receiving treatment for MDR-TB (using second line anti TB drugs)


44444444

Result

Target


111000Pending result

21111110

Result

Target





YearValue

Baseline

Indicator 4.2 - Number of centers established for treating MDR-TB


1081081088181818181

Result

Target


530000000

5654542828282828

Result

Target





YearValue

Baseline

Indicator 4.1 - Number of lab technicians trained in detection of MDR cases

SDA - Treatment: Control of drug resistance

Objective 4 - Better control of MDR TB

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Pending result90,000Pending result90,000Pending resultPending result

40,000 brochures,

15,000 booklets, 6 TV

spots and 12 Radio programs

120,000120,000120,00090,00090,00090,00090,000

40,000 rochures,

20,000 booklets, 6 TV

spots and 12 Radio programs

Result

Target


30000 brochures;

15000 booklets;

10500 brochures;

4000 booklets;

10500 brochures;

4000 booklets;000Pending resultPending result

40000 brochures;

20000 booklets;

30000 brochures;

15000 booklets;

20000 brochures;

10000 booklets;

20000 brochures;

10000 booklets

20000 brochures;

10000 booklets

20000 brochures;

10000 booklets

20000 brochures;

10000 booklets

20000 brochures;

10000 booklets

Result

Target


NNJul-20041000 brochures, 500

booklets,

Level 2-Service Points supported



YearValue

Baseline

Indicator 5.1 - Number Radio/TV programs, posters, brochures and booklets developed and distributed

Pending result18Pending result18Pending resultPending result6 TV spots and

12 Radio programs

1818181818181818

Result

Target


92 TV spots; 6

Radio programmes

0

6 TV spots; 12 Radio

programmes

3 TV spots; 6 Radio

programmes

3 TV spots; 6 Radio

programmes

Result

Target


NN20043 TV Spots

Level 2-Service Points supported



YearValue

Baseline

Indicator 5.2 - Number of Radio/TV programs produced and aired

SDA - Prevention: Behavioral Change Communication - Mass Media

Objective 5 - Production of health education materials of proper design and content

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23million/70million

23million/70million

Result

Target


23000000/70000000

32.9%

16000000/70000000

22.9%

12000000/70000000

17.1%

6000000/70000000

8.6%0Pending resultPending resultPending result

23000000/70000000

32.9%

16000000/70000000

22.9%

12000000/70000000

17.1%

8000000/70000000

11.43%

8000000/70000000

11.43%

6750000/70000000

9.64%

4500000/70000000

6.43%

2500000/70000000

3.57%

Result

Target


NNJul-20042%Level 3-People reached



YearValue

Baseline

Indicator 5.4 - Other: Number of people reached by mass media

Not in attachment 3

Result

Target


00000000

00000000

Result

Target


NNJul-20040Level 0-Process/Activity Indicator



YearValue

Baseline

Indicator 5.3 - Updating the website

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Pending result15Pending result15Pending resultPending resultPending result

2727272715101010

Result

Target


10

10

Result

Target


NN20040Level 0-Process/Activity Indicator



YearValue

Baseline

Indicator 6.1 - Number of governorates with e-surveillance

SDA - Other: Information System and Operational research

Objective 6 - Establishing a national electronic registration system

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98%4411445014Level 1-People trained

90%

60%0%

30%

100%Period Value Period Value

Target Result

Indicator 1.3 - Number of service deliverers trained in Epidemiology biostatistics and quality assurance

Cannot Calculate58

Not in attachment 3

9Level 0-Process/Activity Indicator

90%

60%0%

30%


Target Result

Indicator 1.2 - Number of central staff attending international conferences e.g. IUATLD


90%

60%0%

30%


Target Result

Indicator 1.1 - Number of center staff trained on program management incl. those attending national/international training courses

SDA SDA - Supportive Environment: Health systems strengthening

Objective 1 Promoting strong managerial capacity

Objective 2 Strengthening case detection

Latest reporting due period : 14 (01.Oct.07 - 31.Dec.07)

2.2.3. Cumulative Progress To Date

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Cannot Calculate08

Not in attachment 3

9Level 3-People reached

90%

60%0%

30%


Target Result

Indicator 2.4 - Number of TB patients (new smear positive) detected under DOTS due to the newly established diagnostic units

92%19,2691420,87414Level 3-People reached

90%

60%0%

30%


Target Result

Indicator 2.5 - Number of TB patients (new smear positive) detected in the chest facilities within MOPH and the other sectors starting treatment under DOTS (National figure)

54%35146514Level 2-Service Points supported

90%

60%0%

30%


Target Result

Indicator 2.3 - Number of renovated laboratories in the existing chest facilities

94%1011410814Level 1-People trained90%

60%0%

30%


Target Result

Indicator 2.1 - Number of lab technicians trained


90%

60%0%

30%


Target Result

Indicator 2.2 - Number of new health facilities providing lab diagnosis for TB

SDA SDA - Prevention: Identification of Infectious Cases

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90%

60%0%

30%


Target Result

Indicator 3.6 - Number of NGO service deliverers trained on following up defaulters

100%8989Level 0-Process/Activity Indicator

90%

60%0%

30%


Target Result

Indicator 3.5 - Number of workshops held with the partners

SDA SDA - Supportive Environment: Coordination and partnership development (national, community, public-private)

Cannot CalculateN: D: P: 2.6 %

12N: 277D: 16,290P: 1.7 %


90%

60%0%

30%


Target Result

Indicator 3.4 - New smear positive cases registered under DOTS who fail treatment (number and %)

SDA SDA - Treatment: Control of drug resistance

Cannot Calculate22,4398

Not in attachment 3


90%

60%0%

30%


Target Result

Indicator 3.3 - Number of people receiving DOTS treatment

Cannot Calculate114

14660/16290 (89%)


90%

60%0%

30%


Target Result

Indicator 3.2 - Number and % of smear-positive TB cases registered under DOTS who are successfully treated (figure relates to National Program) (Not cumulative)

106%19,3141418,28214Level 1-People trained

90%

60%0%

30%


Target Result

Indicator 3.1 - Number of service deliverers trained in DOTS strategy and proper diagnosis of TB cases (doctors, nurses, peripheral health staff)

SDA SDA - Treatment: Timely detection and quality treatment of cases

Objective 3 To increase treatment success case

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Cannot Calculate08

Not in attachment 3

9Level 0-Process/Activity Indicator

90%

60%0%

30%


Target Result

Indicator 5.3 - Updating the website

Cannot Calculate23million/70million

923million/70million


90%

60%0%

30%


Target Result

Indicator 5.4 - Other: Number of people reached by mass media

75%90,00014120,00014Level 2-Service Points supported

90%

60%0%

30%


Target Result

Indicator 5.1 - Number Radio/TV programs, posters, brochures and booklets developed and distributed


90%

60%0%

30%


Target Result

Indicator 5.2 - Number of Radio/TV programs produced and aired

SDA SDA - Prevention: Behavioral Change Communication - Mass Media

Objective 5 Production of health education materials of proper design and content

28%721426114Level 3-People reached

90%

60%0%

30%


Target Result

Indicator 4.3 - Number of TB patients receiving treatment for MDR-TB (using second line anti TB drugs)


90%

60%0%

30%


Target Result

Indicator 4.2 - Number of centers established for treating MDR-TB


90%

60%0%

30%


Target Result

Indicator 4.1 - Number of lab technicians trained in detection of MDR cases

SDA SDA - Treatment: Control of drug resistance

Objective 4 Better control of MDR TB

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56%15142714Level 0-Process/Activity Indicator

90%

60%0%

30%


Target Result

Indicator 6.1 - Number of governorates with e-surveillance

SDA SDA - Other: Information System and Operational research

Objective 6 Establishing a national electronic registration system

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258,633258,633425,223425,221Summary Period Budget:

01.Apr.0801.Jan.0801.Oct.0701.Jul.0701.Apr.0701.Jan.0701.Oct.0601.Jul.06Period Covered From:

Budget Period 16

Budget Period 15

Budget Period 14

Budget Period 13

Budget Period 12

Budget Period 11

Budget Period 10

Budget Period 9

30.Jun.0831.Mar.0831.Dec.0730.Sep.0730.Jun.0731.Mar.0731.Dec.0630.Sep.06Period Covered To:

USDUSDUSDUSDUSDUSDUSDUSDCurrency:

4,032,0144,032,0144,032,0144,032,0143,773,3823,514,7493,514,7493,089,526Cumulative Budget Through:

Expenditure Categories

Program Activities

Implementing Entities

425,221425,221425,221258,633258,633258,633258,633354,112Summary Period Budget:

01.Apr.0601.Jan.0601.Oct.0501.Jul.0501.Apr.0501.Jan.0501.Oct.0401.Jul.04Period Covered From:

Budget Period 8

Budget Period 7

Budget Period 6

Budget Period 5

Budget Period 4

Budget Period 3

Budget Period 2

Budget Period 1

30.Jun.0631.Mar.0631.Dec.0530.Sep.0530.Jun.0531.Mar.0531.Dec.0430.Sep.04Period Covered To:

USDUSDUSDUSDUSDUSDUSDUSDCurrency:

2,664,3052,239,0841,813,8631,388,6421,130,010871,377612,745354,112Cumulative Budget Through:

Expenditure Categories

Program Activities

Implementing Entities

2.3.2. Program Budget

Expenditures' Burn Rate (as of end date of the latest PU)

5% Funds Remaining (to date) 326,275 $

Time Remaining (as of end date of the latest PU) 18 months Disbursed by TGF (to date) 3,705,739 $

% Time Elapsed (as of end date of the latest PU) 70% % disbursed by TGF (to date) 92%

Grant Duration (months) 60 months Grant Amount 4,032,014 $

2.3.1. Grant Financial Key Performance Indicators (KPIs)

2.3. Financial Performance

- Comments and additional information

2.3.3. Program Expenditures

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2.3.5. Summary of Financial Accountability Issues from PR Annual Audit Report

As there were few activities achieved, and the bulk of the funds were committed to the IT tender, the Audit Report is limited to the review of the amount spent against the related documentation.

Period Covered From 23.Sep.04 To 30.Jun.05

Date Received 20.Oct.05 Expected Date

2.3.4. Cumulative Program Budget, Expenditures and Disbursement to Date

Rating Description

B2 Inadequate but potential demonstratedC Unacceptable

B1 Adequate

A1 Exceeding expectationsA2 Meeting expectations

2.4. Progress Update and Disbursement Information

Progress Updates Disbursement Information

2a. Pharmaceuticals $ 143,809 $ 143,809

2. Health product expenditures vs. Budget (already included in "Total Actual" above) $ 145,409 $ 145,409

1a. PR's Total expenditure $ 200,766 $ 200,766

1b. Disbursements to sub-recipients

1. Total actual expenditures vs. budget $ 200,766 $ 4,032,014 $ 200,766 $ 3,831,248

2b. Health products, commodities and equipment $ 1,600 $ 1,600

Period PU10: 01.Jul.07 - 31.Dec.07 Actual Expenditures

Cumulative Budget

Cumulative Expenditures Variance

A total monthly compensation for staff has a slight variance from one month to another which is due to the members participation in the program which led to exceeding the budget line item.

Reason for variance

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Summary of Progress Reasons for variance between PR Request and Actual Disbursement

Little progress was made due to small cash amount received for first disbursement period.

Grant had a very slow start due to government changes and changes in LFAs. However with the recent strengthening of the PMU through the appointment of a Progam Manager it is believed that the grant will go back on track and targets will be delivered.

2 01.Jul.04 - 31.Mar.05

B2 2 1,432,786 $ 914,529 20 Jul 2005

PU PU Period TGF Rating DR DR Period

Covered PR Request Disbursement Amount

Disbursement Date


First disbursement no evaluation of performance This first disbursement was only a partial disbursement due to the non-fulfillment of the CPs to procurement health products. Once these CPs are met the remaining amount can be disbursed.

1 1 794,645 $ 354,112 15 Jun 2004



Disbursement Date


Limited progress as been achieved during this period. The PR has been experiencing administrative problems due to lack of a Program Management Unit (PMU). However, approval from the Green Light Committee has been received and funds requested are for direct payment to IDA.

n/a

3 01.Apr.05 - 30.Jun.05

B2 3 55,345 $ 55,345 08 Feb 2006



Disbursement Date


Performance for activities of the National TB program have been enhanced by the GF's contribution. In spite of procurement delays, the grant performance is beginning to show early signs of potential for accelerated success.

n/a

5 01.Oct.05 - 31.Dec.05

B1 5 N/A



Disbursement Date


PR has overcome administrative problems and the GF focal point of the recently established PMU is very responsible. In addition, the CCM has been restructured and is monitoring effective grant implementation.

Above amount represents the outstanding balance from the Phase 1 amount, US $ 55,345.15 representing amount for GF direct payment of MDR drugs has been deducted.

4 01.Jul.05 - 30.Sep.05

B1 4 1,211,585 $ 1,156,233 22 Feb 2006



Disbursement Date

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The PR has achieved over 70% of the intended target for 10 of the 21 indicators. The PR has achieved over 20% of the target for 3 of the 21 indicators and no more progress results for 8 of the 21 indicators. The PR has demonstrated potential to achieve satisfactory programmatic results as set out in the grant agreement. Delays in starting some activities are noticed in this reporting period, although better performance in activities are shown as a whole and this is reflecting in the PR's cash burn rate which became aprox. 85%. Based on the programmatic and financial peferformance, the PR's performance is satisfactory.

10 01.Jul.07 - 31.Dec.07

B1 10 01.Jan.08 - 30.Jun.08

262,340 N/A



Disbursement Date


The programme continues to perform well.

9 01.Jan.07 - 30.Jun.07

B1 9 01.Jul.07 - 31.Dec.07

404,048 N/A



Disbursement Date


PR has strengthened its PMU, due to late receipt of laboratory equipment and MDR drugs however, some activities could not be implemented but the delivery of laboratory equipment and MDR drugs are confirmed for the subsequent quarter.

n/a

6 01.Jan.06 - 31.Mar.06

B1 6 N/A



Disbursement Date


Program continues to catch up on early delays and program is performing according to schedule

7 01.Apr.06 - 30.Jun.06

B1 7 N/A



Disbursement Date


Overall performance of this grant is satisfactorily. The PMU has been strengthened and the PR is able to report good results.

8 01.Jul.06 - 31.Dec.06

B1 8 55,913,185 N/A



Disbursement Date

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External financial issues (e.g. inflation, currency depreciation, etc.)

Program management issues (e.g. changes in PR/sub-recipients, problems with data collection, quality assurance, etc.)

The management of the grant was handled by the national TB program. The program manager expected that work on the grant could easily be absorbed in their daily work. This unfortunately did not work as it should despite several serious messages from the GF outlining concerns about the slow implementation of the grant. The CCM and the PR decided to establish a post for a focal point who would be responsible for the implementation and reporting of the program. This person was identified only in September and so far things are moving at a quicker pace.

Issues with the CCM (e.g. changes in membership, composition, etc.) CCM in Egypt is inclusive in its representation of national partners however there are problems with international representation and other structural issues. In June 2005 the Vice Chair of the CCM changed from being a government official to become the WR, and multilateral and bilateral organizations have been invited to become members. Interest among those is quite low as they are not working in TB. Plans to ensure that conflict of interest is mitigated are underway and the CCM has put a plan in place to effectively monitor the grant implementation.

Significant adverse external influences (e.g. force majeure, change in government, natural disaster, etc.)

Major changes in the nature of the epidemic

Major changes in the program supporting environment (e.g. changes in th partner relationships, introduction of new partners, etc.)

Title Explanatory Notes

2.5. Contextual Information


14 14 N/A



Disbursement Date


15 15 N/A



Disbursement Date


13 01.Jan.00 - 13 N/A



Disbursement Date


11 01.Jan.00 - 11 N/A



Disbursement Date


12 01.Jan.00 - 12 N/A



Disbursement Date

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Issues Description of time-bound actions

Time-bound Actions

Rationale for Phase 2 Recommendation Amount

Performance Rating B2. Inadequate but potential demonstrated

Recommendation Category Select

Rationale for Phase 2 Recommendation Category

1. Accountability within the Program Management Unit has to be further clarified and M&E and financial management has to be further strengthened. 2. Proposal did not include adequate impact indicators 3. Persistent delays in procurement slows down implementation 4. It is unclear at this stage if there will be any savings from the procurement of IT and Laboratoray equipment.

1. PR should tighten the operational structure of the Program Management Unit and explain the relevance of each person / function on the organizational chart with regard to the grant. In addition the PR should provide monthly updates on progress. 2. Prior to Phase 2 signing: Attachment 3 to be revised to reflect adequate impact indicators. 3. Within the next 3 months: Provide evidence that laboratory equipment is up and running. 4. Within 1 week after receipt of IT and Laboratory Equipment: Provide a detailed overview of real expenditure occured and any savings made in the process have to be allocated and used for the purchase of MDR drugs.

2.6. Phase 2 Grant Renewal

Additional Contextual Issues Tuberculosis is still an important public health problem in Egypt. It is estimated that 19,780 people develop TB and 2,299 people die of TB in Egypt every year. Although the TB program is quite strong it has failed to achieve the global targets.The grant has faced significant delays mainly because of the lack of dedicated personnel; difficulty in understanding GF processes; weak capacity of the LFA; and heavy bureaucratic government procedures on procurement. However improvement were made in the grant implementation. This was enhanced with the change of management in the TB programme which brought on a new manager eager and willing to work within Global Fund principles of performance based funding. The CCM has gone through major restructuring which also improved its governance and composition.

Title Explanatory Notes

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grant performance report - print version - ccs.gov.egccs.gov.eg/ntp/pdf/2egyt_117_210_gpr.pdf ·...

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