Document o f The World Bank

FOR OFFICIAL USE ONLY

Report No: 3771 8

PROJECT PAPER

ON

PROPOSED ADDITIONAL FINANCING

IN THE AMOUNT OF

SDR 6.8 MILLION (US$lO.O MILLION EQUIVALENT)

TO THE REPUBLIC OF MADAGASCAR

FOR A

SECOND COMMUNITY NUTRITION PROJECT

October 25,2006

Human Development I11 Country Department 1 Africa Region

This document has a restricted distribution and may be used by recipients only in the perfonnance o f their official duties. I t s contents may not otherwise be disclosed without World Bank authorization.

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CURRENCY EQUIVALENTS

(Exchange Rate Effective October 17,2006)

Currency Unit = Ariary (MGA) MAG 2133 = USDl

SYSTEM OF WEIGHT AND MEASURES

Metric 1 meter (m) 1 square kilometer (km2) 1 hectare 1 metric ton (m ton)

U S Equivalent 3.28 feet (e.) 0.386 square miles (sq. mi.) 2,47 acres (a) 2,204 pounds (Ib.)

FISCAL YEAR January 1 - December 31

ABBREVIATIONS AND ACRONYMS

CAC CAS CDD CNN EU FID GoM GTZ ICR IDA LDF MDAT -

NGOS - PAD - PNAN - PNN - PNNC

PRSP - ONN - S IF -

-

Centre d'appui aux communes (Commune Support Centres) Country Assistance Strategy Community Driven Development Conseil National de Nutrition (National Nutrition Council) European Union Fonds d 'intervention pour le De'veloppement (Community Development Fund) Government o f Madagascar German Agency for Technical Cooperation Implementation Completion Report International Development Association Local Development Fund Ministzre de la De'centralisation et de I'Ame'nagement du Territoire (Ministry o f Decentralization and Regional Planning) Non-Governmental Organizations Project Appraisal Document Plan National d 'Action pour la Nutrition (National Nutrition P h ) Politique National de Nutrition (National Nutrition Policy) Programme National de Nutrition Communautaire (National Community- Based Nutrition Program) Poverty Reduction Strategy Paper OfJice National de Nutrition (National Nutrition Office) Social Investment Fund

Vice President: Gobind T. Nankani Country Director: Ritva S. Reinikka

Sector Manager: Laura Frigenti Task Team Leader: Montserrat Meiro-Lorenzo

M A D A G A S C A R Second Community Nutr i t ion Project-Additional Financing

TABLE OF CONTENTS

Page

Project Paper Data Sheet ................................................................ i

A . B . C . D . E . F . G . H . I .

Introductory Statement ......................................................... 1

Background and Rationale fo r Addit ional Financing .................... 1

Proposed Changes ................................................................ 4

Consistency with CAS .......................................................... 5

Appraisal o f Scaled-up Project Activities ................................... 6

Expected Outcomes .............................................................. 7

Benef i ts and Risks ............................................................... 7

Financial Terms and Conditions fo r the Addit ional Financing ........ 8

Credit Conditions and Covenants ............................................. 8

ScheduleA ................................................................................. 9

Schedule B ................................................................................ 10

Schedule C ................................................................................ 12

MADAGASCAR

SECOND COMMUNITY NUTRITION PROJECT-ADDITIONAL FINANCING

PROJECT PAPER DATA SHEET

Project Name: Additional Financing-

Borrower: Government o f Madagascar Responsible agency: Projet de Surveillance et Education des Ecoles et des Communautds en matiGre dyl imentat ion et de Nutr i t ion Elargie- (PNNC/SEECALINE) Revised estimated disbursements (Bank FY/US$m) FY I 2007 I2008 I2009

from Bank policies?

Revised project development objectives/outcomes The development objectives (PDO) o f the project have not been revised. The new outcomes include coverage o f over 500,000 children under 5, and implementation of the institutional set-up according to the National Nutrition and Food Security Policy (revised Component 3). PDO indicators have been revised to include new activities, and three o f the original outcome indicators have been eliminated. Instead, the Bank and the Government have agreed on measuring output indicators that are direct proxies for the outcome indicators that have been eliminated.

roject trigger any new safeguard policies? No - For Additional Financing

[ ] Loan [XI Credit [ ] Grant For Loans/Credits/Grants:

Total Bank financing (uS$m.): 10 Proposed terms: IDA standard

Financing Plan (US$m.) Source Local Foreign Total

Borrower 5.0 0.0 5.0 IDA Communities/Bene ficiaries Total

5.0 0.0 10.0

5.0 0.0 5.0

10.0 0.0 15.0

i

A. Introductory Statement

1. additional financing in an amount o f SDR 6.8 million (US$lO million equivalent) to the Republic o f Madagascar for the Second Community Nutrition Project (P100966) (CR.3060-1-MAG). I t also proposes extending the Closing Date o f the Project by two years, from December 3 1 , 2006 to December, 3 1 2008. The proposed Additional Financing would be on standard IDA terms with a maturity o f 40 years and commitment fee not to exceed 0.5 percent.

This Project Paper seeks the approval o f the Executive Directors to provide

2. investment costs associated with the scaling-up o f the Project activities to cover selected communes in a l l the districts in Madagascar, thus enhancing the impact o f the Project; and (ii) investments, training, and technical assistance to finalize the development and implementation of the institutional framework for nutrition activities as per the National Nutrition Policy (PNN).

The proposed Additional Financing would finance (i) the incremental

3. Under the scaled-up activities the Project would increase i t s coverage from 50 percent to over 70 percent o f the child target population (from about 1,200,000 to at least 1,700,000 children under five). I t would also reach about 1 million pregnant and lactating women (53 percent o f the target population), 3 million primary school-aged children (through de-worming campaigns), and 1.5 million children at school (through health and nutrition education program and iron fortification). These targets would be achieved by extending the Project’s geographic scope from 62 districts to all o f Madagascar’s 110 districts, and adapting the program to the new harmonized national community program. Finally, at the end o f the Project period the institutional set-up described in the PNN wi l l be operational.

B. $10 million.

Background and Rationale for Additional Financing in the amount of U S

4. approved on May 7, 1998 and became effective on November 2, 1998. The total project cost was US$42 million o f which US$27.6 equivalent provided by the IDA Credit. US$l1.6 million was co-financed by the World Food Program and the Government, and beneficiaries contributed US$2.7 million. A supplemental credit (SDR 7.3 million) was approved on December 1,2003, to cover the additional cost associated with the emergency situation that arose from the cyclones that struck Madagascar in 2000 and the political turbulence in 2002. Moreover, in 2004 a nutritional emergency that was declared after the passage o f two cyclones in January and March 2004. Resources from the Supplemental Financing covered also activities to respond to said emergency. To date, 85 percent o f the original and Supplemental Credit resources have been disbursed. The balance (about US$1.8 million) i s expected to be fully disbursed by December 2006 (approximate effectiveness date o f the proposed Additional Financing).

The Madagascar Second Community Nutrition Project (SDR 20.4 million) was

5. The Credit Agreement has been amended five times during implementation to reflect changes in credit closing dates, supplemental financing, and changes in activities. Credit Components have remained the same. The first amendment i s dated February 15,2002 (changes in activities); the second June 3,2003 (reallocation); the

1

third December 1,2003 (Supplemental Financing); thefourth November 2, 2004, and thefifth amendment in December 14,2005 (both extensions o f the closing date).

6. The development objectives (DO) o f the Project, which remain unchanged, are to: (i) improve the nutritional status o f children under the age o f three, pregnant and lactating women, and school-aged children; and (ii) ensure long-term sustainability o f nutrition outcomes by improving the quality and quantity o f food intake by children at home. The Project i s implemented by the Projet de Surveillance et Education des Ecoles et des Communautds en matiire dWimentation et de Nutrition Elargie- (PNNC/SEECALINE) an executing agency operating since 1993 that has demonstrated capacity in effectively supporting poor communities and in monitoring nutritional status through contracting local NGOs whose capacity has been built by the project.

7. previously amended to read as follows:

The Project finances four components the activities o f which have been

Comuonent 1: Community Nutrition Program: - (i) growth monitoring and promotion for children under three; (ii) vitamin A supplementation for children under three and lactating women; (iii) referral o f severely malnourished children to health services; (iv) information, education and communication (IEC) and community mobilization; (v) support to community-based activities aimed at improving nutrition, hygiene and sanitation in villages (welfare funds); and (vi) training o f community nutrition workers and social workers.

Comuonent 2: School Nutrition Prozram: (i) irodfolate supplementation for enrolled primary school children; (ii) deworming o f enrolled and non-enrolled children aged 3- 14 years; (iii) IEC as well as nutrition and hygiene promotion in the classroom; (iv) monitoring o f the iodization o f salt; (v) support to school-based activities aimed at improving nutrition and hygiene in the school environment; and (vi) training o f primary school teachers in nutrition and hygiene.

Comvonent 3: Intersectoral activities: (i) in the health sector, support to the Ministry o f Health to contribute to the cost o f the training program on the Integrated Management o f Childhood Il lness (IMCI); (ii) in the agriculture sector, support to a few pilot projects aimed at disseminating technical guidelines on improved diversification and storage o f agricultural and food products.

Comuonent 4: IEC. Training and Project Management: - (i) information, education communication, training, and management information system, and (ii) project coordination and management.

8. demonstrated by the recent impact evaluation which showed a 10 percent reduction in underweight in malnourished children under three, after two years in the National Community Based Nutrition Program (PNNC). Furthermore, the PNNC has had a significant effect in terms o f longer-term nutritional outcomes, with a reduction o f moderate stunting o f 3.2 percent and about 2.4 percent for severe stunting. These results are particularly striking if we consider that communities in the project areas had higher than average incidence o f shocks, poverty and initial malnutrition rates, and that malnutrition rates in the rest o f the country have increased during the same

The Project has been successful in reaching i ts developmental objectives as

2

period. In addition, the program reaches about 500,000 pregnant and lactating women, and the highly satisfactory school nutrition program covers almost 2 mil l ion school- aged children. Projections using impact and monitoring data suggest that, with the proposed scaling-up financing Madagascar i s likely to achieve the Millennium Development Goals (MDG) nutrition target by 20 15.

9. financial management, compliance with agreed procurement schedules, and compliance with safeguards policies have been satisfactory throughout implementation, all the covenants have been honored, and monitoring and evaluation was rated highly satisfactory in recent project status reports. If Additional Financing was not sought the Proposed ICR rating would be at least satisfactory and potentially highly satisfactory, as the measurable targets for the developmental objectives have been achieved and surpassed.

Implementation performance has been satisfactory all along. Project and

10. Malnutrition has always been a serious development problem in Madagascar. The last Demographic and Health Survey (DHS 2003-04) indicated that about 44 percent o f Malagasy children under five years o f age are chronically malnourished or stunted. Analysis o f malnutrition data among the different income groups confirms that malnutrition i s largely a poor people’s problem. For over 10 years the Government o f Madagascar (GoM) has undertaken a variety o f programs, with the assistance from the World Bank and other donors, to reduce malnutrition, with varied results. As a result malnutrition prevalence in Madagascar has been decreasing albeit very slowly. Studies in Madagascar and the rest o f the world indicate that, except in famine situations, lack o f knowledge, poor feeding, health and caring practices, and inadequate (quality wise) food production and consumption are the main determinants o f chronic malnutrition. Recurrent infectious diseases, especially diarrhea, measles, malaria, and helminthes infection cause bouts o f acute malnutrition and contribute to chronic growth retardation.

1 1. Madagascar culminated with the development o f the new PNN, and the National Plan o f Action for Nutrition (PNAN). The PNAN identifies the PNNC as the key strategy to prevent malnutrition and achieve the MDG for nutrition - halving underweight by 201 5. The PNNC i s a consensual manual that identifies the package o f services and the delivery mechanisms to prevent, detect, and treat malnutrition at community level. In addition, the PNN recognizes the need for a coherent institutional framework to ensure adequate policy guidance, coordination, monitoring and evaluation, and the execution o f Nutrition activities in a sustainable manner.

This has led to a worldwide shift in strategies to curb malnutrition, which in

12. The G o M moved rapidly and effectively to implement the P N N by creating the National Nutrition Council (CNN) and National Nutrition Office (ONN) by decree. It also took over financing community-based activities from the IDA Credit resources to budget support, increasing the likelihood o f their financial sustainability, and it initiated efforts to integrate the PNNCEEECALINE within the institutional framework. The institutional framework has been only partially implemented for lack o f an adequate institutional analysis and financial resources.

13. in 2006, have limited the capacity o f the Government to finance the planned start-up

Urgent investments in 2005 after the 2004 cyclones as well as revenue shortages

3

costs to: (i) extend the PNNC to al l the 11 0 districts; (ii) fully implement the institutional framework according to the PNN, the National Decentralization Policy and the institutional analysis being carried out; and (iii) set-up a national monitoring and evaluation system for nutrition activities including a malnutrition status early warning system. The requested IDA resources would finance such activities, increasing the likelihood that Madagascar w i l l reach the MDG in nutrition and increasing the institutional sustainability o f the community nutrition activities.

14. the financial needs o f the Second Community Nutrition Project rather than preparing a new investment project because: (i) the Government did not request additional resources until August 2006, when it became clear that the projected internal revenue resources for the coming years would not be sufficient to cover the additional investment required to expand activities and institutionalize the national Nutrition Policy; (ii) the resources o f the existing Supplemental Financing are fully committed; and, (iii) the amount o f financing requested and the short implementation period do not justify the preparation o f a new operation. Regional management has endorsed the Additional Financing even as it acknowledges that it implies an unusually long project l i fe (1 0 years). However, it has been agreed that in the future, any additional financing that may be required would be addressed through a new project.

Additional Financing was deemed as the appropriate Bank instrument to address

C. Proposed Changes

15. Although the Project’s DO would remain unchanged, one Project Component would be modified to reflect the efforts to operationalize the institutional framework as per the PNN. Moreover, activities under Component 1 would go from covering children under three to cover children under five, and activities under Component 2 would be progressively handed over to the Ministry o f Education. Alternative outcome indicators, for which base line and intermediate data exist, are proposed in some cases because several o f the original Project indicators have proven very difficult and expensive to measure (see para. 29). The new outcome indicators would apply to the duration o f the Project (10 years).

16. Component 3 : Intersectoral activities would be renamed “Institutionalization o f the PNN”, and would include activities to operationalize the PNN. Specifically activities under the revised Component 3 would include training, technical assistance and goods to: (i) increase capacity o f the C N N to carry out i t s policy setting and strategy definition role; (ii) increase the capacity o f selected executing agencies to define and manage nutrition prevention and curbing activities; (iii) development and implementation o f the national monitoring and evaluation system for nutrition activities, and the National Food and Nutrition surveillance system including the early malnutrition warning system; and (iv) increase capacity o f the ONN to perform i ts intersectoral coordination, monitoring and evaluation, research, and resource mobilization mandates. To measure the results o f the proposed new activities, the team identified the institutional mandates not being fdfilled by the C N N and ONN. Table B includes the base-line and the fulfillment o f those mandates corresponds to the target to be achieved before the end o f the Project. As the ongoing institutional analysis results are known, some o f those indicators and targets may be refined. The outcomes and outputs o f these activities would be included in the results framework.

4

17. Closing Date and implementation schedule and bringing up to date some o f the details to conform to current project implementation. The total additional project cost, including taxes and duties, i s estimated at US$15 million equivalent with the following breakdown: US$l 0 million provided by IDA, US$5 million fiom Government. O f the US$1 5 million, US$5 million would finance investment, training and supervision for 1500 to 2000 new community nutrition sites and reinvestments in some o f the old 3,600 sites. Another US$5 million, which would be the Government’s contribution, would finance recurrent costs o f the community-based activities in the new sites, plus about 110 pilot sites that would implement a more intensive version o f current community mobilization activities (US$3 million), cost-effectiveness studies and recurrent costs for the ONN (US$2 million). About US$3 million would finance the investment and some recurrent costs to set up the National Nutrition Activities Monitoring and Evaluation System including the Nutritional Status Surveillance and Early Warning System. The additional US$2 million would be used to finance institutional strengthening o f the ONN, the CNN and the executing agencies, and carry-out impact evaluation studies. The estimated costs to maintain the additional community based nutrition activities are US$700,000 a year. The breakdown o f estimated costs i s shown in Schedule A. Schedule B lays out the project’s financing plan and disbursement schedule. A summary o f procurement arrangements i s given in Schedule C.

Complementary changes include project costs, financing plan and schedule,

18. they are working well. The executing unit o f the Second Community Nutrition Project, PNNCISEECALINE, has demonstrated capacity to intervene effectively at the community level and to undertake large scale operations.

Implementation mechanisms would be the same as for the ongoing project, as

19. o f the closing date from December 3 1 , 2006 to December 3 1 , 2008 i s proposed. Without such an extension the project would not be able to finalize the planned activities. Accordingly, the new Financial Agreement would reflect the new closing date.

As part o f the request for the Additional Financing, a concomitant extension

D. Consistency with CAS

20. In August 2003, the Government finalized i t s Poverty Reduction Strategy Paper (PRSP), following a broad and inclusive participatory process. The overarching goal o f the PRSP i s to cut the poverty rate by half in ten years, from 70 percent in 2003 to 35 percent in 2013. To achieve this objective, the strategy has three main axes based on the principle o f public private partnership: (i) restoring rule o f law and ensuring a well-governed society; (ii) promoting economic growth with a large social base; and (iii) establishing human security and enlarging social protection.

2 1. support the implementation o f Madagascar’s PRSP. The CAS refocused the existing portfolio to better align i t se l f to the PRSP objectives, and address the key constraints to broad-based growth. The Second Community Nutrition Project i s one o f the key operations o f the 2003 CAS which aims at having a much larger impact on rural poverty. The CAS also aims at protecting the most vulnerable against shocks.

The November 2003 Country Assistance Strategy (CAS), was designed to

5

22. A new CAS i s under preparation and i s expected to be presented to the Board in March 2007. The new CAS sees nutrition as central to achieving i t s objectives both in reducing bottlenecks to investment and growth in rural areas, and in improving the scope and quality o f service delivery.

E. Appraisal of Scaled-up Project Activities

23. Although the Project i s being scaled up, and some activities destined to support implementation o f the institutional framework would be included, it remains as originally designed and appraised. The economic, financial, technical, institutional, fiduciary, and social aspects o f the activities to be undertaken with the additional financing remain the same as in the original project, as do the disbursement categories.

24. appraisal report o f the original project, there could likely be a positive impact on the environment since i t would contribute to improved hygiene and sanitation in schools and at home. The environmental classification category remains C.

There i s no change in environmental aspects and as stated in the project

25. The proposed scale-up does not involve any exceptions to Bank policies.

26. Financial transactions pertaining to the Additional Financing wil l be recorded and monitored by the PNNC/SEECALINE, which has considerable experience and a good track record in managing Bank funds and whose financial management arrangements were reviewed to determine whether they are s t i l l acceptable to the Bank. They are detailed in the Aide Memoire o f October, 2006. The conclusion o f this review rated the project financial management system "globally satisfactory." However, the following measures need to be taken to hrther improve the system: i) update the existing accounting manual o f procedures to reflect agreed changes in the project organizational structure/procedures and provide the models o f quarterly financial management reports required under the supplemental credit; ii) organize training to ensure adequate preparation o f these reports by the project staff; iii) review and reconfigure the current accounting software to ensure timely production o f financial management reports. It was agreed at appraisal that these actions should be implemented by November 15,2006. Since the disbursement o f the supplemental resources would be done on the basis o f SOEs, these measures do not constitute a condition for the processing o f the Additional Financing.

27. Project, allocations and disbursements under the new Credit (CR. 3060-1-MAG) would be done under a single category grouping all the former categories. However, the Project Unit wi l l maintain i t s internal accounting systems unchanged.

To simplify reallocations among categories during the last two years o f the

28. accounting firm that has already been recruited in accordance with International Standards o f Auditing. The Government wi l l amend the contract o f the current auditors in order to include in their assignment the audit o f the supplemental Credit. The audit reports wi l l be submitted to IDA not later than six months after the end o f each fiscal year. The terms o f reference o f the audit have already been reviewed by the financial management specialist o f the Bank/IDA to ensure the adequacy o f the audit scope. The Implementation Completion Report (ICR) wi l l be prepared within

The project's financial statements wi l l be audited annually by an international

6

six months after December 2008 Credit closing. The same special account wi l l be used as for the original credit with an authorized allocation amount o f US1.6 million for the additional financing. Statements o f Expenditures (SOEs) would be used for all expenditures under contracts below the Association’s prior review limits.

29. Procurement o f goods and services wil l be carried out as stated in the Financial Agreement o f November 30,2006 and the revised PNNCBEECALINE’s Implementation Manual, and wil l be undertaken in accordance with World Bank Guidelines for procurement o f goods and works under IDA Credits (as revised on May 2004) and World Bank Guidelines for Selection and Employment o f Consultants by World Bank Borrowers (as revised on May 2004). The same procurement methods used under the ongoing project wi l l be applied to the Additional Credit, namely: international competitive bidding, national competitive bidding, national shopping, UN agencies, procurement o f small works and community participation. At appraisal the procurement plan for the Additional Financing resources was evaluated and found satisfactory.

F. Expected Outcomes:

30. Key outcome indicators for the project and output indicators for each component were defined and are presented in Annex 1 o f the original PAD. Most o f the output indicators wi l l continue to apply but covering a bigger territory, and together with new indicators to measure improvements on implementation o f the institutional framework as per the PNN, are presented in Schedule B.

3 1. indicators in the original PAD in a meaningful way. Specifically, it i s very costly and impractical to measure the levels o f Vitamin A, iron and Helminths infection in children o f different age groups in the Project areas (more than half o f the country). Moreover, there i s a clear consensus in the literature on the direct relationship between Vitamin A supplementation, and twice a year deworming and substantial improvement on those outcome indicators. Conversely, the key outcome indicator on the level o f malnutrition in children under 3 has been measured regularly in the project sites. As a result, the Bank and the Government have agreed to amend the original indicators o f the Project to those presented in Annex B, which include output indicators that are direct proxies for the outcome indicators that have been taken away. The new indicators table includes the comments from the quality specialist. A reduced set o f key indicators i s reflected in the Credit’s Financial Agreement.

However, i t has been impossible to measure three o f the six outcome

G. Benefits and R i s k s

32. extension o f a successful methodology to the entire country, in a financially and institutionally sustainable manner. Indeed, the Government’s commitment to finance the recurrent cost o f community-based activities increases substantially the likelihood o f financial sustainability of the activities. In addition, the implementation o f the institutional framework o f the PNN wil l help clarify the roles o f the different actors while improving the country’s capacity to monitor and evaluate nutrition intervention and to detect and act early in case o f deterioration o f the nutritional status o f the population.

Benefits: The key Project benefits are the prevention o f malnutrition and the

7

33. As with the f i rs t credit, other benefits o f the Project through i ts community- based interventions, include: (i) empowered communities to deal with malnutrition; (ii) positive changes in caring practices related to the preparation o f food, hygiene, and feeding at the household level, especially for children, pregnant and lactating women; (iii) an inter-sectoral approach to combat malnutrition through village communities, schools and health centers; and (iv) participation o f civil society to organize communities and assist them in implementing community nutrition interventions, thus creating local capacity to further develop these interventions.

34. Risks: The original project rated institutional capacity at high risk. This however has been mitigated by substantial training and through learning by doing by PNNCBEECALINE and the local NGOs. Another threat to the project could be the limited food availability in the affected areas, which in turn i s mitigated by the on- going World Food Program operation to distribute food to prevent the development o f widespread famine and further deterioration o f the nutritional status o f households most affected.

35. activities as resources would need to be redirected to the resulting nutritional emergency in the most affected areas. In this case preference wi l l be apportioned to community-based activities versus institutional development activities. However, behavior changes in most o f the Project communities, together with World Food Program food distribution in such situation, should help minimize the effect o f the emergency in the nutritional status o f children under five. Moreover, works have been deliberately left as an eligible expenditure in case some rehabilitation o f existing sites i s needed due to said cyclones.

Finally, a heavy cyclone season could delay the implementation o f some

H. Financial Terms and Conditions for the Additional Financing

36. The additional financing wi l l be provided as an IDA credit. The Country Financing Parameters, approved on May 12, 2005, allow for up to 100 percent disbursement including taxes and duties. The Country Financing Parameters also allow for recurrent cost financing where required, provided that the implications o f recurrent cost financing on Madagascar’s fiscal situation and debt sustainability are taken into consideration. On those bases, reimbursement for eligible expenditures under the new Credit 3060-1-MAG would be honored at 100 percent.

I. Credit Conditions and Covenants

37. Agreement no additional conditions o f effectiveness or Covenants are required.

Except for submission o f a satisfactory legal opinion on the Financial

8

Schedule A Page 1 o f 1

10,050,000

REPUBLIC OF MADAGASCAR

4,950,000 1 15,000,000 I 33 Y o 5,000,000

SECOND COMMUNITY NUTRITION ADDITIONAL FINANCING

ESTIMATED ADDITIONAL PROJECT COSTS AND FINANCING (in US$)

I - ESTIMATED PROJECT COSTS

Total Project Costs

I1 - PROJECT FINANCING (in US$million)

IDA Government

10.0 5.0

Total 15.0

9

Schedule B Page 1 of 2

Number and proportion o f children <3 enrolled in the growth monitoring and promotion program. Number and proportion o f malnourished children and pregnant women receiving supplemental

REPUBLIC OF MADAGASCAR SECOND COMMUNITY NUTRITION ADDITIONAL FINANCING

176 900lyear 690 000/year 970 000/year (97%) (76%) (90%) 182 000/year

152 000/year 93 560/year NA* NA*

KEY PERFORMANCE INDICATORS FOR COMMUNITY NUTRITION PROGRAM

. . lactating women receiving vitamin A supplementation.

Number and proportion o f community nutrition workers and social workers trained in nutrition techniques and IEC Number and proportion o f women involved in growth monitoring and promotion and IEC activities Number o f nutrition-related activities designed and implemented by village communities. CNN functional.

In 2006, the CNN has been established but i t i s not

nent Objectives I Base line I Actual 2004 1 Actual 2006 I Estimate 2008

(90%) (70%) (goo/,) Women=50 000 Women=45 000 Women=200 000 Women=430 00

(11%) (10%) (15%) (20%)

969 1428 5 550 8 900

141 510/Y 483 000 IY 679 700/Y (50%) (50%) (70%) 1152 400 1200

145 600/Y

808 (38%) (7%) (22%) 2007. The CNN reviews and send to P M for approval the PNNs institutional framework derived from the institutional analysis by 2007

50.9% 36% 24% 20%

41.8% N o data N o data NA*

N o data No data N o data NA*

N o data N o data N o data NA*

Underweight reduced(W/A < 2 S.D.) by 30 % among children under three. Vitamin A deficiency reduced by 30 % among children under three. Iron deficiency anemia reduced by 25% among enrolled primary school children. Helminthes infections reduced by 25 % among children age 3-14 years. Improved quality and quantity o f food provided to 20% mothers

feeding. Number and prooortion o f children <3 and I <3=248 OOO/Y. I <3=171 OOO/Y. I <3=300 OOO/Y. I <3=670 OOO/Y

The CNN reviews and approves ONNs 2008 budget. 2007. Approval by CNN o f the internal procedures and organigram o f ONN elaborated on the basis o f the institutional analysis results.

In 2006, the ONN has been established but i t i s not structured yet to carry-out all i ts functions. Likewise lacks the adequate personnel and means to carry-out all i ts functions. National Nutrition Monitoring and Evaluation System (SNSE) Implemented.

On the bases o f the institutional analysis and the PNN the ONN has the adequate Human material and financial resources to carry out its mandate (end o f Project) The SNES i s implemented, that i s produces reports that allow to monitor outputs o f all community-based activities (end o f Project)

In 2006 the system i s starting to be designed. * Those indicators became non applicable because they where not measurable. See paragraph 29

10

KEY PERFORMANCE INDICATORS FOR SCHOOL NUTRITION PROGRAM

Actual 2006

Number o f school-aged children dewormed (enrolled and non-enrolled).

Number o f school children receiving weekly iron supplements.

Number o f schools testing iodized salt used in the households o f school children.

Estimate 2008

Number o f schools receiving small grants for nutrition interventions.

PAD Estimate (Per year)

Actual 1'' supplemental

(2004)

694 O O O N (50%) 516 O O O N 1 700 OOOIY

(1 00%)

283 OOON 216000N 1 (50%)

3 000 OOOIY (100%)

16001Y (20%) 12601Y

1 500 OOOIY (100%)

40 (3%) 1260 1

1 500 O O O N (100%)

9 O O O N ( 100%)

9 OOOIY ( 100%)

2oo I NA (15Yo)

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Schedule C Page 1 of 2

National Competitive Bidding (NCB)

SECOND COMMUNITY NUTRITION ADDITIONAL FINANCING

PROCUREMENT METHODS AND DISBURSEMENTS

Other Methods'

I. SUMMARY OF PROPOSED PROCUREMENT ARRANGEMENTS (in US$)'

Civil Works

Goods

I Procurement Methods

0 0 (0) (0)

2 200 000 1 100 000 3 300 000

Drugs

Total

(2 200 000) (1 100 000) (3 300 000) 250 000 250 000

Community Fund Grants

Consultants' services, and audits

(250 000) (250 000) 600 000 600 000

(600 000) (600 000) 1 700 000 1 700 000

Training (1 700 000) (1700 000) 1 600 000 1 600 000

Operating Costs

TOTAL

Figures in parentheses are the respective amounts financed by the supplemental IDA credit. Other methods include use o f consultants according to Bank guidelines and national shopping.

1

2

(1 600 000) (1 600 000) 2 550 000 2 550 000

(2 550 000) (2 550 000) 2 200 000 7 800 000 10 000 000

(2 200 000) (7 800 000) (10 000 000)

Schedule C Page 2 of 2

Amount of the credit allocated

(in US$)

11. ALLOCATION AND DISBURSEMENT OF THE ADDITIONAL FINANCING (in US$)

Amount o f the credit allocated

(in SDR)

Category

(1) Civ i l Works, goods, community h n d grants, consultant services and audits, training and operating costs.

10 000 000 6 800 000

Cumulative

YO o f Expenditures T o Be Financed

1 000 000 5 000 000 10 000 000

100% expenditures

111. ESTIMATED DISBURSEMENT SCHEDULE OF THE ADDITIONAL FINANCING (in US$)

IDA FY 2007 2008 2009

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