Document of The World Bank Report No: ICR2470 IMPLEMENTATION COMPLETION AND RESULTS REPORT (IDA-46050, TF-94372) ON A CREDIT IN THE AMOUNT OF SDR 6.8 MILLION (US$10 MILLION EQUIVALENT) AND A GRANT FROM THE GLOBAL FOOD CRISIS RESPONSE MULTI-DONOR TRUST FUND IN THE AMOUNT OF US$8 MILLION TO THE REPUBLIC OF SENEGAL FOR A RAPID RESPONSE CHILD-FOCUSED SOCIAL CASH TRANSFER AND NUTRITION SECURITY PROJECT February 21, 2013 Human Development II AFCF1 Africa Region 1    CURRENCY EQUIVALENTS (Exchange Rate Effective as of January 21, 2013) Currency Unit = CFA Francs (CFAF) CFAF 1000 = US$ 2.03 US$ 1.00 = CFAF 492.64 FISCAL YEAR January 1 – December 31 ABBREVIATIONS AND ACRONYMS CEA Community Executing Agency c-IMCI Community-based Integrated Management of Childhood Illnesses CLM Cellule de Lutte contre la Malnutrition (Coordination Unit for the Fight against Malnutrition) CMAM Community Management of Acute Malnutrition F CFA Franc Communauté Financière Africaine (West Africa CFA Franc) FM Financial Management GFPR Global Food Price Crisis Response ICR Implementation Completion and Results Report IDA International Development Association IDF Institutional Development Fund IFR Interim un-audited Financial Reports IMF International Monetary Fund ISR Implementation Status Report LG Local Government LPSP Local Payment Service Provider LQAS Lot Quality Assurance Sampling MDG Millennium Development Gold MDTF Multi-Donor Trust Fund MOHP Ministry of Health and Prevention NETS Nutrition ciblé sur l’Enfant et Transferts Sociaux (Child-Focused Social Cash Transfer and Nutrition) NGO Non-Governmental Organization NSPS National Social Protection Strategy PDO Project Development Objective PRN Programme de Renforcement de la Nutrition (Nutrition Enhancement Program) PRSP Poverty Reduction Strategy Paper SMART Standardize Monitoring and Assessment for Relief and Transition SSA Sub-Sahara Africa SUN Scaling-Up Nutrition TF Trust Fund UNICEF United Nation Children’s Fund i    Vice President: Makhtar Diop Country Director: Vera Songwe Sector Manager: Trina Haque Project Team Leader: Menno Mulder-Sibanda ICR Team Leader: Menno Mulder-Sibanda ii    Senegal - Rapid Response Child-focused Social Cash Transfer and Nutrition Security Project CONTENTS A. Basic Information ................................................................................................................. v B. Key Dates ............................................................................................................................. v C. Ratings Summary ................................................................................................................. v D. Sector and Theme Codes .................................................................................................... vi E. Bank Staff ............................................................................................................................ vi F. Results Framework Analysis .............................................................................................. vii G. Ratings of Project Performance in ISRs............................................................................... x H. Restructuring ........................................................................................................................ x I. Disbursement Graph ............................................................................................................. x 1. Project Context, Development Objectives and Design ........................................................... 1 1.1 Context at Appraisal ........................................................................................................... 1 1.2 Original Project Development Objectives (PDO) and Key Indicators .............................. 2 1.3 Revised PDO and Key Indicators, and reasons/justification ............................................. 2 1.4 Main Beneficiaries ............................................................................................................. 2 1.5 Original Components ......................................................................................................... 3 1.6 Revised Components........................................................................................................... 4 1.7 Other significant changes ................................................................................................... 4 2. Key Factors Affecting Implementation and Outcomes ......................................................... 5 2.1 Project Preparation, Design and Quality at Entry............................................................. 5 2.2 Implementation ................................................................................................................... 6 2.3 Monitoring and Evaluation (M&E) Design, Implementation and Utilization ................... 8 2.4 Safeguard and Fiduciary Compliance................................................................................ 8 2.5 Post-completion Operation/Next Phase ............................................................................. 9 3. Assessment of Outcomes ........................................................................................................... 9 3.1 Relevance of Objectives, Design and Implementation .......................................................... 9 3.2 Achievement of Project Development Objectives ............................................................... 10 3.3 Efficiency ............................................................................................................................ 16 3.4 Justification of Overall Outcome Rating ............................................................................ 17 3.5 Overarching Themes, Other Outcomes and Impacts .......................................................... 17 3.6 Summary of Finding of Beneficiary Survey and/or Stakeholder Workshops ...................... 18 iii    4. Assessment of Risk to Development Outcome ....................................................................... 19 5. Assessment of Bank and Borrower Performance ................................................................ 20 5.1 Bank Performance ............................................................................................................ 20 5.2 Borrower Performance ..................................................................................................... 21 6. Lessons Learned ...................................................................................................................... 22 7. Comments on Issues Raised by Borrower/Implementing Agencies/Partners ................... 24 Annex 1. Project Costs and Financing ...................................................................................... 26 Annex 2. Economic and Financial Analysis .............................................................................. 27 Annex 3. Bank Lending and Implementation Support/Supervision Processes ..................... 28 Annex 4. Impact Evaluation of the Cash Transfer Component .............................................. 29 Annex 5. Summary of Borrower's ICR and/or Comments on Draft ICR ............................. 31 Annex 6. List of Supporting Documents ................................................................................... 32 MAP of the Republic of Senegal ................................................................................................ 35 iv    A. Basic Information Rapid Response Child- Focused Social Cash Country: Senegal Project Name: Transfer and Nutrition Security Project Project ID: P115938 L/C/TF Number(s): IDA-46050,TF-94372 ICR Date: 01/18/2013 ICR Type: Core ICR GOVERNMENT OF Lending Instrument: ERC Borrower: SENEGAL Original Total USD 18.0M Disbursed Amount: USD 18.6M Commitment: Revised Amount: Environmental Category: C Implementing Agencies: Cellule de Lutte contre la Malnutrition (CLM) Cofinanciers and Other External Partners: B. Key Dates Revised / Actual Process Date Process Original Date Date(s) Concept Review: 02/10/2009 Effectiveness: 09/11/2009 09/11/2009 Appraisal: 02/20/2009 Restructuring(s): 12/01/2011 Approval: 05/06/2009 Mid-term Review: Closing: 12/31/2011 08/31/2012 C. Ratings Summary C.1 Performance Rating by ICR Outcomes: Highly Satisfactory Risk to Development Outcome: Moderate Bank Performance: Satisfactory Borrower Performance: Satisfactory C.2 Detailed Ratings of Bank and Borrower Performance (by ICR) Bank Ratings Borrower Ratings Quality at Entry: Satisfactory Government: Satisfactory Implementing Quality of Supervision: Highly Satisfactory Highly Satisfactory Agency/Agencies: Overall Bank Overall Borrower Satisfactory Satisfactory Performance: Performance: v    C.3 Quality at Entry and Implementation Performance Indicators Implementation QAG Assessments (if Indicators Rating Performance any) Potential Problem Project at Quality at Entry No None any time (Yes/No): (QEA): Problem Project at any time Quality of Supervision No None (Yes/No): (QSA): DO rating before Highly Satisfactory Closing/Inactive status: D. Sector and Theme Codes Original Actual Sector Code (as % of total Bank financing) General education sector 3 3 Health 49 49 Other social services 44 44 Public administration- Health 4 4 Theme Code (as % of total Bank financing) Child health 8 8 Decentralization 4 4 Global food crisis response 25 25 Nutrition and food security 40 40 Social safety nets 23 23 E. Bank Staff Positions At ICR At Approval Vice President: Makhtar Diop Obiageli Katryn Ezekwesili Country Director: Vera Songwe Habib M. Fetini Sector Manager: Trina S. Haque Eva Jarawan Project Team Leader: Menno Mulder-Sibanda Menno Mulder-Sibanda ICR Team Leader: Menno Mulder-Sibanda ICR Primary Author: Helle M. Alvesson   vi    F. Results Framework Analysis Project Development Objectives (from Project Appraisal Document) The PDO is to reduce the risk of nutrition insecurity of vulnerable populations, in particular children under five in poor rural and urban areas by scaling up the Government Nutrition Enhancement Program and providing cash transfers to vulnerable mothers of children under five. Revised Project Development Objectives (as approved by original approving authority) (a) PDO Indicator(s) Original Target Actual Value Formally Values (from Achieved at Indicator Baseline Value Revised approval Completion or Target Values documents) Target Years Target population (children under five) reached by the community nutrition Indicator 1 : program (percent) Value quantitative or 22 45 65 Qualitative) Date achieved 12/31/2008 12/30/2011 12/31/2012 Comments (incl. % End-of-project target surpassed by 36% (Source: Project Monitoring System) achievement) Indicator 2 : Mothers targeted providing exclusive breastfeeding (percent) Value quantitative or 34 44 62 Qualitative) Date achieved 12/31/2008 12/30/2011 06/30/2012 Comments (incl. % End-of-project target surpassed by 36% (Source: LQAS) achievement) Indicator 3 : [CORE] Direct [female] project beneficiaries of cash transfer program (number) Value quantitative or 0 50,000 55,323 Qualitative) Date achieved 12/31/2008 12/30/2011 06/30/2012 Comments (incl. % End-of-project target surpassed by 11% (Source: Project Monitoring System) achievement) Indicator 4 : Selected beneficiaries who receive all intended cash transfers (percent) Value quantitative or 0 80 96 Qualitative) Date achieved 12/31/2008 12/30/2011 06/30/2012 Comments (incl. % End-of-project target surpassed by 20% (Source: Project Monitoring System) achievement) vii    (b) Intermediate Outcome Indicator(s) Original Target Actual Value Formally Values (from Achieved at Indicator Baseline Value Revised Target approval Completion or Values documents) Target Years Indicator 1 : Children 6-59 months screened for acute malnutrition (percent) Value (quantitative 0 80 90 or Qualitative) Date achieved 12/31/2008 06/30/2012 Comments (incl. % End-of-project target surpassed by 13% (Source: Project Monitoring System) achievement) Indicator 2 : Children 0-24 months showing adequate weight gain (percent) Value (quantitative 60 75 81 or Qualitative) Date achieved 12/31/2008 06/30/2012 Comments (incl. % End-of-project target surpassed by 8% (Source: Project Monitoring System) achievement) Indicator 3 : Pregnant women making at least 4 prenatal care visits (percent) Value (quantitative 39 51 51 or Qualitative) Date achieved 12/31/2008 06/30/2012 Comments (incl. % End-of-project target fully met. (Source: LQAS) achievement) Mothers of target children who participate in monthly information and Indicator 4 : education sessions (percent) Value (quantitative 80 80 95 or Qualitative) Date achieved 12/31/2008 06/30/2012 Comments (incl. % End-of-project target surpassed by 19% (Source: Project Monitoring System) achievement) Indicator 5 : Targeted children 6-59 months receiving vitamin A supplementation (percent) Value (quantitative 80 80 94 or Qualitative) Date achieved 12/31/2008 12/30/2011 Comments (incl. % End-of-project target surpassed by 18% (Source: LQAS) achievement) Targeted children in primary education receiving weekly micronutrient Indicator 6 : supplements (percent) Value (quantitative 80 80 95 or Qualitative) Date achieved 12/31/2008 06/30/2012 Comments (incl. % End-of-project target surpassed by 19% (Source: Project Monitoring System) achievement) Targeted children in primary education deworming medication twice in a one- Indicator 7 : year (percent) viii    Value (quantitative 80 80 95 or Qualitative) Date achieved 12/31/2008 12/30/2011 06/30/2012 Comments (incl. % End-of-project target surpassed by 19% (Source: Project Monitoring System) achievement) Indicator 8 : Quantity of salt adequately iodized by small producers (tons) Value (quantitative 87,000 139,000 73,299 or Qualitative) Date achieved 12/31/2008 12/30/2011 11/30/2012 Due to seasonal variation and a six-fold price increase in the fortificant, the Comments (incl. % production figures fell short. Last year's production was 113,000 tons (Source: achievement) Project Monitoring System) Indicator 9 : Quantity of adequately fortified oil with vitamin A by oil industry (litres) Value (quantitative 0 80,000 107,178 or Qualitative) Date achieved 12/31/2008 12/30/2011 11/30/2012 Comments (incl. % End-of-project target surpassed by 34% (Source: Project Monitoring System) achievement) Local Governments incorporating nutrition objectives and interventions in Indicator 10 : Local Development Plans (percent) Value (quantitative 0 25 31 or Qualitative) Date achieved 12/31/2008 12/30/2011 03/31/2012 Comments (incl. % End-of-project target surpassed by 24% (Source: Project Monitoring System) achievement) Indicator 11 : Selected beneficiaries who do not meet eligibility criteria (inclusion error) Value (quantitative 0 20 2.5 or Qualitative) Date achieved 12/31/2008 12/30/2011 06/30/2012 Comments (incl. % The target was to stay below 20% and this result is well below (more than 85%) achievement) that target (Source: Project Monitoring System) Indicator 12 : Transfers made by local payment service providers (percent) Value (quantitative 0 80 100 or Qualitative) Date achieved 12/31/2008 12/30/2011 06/30/2012 Comments (incl. % End-of-project target surpassed by 25% (Source: Project Monitoring System) achievement) Development and adoption by the government of an efficient child-focused Indicator 13 : social cash transfer scheme as part of the NSPS (Y/N) Value (quantitative N Y Y or Qualitative) Date achieved 12/31/2008 12/30/2011 06/30/2012 Both, the social cash transfer to mothers of vulnerable children and the Comments (incl. % community targeting system have been adopted by the Government (Source: achievement) Government)     ix    G. Ratings of Project Performance in ISRs Date ISR Actual Disbursements No. DO IP Archived (USD millions) 1 10/16/2009 Satisfactory Satisfactory 0.00 2 02/18/2010 Highly Satisfactory Highly Satisfactory 2.29 3 09/13/2010 Highly Satisfactory Highly Satisfactory 3.12 4 02/26/2011 Highly Satisfactory Highly Satisfactory 4.06 5 11/05/2011 Highly Satisfactory Highly Satisfactory 6.97 6 01/22/2012 Highly Satisfactory Highly Satisfactory 8.05 7 07/25/2012 Highly Satisfactory Highly Satisfactory 8.88 8 08/25/2012 Highly Satisfactory Highly Satisfactory 8.88 H. Restructuring (if any) ISR Ratings at Amount Board Restructuring Restructuring Disbursed at Reason for Restructuring & Key Approved PDO Date(s) Restructuring Changes Made Change DO IP in USD millions Reallocation and extension of 12/01/2011 N HS HS 6.97 closing date I. Disbursement Profile1                                                                1 The difference between the higher actual than original disbursement represents the $8 million grant from the GFRP-MDTF which was not included in the original forecast. x    1. Project Context, Development Objectives and Design (this section is descriptive, taken from other documents, e.g., PAD/ISR, not evaluative) 1.1 Context at Appraisal (brief summary of country and sector background, rationale for Bank assistance) The implications of a series of domestic and external shocks became visible during 2008. The sharp rise in global food and fuel prices in addition to the poor rains in 2006 and 2007, which led to decreased agricultural production, had a direct negative impact on the cost of living. Senegal imported 80 percent of its rice and 100 percent of its wheat, and as a result the outlook for poor urban and rural households’ purchasing power and accumulated debt burden deteriorated. As a result, food insecurity and the risk of increased levels of child malnutrition and mortality increased. Prevalence surveys conducted by the Government in high risk areas confirmed high levels of acute malnutrition in mid-2008, which for young children can lead to life-long cognitive and productivity shortfalls. Between 45 and 50 percent of households were found to suffer from food insecurity in the most afflicted regions. In addition to higher prices on food and fuel, the Government was facing loss of tax revenues, which implied severe budget constraints. The economy had slowed down since 2006 and the growth rate of 4.5 percent between 1995 and 2005 had fallen to almost half. As a response to the emerging crisis, the Government expanded in 2007 tax breaks and subsidies on rice and other commodities, which proved unsustainable by the end of 2008. Furthermore, the response was ill-targeted to the poor segments of the population and the continued need to minimize the impact of the crisis directed the attention of the Government to the opportunities of targeted social cash transfers. The Government had developed the National Social Protection Strategy 2005-2015 as an integral part of the Poverty Reduction Strategy Paper (2002 and 2007). Few safety nets and social transfers had been introduced however, and there was limited knowledge about the mechanisms through which such programs could be built. Before the series of shocks Senegal had made considerable progress on MDG related targets and reduced child mortality by 30 percent and maternal mortality by 21 percent since 1990. More recently, the country had succeeded in turning stagnating malnutrition rates around and seen a significant reduction in malnutrition rates since 2000. Stunting levels had decreased substantially from 30 percent in 2000 to 20 percent in 2006.2 The National Nutrition Development Policy of 2001 (updated in 2006) had laid out the national goals on nutrition. The Nutrition Enhancement Program (PRN) was providing the implementation framework. The Rapid Response Child-focused social Cash Transfer and Nutrition Security Project (NETS) supported the PRN and introduced a new component on cash transfers. The PRN was structured in three phases; phase 1 (2002-2006) for the development of the implementation framework for the program in three Regions; phase II (2007-2013) aimed at scaling up; and phase III is meant for final consolidation. The Bank and other development partners are supporting the PRN in the second phase. Monthly monitoring data showed a continuously steep decrease in the proportion of children under 3 with malnutrition in the intervention areas from 27 percent in early 2004 to about 10 percent by late 2005. The PRN developed a community nutrition platform, which was well-adjusted to the local circumstances, in regions with high levels of malnutrition. The Bank’s support to Phase 1 was rated as highly satisfactory in 2007.                                                              2 Current stunting levels have been further reduced and are now measured at 16 percent (2012). 1    The risk of losing the gains in reducing malnutrition rates of the prior 5-10 years was considered high. Through its engagement since the inception of PRN in 2002, the Bank has been instrumental in: (i) designing and supporting the implementation of the community-based nutrition approaches in the PRN and (ii) developing the national strategies and policies on nutrition and food security. The PRN model functioned well, but could not be scaled up nationwide due to lack of funding. Given these prior experiences in establishing both an institutional and community-based nutrition platform, the Bank’s continued involvement was considered essential to mitigate the negative effects of the domestic and external shocks and to provide direct support to the households most at risk of malnutrition. The project was well aligned with Bank priorities in relation to nutrition and cash transfers. A key objective of the Country Assistance Strategy (2007) was to increase access to social services. In the PRSP (2007) pillar II the need of accelerated development of human capital through nutrition was highlighted and in pillar III the importance of combating vulnerability through cash transfers was emphasized. Most importantly the National Social Protection Strategy (2005-2015) was providing the recently formulated priorities in developing social safety nets in Senegal. 1.2 Original Project Development Objectives (PDO) and Key Indicators (as approved) As presented in the Emergency Project Paper, the PDO is to reduce the risk of nutrition insecurity of vulnerable populations, in particular children under five in poor rural and urban areas by scaling up the Government Nutrition Enhancement Program and providing cash transfers to vulnerable mothers of children under five. The PDO was measured through the following key indicators: (i) Target population (children <5) reached by the community nutrition program (45 %); (ii) Mothers targeted providing exclusive breastfeeding for the first six months (+30 %); (iii) Number of beneficiaries (individual mothers) of the cash transfer program (50,000); (iv) Selected beneficiaries who receive all intended cash transfers (80 %). 1.3 Revised PDO (as approved by original approving authority) and Key Indicators, and reasons/justification No revision of the PDO or key indicators was conducted. 1.4 Main Beneficiaries, (original and revised, briefly describe the "primary target group" identified in the PAD and as captured in the PDO, as well as any other individuals and organizations expected to benefit from the project) As indicated in the PDO the project aimed to achieve results through two complementary activities. The primary target population of the community-based nutrition program (Component 1) was children under five in poor rural and urban areas. It was estimated that the number of children reached would increase from 320,000 to 710,000 in rural areas. In addition, 1,500 000 mothers were expected to be reached with behavior change communication and counseling. The local government structures benefited from improved collaboration with CLM and CEAs and capacity strengthening in project management. Distribution of micronutrients and deworming medication was carried out in primary schools estimated to reach around 300,000 children (older than five years) (Component 2). The whole population in the project areas was expected to benefit from fortified foods becoming available in the targeted areas. In addition, the Ministry of Health and the Ministry of Education benefited from strengthening implementation capacity. 2    The direct beneficiaries of the social cash transfers (Component 4) were 50,000 vulnerable mothers with children 0-5 year old in selected pilot health districts with critical levels of malnutrition. Siblings and other members of the household receiving the social cash transfers were expected to indirectly benefit from the project through reduced food insecurity in the household. The total beneficiary population of the cash transfers is estimated by the ICR authors to be at least 300,000 people. 1.5 Original Components (as approved) The implementing agency is the Coordination Unit for the Fight Against Malnutrition (CLM). Its role was to coordinate and supervise the multiple actors involved in the PRN. NETS provided support to the scaling-up of the number of communities implementing nutrition security activities as an integrated part of PRN and the piloting of a cash transfer mechanism. Component 1: Community-based Nutrition (IDA US$6.6 million; MDTF US$3.1 million). The scale- up of the existing PRN package of community-based nutrition and health services was the core activity. The scale-up was implemented by Local Governments (LG) who in turn contracted-out the community- based nutrition interventions to a Community Executing Agency (CEA), generally a non-governmental or community-based organization.3 Each CEA covered at least one district. The scale-up consisted both of mobilizing new districts with high malnutrition rates and to accomplish higher coverage in already mobilized health districts. In communities with more than 1,000 inhabitants an intensive intervention was implemented, which imply monthly mobilizations of women and children and a less intensive model in communities with less than 1,000 inhabitants with services provided quarterly. The project financed:  Community-based growth promotion and Integrated Management of Childhood Illnesses (c-IMCI) sessions for children under two during which mothers were counseled on the nutritional status of their child, on improved infant and young child feeding practices, on recognition of danger signs during illness and on home-based care. Except for the growth monitoring activities, children in the ages 3-5 were offered the same services as children under two.  Provision of iron and Vitamin A supplements, deworming medication and insecticide treated bed- nets. The behavior change communication and counseling that was provided to mothers also targeted pregnant women and provided specific recommendations related to pregnancy and delivery.  Nutrition education for mothers with cooking demonstrations using local foods.  Mobilization of extended caregivers to take part in social and behavior change communication activities. Grandmothers, in-laws and other relatives are important for the survival of infants and young children.  Screening of acute malnutrition and education on community management of the identified cases of acute malnutrition (CMAM).  Community-level communication activities to create demand for iodized salt, Vitamin A, iron supplements and dietary diversification.  Training and supervision of nutrition aides in the communities providing the services to the community on a voluntary basis. Component 2: Sectoral Support for Nutrition Results (IDA US$1.3 million). This component was executed by the Ministry of Education and the Ministry of Health and Prevention (MOHP) with the                                                              3 During the first phase of the PRN the contracts were signed by CLM and CEAs expecting a less active role of the LGs. This implementation arrangement was modified to provide management and control of the implementation to the LG about a year before NETS became effective. 3    support from CLM to reach children in primary schools with the minimum intake of micronutrients. The project financed periodic distribution of micronutrient supplements and deworming medicine. The National Committee for Food Fortification, a sub-committee of the CLM, was supported in the fortification of oil with vitamin A and wheat flour with iron. Salt iodization by local producers was to be enhanced. The project financed the development, social marketing and quality control of these food fortifications. Component 3: Support to Implementation, Monitoring and Evaluation of Nutrition Development Policy (IDA US$700.000). To be implemented by the central and regional level implementation agency, this component was intended to (i) adapt the existing Monitoring and Evaluation system to include the cash transfer pilot; (ii) improve data bases for targeting mechanisms for use in activities related to the community nutrition platform and the cash transfers; and (iii) conduct impact evaluation, process evaluation and beneficiary assessment of the pilot child-focused social cash transfers. Component 4: Child-focused Social Cash Transfers (IDA US$1.4 million; MDTF US$4.9 million). This component was implemented by the existing actors involved in the PRN in selected pilot health districts that already implemented the PRN package of community-based nutrition interventions. Beneficiaries were identified through geographical, categorical and community-based targeting. Geographical targeting was used to identify districts with high poverty, malnutrition and food insecurity levels. Categorical targeting limited the eligibility to mothers with children 0-5 years old. Community- based targeting criteria for eligibility of vulnerable mothers with at least one child 0-5 years were used to select mothers living in households with inadequate levels of food consumption and limited household possessions. Monitoring Committees were established to monitor the targeting, selection and validation process of beneficiaries (e.g., Local Selection Committees, Regional Monitoring Committees). In addition, the contracted CEAs (for the activities in component 1), were verifying the eligibility of beneficiaries and conducted quality controls of sub-samples of the selected beneficiaries. Selected mothers were eligible for bimonthly unconditional transfers for a period of six months. The pilot had a phased implementation structure with subsequent 6-month intervention periods in the different pilot districts. The transfer pilot was accompanied by a strong communication campaign to promote messages on maternal and child preventive measures. The project financed:  Cash transfers to eligible vulnerable mothers to children under five in the amount of CFA 14,000 bimonthly during 6 months (total CFA 42,000) intended to reach 50,000 mothers.  Contracting-out the distribution mechanism to a financial institution with local outlets as close to beneficiaries as possible. 1.6 Revised Components No revisions have been implemented. 1.7 Other significant changes (in design, scope and scale, implementation arrangements and schedule, and funding allocations) The closing date of the project was extended once from December 31, 2011 to August 31, 2012 to make up for initial delays due to the absence of formal payment service provider outlets in remote areas and the need to develop ad-hoc distribution arrangements. The extension of eight months was accompanied by a reallocation of US$ 1,800 000 to strengthen the component on sub-grants for community nutrition sub-projects. This reallocation was possible due to higher contributions by development partners and by the government to cover costs on drugs, 4    pharmaceutical supplies, and operational costs of the program. The extension and reallocation did not result in cancellation of planned activities but enabled the completion of the planned number of sequenced six-month intervention periods of cash transfers (component 4). 2. Key Factors Affecting Implementation and Outcomes 2.1 Project Preparation, Design and Quality at Entry (including whether lessons of earlier operations were taken into account, risks and their mitigations identified, and adequacy of participatory processes, as applicable) The project design built on lessons learned and successes of the ongoing nutrition program PRN. The PRN had been able to significantly lower the risk of a child having a weight less than -2 standard deviations below international norms.4 In addition, health care and health care seeking behaviors were improved in the program communities compared to the control communities. PRN was mitigating some of the consequences of the deteriorating living conditions in intervention areas and the scale-up was well- timed. There was strong agreement about the importance of (i) increasing the coverage of the program and include new hard to reach areas with high malnutrition; (ii) applying the same guiding principles of implementation such as to encourage the LGs to promote contextualized implementation approaches and for LGs to take the lead in the implementation of the project; (iii) emphasizing multi-sectoral collaborations at all levels; and (iv) building the cash transfer on the nutrition platform, applying a community-based targeting approach. The extensive knowledge of stakeholders on the nutrition situation and on regional diversity resulted in identifying qualified specific risks in piloting the cash transfer. The risk mitigation measures incorporated into program design were detailed and operational such as for example foreseeing the need of identification cards for beneficiaries without national identity cards. The up-to-date risk assessment contributed to succeeding with the fast-track emergency preparations. Three principles guided the design of the cash transfer: securing funds, targeting mechanisms and speed of the response. The lack of prior experiences on cash transfers and initial skepticism expressed on the feasibility by some stakeholders, designing a verified process of beneficiary identification and transfer of funds, was of paramount importance. The selection of vulnerable mothers was based on a high degree of participation by community-based nutrition aides and local leaders as close to the beneficiaries as possible with support provided by the local CEA. Verification was conducted at the level of “arrondissement�, which is the level of government closest involved in the delivery of health, education and social services. The third principle of the need of a fast-track response was accomplished through different methods: (i) the approval of processing the operation under the OP 8.0 met the emergency nature of the crisis; (ii) a Standardize Monitoring and Assessment for Relief and Transition (SMART) survey was conducted before project effectiveness in 2008 in which it was observed that the acute malnutrition rate was increasing; (iii) the survey results informed the selection of scale-up districts in which the impact of the droughts and food crisis were mostly felt. At project effectiveness CLM had prepared a scale-up plan; and (iv) CLM together with partners intensified the community-level screening of children before effectiveness. Development partner and government collaborations were well established, which benefitted the fast design of the transfer pilot. UNICEF in particular had conducted a series of studies on the need and potentials of cash transfers (feasibility study, social protection measures to children, simulation study on                                                              4 Alderman et al 2008. 5    costs and impact) which served as the analytical background for the specific construction of the transfers. The decision to select mothers as the recipients of the transfer was made on this background. This enhanced institutional environment in nutrition was contributing to the ability of the CLM to broaden its activities to the field of social protection. Central level Government recognized that the food price subsidy programs were difficult to sustain over the time period necessary to mitigate the impact of the domestic and external shocks that were dampening growth. IMF reports continuously emphasized this risk. The need to explore alternative mechanisms of reducing economic vulnerabilities made the testing of a functional social cash transfer system important. Therefore, a large scale pilot was adopted. This decision was guided by the principle of designing the transfer on the basis of the “minimum needed�5 to achieve results. This would leave Senegal with lessons learned that would have a better chance of continuation and it was argued that it would be easier to increase than decrease the amount and pilot period, if changes needed to be adjusted during the implementation period. The amount of FCFA 7,000 per month was thus used as the minimum needed based on the analytical work by UNICEF related to the cost of a minimum food basket. The duration of six months was also considered to be the absolute minimum needed to help mothers overcome their (conjunctural) financial stress. Furthermore, given the variation in living conditions, agro-ecological zone and vulnerability to natural shocks, access to social services, and cultural and religious diversity among districts, it made good sense to take the opportunity of the pilot to learn from these different contexts. The implementation of the cash transfer as a pilot appropriately addressed the risks to the outcome of the new component and took also into account the knowledge gap that prevailed concerning the feasibility of cash transfers in Senegal. During preparations it was established that three alternative payment providers were available and the selection criteria were specified when the project went effective. A back-up plan for remote areas and areas with security concerns was also prepared, and this identified the CEAs that were already present in these areas as the best positioned. When it became clear, after the project became effective, that the coverage of the selected payment provider in some areas was not sufficient for the project needs, the pilot districts with the highest vulnerability to the impact from the crisis had already been notified about their selection. The CLM therefore made the decision to identify alternative distribution mechanisms rather than abandoning these districts. This illustrates the excellent collaboration CLM had developed with the LGs and the emphasis of piloting the transfers where they were known to be most needed. 2.2 Implementation (including any project changes/restructuring, mid-term review, Project at Risk status, and actions taken, as applicable) The majority of CEAs had contracts with LGs prior to project start, which indicated that (i) they had demonstrated high performance levels; and (ii) they were well established institutionally and among communities in their district(s) of implementation. The benefits of implementation continuity were also true for CLM at central and regional level. CLMs strong reputation as working directly with LGs and with communities to encourage local solutions eased the quick acceptability of implementing the pilot in spite of its perceived pioneering nature. The rationale and reality of cash transfers were new for all stakeholders in the districts and the initial constraints of communicating the implementation mechanisms and the roles of each stakeholder, was overcome by the positive expectations of the CLM and in extension the experience that CEAs delivered results.                                                              5  Simulations for Senegal had shown that a transfer size of 35 percent of the adult poverty line per school-aged child would reduce headcount poverty by 30 percent and the poverty gap by 40 percent (World Bank 2009b).   6    A memorandum of understanding was signed between LPSP and CLM after the completion of a selection process based on qualifications (high coverage rate of local offices and conduction of external audits). During a short period, the necessary monitoring tools, beneficiary identification, and verification measures were developed and agreed upon. The number of beneficiaries that collected transfers at the LPSP outnumbered the normal number of visitors, which was solved by setting separate opening hours and larger rooms available to accommodate women. The decentralization of the project management structure from the CLM to the LG was initiated about one year before the effectiveness of NETS but was strengthened throughout the project period. The leading role by the Presidents of Local Councils and the involvement of the Regional Governor, “Préfet�, “Sous- prefet� has grown very strong as exemplified in their active participation in the selection and verification of beneficiaries in the transfer pilot. As part of the verification measures, each woman had to personally pick up her transfer at the LPSP. During the payment of the first transfers, nutrition aides, CEA representatives and even at times Presidents of Local Councils accompanied women to the LPSP to assure the organization of the transfer. Their presence was also a way to demonstrate the legitimacy of the program, which exemplifies the unexpectedness of the transfer from the perspective of women but also the strong involvement of the LG in the management of the pilot. It became clear that the LPSP did not have physical presence in all of the pilot districts, which required the CLM to invent alternative distribution mechanisms. The back-up plan of using the CEAs was not applied due to security concerns of the risk of transporting cash in remote areas by the CEAs. Mobile LPSP units were created which made it very convenient for beneficiaries to pick up the transfer in own or neighboring villages, but was more time consuming for LPSP and the financial officers at CLM who were overseeing these distributions. In some districts where LPSP had no presence, the CLM staff escorted by the local Gendarmerie distributed the transfers. This exemplifies the paramount importance CLM placed on securing that funds reached the selected vulnerable women. In a few districts, where LPSP had local offices, the distance for beneficiaries to travel to pick up the bimonthly transfer was more time-consuming and costly than anticipated. For these households, a considerably amount of the transfer (a third or in some instances up to a half) was spent on transportation costs, which illustrates the additional costs associated with reaching remote rural districts. In some districts the six months of transfers were coinciding with the season of low access to food. The timing, even though unplanned, was perceived as recognition of the Government of the hardship of these districts. This served as an even stronger motivator for stakeholders to support the implementation. The CLM, housed under the Prime Minister’s Office, is the obvious entry point for all policy dialogue on nutrition. Different donors have projects with the CLM and associated national structures on food fortification, the management of acute malnutrition, salt iodization and food security. Donor coordination is ensured through joint missions and periodic technical reviews. From the start of the project in 2009, the presidential elections of 2012 were already on everybody’s mind. National election campaigning started in 2009 and continued until the election in March 2012. This context was not optimal for a constructive policy dialogue on social protection and safety net issues. The opposition party (later winning the elections) campaigned heavily on the need of social protection measures. The politicization of safety nets implied increased interest in cash transfers but also risk of perceiving CLM as engaging in politics by association of social protection. This dampened the activity level of the CLM in promoting the results of the pilot at the national level as the election approached. 7    2.3 Monitoring and Evaluation (M&E) Design, Implementation and Utilization The existing integrated monitoring and information system of the PRN was employed for the scale up supported by the project. Data is collected on a monthly basis in the communities on project activities, service quality, outcome indicators and costs. The system is managed by the CLM and is linked to the subcontracted CEAs so as to respond to their own monitoring needs. The monitoring system also integrates the implementation progress of health and education sector plans (component 2). The selected indicators were adequate for monitoring progress of the PDO and all intermediate indicators. Data is of good quality and reports are timely and complete. The application of the M&E system included regular feed-back to regional stakeholders which improved the implementation process. The design of the monitoring system also made analysis of results possible during the joint supervision missions. To monitor the progress of the cash transfer new tools were developed and integrated into the system. The CEAs submitted bimonthly reports on the current status of cash payments per district. The new monitoring tools have worked effectively and data has been collected and provides data to all indicators of NETS. Evaluation studies were restricted to the cash transfer component, because: (i) a rigorous impact evaluation of the PRN – showing significant impact of the intervention on nutritional status and a broad range of nutrition outcomes including infant and young child feeding behaviors – was conducted during the first phase (2004-2006); and (ii) the cash transfers represented a pilot experience for the Government. The evaluation of the cash transfer pilot entails: (i) an impact evaluation comparing base and end-line data in randomly selected intervention and control communities (see Annex 4); (ii) a process evaluation that assessed the effectiveness of the cash delivery to beneficiaries, the utilization of services and the validity of the targeting process; and (iii) a beneficiary satisfaction assessment. All three evaluations studies have been completed and are available for the ICR. They are also of great use for designing future safety net and cash transfer programs.   2.4 Safeguard and Fiduciary Compliance (focusing on issues and their resolution, as applicable No safeguards were triggered by the project. Fiduciary compliance has been rated Satisfactory in ISRs throughout the project period. The project has benefitted from a stable financial management group that had a high managing capacity. Procurement: The procurement plan was in place at project start and was based on the system developed in the parallel Bank support to PRN 2 (P097181). The implementation of the procurement methods was satisfactory according of the Bank, and the internal control system performed well. Disbursement and financial management: The project has disbursed 100 percent of the IDA credit and 100 percent of the MDTF grant. The annual planning and budgeting process was of high quality. The management of the innovative contracting arrangements between LG, CEA and CLM were well conducted. The selection of the LPSP to manage the distribution of the cash transfers was also well set-up and monitored very closely during the implementation process. When it took longer than the agreed 15 days for the LPSP to check the transfer balance and submit report of a completed region, and further to IDA recommendation, the CLM formed a team to assist in the verification process in order to timely submit the transfer balance and report. 8    The CLM was the first implementing agency to use the Inter Un-Audited Financial Reports system (IFR) when it was introduced in Senegal. To date, there are only five additional World Bank projects in Senegal who are qualified to do the IFR, which confirms the good standards of the fiduciary compliances of the CLM. The project has complied with the requirements to submit annual audit reports. All audit reports have been submitted on time with unqualified audit opinions and have been acceptable to IDA. 2.5 Post-completion Operation/Next Phase (including transition arrangement to post-completion operation of investments financed by present operation, Operation & Maintenance arrangements, sustaining reforms and institutional capacity, and next phase/follow-up operation, if applicable) The PRN is currently completing its second phase (2007-2013) under which the scale-up of the nutrition security program (component 1, 2 and 3) continues with public as well as donor funding. The CLM plays a critical role in the coordination of the nutrition policy and is the entry point for all nutrition policy dialogue with development partners. The technical and organizational capacity of the CLM is high. Accordingly, the Bank will continue the policy dialogue on health, nutrition and safety nets with the CLM. Currently, social protection programs are high on the policy agenda and budgetary allocations have been made for the continuation of safety net operations. In addition, the World Bank will provide IDA support to the implementation of the social protection policy. The CLM has produced several products for dissemination of results and lessons learned including an analysis of the importance of targeting mechanisms, which are being used to adjust and guide (additional) safety net programs. Discussions on the operational details of various social protection schemes are ongoing; hence the specific ways in which the Government will use the lessons learned on targeting, transfer mechanism, communication, and social mobilization from this cash transfer pilot are not yet finalized. One major challenge is the coordination of a large number of public institutions, many of which – apart from the CLM – have limited or no capacity to manage safety net and/or cash transfer schemes. The CLM is currently preparing the third phase of the PRN, which will position the CLM at the center of a new partnership for nutrition development, and strengthen its role in coordination and policy oversight. The last five years have highlighted the need to strengthen the mobilization and coordination capacity of the CLM in order to be responsive of rapidly changing needs. 3. Assessment of Outcomes 3.1 Relevance of Objectives, Design and Implementation (to current country and global priorities, and Bank assistance strategy) The relevance of the project’s development objective, design and implementation was high: The project supports two sets of appropriate cost-effective programs: (i) one that offsets the income effect of the shock through targeted social cash transfers; and (ii) one that seeks to mitigate its consequences on human development outcomes such as the health and nutrition status of children. These activities are fully consistent with the Country Assistance Strategy (2007), the Poverty Reduction Strategy (2006), the Nutrition Development Policy (2006) and the National Social Protection Strategy (2005). 9    Importantly, all these activities remain highly relevant in light of the global economic downturn and the continuing rise in food prices. In addition, 2012 has seen a severe drought affecting the whole of the Sahel region, and the new government is forced to apply new fiscal austerity measures, all of which need to be balanced with mitigating actions in the social sector. As a result of these economic shocks (i.e., sharp increase of food prices, a decrease in remittances), living conditions of the poorest households are again deteriorating, with an increase in the level of household indebtedness and a reduction in the quality and frequency of meals, thus increasing food insecurity and malnutrition. The current drought affecting the region is turning the conditions into a near crisis situation in several pockets of the country. The CLM has recently conducted a national nutrition survey to assess the situation at Department level (i.e., sub-Regional level). These survey results will be used to develop appropriate micro-plans to continue to target appropriate cost-effective programs, including the child focused cash transfer scheme. The Government has adopted the successful targeting mechanism applied under the cash transfer pilot for a range of humanitarian actions being put in place in response to the current crisis. The PRN builds on the global consensus of the importance of community nutrition programs as articulated in the Bank’s strategy document “Repositioning Nutrition as Central to Development (2006) and the Copenhagen Consensus (2008 and 2012).6 A cross-country review of successful programs has shown that malnutrition can be reduced two to four times faster than in the absence of such a program.7 The main thrust of community-based nutrition and health programs is education and counseling regarding mother and child care practices, and links to essential health services. The proposed interventions are supported by the evidence provided in the Lancet Series on Maternal and Child undernutrition (2008). Moreover, similar programs around the continent have shown the effectiveness of the community-based communication and services strategy in reducing malnutrition through behavior change. 3.2 Achievement of Project Development Objectives (including brief discussion of causal linkages between outputs and outcomes, with details on outputs in Annex 2) The PDO is measured through four project outcome indicators. Two indicators measure the achievements in the community nutrition program and the other two capture the result of the cash transfer pilot. The indicators are measured through several data collection methods of which the most important are (i) Project Monitoring System; (ii) independent Lot Quality Assurance Sampling (LQAS) surveys; (iii) an impact evaluation of the cash transfers, which studies the causal linkages between intervention input and project result; and (iv) a process evaluation of the cash transfers. The mix of monitoring data and evaluation studies makes it possible to present results on some of the indicators from more than one source. In spite of the emergency character of the project, an emphasis was placed on measuring both results and processes. All PDO indicators have exceeded their targets                                                                6 At www.copenhagenconsensus.com 7 See Chapter 56 in Disease Control Priorities in Developing Countries (2nd Edition) 10    Table 1. Summary of achievements of project indicators8 Achievements Outcomes No Intermediate Outcomes No Total % Achieved 1,2,3,4 4 1,2,3,4,5 6,7,9,10,11, 12, 13 12 16 94 Partially achieved 0 0 0 0 0 Not achieved 0 0 8 1 1 6 Not measured 0 0 0 0 0 Total 4 13 13 17 100 Project Development Objective 1: Target population (children under 5) reached by the community nutrition program (%). The target was to increase the percentage of reached children from 22 percent at baseline to 45 percent as the end of the project. The source of data is the Project Monitoring System. The end target was surpassed and the project reached a total of 65 percent of under-5 year old children or 1,340,875 children of whom 453,997 urban (58%) and 886,878 rural (70%). This surpass corresponds to more than 414,500 children. The significance of this wide reach is that the impact of the interventions will have a more direct influence on the national indicators. Senegal is the only country in Sub-Saharan Africa that has succeeded in reaching such a high proportion of children through a community nutrition project at an annual cost per child of approximately $5. This achievement has had a strong demonstration effect on other countries such as Mauritania, Ghana, Benin, Ivory Coast, Djibouti, Burkina Faso, Mali and Malawi. Many of these countries have sent delegations to learn from the Senegal experience with multi-sectoral policy coordination and large-scale decentralized implementation. Project Development Objective 2: Mothers targeted providing exclusive breastfeeding (%). The target was to increase exclusive breastfeeding by 30 percent from a baseline level at 34 percent to 44 percent. The source of data is comparison of data from LQAS surveys at base- and end-line. The end- target was surpassed and 62 percent of mothers did exclusively breastfeed their children. This result is also very impressive given the short duration of the project and can be linked to the intensive support provided to breastfeeding mothers by the project community support groups that consisted of regular counseling and behavior change communication in the communities where new mothers live. The Knowledge-Practice-Coverage survey (2006) and the Project Impact Evaluation (2007) under the first phase of the PRN (2002-2006) confirmed the role of the project in increasing the exclusive breastfeeding ratio.9 The trend of gradual improvement in exclusive breastfeeding in the last ten years as the project coverage has gradually increased and the promotion of exclusive breastfeeding has been intensified, indicates that the project has contributed to this improvement. Project Development Objective 3: Number of beneficiaries (individuals) of cash transfer program. The baseline was 0 and end-line 50,000 women. Beneficiaries were registered in cohorts of 6 months periods in the Project Monitoring System. The PDO indicator (which also was a core indicator) was surpassed by more than 10 percent and a total of 55,323 women received cash payments through the program, providing potential benefits to more than 300,000 people. These results are significant because: (i) it provides lessons on managing a cash transfer scheme at scale; and (ii) demonstrates that cash transfer schemes are a viable safety net option to protect vulnerable families from the economic impact of external shocks.                                                              8 One intermediate indicator that was not fully achieved did not have any impact on the achievement of the PDO; it was an indicator that reflected the coordination with other donors which provided support to Senegal’s salt iodization program. 9  Cellule de Lutte Contre la Malnutrition (2006) ; Centre de Recherche pour le Développement Humain (2007)  11    According to the process evaluation, there were very few instances in which the selection/non-selection of women was contested.10 This achievement should be understood in the light of the pilot nature of the cash transfers. Pilots are often associated with high risks because of the innovations applied and the lack of experience on the specific implementation arrangements. Community-based social cash transfers was a totally new experience for Senegal and risks of corruption, leakage, implementation inefficiencies such as payment delays, and unintended negative consequences such as stigmatization of damage to the social fabric, would have policy as well as political repercussions over and beyond the pilot project. The successful management of these risks by the project is thus quite remarkable. Project Development Objective 4: Selected beneficiaries who receive all intended cash transfers (%). The baseline was 0 and end-line was 80 percent. The data source for the indicator was the Project Monitoring System. The outcome of 96 percent was also well above the target. The findings in the Beneficiary Assessment on a sub-sample of 500 beneficiaries also confirm that practically all the selected women were reached with and received their complete cash transfers.11 The emphasis on quality-control and detailed verification arrangements has led to this very high transfer completion rate. The community nutrition program provided the platform for informing women about the cash transfer schedule of payment, the amount they were expected to receive and the logistics surrounding the actual transfer including the need to bring an identity card. This fourth PDO indicator was included as an efficiency indicator of a crucial risk in the untested management of cash transfers. The target was set according to international experience. Hence, the achievement of close to 100 percent success rate is quite remarkable. The project outcomes were furthermore measured by 13 intermediate outcome indicators, which measure achievements in all four components. The project has reached or surpassed 12 of 13 intermediate indicators. One intermediate indicator that was not fully achieved did not have any impact on the achievement of the PDO; it was an indicator that reflected the coordination with other donors which provided support to Senegal’s salt iodization program. Achievements in component 1 were captured through five intermediate indicators in addition to the two PDO indicators presented above. The screening for acute malnutrition among children 6-59 months was an important activity throughout the project period to prevent child morbidity and mortality due to the worsening food price crisis. The target was to reach 80 percent of children in the project areas. The result at project closure was 90 percent, which clearly illustrates the intensity and extensiveness of the mobilization of communities. It corresponds to 1 072 888 children screened for acute malnutrition, which is about 120 000 children above the target. A similar high level of performance was also accomplished in the indicator measuring children (6-59 months) receiving Vitamin A supplementation. The target for this indicator was 80 percent, which was well surpassed at 94 percent. Children 0-24 months showing adequate weight gain is a very important measurement of the evidence for the “window of opportunity� of nutrition interventions targeting children in this age group. The end-of- target was 75 percent and the result achieved was as high as 81 percent, which represents a very important outcome of the project. Behavior change communication and counseling activities reached mothers and pregnant women to a very high extent. The indicator on mothers of target children (under five) who participate in monthly information and education sessions (%) was planned to be accomplished in scale-up communities at the                                                              10  N Ravaozanany (2013).  11  Aysatou Ndiaye and Madické Niang (2012).  12    same high levels as the already mobilized PRN communities at 80 percent. The end-of-target was surpassed at 91 percent, which equals a total of 1 729 870 mothers. The project reached 209 000 mothers more than planned. This result is extraordinarily high for community-based nutrition projects, which also include hard-to-reach regions that normally require additional resources for mobilization. Findings from the impact evaluation12 on the cash transfer suggest that the proportion of women participating in monthly information and education sessions before and after the distribution of the transfer increased significantly from 36 percent to 60 percent. A similar increase was not seen in control areas indicating that the increased participation is directly linked to the cash transfer activities. The last indicator related to component 1, pregnant women making at least four prenatal care visits (%), was reached but not with the same high marginal as indicators that were accomplished through the primary input of the LGs and subcontracted CEAs. The prenatal care visits increased with 30 percent, which was in line with the end-target. Achievements in component 2 were measured through four intermediate indicators, which involved progress made by the Ministry of Education in addition to the multiple actors in the private sector, thus reflecting well the multi-sectoral nature of the project. Two indicators reflected the contributions of the Ministry of Education in targeting children in primary education receiving weekly micronutrients supplements (%) and receiving deworming medication twice in a one-year period (%). Both indicators had end targets at 80 percent. Both indicators were well above the end target and reached 95 percent. The result corresponds in absolute numbers to a total of almost 300,000 school children. The quantity of salt adequately iodized by small producers was intended to increase from 87 000 tons to 139 000 tons over the project period. During the first three quarters of 2012 a total of 73,299 tons of salt was iodized and the target was not achieved. Several factors have negatively impacted the lower than anticipated quantity of salt iodized: (i) the prize of the products used for the iodization process more than doubled in 201113; (ii) price differentiation between iodized and non-iodized salt is not permitted in Senegal, which posed financial constraints on the small-scale producers choosing to iodize the salt; (iii) the neighboring countries Mali and The Gambia allow import of non-iodized salt, which was attractive alternative markets of non-iodized salt for the producers; (iv) the control of trade with non-iodized salt in Senegal and across its borders is limited. Collaborations with private producers of oil were successfully established during the project period. Quantity of adequately fortified oil with vitamin A by oil industry (liters) was the indicator measuring this new activity in Senegal where the Government bought oil from local producers after which it was fortified by the oil industry. Through this mechanism the government prevented that oil was sold without fortification. The baseline was 0 liters and the end-of-target was 80 000 liter. To present one year’s production we have added the production data from the fourth quarter of 2011 to the production in the first three quarters of 2012. The end-of-target was surpassed and the result reached 107 178 liters indicating the success of this new private public partnership. Achievements in Component 3 were measured through the percentage of Local Governments incorporating nutrition objectives and interventions in Local Development Plans. This outcome reflects a change in design that was made in PRN implementation at the time of the start of the NETS project,                                                              12  Cellule de Lutte Contre la Malnutrition – Institut Fondamental d’Afrique Noire Cheikh Anta Diop de Dakar, Laboratoire de Recherche sur les Transformations Economiques et Sociales (2012).  13 The demand on potassium iodate increased dramatically after the earthquake and tsunami leading to the nuclear plant disaster in Japan in 2011. The price increased from 14,000 to 30,000 CFAF. 13    which led to greater participation of LGs in the implementation of the nutrition security activities. The baseline was therefore 0 and the end-of-target was 25 percent. The result was at end of project 31 percent. The program undertook a range of capacity enhancing measures to strengthen the performance of the decentralized structures at the regional and local levels, including LG representatives who are playing a more important role in the implementation and management of the program. In addition to the project support, the Team also mobilized an IDF Grant in support of CLM’s efforts to strengthen the operational evaluation and monitoring capacity of local leaders. In 2012, CLM together with development and implementation partners conducted a national anthropometric survey using the SMART methodology. The survey showed that current stunting levels have been further reduced and are now measured at 16 percent (2012). This is the lowest rate of stunting seen in Sub-Sahara Africa (SSA). Achievements in Component 4 were measured by three intermediate indicators in addition to the two PDO indicators presented above. Evaluations studies (impact and process) and beneficiary assessment were carried out to learn from the pilot experience. The impact evaluation attributed several outcomes to the cash transfer intervention as indicated below and briefly described in Annex 4. High quality in the implementation of the cash transfer was emphasized by the CLM. An indicator was chosen to measure the inclusion error of women receiving the transfer. Selected beneficiaries who do not meet eligibility criteria (inclusion error)(%). The end-of-target was 20 percent. From the start, and throughout the project period, the much lower level of inclusion error of 2.5 percent was accomplished. The verification process was thorough and built on the need for local selection committees to take the lead in identifying beneficiaries. CEAs were already well-known in the pilot communities and were trained in the cash transfer implementation arrangements. They were responsible for verifying the list of beneficiaries in addition to the Monitoring Committees. This arrangement contributed to the success in adhering to the eligibility criteria. Given the fact that subcontracting of a local payment service provider (LPSP) to reach beneficiaries in multiple districts was never tested before, an intermediate indicator was formulated to measure the transfers made by local payment service providers (%) with an end-or-target at 80 percent. The project succeeded in distributing all 100 percent of transfers through LPSP. In the areas with constraints in accessing the cash transfers and mobile units of LPSP were created, the CEAs were clearly distancing themselves from the actual handling of cash. The unambiguous role of CEAs contributed to the streamlined implementation. Complete transfers have been received by the women and children most in need as indicated in the findings from the impact evaluation. It was found that cash transfers had a positive effect on the number of meals given to children under five. The proportion of households in which children received at least four meals/snacks per day significantly increased from 26 to 54 percent in the intervention areas before and after the cash transfer. In the control areas this proportion also increased but by a smaller margin (from 21 to 37 percent). This result has contributed to improvement in the general food insecurity (composed indicator) of the household. It has slightly dropped in intervention areas from 31.4 percent before the cash transfers to 30.9 percent after. This drop might seem modest but in comparison to the increase in control areas from 35.4 percent to 42.4 percent, the impact is better apprehended. It illustrates the fact that the project was implemented during a period of worsening living conditions due to the global economic crisis. The increase in food insecurity in the control areas indicates what would have happened in the intervention areas without the project activities. 14    In addition, children in the intervention areas experienced some health benefits as compared to the control areas according to findings in the impact evaluation. The cases of diarrhea decreased at the same time as the likelihood of the child having a vaccination card and to receive the vaccinations regularly were slightly higher in the intervention area. The behavior changes that led to these improvements in child health and child feeding practices were accomplished even though the cash transfers were unconditional. The cash transfers were accompanied by an elaborate communication strategy targeting all the different stakeholders with specific messages on the cash transfer program’s objectives, target groups and expected results. This communication came in addition to the ongoing program communication of the PRN on key family practices for maternal and child health and nutrition. The communication strategy included a broad range of communication activities including: large community meetings with discussions, drama and songs; group education; orientation and decision meetings with local authorities; and counseling and other forms of inter-personal communication. Findings from the Beneficiary Assessment demonstrate that mothers spent the cash on expenses for the child under five and the household as a whole (71%) while 22 percent spent the cash exclusively on the child and 6 percent spent a part of the allocation on an income generating activity. Furthermore, the type of expenses that were covered by the transfer is in order of frequency: food (99 %); clothes to the child (77%); health care and medicines (70%); shoes for the child (66%) and donation of a part of the transfer to another person (27%). These findings indicate that the project was able to promote the transfers in the right way using “soft� conditions through persuasive communication. A conditional scheme would have raised the complexity and costs of the project by adding the need for objective verification measures and defining appropriate conditions which appeared unnecessary given the high uptake in PRN activities. Development and adoption by the government of an efficient child-focused social cash transfer scheme as part of the NSPS was the final indicator of component 4. During 2012 the CLM disseminated lessons learned on the pilot including detailed analysis of the targeting mechanism applied. The Government has assessed the very positive experiences and results, and has adopted the cash transfer scheme including the more specific lessons learned on the targeting and verification procedures. Project achievement: The country’s commitment and the Bank’s support to the nutrition policy since 2000 has been accompanied with a significant reduction in malnutrition rates, notably stunting. Stunting levels had decreased substantially from 30 percent in 2000 to 20 percent in 2006 and to 16 percent in 2012. The SSA average rate of stunting is 39 percent. Other countries with a low level of stunting are Mauritania (23 percent), The Gambia (24 percent) and Ghana (28 percent). At the other end of the spectrum are countries like Burundi (58 percent), Ethiopia (51 percent), Madagascar (50 percent), Malawi and Niger (both with 47 percent). Based on the results from the impact evaluation under the first phase, the large scale coverage of the PRN, and the weak economic growth of the past 10 years, it is likely that the program has contributed considerably to the reduction of stunting. The achieved results of the community nutrition activities created a strong demonstration effect. As indicated earlier, various countries sent delegations to learn from the Senegal experience with multi- sectoral policy coordination and large-scale decentralized implementation. Moreover, in 2011, Senegal joined the global Scaling-up Nutrition (SUN) movement which calls for strong Government stewardship and enhanced donor coordination of nutrition initiatives. SUN membership does not result in increased financial resources but it provides an international forum where evidence and experiences are exchanged. The increased visibility of the CLM has also increased the interest from other countries from all over the world with interest in scaling up nutrition policies and programs.   15    3.3 Efficiency (Net Present Value/Economic Rate of Return, cost effectiveness, e.g., unit rate norms, least cost, and comparisons; and Financial Rate of Return) As a result of the subsidiarity principle, the management structure at the central and regional levels is kept to the minimum, e.g., the number of professional staff for all programs and projects (including those funded by other donors) at central level is less than 15. Moreover, as the program (funded by this and another IDA project, Senegal Nutrition Enhancement Program II (P097181) and local stakeholder involvement matured, the number of regional offices was kept at three (compared to six during the first phase) – despite the broadening of the program scope and the tripling of the program coverage (from 20% to over 60% of the total number of urban and rural children under five reached) over the same period. As a result, project management has incurred just three percent of the overall project costs so far. This includes overhead costs, which stands at two percent. In part this is due to the fact that the program is supported by the Senegal Nutrition Enhancement Program II. In this project, project management represents 13 percent of which three percent are overhead. For both projects combined, project management represents eight percent of actual project costs. These efficiency results of the cash transfer pilot compare favorably to the management cost of another like-minded safety pilot using food vouchers in poor peri-urban areas implemented by the World Food Program during the same period. In this food voucher pilot, management costs (excluding monitoring and evaluation) represented 26 percent of the project costs compared to 3 percent for the cash transfer pilot.14 The project is also characterized by a strong technical efficiency. The implemented activities are among the most cost-effective interventions to improve nutrition outcomes15 with some of the highest cost- benefit ratios in terms of poverty reduction and economic development.16 These interventions were implemented using the subsidiarity principle by which “matters ought to be handled by the smallest, lowest or least centralized competent authority�. Most interventions were implemented by community members. CEAs provided critical assistance in community mobilization and organization, financial management, program innovations, and integration of programs at community level. LGs were in charge of overseeing health and nutrition development efforts, monitoring and evaluation, social mobilization and coordination among stakeholders and programs. And the public service delivery systems (i.e., health, agriculture) provided technical guidance, training and supervision. This platform of functional partnerships at the local level, which has raised the efficacy of community nutrition, health and food security efforts, was developed under the community nutrition program and successfully used for the incorporation of other program interventions such as the distribution of bed nets, the production of iodized salt by small producers, the management of acute malnutrition, the promotion of community gardens, and, in this project, the social cash transfers to vulnerable mothers and children. During 2012, the push for “shared� responsibility by the local stakeholders, led to the expansion of PRN interventions to also include fortification with micronutrients of children's food at the household level, and to additional household food security interventions, such as the promotion of community grain banks and small livestock. Spillover effects include a stronger partnership between LGs and CEAs on a broad range of local development issues, and better harmonization of interventions (including those funded by other donors through parallel systems) through making CEAs part of national programs. To enhance                                                              14 J Van Domelen, 2012 15  See: Lancet Series Maternal and Child Undernutrition (2008); Repositioning Nutrition as Central to Development World Bank (2006).  16  This was concluded in the Copenhagen Consensus 2008 and 2012.  16    efficiency, CEAs are recruited on the basis of their capacity to operate on a larger scale. In addition, CEAs’ overhead is limited at nine percent of the sub-grants. The use of NGOs and CBOs as CEAs to work in partnership with the District Health System and LG structures was found to be a more cost-effective way to conduct the fight against malnutrition than using government structures only. This was back in 2002, when the first phase of the program was designed. Since then, capacity of CEAs and LGs has increased, such that LGs are taking a stronger stewardship role at local level. In addition, CEAs and LGs are horizontal structures which allow for broader and more inclusive approaches to community mobilization. CEAs are also more innovative and adaptable than the vertical public service delivery systems. By letting CEAs do what they do best, the program has been successful in reaching a broader range of target groups more effectively through for example, pregnant women solidarity clubs, grandmother forums, and religious women circles in areas with large and strong brotherhoods like in the region of Touba. CEAs and LGs have developed complementary partnerships in which the CEA is a technical and executing arm of the LGs. In the future, it is likely that the role of LGs will continue to grow and they may ultimately incorporate most of the CEAs responsibilities. It is also likely that CEAs will continue to provide a technical assistance role to LGs and innovate with community mobilization approaches for new challenges and target groups. 3.4 Justification of Overall Outcome Rating (combining relevance, achievement of PDOs, and efficiency) Rating: Considering the high relevance of the project due to the emerging crisis and rise in food prices during the design of the project, the current risks due to the continued global food price crisis, the achievements of the PDO and the intermediate indicators with all PDO indicators having surpassed their targets, the performance of the project as a rapid response, and the well-designed implementation arrangements leading to high technical efficiency, the overall outcome rating for the project is Highly Satisfactory. Any challenges the project encountered all related to the processes of implementation and did not impact the project’s progress towards the achievement of PDO outcomes. 3.5 Overarching Themes, Other Outcomes and Impacts (if any, where not previously covered or to amplify discussion above) (a)Poverty Impacts, Gender Aspects, and Social Development The direct beneficiaries of the cash transfers are the poorest groups of women in the communities. The targeting involved a three stage selection process: (i) geographical selection of the most vulnerable districts; (ii) categorical selection of mothers with a child under the age of five as the most vulnerable people in the household; and (iii) community-based selection using a mix of national and local criteria. There is no evidence of stigmatization of poverty in the project; instead there were some indications of beneficiaries expressing an increasing interest in participating in the PRN. That non-beneficiaries expressed solidarity with beneficiaries supports this. The cash transfers were issued to women. The main reason for this, despite intensive debates during the preparation of the project, was a concern that women would not be able to control the use of the transfers if the money were directed to the men. In the communication strategy it was emphasized that the cash transfers were intended to protect the nutritional well-being of children and that the cash therefore was given to mothers of vulnerable children under five. Findings in the beneficiary assessment indicate that women to a large extent were able to control the spending from the cash transfers. 17    The transfers have strengthened the linkages between nutrition, citizenship and governance. The actual transfer of cash was made on the basis of identity proof of the woman. Hence it increased the need to obtain formal identity cards, or, if that was impossible, an identity assurance from the local Mayor of the community. Many beneficiaries entered a credit institution for the first time; signed a document with their personal name for the first time, which was described as an empowering experience. At the start of the project there were no expectations that direct government support (cash) would reach individual women. Among the beneficiaries there were suspicions and disbelief that the cash in fact would be distributed without conditions. This changed when cash transfers were actually distributed in the pilot areas. Findings suggest that more women have applied for the national identity card after the pilot. The increased visibility of LG representatives in the project, for example during visits to communities during the verification process of selected beneficiaries, also reinforced the message that the Government was assisting poor women and children. (b) Institutional Change/Strengthening (particularly with reference to impacts on longer-term capacity and institutional development) Even though this was a rapid response project that was implemented on the premise that capacity existed, the project has contributed to institutional development as described in section 3.3. In addition, the CLM has developed an extensive operational experience in the implementation of cash transfer programs in hard-to-reach areas in Senegal. The lessons learned on the importance of the targeting procedures of cash transfers has strengthened the agency’s capacity in social development, which spills over to other agencies in need of knowledge of improving the access to social services in rural areas. The continued unmet need of safety nets in Senegal and the success of the project in establishing effective targeting and distribution mechanisms are important for future support to the strengthening of the sector. (c) Other Unintended Outcomes and Impacts (positive or negative) CEAs have enhanced their theoretical and operational understanding of the role of safety nets in the communities where they are working. This experience enriches their analysis of opportunities and constraints in reaching the most vulnerable households in other projects that seek to reduce vulnerabilities. Moreover, the project had a clear demonstrative effect on other countries which have taken inspiration and information on lessons learned from Senegal, and are replicating those in their respective countries, thereby extending the potential impact of the project to many more women and children beyond the borders of Senegal. 3.6 Summary of Findings of Beneficiary Survey and/or Stakeholder Workshops (optional for Core ICR, required for ILI, details in annexes) CLM conducted a Beneficiary Study on the cash transfer pilot which was completed at the end of the project. In 30 randomly selected villages, 500 women who had received the cash transfer were included in the assessment. Focus group discussions with non-beneficiaries were also conducted. The perceptions and experiences of beneficiaries were very positive on the received services and on the impact the transfers had made on children’s nutrition status. 18    The main findings are: (i) the majority of women (70 percent) were aware of the applied criteria of selection; (ii) they confirm to have received the three allocations at LPSP offices and the far majority are satisfied with the services received; (iii) one third of the women express that they had preferred to receive the transfer more often than bimonthly; (iv) the far majority have participated in group or individual education sessions on maternal and child health; (v) the transfers have been spent exclusively on the child under five and/or on the household as a whole including the child. 4. Assessment of Risk to Development Outcome Rating: Moderate The enhanced capacity of and improved project ownership by LGs is reassuring for mitigating future risks to the development outcome. LG-representatives’ acquired knowledge on the living conditions and vulnerabilities of its population, their contribution to the success of bringing a multitude of nutrition- enhancing services, including the cash transfers, to its constituents, are fundamental building blocks of the enhanced institutional environment. The general movement toward local development and decentralization is supported by the Government, the LGs themselves and development partners. The recent assessment made in the World Bank Participatory Local Development Project17 indicates that the pace of the general decentralization reforms is uncertain but decentralization is not likely to be reversed. The expertise and experience of CLM’s implementation coordination of the nutrition policy is uncontested in the Senegal civil service. Nutrition policies have been supported by the Government over more than a decade and the Government has increased its annual support to the CLM from the national budget from F CFA 145 million during the first phase, to F CFA 1,172 million since 2007. In 2012, the Government increased its contribution to F CFA 1,372 million and, with the purpose to render the nutrition programs sustainable, committed itself to further increase public financial support to the CLM by F CFA 500 million per year until 2016 to reach an annual total of F CFA 3,572 million. Senegal remains vulnerable to volatile and higher food prices. This situation erodes purchasing power of poor families and poses a serious nutrition risk to the vulnerable population many of whom benefited from NETS. In addition, Senegal remains vulnerable to the effects of climatic shocks (droughts, pests, flooding). While regional efforts for early warning in the Sahel have improved over the past decade, the domestic surveillance and the rapid response capacity remain weak. While the approach of cash transfers has been adopted by the Government, the building of a comprehensive social protection program is still in the making. The NETS pilot successfully demonstrated the feasibility and effectiveness of cash transfers with beneficiaries directly benefitting from them. It is important that the ongoing discussions on the development of future social safety nets are further benefitting from the implementation experiences of the CLM.                                                                17 See World Bank 2012: Implementation Completion and Results Report (IDA-41660). 19    5. Assessment of Bank and Borrower Performance (relating to design, implementation and outcome issues) 5.1 Bank Performance (a) Bank Performance in Ensuring Quality at Entry (i.e., performance through lending phase) Rating: Satisfactory The Bank team was diligent in following the implications of successive external shocks. Since August 2008, the team started consultations on the possibility of a Global Food Crisis Response Program (GFRP) support, though resources had not yet been identified. In December 2008, the team submitted a timely and well-conceived application to the GFRP Multi-Donor Trust Fund. Senegal competed with eight other proposals of which only two were retained, Zimbabwe and Senegal, each awarded a total of US$8 million. In February 2009, an additional US$20 million became available to the country for GFRP support from the redeployment of cancelled IDA, and through proactive country team consultations, the team secured an additional US$10 million for the nutrition and cash transfer response. With the resources secured, the team started preparations immediately in order to support the Government to develop a rapid response to the evolving crisis. The project was appraised in the same month of February, negotiated in March, and approved by the Board on May 6, 2009. The Bank team had expertise and experience in preparing the community nutrition project and had a strong relationship with the government. The team was also well acquainted with other agencies and partners in nutrition. This knowledge and position was well used to expand the scope of the ongoing Bank support in nutrition to include the cash transfer pilot. While the Government was very interested in the idea of cash transfers, it was also hesitant to engage in such a high risk intervention during a pre-election period. The team composition of experts in social protection, nutrition and multi-sectoral institution building contributed to the effective and inclusive preparation phase. High-quality technical discussions on design alternatives resulted in a well-adapted implementation schedule. These discussions also contributed to a high level of ownership of the decisions on design. In spite of the lack of prior cash transfer interventions in Senegal to learn from, the preparation of the project progressed in an expedited manner fully in line with the intentions of the GFRP. The selected financing instrument was an Emergency Recovery Credit. The initial disbursement was delayed because of: (i) the legal clause that the project had to disburse the Trust Fund prior to start disbursing from the IDA credit; and (ii) a four month delay in setting up and activating the Trust Fund due to internal problems at the level of the loan department of the Bank. In addition, being an emergency project which was prepared and negotiated in less than two months, not all details had been worked out at negotiations. The project experienced initial implementation delays because the LPSP’s coverage was inadequate in the targeted districts. As a result, the project underwent a CD Approval Level 2 restructuring to: (i) extend the closing date by eight months; and (ii) effectuate a reallocation of resources between categories. The restructuring did not affect the performance indicators or the results. (b) Quality of Supervision (including of fiduciary and safeguards policies) Rating: Highly Satisfactory The project has benefited from regular and structured supervision missions, which have been well documented in approximately two Aide-Memoires per year. The Aide-Memories have included specific recommendations on next steps as agreed with the CLM, development partners and during the broad 20    consultations with Government that the missions initiated. The missions were conducted jointly with development partners and the Bank team has taken an active role in improving coordination measures. The Bank team has provided technical support to secure that the PDO was reached in a manner that also encouraged CLM to develop home-grown solutions. The recognition of CLM as experts in their field during the supervision was very effective in moving the project forward while adjusting the implementation based on lessons learned to the challenges that arose. In addition, as the acting donor convener for the SUN movement, the Bank team encouraged the CLM to strengthen interactions with other African countries that are strengthening their nutrition policies and programs. Bank approval of the government request to extend the project period with eight months made it possible for CLM to make up the initial delay caused by the design of the legal clause in the disbursement. The extension was important (i) to complete the planned implementation; and (ii) to present the new government after the election in March 2012 to the pilot’s results and lessons learned. c) Justification of Rating for Overall Bank Performance Rating: Considering the proactive response to the emerging economic crisis, the appropriated design of the first large scale cash transfer pilot in Senegal, the exceptionally fast preparation of the project, and the structured yet culturally sensitive supervisions, the overall rating for Bank performance is Satisfactory. 5.2 Borrower Performance (a) Government Performance Rating: Satisfactory The Government has made progress in reducing malnutrition through its continued political commitment to address the multi-sectoral nature of nutrition by broadening the scope of nutrition interventions to include bed net distribution, the community management of acute malnutrition, food fortification, social cash transfers, and most recently, food diversification. The Government has advanced the sectoral support to nutrition through the adoption of food fortification standards to guide and control all food fortifications in Senegal. The progress on decentralization to LGs has strengthened the contextual implementation of the project, moved nutrition decisions closer to the users of services and secured successful targeting and verification mechanisms in cash transfers. The support to CEAs as part of the national scale-up of the nutrition program is another important aspect. The project benefited during the design and implementation from the continuous support by the Prime Minister’s Office. The Ministry of Economy and Finance has been engaged in the implementation of the project and has also strengthened the efficiency targeting. There has been less progress in the production of national health statistics. The retention of data as a means of protest by the health districts since 2010 is a constraint as MOH is unable to disseminate any national health and nutrition statistics. During the project life, the Government increased its annual support to the CLM from the national budget from F CFA 1,172 million to F CFA 1,372 million in 2012 and, with the purpose to render the nutrition programs sustainable, committed itself to further increase public financial support to the CLM by F CFA 500 million per year until 2016 to reach an annual total of F CFA 3,572 million. The Government has adopted the cash transfer pilot and can build further on the findings and lessons learned in the policy making on safety nets and crisis management.   21    (b) Implementing Agency or Agencies Performance Rating: Highly Satisfactory The CLM demonstrated ownership, high motivation and skills to scale-up the PRN but also to design and implement an innovative cash transfer pilot. The CLM applied its experience and good working relationship with the Bank and other development partners to build on lessons learned in other low- income countries and adapted them to the Senegalese context. The CLM’s extensive experience with results-based management improved the design of the unique community-based targeting and verification process. The choice of community-based implementation of the pilot reflects the strong relationship with local partners that the CLM has nurtured. The CLM implemented the project by example and developed pragmatic and innovative solutions, which advanced the project in line with the intended purpose of the emergency response. Illustrative examples are the re-negotiations with LPSP to provide mobile transfer units, mobilization of local authorities and the provision of security of the transfers, and the development of alternative data collection methods. The CLM has, in a systematic way, addressed the lack of access to national health statistics through conducting a mixture of household surveys and lot quality assurance sampling surveys. The agency has succeeded in expanding the M&E system to fully integrate the cash transfers while maintaining the same high level of performance. The CLM is disseminating the results of the pilot and has produced a documentary that has been aired on national TV. Other products are under preparation. Advocacy measures include an analytical paper on the community-based targeting experience. The CLM coordinator retired in 2011 and a new coordinator was selected from within the agency with no decrease in the level and quality of implementation. The team spirit and engagement of CLM staff to accomplish results is remarkable and is characterized by clear roles and mandates of team members. The understanding and knowledge of the operational realities is high and team members regularly visit the field. The strong sense of the mandate of the team is exemplified by FM staffs’ participation in the pilot in the hard-to-reach areas to assure quality and secure the funds. Despite the initial disbursement delay due to internal Bank failures, the client was able to start implementation using public resources. Despite logistical challenges during implementation, the client maintained an expeditious implementation schedule and by the end of the project in August 2012, the project had fully disbursed (100%) on both the Credit and the Grant. (c) Justification of Rating for Overall Borrower Performance Rating: Based on the political commitment to reduce malnutrition, on the efforts to bridge the gap between evidence of benefits of cash transfers in other countries and the lack of implementation experience in Senegal, the capacity to manage an experimental project, and the constant emphasis on achieving results, the overall performance of the Borrower is rated Satisfactory. 6. Lessons Learned (both project-specific and of wide general application) Nutrition indicators can improve even in the Senegal context of weak and uneven economic growth. The effectiveness of investing in health and nutrition services in circumstances of limited fiscal resources is encouraging for low-income countries that are constrained by the ongoing global crisis. 22    The institutional set-up in the Prime Minister’s Office greatly enhanced coordination of the policy dialogue between multiple stakeholders and sectors. This increased stakeholders’ shared responsibility of the observed nutrition related problems, which in turn contributed to the enhanced uptake of services. The success the cooking oil fortification with vitamin A highlights the importance of a collaborative environment of multi-sectoral coordination in which the Government increased its support to new fortification policies through the National Committee for Food Fortification in addition to buying the annual production of oil from local producers to be fortified and sold by the oil industry. The problems in achieving the results on salt iodization points to the importance of reaching out even broader to institutions such as the Ministry of Trade in Senegal but also in neighboring countries to prevent the border-trade with un-iodized salt. Finally, gradual but significant increase of Government contribution to the CLM in order to sustain its role as a coordination mechanism of nutrition policies boosts the commitment of public and private stakeholders. Effective communication for behavioral change and counseling require precise messages on the promoted behaviors; built on positive examples that appear easy to take on; and includes a description of how the promoted behavior should be accomplished. The scale-up of the PRN was built on extensive knowledge of the implementing partners on the challenges in keeping children healthy but was also built on the positive practices already performed. The project showed the way by e.g. linking local food demonstrations to the period when children start complementary feeding practices. Community-based nutrition is an essential platform for service delivery of other social and health- related packages. The initial mobilization of targeted communities for nutrition activities successfully absorbed the social transfer pilot. Distribution of bed nets has also proved to be an easy expansion of the original nutrition activities. Extensive mobilization of communities can provide the crucial contact between children and other public and private interventions. A de-sectoralized approach to community mobilization for health and nutrition has shown to produce more innovative, adaptable and inclusive forms of community mobilization including pregnant women solidarity clubs, grandmother forums, and religious women circles in areas with large and strong brotherhoods. Most sector strategies to community development are often vertical in nature and often depend on one trained focal person in the community. Using CEAs to help facilitate the community mobilization process has allowed a broader and more inclusive approach to community mobilization. In addition, if given the mandate, CEAs are more flexible and successful in coming up with new ways of reaching out to target groups, e.g., adolescents, pregnant women, that are generally hard to reach by the classical approaches. Effective strategies to combat the multiple causes of malnutrition require flexibility in the approaches to address them. PRN is driven by a results-based management system which implies continuous adaptation of the program to the results. The flexibility in supplementing the core nutrition activities with malaria prevention, therapeutic care for malnourished children, food fortification, safety nets and food security greatly enhances the results. Cash transfers design should be responding to the underlying conditions of the country context. This pilot benefited from research finding and extensive experience among stakeholders on the barriers of utilization of health services, and on the capacity in the target areas of implementing the intervention, which resulted in unconditional cash transfers. Results were achieved without imposing conditions and administrative costs. It is important to find a level of operational trade-off that takes into account administrative procedures capable of responding to the local conditions, that are simple enough for communities and beneficiaries to understand, and that are robust enough to secure the funds. 23    Community-based targeting is an efficient and effective way of reaching the vulnerable population in rural areas. To succeed it requires sufficient attention paid to local consultation, involvement and communication between the scheme and local stakeholders and beneficiaries. When built on existing collaborations, the targeting mechanism could even be rolled out as a rapid response. Local Government participation in and verification of the targeting mechanism enhanced the institutional legitimacy of the cash transfer scheme. The implementing CEAs were assisting in managing the process but it enhanced trust that they were not also selecting beneficiaries or providing the actual transfers. The inclusion of community leaders and the closest levels of government constituted the building blocks of transparency in targeting. Reliability of data on the impact of cash transfers is strengthened by building the scheme on the existing community nutrition program and its well-functioning project monitoring system. Impact of cash transfers on utilization of health care services and growth monitoring are often solely based on self-reported surveys which can be a limitation. This pilot illustrates the success in integrating the data collection on cash transfers into the monitoring system, which is encouraging for future investments in social protection schemes. Conducting a pilot scheme on cash transfers has allowed testing and adjusting approaches in the design and execution that can be applied to the scaling up of safety net operations. This includes high costs associated with transportation to the LPSP for vulnerable women living in remote areas. The expansion of community nutrition to include safety nets, can strengthen the analysis and understanding of social development of all stakeholders involved. More specifically, community and household constraints in utilizing facility based health and nutrition services, in applying for national identity cards or in securing birth registration of newborns, became clearer during the project implementation. 7. Comments on Issues Raised by Borrower/Implementing Agencies/Partners (a) Borrower/implementing agencies The NETS Project was satisfactorily implemented with the support of all partners, be it at the international level (World Bank, UNICEF), national level (line ministries) or decentralized level (administrative and local authorities). In reviewing the implementation process, it is worthwhile highlighting certain issues. First, among the difficulties that were encountered during implementation, two stand out:  The delay in funds availability which delayed the project start: the project start which had been planned for June was postponed to December 2009; and  The inaccessibility of the offices of the LPSP which resulted in the utilization of a part of the allocation to ensure transportation to the LPSP office. The national authorities also stressed the need for caution due to the fact that this was a new approach requiring a careful analysis of the elements of the context. Secondly, many positive points were noted throughout the implementation process, namely:  The commitment of authorities at the highest level to sustain the fight against malnutrition which translated into a growing State contribution to the PRN budget;  The collaboration between technical partners which participated at all stages of the implementation process from concept to the monitoring and evaluation of activities; 24     The involvement and management by the World Bank at all stages of the process, most notably during the design phase and the development of an evaluation plan in which its technical support was crucial to meet the objectives of the NETS Project; and  The strong involvement of decentralized structures, and foremost the set-up of pilot structures to supervise activities at the local level. The Government has shown strong interest in the experience of the NETS Project. In fact, the NETS framework will serve as reference for the design and implementation of the family allowance under the Social Welfare Program of the Government of Senegal. In partnership with the World Bank and UNICEF, the CLM looks forward to continue the implementation of the NETS Project in areas affected by shocks related to the actual crisis by which certain households are facing real difficulties to gain access to certain basic needs. The NETS continuation will contribute significantly to the implementation of the National Social Protection Strategy by addressing the needs of the most vulnerable people (i.e., children below the age of five) and by supporting the development of a single data base as envisioned by the National Delegate on Social Protection. 25    Annex 1. Project Costs and Financing (a) Project Cost by Component (in USD Million equivalent) Appraisal Actual/Latest Percentage of Components Estimate (USD Estimate (USD Appraisal millions) millions) Community-based nutrition 9.7 10.8 54 Sectoral support 1.3 0.7 7 Implementation M&E 0.7 0.9 4 Cash transfer 6.3 5.8 35 Total Baseline Cost 18.0 18.0 Physical Contingencies 0.0 0.0 0.0 Price Contingencies 0.0 0.0 0.0 Total Project Costs 0.0 0.0 Front-end fee PPF 0.0 0.0 .0 Front-end fee IBRD 0.0 0.0 .0 Total Financing Required 18.0 0.0 (b) Financing Appraisal Actual/Latest Percentage    Source of Funds Type of Estimate Estimate of Cofinancing (USD (USD Appraisal millions) millions) Borrower 0.00 0.00 .00 Global Food Crisis Response 8.00 0.00 .00 Program International Development 10.00 0.00 .00 Association (IDA)   26    Annex 2. Economic and Financial Analysis (including assumptions in the analysis) The Project Paper did not attempt an economic and financial analysis of the overall project. As highlighted in the GFRP document, the urgency of a response prohibits quantitative economic appraisal. Instead, the GFRP proposed a rapid appraisal of the following factors, based on standard good practice for the economic evaluation of public investments: (1) policy context; (2) target beneficiaries; (3) expected benefit, cost-effectiveness, and/or benefit/cost ratios; and (4) analysis of fiscal sustainability. The proposed program was consistent with the framework set out in the GFRP. Policy context: The overall policy context recognized the importance of vulnerability to food insecurity and poverty and the need to increase investments in social protection programs. Targeting beneficiaries: Targeting was explicit in all components of the project. In the scale-up of nutrition security communities, the areas with high malnutrition levels were targeted. The target group of women in the reproductive age and children under five, with intensified activities to children under two, are the segments of the population most vulnerable to the food price crisis. The cash transfer component focused on vulnerable families with children under five years of age (categorical and community-based targeting) in the most affected urban and rural areas (geographical targeting). Expected benefit-cost ratio: The benefits from the project were both direct and indirect as well as short- and longer-term. The combination of social cash transfers and nutrition security activities ensured that the program delivered both immediate program benefits and longer-term development gains. Malnutrition slows economic growth and perpetuates poverty through three routes: (i) direct loss in productivity from poor physical status; (ii) indirect loss from poor cognitive function and deficits in schooling; and (iii) losses owing to increased health care costs. The 2008 and 2012 Copenhagen Consensus by some of the world’s leading economists that looked at the world’s best investments concluded that nutrition investments, notably micronutrients and community nutrition, generate returns among the highest of 30 potential development investments.18 Investments in micronutrients were rated above those in trade liberalization, malaria and water and sanitation. Community-based programs are also cost-effective in preventing malnutrition. Overall the benefit-cost ratios for nutrition interventions range from 5 to 200.19 Fiscal sustainability: The project did not give rise to the creation of open-ended commitments of public resources (e.g. for price support or for subsidies). The components all build on on-going Government policies and were aimed at providing short term financing and associated technical assistance to improve the efficiency and reach of these programs. Good steps have been taken by the Government to provide subsequent support within the fiscal envelope of the country’s macroeconomic program. Nutrition policies have been supported by the Government over more than a decade and the Government has increased its annual support to the CLM from the national budget from F CFA 145 million during the first phase, to F CFA 1,172 million since 2007. In 2012, the Government increased its contribution to F CFA 1,372 million and, with the purpose to render the nutrition programs sustainable, committed itself to further increase public financial support to the CLM by F CFA 500 million per year until 2016 to reach an annual total of F CFA 3,572 million. The costs of the community nutrition interventions are below US$5 per child per year.                                                              18 Copenhagen Consensus Results. Copenhagen Consensus Center, Frederiksberg, Denmark, 2008.  www.copenhagenconsensus.com . 19 Repositioning Nutrition as Central to Development: A Strategy for Large-Scale Action. World Bank, Washington, 2006 27    Annex 3. Bank Lending and Implementation Support/Supervision Processes (a) Task Team members Responsibility Names Title Unit / Specialty Lending/Supervision Lucy Katherine Bassett Social Protection Specialist LCSHS Wolfgang M. T. Chadab Senior Finance Officer CTRLA Alain W. D'Hoore Lead Economist AFTP1 Astou Diaw-Ba Program Assistant AFCF1 Saidou Diop Sr Financial Management Specialist AFTME Maimouna Mbow Fam Sr Financial Management Specialist AFTME Ronnie W. Hammad Senior Operations Officer ECSSD Mamadou Mansour Mbaye Consultant AFTPE Nathalie S. Munzberg Senior Counsel LEGEN Mademba Ndiaye Senior Communications Officer AFRSC Mamadou Ndione Senior Economist AFTP4 Fatou Fall Samba Financial Management Analyst AFTME Afroditi Smagadi E T Consultant LEGAF Ludovic Subran Social Protection Economist LCSHS MNCD Moukim Temourov Resident Representative Z Marietou Toure Diack Program Assistant HRSER Cheick Traore Senior Procurement Specialist AFTPE (b) Staff Time and Cost   Staff Time and Cost (Bank Budget Only)   Stage of Project Cycle USD Thousands No. of staff weeks (including travel and consultant costs) Lending FY09 0.0 26.1 FY10 0.0 0.00 Total: 0.0 26.1 Supervision/ICR FY09 0.0 0.0 FY10 9.9 61.4 FY11 4.8 45.4 FY12 3.0 40.4 FY13 2.6 40.6 Total: 20.3 187.8 28    Annex 4. Impact Evaluation of the Cash Transfer component (if any) The impact evaluation followed a base- and end-line assessment in randomly selected intervention and control areas on the Louga Region. The intervention was implemented at the local government area. A stratified sampling method was followed. First, eight local government areas in both the intervention and control areas were randomly selected. In each local government area, five villages were randomly selected with a probability proportional to size. In each selected village, 20 households were randomly selected. This sampling frame resulted in the comparison of 800 beneficiaries compared to 800 non- beneficiaries. Women were reached in their homes before the cash transfers were implemented in the region of Louga in August 2010 and after the implementation in March 2011 The analysis plan was based on the use of odds ratios using categorical variables. Continuous variables were converted to categorical variables. The principal conclusions of the impact evaluation were: i. Increased number and quality of meals by children under five ii. Reduced morbidity in children under five iii. Improved use of child health services (immunization) and reproductive health services (prenatal care, postnatal vitamin A, IPT for malaria) iv. Increased participation by women in group education sessions on health and nutrition v. Reduced use of coping strategies. Households: The number of coping strategies that a household was using to manage the vulnerability to risk was measured before and after the intervention. A coping strategy index was created to differentiate between households coping with “few� or “many� strategies. Included coping strategies during the last six months were: Take child out of school; reduce health care costs; sold equipment and/or personal assets; sale of livestock; sold land, plots, houses; barter or pawn clothes or jewelry; place children in more affluent homes; increased work of adults; children starting to work; emigration of one or more household members; send household members to beg; participation in a “tontine� in kind; pledge of property. The percentage of households that applied few coping strategies before the intervention increased in fact slightly after the intervention (from 44.5% to 46.7%). However, in the control communities this measurement increased significantly from 52.5 to 65.1%. The difference between intervention and control communities is statistically significant. Mothers: In the intervention areas a significant increase in participation in education sessions on nutrition was noted after the cash transfer intervention. The proportion of women participating before and after the distribution of the transfer increased significantly from 36 percent to 60 percent. A similar increase was not seen in control areas indicating that the increased participation is directly linked to the cash transfer activities. Due to the short project implementation period and the number of observations in the evaluation, behavior change in relation to utilization of healthcare services were difficult to measure. The percentage of women who were provided prenatal consultations, provision of Vitamin A during postnatal consultations, and intermittent preventive treatment of malaria in pregnancy was slightly higher among beneficiaries than non-beneficiaries when measured in a composite indicator. Children: An increased number and quality of meals by children under five was found in the interventions areas. In the intervention area, the percentage of children receiving at least four 29    meals/snacks a day increased from 26 to 54 percent. In the control area, the percentage increased as well – from 21 to 37 percent. The difference between intervention and control is statistically significant. Reduced morbidity in children under five due to diarrhea was noted among children in the intervention communities compared to the control. This positive result was not observed in relation to respiratory infections. In terms of health care utilization patterns, it was found that more infants in intervention areas had a vacation card and the schedule of vaccinations (BCG, yellow fever and measles) were adhered to more often than in control communities. 30    Annex 5. Summary of Borrower's ICR and/or Comments on Draft ICR The Borrower is currently preparing the Borrower’s ICR which will be available in March 2013. Comments by the Borrower are provided below. The NETS Project was satisfactorily implemented with the support of all partners, be it at the international level (World Bank, UNICEF), national level (line ministries) or decentralized level (administrative and local authorities). In reviewing the implementation process, it is worthwhile highlighting certain issues. First, among the difficulties that were encountered during implementation, two stand out:  The delay in funds availability which delayed the project start: the project start which had been planned for June was postponed to December 2009; and  The inaccessibility of the offices of the LPSP which resulted in the utilization of a part of the allocation to ensure transportation to the LPSP office. The national authorities also stressed the need for caution due to the fact that this was a new approach requiring a careful analysis of the elements of the context. Secondly, many positive points were noted throughout the implementation process, namely:  The commitment of authorities at the highest level to sustain the fight against malnutrition which translated into a growing State contribution to the PRN budget;  The collaboration between technical partners which participated at all stages of the implementation process from concept to the monitoring and evaluation of activities;  The involvement and management by the World Bank at all stages of the process, most notably during the design phase and the development of an evaluation plan in which its technical support was crucial to meet the objectives of the NETS Project; and  The strong involvement of decentralized structures, and foremost the set-up of pilot structures to supervise activities at the local level. The Government has shown strong interest in the experience of the NETS Project. In fact, the NETS framework will serve as reference for the design and implementation of the family allowance under the Social Welfare Program of the Government of Senegal. In partnership with the World Bank and UNICEF, the CLM looks forward to continue the implementation of the NETS Project in areas affected by shocks related to the actual crisis by which certain households are facing real difficulties to gain access to certain basic needs. The NETS continuation will contribute significantly to the implementation of the National Social Protection Strategy by addressing the needs of the most vulnerable people (i.e., children below the age of five) and by supporting the development of a single data base as envisioned by the National Delegate on Social Protection. 31    Annex 6. List of Supporting Documents Alderman H, Ndiaye B, Linnemayr S, Ka A, Rokx C, Dieng K, Mulder-Sibanda M. (2008) Effectiveness of a community-based intervention to improve nutrition in young children in Senegal: a difference in difference analysis. Public Health Nutrition: 12(5), 667–673 doi:10.1017/S1368980008002619 Aysatou Ndiaye and Madické Niang (2012). Etude sur la satisfaction des mères ou gardiennes d’enfants bénéficiaires du cash transfert. Cellule de Lutte Contre la Malnutrition. Cellule de Lutte Contre la Malnutrition – Institut Fondamental d’Afrique Noire Cheikh Anta Diop de Dakar, Laboratoire de Recherche sur les Transformations Economiques et Sociales (2012), Evaluation de l’impact du transfert en espèces dans le cadre du projet nutrition ciblée sur l’enfant et transferts sociaux (NETS), Rapport final, Enquête 2 (finale) Cellule de Lutte Contre la Malnutrition (2006). Synthèse des Résultats des Enquêtes sur les Connaissances, Pratiques et Couverture (CPC) des Zones d’Intervention du Programme de Renforcement de la Nutrition. Cellule de Lutte Contre la Malnutrition (2009). Nutrition ciblée sur l’enfant et transferts sociaux nets, Manuel de procédures. Cellule de Lutte Contre la Malnutrition (2009). Nutrition ciblée sur l’enfant et transferts sociaux (NETS), Note d’orientation. Cellule de Lutte Contre la Malnutrition (2009). Projet ‘NETS’ nutrition ciblée sur l’enfant et transferts sociaux, Programme de renforcement de la nutrition. Cellule de Lutte Contre la Malnutrition (2009). Projet ‘NETS’ Plan de Communication. Cellule de Lutte Contre la Malnutrition (2009). Projet ‘NETS’ Processus. Cellule de Lutte Contre la Malnutrition (2009). Projet ‘NETS’ Système de Suivi et Evaluation. Cellule de Lutte Contre la Malnutrition (2011). Activités de suivi Post Formation des Relais été Agents Communautaires en Technique de Négociation dans le cadre du Projet Cash Transfert. Région de Louga, du 08 au 19 Février 2011. Rapport de la Mission. Cellule de Lutte Contre la Malnutrition (2011). Rapport Annuelle de Cellule de Lutte Contre la Malnutrition. Cellule de Lutte Contre la Malnutrition (2012). Documentary on the targeting mechanism of NETS with the title: “Le cash transfert, l’expérience de la CLM.� Cellule de Lutte Contre la Malnutrition (2012). Analyse de la situation nutritionnelle du Sénégal Résultats Enquête SMART 2012. Cellule de Lutte Contre la Malnutrition (2012). Note sur la Politique de Nutrition au Sénégal. Cellule de Lutte Contre la Malnutrition (2012). Situation d’insécurité Alimentaire au Sénégal.Contribution à la stratégie de réponse du Gouvernement. Centre de Recherche pour le Développement Humain (2007). Enquête finale pour l’évaluation de l’impact de l’intervention du Programme de Renforcement de la Nutrition en milieu rural dans les régions de Fatick, Kaolack et Kolda (EIPRN, 2004-2006) J. Van Domelen. Senegal : Social Safety Net Assessment. World Bank, 2012. 32    N Ravaozanany (2013). Etude sur l’efficacité et l’efficience des processus de mise en œuvre du « cash transfer ». Cellule de Lutte Contre la Malnutrition. République du Sénégal (2005). La Stratégie Nationale de Protection Sociale (SNPS) – Sénégal. https://sites.google.com/site/senegalprotectionsociale/Home/strategie-nationale-de-protection-sociale Document de Stratégie pour la Croissance et la Réduction de la Pauvreté 2006-2010 (DSRP II). République du Sénégal (2001). Lettre de développement de la Politique de Nutrition 2001 (revised in 2006). République du Sénégal (2007). Plan Stratégique du Programme de Renforcement de la Nutrition (2007-2011) République du Sénégal (2011). Le projet de nutrition et transferts sociaux ciblés sur l’enfant –NETS), Présentation générale, Réunion du Comité Régional de Suivi, Tambacounda. République du Sénégal, Primautre, Cellule de Lutte contre la Malnutrition, Bureau Exécutif National (2011). Rapport final sur la mise en œuvre du projet NETS, District sanitaire de Darou Mousty, Kébémer et Louga. Senegal: Protection Sociale. Site presenting documents and ressources on social protection activities in Senegal. Link: https://sites.google.com/site/senegalprotectionsociale/ World Bank. 2006. Senegal - Second poverty reduction strategy paper and joint IDA-IMF staff advisory note. Washington D.C. - http://documents.worldbank.org/curated/en/2006/12/7727158/senegal-second-poverty-reduction- strategy-paper-joint-ida-imf-staff-advisory-note World Bank (2007) Senegal - Country Assistance Strategy. Washington D.C. http://documents.worldbank.org/curated/en/2007/05/7591326/senegal-country-assistance-strategy World Bank (2009a). CONCEPT NOTE Social Cash Transfers as a Lead Instrument in Child-Centred Social Protection in Senegal 18 January 2009. World Bank (2009b). Emergency Project Paper under the Global Food Crisis Response Program on a proposed grant from the Multi-Donor Trust Fund in the amount of US$8 million and a proposed Credit in the amount of SDR 6.8 million (US$10 million equivalent) to the Republic of Senegal for a Rapid Response Child-Focused Social Cash Transfer and Nutrition Security Project. Report No: 477740-SN. World Bank (2009-2012). Series of #7 Aide-mémoire Republic du Senegal. Programme de Renforcement de la Nutrition, Phase II. Project de Renforcement de la Nutrition 2 (PRN2;CR4245-SE) Project de Nutrition Enfants et Transfert Sociaux (NETS; Cr4605-SN; TF094372) Project de Renforcement d’Evaluation Operationelle en Nutrition (TF095495). World Bank (2009-2012). Series of #8 Implementation Status and Results (ISR) results on Rapid Response Child- Focused Social Cash Transfer and Nutrition Security Project (P115938). World Bank (2012). Implementation and Completion and Results Report (IDA-41660) on a credit in the amount of SDR 34.90 million (US$ 50.05 million equivalent) to the Republic of Senegal for a Participatory Local Development Project. World Bank (2011). Restructuring of the rapid response child focused social cash transfer and nutrition security project, Credit 4505-SN, Project ID P115938, Report No 65826-SN. UNICEF (2009). Etude de faisabilité pour un programme de transferts sociaux monétaires comme instrument majeur d’une protection sociale centrée sur l’enfant au Sénégal. http://www.unicef.org/wcaro/documents_publications_3383.html 33    UNICEF (2009). Pauvreté des enfants : un rôle pour les transferts monétaires en Afrique de l’Ouest et du Centre, Note de synthèse – Politiques Sociales. http://www.unicef.org/wcaro/wcaro_29_UNICEF_ODIbriefing_paper__especes_LOW.pdf UNICEF (2009). La Protection Sociale des Enfants en Afrique de l’Ouest et du Centre. Étude de cas du Senegal. http://www.unicef.org/wcaro/wcaro_unicef_odi_Protection_sociale_des_enfants_Senegal.pdf UNICEF (2009). La protection Sociale pour combattre la pauvreté des enfants https://sites.google.com/site/senegalprotectionsociale/combattre-la-pauvrete-des-enfants UNICEF (2011). Couts et Impacts d’un programme de transferts sociaux monétaires au Senegal : Resultats des simulations. Rapport Final. https://sites.google.com/site/senegalprotectionsociale/ 34    18°W 16°W 14°W M A U R I TA N I A SENEG AL SELECTED CITIES AND TOWNS Sénégal To Podor Nouakchott REGION CAPITALS Rosso Doue Dagana NATIONAL CAPITAL SENEGAL Ndiayène Richard-Toll Haïré Lao RIVERS Lac de Guier SAINT- To MAIN ROADS LOUIS Kaedi Mbout Saint-Louis RAILROADS 16°N 16°N Thilogne REGION BOUNDARIES Mpal Va Lagbar ll ée d u Fer INTERNATIONAL BOUNDARIES Léona lo Ndiaye Louga Matam Koki Tioukougne Peul This map was produced by the Map Design Unit of The World Bank. Kébémèr Daraa Linguère The boundaries, colors, denominations and any other information shown on this map do not imply, on the part of The World Bank Fâs Boye Group, any judgment on the legal status of any territory, or any Va én S llée ég endorsement or acceptance of such boundaries. 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