FOR OFFICIAL USE ONLY Report No: PAD2664 INTERNATIONAL DEVELOPMENT ASSOCIATION PROJECT APPRAISAL DOCUMENT ON A PROPOSED GRANT IN THE AMOUNT OF SDR 35.9 MILLION (US$50 MILLION EQUIVALENT) AND A GRANT IN THE AMOUNT OF US$10 MILLION FROM THE GLOBAL FINANCING FACILITY TO THE REPUBLIC OF MALAWI FOR AN INVESTING IN EARLY YEARS FOR GROWTH AND PRODUCTIVITY IN MALAWI PROJECT November 27, 2018 Health, Nutrition, and Population Global Practice Africa Region This document has a restricted distribution and may be used by recipients only in the performance of their official duties. Its contents may not otherwise be disclosed without World Bank authorization. CURRENCY EQUIVALENTS (Exchange Rate Effective September 30, 2018) Currency Unit = Malawi Kwacha (MWK) MWK727.29388491 = US$1 US$1.39525000 = SDR 1 FISCAL YEAR July 1 – June 30 ABBREVIATIONS AND ACRONYMS ARR Average Rate of Return AARR Average Annual Rate of Reduction ADC Area Development Committee AEDO Agriculture Extension and Development Officer AIDS Acquired Immune Deficiency Syndrome ANC Antenatal Care APT Area Project Team AWPB Annual Work Plan and Budget cAWPB Community Annual Work Plan and Budget CBCC Community-based Childcare Center CERC Contingent Emergency Response Component CERIP Contingent Emergency Response Implementation Plan CG Care Group CPW Child Protection Worker DA Designated Account DADO District Agriculture Development Officer dAWPB District Annual Work Plan and Budget DCA Department of Child Affairs DEC District Executive Committee DFID U.K. Department for International Development DFMO District Financial Management Officer DHO District Health Officer DHS Demographic and Health Survey DIP District Implementation Plan DLI Disbursement-linked Indicator DNHA Department of Nutrition, HIV, and AIDS DPT District Project Team DSWO District Social Welfare Officer ECD Early Childhood Development EEP Eligible Expenditures Program ESMP Environmental and Social Management Plan FM Financial Management GDP Gross Domestic Product GER Gross Enrollment Rate GFF Global Financing Facility GoM Government of Malawi GRM Grievance Redress Mechanism HSSP Health Sector Strategic Plan HIV Human Immuno-Deficiency Virus HSA Health Surveillance Assistant IEY Investing in the Early Years IFMIS Integrated Financial Management Information System IFR Interim Financial Report IPF Investment Project Financing IRI Intermediate Results Indicator ISPIC Intersectoral Project Implementation Committee IVA Independent Verification Agent JICA Japan International Cooperation Agency M&E Monitoring and Evaluation MASAF Malawi Social Action Fund MDAT Malawi Developmental Assessment Tool MGDS Malawi Growth and Development Strategy MIYCF Maternal, Infant, and Young Child Feeding MNP Micronutrient Powder MoAIWD Ministry of Agriculture, Irrigation, and Water Development MoEST Ministry of Education, Science and Technology MoFEPD Ministry of Finance, Economic Planning, and Development MoGCDSW Ministry of Gender, Children, Disability, and Social Welfare MoHP Ministry of Health and Population MoLGRD Ministry of Local Government and Rural Development NGO Nongovernmental Organization PDO Project Development Objective PFT Project Facilitation Team PIM Project Implementation Manual PPSD Project Procurement Strategy for Development RBM Reserve Bank of Malawi RMNCAH-N Reproductive, Maternal, Newborn, Child and Adolescent Health, and Nutrition SAM Severe Acute Malnutrition SBCC Social and Behavioral Change Communication SCT Social Cash Transfer SDR Special Drawing Rights STEP Systematic Tracking of Exchanges in Procurement TA Technical Assistance ToR Terms of Reference UBR Unified Beneficiary Registry UNICEF United Nations Children’s Fund USAID United States Agency for International Development VDC Village Development Committee VSL Village Savings and Loans WMA Water Monitoring Assistant Regional Vice President: Hafez M. H. Ghanem Country Director: Bella Bird Senior Global Practice Director: Timothy Grant Evans Practice Manager: Magnus Lindelow Ziauddin Hyder, Blessings Nyanjagha Botha, Innocent Task Team Leader(s): Kibira Najjumba Mulindwa The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) TABLE OF CONTENTS DATASHEET.....................................................................................Error! Bookmark not defined. I. STRATEGIC CONTEXT ...........................................................................................................8 A. Country Context.......................................................................................................................... 8 B. Sectoral and Institutional Context ............................................................................................... 9 C. Relevance to Higher Level Objectives ........................................................................................ 18 II. PROJECT DESCRIPTION ......................................................................................................19 A. Project Development Objective................................................................................................. 19 B. Project Components ................................................................................................................. 19 C. Project Beneficiaries ................................................................................................................. 25 D. Project Instrument and Financing.............................................................................................. 26 E. Results Chain ............................................................................................................................ 27 F. Rationale for Bank Involvement and Role of Partners ................................................................ 27 G. Lessons Learned and Reflected in the Project Design ................................................................ 28 III. IMPLEMENTATION ARRANGEMENTS ................................................................................30 A. Institutional and Implementation Arrangements ....................................................................... 30 B. Results Monitoring and Evaluation Arrangements ..................................................................... 33 C. Sustainability ............................................................................................................................. 34 IV. PROJECT APPRAISAL SUMMARY .......................................................................................34 A. Technical, Economic, and Financial Analysis............................................................................... 34 B. Fiduciary .................................................................................................................................... 38 C. Safeguards................................................................................................................................. 41 V. KEY RISKS ...........................................................................................................................43 VI. RESULTS FRAMEWORK AND MONITORING .......................................................................46 ANNEX 1: IMPLEMENTATION ARRANGEMENTS AND SUPPORT PLAN ......................................61 ANNEX 2: DLI AND DLR MATRIX ...............................................................................................74 ANNEX 3: TEAM LIST .................................................................................................................76 ANNEX 4: MAP..........................................................................................................................77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) DATASHEET BASIC INFORMATION BASIC INFO TABLE Country(ies) Project Name Malawi Investing in Early Years for Growth and Productivity in Malawi Project ID Financing Instrument Environmental Assessment Category Investment Project P164771 B-Partial Assessment Financing Financing & Implementation Modalities [ ] Multiphase Programmatic Approach (MPA) [✓] Contingent Emergency Response Component (CERC) [ ] Series of Projects (SOP) [ ] Fragile State(s) [✓] Disbursement-linked Indicators (DLIs) [ ] Small State(s) [ ] Financial Intermediaries (FI) [ ] Fragile within a non-fragile Country [ ] Project-Based Guarantee [ ] Conflict [ ] Deferred Drawdown [ ] Responding to Natural or Man-made Disaster [ ] Alternate Procurement Arrangements (APA) Expected Approval Date Expected Closing Date 19-Dec-2018 28-Jun-2024 Bank/IFC Collaboration No Proposed Development Objective(s) The project development objective is to improve coverage and utilization of early childhood development services with focus on nutrition, stimulation and early learning from conception to 59 months in selected districts of Malawi. Components Component Name Cost (US$, millions) Page 1 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) Community-based nutrition and early stimulation interventions 26.20 Center-based early learning, nutrition and health interventions 19.30 Multisectoral coordination, capacity and system strengthening 14.50 Contingent Emergency Response Component 0.00 Organizations Borrower: Ministry of Finance, Economic Planning and Development Implementing Agency: Ministry of Gender, Children, Disability and Social Welfare Ministry of Health and Population Ministry of Local Government and Rural Development PROJECT FINANCING DATA (US$, Millions) SUMMARY -NewFin1 Total Project Cost 60.00 Total Financing 60.00 of which IBRD/IDA 50.00 Financing Gap 0.00 DETAILS -NewFinEnh1 World Bank Group Financing International Development Association (IDA) 50.00 IDA Grant 50.00 Non-World Bank Group Financing Trust Funds 10.00 Global Financing Facility 10.00 IDA Resources (in US$, Millions) Credit Amount Grant Amount Total Amount National PBA 0.00 50.00 50.00 Page 2 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) Total 0.00 50.00 50.00 Expected Disbursements (in US$, Millions) WB Fiscal Year 2019 2020 2021 2022 2023 2024 Annual 2.60 12.60 16.30 8.90 5.70 3.90 Cumulative 2.60 15.20 31.50 40.40 46.10 50.00 INSTITUTIONAL DATA Practice Area (Lead) Contributing Practice Areas Health, Nutrition & Population Agriculture, Education, Social Protection & Labor, Water Climate Change and Disaster Screening This operation has been screened for short and long-term climate change and disaster risks Gender Tag Does the project plan to undertake any of the following? a. Analysis to identify Project-relevant gaps between males and females, especially in light of Yes country gaps identified through SCD and CPF b. Specific action(s) to address the gender gaps identified in (a) and/or to improve women or Yes men's empowerment c. Include Indicators in results framework to monitor outcomes from actions identified in (b) Yes SYSTEMATIC OPERATIONS RISK-RATING TOOL (SORT) Risk Category Rating 1. Political and Governance z High 2. Macroeconomic z High 3. Sector Strategies and Policies z Moderate 4. Technical Design of Project or Program z Substantial Page 3 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) 5. Institutional Capacity for Implementation and Sustainability z Moderate 6. Fiduciary z High 7. Environment and Social z Moderate 8. Stakeholders z Moderate 9. Other 10. Overall z Substantial COMPLIANCE Policy Does the project depart from the CPF in content or in other significant respects? [ ] Yes [✓] No Does the project require any waivers of Bank policies? [ ] Yes [✓] No Safeguard Policies Triggered by the Project Yes No Environmental Assessment OP/BP 4.01 ✔ Performance Standards for Private Sector Activities OP/BP 4.03 ✔ Natural Habitats OP/BP 4.04 ✔ Forests OP/BP 4.36 ✔ Pest Management OP 4.09 ✔ Physical Cultural Resources OP/BP 4.11 ✔ Indigenous Peoples OP/BP 4.10 ✔ Involuntary Resettlement OP/BP 4.12 ✔ Safety of Dams OP/BP 4.37 ✔ Projects on International Waterways OP/BP 7.50 ✔ Projects in Disputed Areas OP/BP 7.60 ✔ Legal Covenants Page 4 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) Sections and Description The Recipient shall not later than thirty (30) days after the Effective Date establish the Project Steering Committee with a mandate, resources, terms of reference and functions, satisfactory to the Association, and thereafter, maintain said Project Steering Committee throughout the Project implementation. Sections and Description The Recipient shall maintain throughout the Project implementation, the Intersectoral Project Implementation Committee with a mandate, resources, terms of reference and functions, satisfactory to the Association. Sections and Description The Recipient shall maintain throughout Project implementation, the District Project Teams with resources, functions and terms of reference, satisfactory to the Association. Sections and Description The Recipient shall maintain, throughout Project implementation, and publicize the availability of a grievance redress mechanism, in form and substance satisfactory to the Association, to hear and determine fairly and in good faith all complaints raised in relation to the Project, and take all measures necessary to implement the determinations made by such mechanism in a manner satisfactory to the Association. Sections and Description The Recipient shall, not later than May 31 of each year prepare and furnish to the World Bank, a consolidated annual program of activities proposed for implementation under the Project during the following Fiscal Year, together with a proposed budget for the purpose. Conditions Type Description Effectiveness The Grant Agreement has been executed and delivered and all conditions precedent to its effectiveness or to the right of the Recipient to make withdrawals under it (other than the effectiveness of this Agreement) have been fulfilled. Type Description Effectiveness The Recipient has prepared and adopted the Project Implementation Manual, in form and substance satisfactory to the Association. Type Description Effectiveness The Recipient has established the Project Facilitation Team (PFT) with functions and terms of reference, satisfactory to the Association, and has in accordance recruited to said PFT a project coordinator, financial management specialist or accountant, a procurement specialist, and other key staff, all in accordance with the provisions of the Procurement Regulations. Type Description Disbursement Notwithstanding the provisions of Part A [of the Financing Agreement], no withdrawal shall Page 5 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) be made: (a) for payments made prior to the date of this Agreement; or (b) for any DLI or DLR under Category (1) unless the Association has received from the Recipient or the Independent Verifiers, the EEP Spending Reports confirming that the DLI and DLR have been achieved and containing a proposal for disbursement under each Withdrawal; or (c) under Category (3) for Emergency Expenditures under Part D of the Project, unless the Association is satisfied, and has notified the Recipient of its satisfaction, that all of the following conditions have been met in respect of said activities: (i) the Recipient has determined that an Eligible Crisis or Emergency has occurred, has furnished to the Association a request to include said activities in the CERC Part in order to respond to said Eligible Crisis or Emergency, and the Association has agreed with such determination, accepted said request and notified the Recipient thereof; (ii) the Recipient has prepared and disclosed all safeguards instruments required for said activities, and the Recipient has implemented any actions which are required to be taken under said instruments, all in accordance with the provisions of Section I.G of Schedule 2 to this Agreement; and (iii) the Recipient has adopted a CERC Operations Manual in form, substance and manner acceptable to the Association and the provisions of the CERC Operations Manual. Type Description Disbursement With respect to the withdrawals under Category (1), payments shall be made on a bi-annual basis each year during Project implementation upon timely submission by the Recipient of a withdrawal request acceptable to the Association, such withdrawal request shall include evidence in form and substance acceptable to the Association of: (i) EEPs incurred for the period preceding the withdrawal request as presented in the EEP Spending Reports; and (ii) supporting documentation confirming that the Recipient has complied with the respective DLIs and DLRs, as verified by the Independent Verifiers. Type Description Disbursement Notwithstanding the provisions of paragraph 1(a) and (b) and 2 of this Section [of the Financing Agreement], if the Association is not satisfied that a particular DLI has been fully achieved, the Association may, at its discretion: (i) authorize the withdrawal ofsuch lesser amount of the unwithdrawn proceeds allocated to said DLI, which in the opinion of the Association corresponds to the degree of achievement of such DLI; (ii) authorize the unwithdrawn amount by which such disbursement has been reduced due to partial achievement of a DLI, be carried forward to subsequent Withdrawals; and/or (iii) cancel all or portion of the proceeds of the Financing allocated to such DLI. Type Description Disbursement If, at any time, the Association determines that any portion of the Financing under the Project was used for items improperly procured in violation of Section III to this Schedule, Page 6 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) was not used for Eligible Expenditures or, in case of the Eligible Expenditure Programs of Parts A.2 B.1 and C.1 of the Project, was not supported by evidence of actual spending by the Recipient under said Eligible Expenditure Programs and/or by evidence of satisfaction of other criteria set forth in this Agreement or in the Project Implementation Manual, the Recipient shall refund any such portion to the Association as the Association shall specify by notice to the Recipient. The Association may, at its own discretion, cancel such refunded amount. Page 7 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) I. STRATEGIC CONTEXT A. Country Context 1. Malawi is a landlocked, low-income country in south-eastern Africa neighboring Mozambique, Tanzania, and Zambia. With 20 percent of its area being Lake Malawi and a growing young population (total population of 17.4 million in 2017), Malawi’s land is increasingly under pressure with 200 people per square kilometer. With low annual gross domestic product (GDP) and higher volatility than the rest of Sub-Saharan Africa, its per capita gross national income was US$320 in 2017.1 Half the population lives below the national poverty line, with an even higher proportion in rural areas. Moreover, poverty levels increased slightly between 2010 and 2016, in particular in rural areas.2 With a Human Capital Index3 of 0.41 in 2017, Malawi’s status is slightly above the regional average, and higher than the average for its income group.4 However, inadequate household food security has driven many families and communities into abject poverty and Malawi is ranked 90 out of 119 countries 5 on the Global Hunger Index.6 Existing social safety net programs are in place but with little impact on poverty due to low coverage and poor targeting. 2. Economic development in Malawi is heavily dependent on the agriculture sector, adversely affected by extreme climatic events. Agriculture contributes 30 percent of GDP, 80 percent of total export earnings, and 85 percent of employment.7 Agricultural production and household food security, have been negatively affected by frequent droughts and floods. For example, prolonged droughts in 2015 and 2016 reduced agricultural production by 14.7 percent and 30.0 percent respectively, pushing people into poverty and hunger. In 2016, 6.7 million people were food insecure, up from 2.8 million people in 2015. 8 The Government of Malawi’s (GoM) National Resilience Strategy seeks to break the recurrent cycle of food insecurity by implementing resilient agricultural policies and programs targeting small landholder households. 3. Despite limited progress in reducing poverty in monetary terms, Malawi has notable gains in non-monetary measures of poverty. The rate of enrollment in primary education has increased, significant reduction was achieved in the under-five mortality rate and there has been modest success in reducing stunting9 (chronic malnutrition) among under-five children (from 47 percent in 2010 to 37 percent in 2015/16). However, Malawi’s level of human development remains low and there has been little or marginal gains for the bottom 40 percent of the population. 10 Stunting of children under five years is higher in rural areas (39 percent) than in urban areas (25 percent); and among children in the lowest 1 World Bank. 2017. Country Economic Memorandum. 2 National Statistical Office. Fourth Integrated Household Survey (HIS 4), 2017 3 The HCI measures the amount of human capital that a child born today can expect to attain by age 18. It conveys the productivity of the next generation of workers compared to a benchmark of complete education and full health. In Malawi, a child born today will be 41 percent as productive when she grows up as she could be if she enjoyed complete education and full health. 4 World Bank. 2018. Malawi Human Capital Index. www.worldbank.org/humancapitalproject. 5 International Food Policy Research Institute, 2017. 6 This is a composite indicator of undernourishment and child mortality. 7 Malawi Economic Monitor, May 2017. 8 Malawi Economic Monitor, May 2017. 9 Low height for age defined as height-for-age less than –2 standard deviation score. 10 World Bank. 2017. Country Economic Memorandum for Malawi. Page 8 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) wealth quintile (46 percent) as compared to the highest wealth quintile (24 percent). 11 Early childbearing and marriages, and high fertility12 contribute to poor health and nutrition outcomes, low education attainment, and a cycle of intergenerational poverty, particularly amongst the youth, adolescent girls, and women. B. Sectoral and Institutional Context 4. Over the past 25 years, Malawi has made progress in increasing the coverage for key maternal, child health, nutrition, education, water, and sanitation interventions, leading to improvements in early childhood development (ECD) outcomes. Notably, Malawi has performed above the average for low- income countries in several key human development indicators (table 1) and is among the 11 countries 13 in Africa that achieved the Millennium Development Goal 4 target of under-five mortality. Despite these gains, there are disparities in service coverage and outcomes by geographical location (urban-rural), income status, level of education, gender, and age. A heavy burden of disease, particularly due to Human Immuno-Deficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS), malaria, and tuberculosis, coupled with high fertility and maternal mortality, poor quality of services and critical shortages of human resources, medicines, and other health system inputs, prevent Malawi from realizing further gains in health and nutrition outcomes. 11 National Statistical Office (NSO) and Inner City Fund (ICF) International, 2016. 12 In 2015/16, the total fertility rate for women ages 15–49 was estimated at 4.4 children per woman and the percentage of adolescent girls ages 15–19 who have begun childbearing was estimated at 29 percent. 13 The 11 countries are Egypt, Ethiopia, Eritrea, Liberia, Madagascar, Malawi, Mozambique, Niger, Rwanda, Uganda, and Tanzania. Page 9 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) Table 1. Key Outcomes/Intervention Coverage - Malawi versus Low-income Countries Malawi Low- Key Health and Nutrition Outcomes income 1990 2015 Countries Prevalence of stunting in children under five (%) 49a 37a 38 b Under-five mortality rate (deaths per 1,000 live births) 242 64 76 Maternal mortality ratio (deaths per 100,000 live births) 957 634 496 Total fertility rate (Number of children per women) 7.0 4.4a 4.8 Adolescent fertility rate (births per 1,000 women ages 15–19) 176 137 99 Intervention Coverage Maternal and child health Pregnant women with at least 4 ANC visits (%) 63a 51a 40d a a Children aged 12-23 months fully vaccinated (%) 82 71 80d Children ages 6–59 months given vitamin A in the past 6 months (%) — 64a 63d Nutrition for infants and young children Early initiation of breastfeeding (within 1 hour after birth) (%) 57a 76a 51e a a Exclusive breastfeeding (% of children under 6 months) 6.5 61 46 Minimum acceptable diet for children ages 6–23 months (%) — 8a 16 Early learning and development Gross enrollment ratio, pre-primary, both sexes (%) — 32c 18 Pupil-teacher ratio in pre-primary education (headcount basis) — 91c 26 Water, sanitation, and hygiene Improved sanitation facilities (% of population with access) 29 41 28 Improved water source (% of population with access) 43 90 66 Access to clean cooking fuel and technologies (% household) 1 3 8.6 Social protection Birth registration (% of under-five children with birth certificate) — 17a 45 Source: World Development Indicators except for: a. Malawi Demographic and Health Surveys (DHSs); b. United Nations Inter-Agency Group for Child Mortality Estimation (2015); c. Ministry of Gender, Children, Disability, and Social Welfare (MoGCDSW); d. 2015 World Health Statistics; e. Sub-Saharan Africa data from United Nations Children’s Fund (UNICEF) (2016): From the First Hour of Life. Note: ANC = Antenatal Care. For vaccination of children in other low-income countries, measles coverage for 1- year-olds is used as a proxy. Underlying Constraints to Improved ECD 5. Despite a slower rate of reduction in the prevalence of stunting (0.5 percent reduction over the last 25 years), high population growth has led to an increase in the absolute number of stunted under- five children in Malawi. Between 2004 and 2015/16, the under-five population increased from 2.4 million to 3.5 million and this contributed to an increase in the number of stunted under-five children from 1.26 million in 2004 to 1.31 million in 2015/16. With a total fertility rate of 4.4 births per woman and a high adolescent fertility rate (137 births per 1,000 women ages 15–19), the country’s population is projected to rise to 30.3 million by 2035,14 which will increase the absolute number of stunted children if high impact interventions are not implemented at scale. 14 Population projections - Malawi National Statistics Office. Page 10 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) 6. Early marriages and adolescent childbearing in Malawi increases gender inequalities and expose many newborns and infants to multiple risks, including stunting. About 46 percent of young women (ages 18–22 years) were married before their 18th birthday—one of the highest percentage of early marriage in Sub-Saharan Africa. Nearly a third of young women (15-19 years) have begun childbearing,15 and this perpetuates gender inequalities against girls and women, posing a significant risk to the nutrition status of the child as adolescent pregnancy is associated with higher risk of neonatal deaths, stillbirths, preterm births, and low birth weight.16 Specifically, early marriages have a huge bearing on gender inequalities against girls because they increase lifetime fertility by 18 percent, and prevents girls from advancing to higher levels of education. For example, the gross enrolment ratio (GER) at primary school at 147 percent is very high but it reduces to 41 percent at secondary school mainly due to high dropout of girls as a result of high teenage pregnancies and early marriages. In addition, the likelihood of infants born to teenage mothers being stunted is 6.3 percent higher than infants born to adult mothers. Moreover, although early ANC can have a positive impact on stunting levels, ANC attendance within the first trimester in Malawi is very low (24 percent). Therefore, actions to improve adolescent girls’ health and nutrition should focus on prevention of early marriage and adolescent pregnancy, early ANC, and ensuring that pregnant and lactating teenage mothers are adequately nourished. If adequately implemented, these interventions could help to reduce gender inequalities against girls and women. 7. The prevalence of stunting among children in Malawi increases with a child’s age and the key underlying factors vary at each age group. Stunting levels are relatively stable in the first 6 months of life but increase steadily from 7 months through the first 23 months with the peak being 42–45 percent at 18–47 months. Using results from Malawi’s DHS for 2010 and 2015/16, the factors associated with stunting in under-five children were analyzed by using UNICEF’s hierarchical framework on the causes of malnutrition.17 The results are presented in two graphs in figure 1. The immediate or proximate factors associated with stunting in under-five children are low weight at birth, diarrheal disease, and inadequate diet for the child. For instance, detailed review of breastfeeding practices in Malawi shows that exclusive breastfeeding declines from 81 percent at 0–1 months to 34 percent at 4–5 months, while the percentage of children ages 6–23 months consuming a minimum acceptable diet is only 8 percent. Low intake of animal source foods by pregnant and lactating mothers, vital in maintaining adequate health and nutrition during pregnancy and early childhood, is one of the key underlying problems. At the child level, low birth weight was the most prominent factor leading to stunted growth, but the level of association with stunting differed when the analysis was stratified by age (0–23 and 24–59 months). Each of the immediate factors can also be attributed to problems at the household level. The underlying factors at the household level are mother's height (<152 cm), less than four ANC visits, mother's body mass index18 (<18), poorest 40 percent of population, and lack of vaccination. However, the degree of association varies by child’s age group. Factors associated with stunting at the household level are also correlated with factors at the community level. In Malawi, these are early marriage and high levels of adolescent pregnancies, low level of mother’s education, and inadequate access to safe drinking water and good sanitation. Given the abovementioned factors, preventing malnutrition in Malawi requires interventions at both the community and household levels. At the household level, most of the factors that have been identified 15 Multiple Indicator Cluster (MICS) 2017 survey. 16 https://www.bmj.com/content/bmj/351/bmj.h4173.full.pdf. 17 http://siteresources.worldbank.org/INTLACREGTOPNUT/Resources/UNICEF_Framework.pdf . 18 Body weight in kilogram divided by height in meter square. Page 11 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) can be addressed by changing the behaviors of individuals and families. This includes choices on reproductive health, feeding and hygiene practices, and health care seeking behavior. Figure 1. Factors Associated with Stunting in Malawi and Distribution by Age Group Source: Malawi, 2010 and 2015/16 DHSs. 8. Malawian children have low access to water, good sanitation, and hygiene services, which are essential for optimal child growth and development. While access to any water source increased from 43 percent in 1990 to 90 percent in 2015, the progress on improving sanitation has been slower (from 29 percent in 1990 to 41 percent in 2015) (table 1). Moreover, there is high exposure to fecal pathogens because of limited fecal sludge management services, especially in peri-urban areas. Many young children are likely to suffer from tropical enteropathy or chronic inflammation of the small intestines, caused by continuous exposure to poor environmental sanitation and is one of the key causes of child undernutrition. Declining water resources, obsolete infrastructure, and aging water systems create large gaps between the supply and demand for safe water. Furthermore, water resources are highly variable between wet and dry seasons and from year to year, such that the country’s water storage capacity is one of the lowest in the region. Thus, low access to safe drinking water and good sanitation are binding constraints to Malawi’s ECD efforts. 9. Limited access to responsive parenting education, early stimulation, and early learning contributes to poor education outcomes in Malawi. About 48 percent of children enroll in grade 1 (first year in primary school) late, and there is high repetition at the early primary grades, estimated at 25 percent and 20 percent for grades 1 and 2, respectively.19 In addition, there is insufficient mastery of reading skills in the formative stages of learning and this explains why more than 80 percent of pupils in the second year in primary school were unable to read a single familiar word.20 Consequently, Malawi still 19 http://documents.worldbank.org/curated/en/868571468321240018/pdf/92988-REVISED-PUBLIC-WB-ECD-Mar2016-ENG-v2- web.pdf. 20 World Bank. 2018. World Development Report 2018: Learning to Realize Education’s Promise. Washington, DC: World Bank. Page 12 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) records the lowest scores in the regional Southern Africa Consortium for Measurement of Education Quality examinations. To improve education outcomes, Malawi must increase investments in responsive parenting, early stimulation, and early learning. 10. Protecting young children from poverty, hunger, food insecurity, and stress is one of the most cost-effective investments in human development.21 In Malawi, low household income coupled with inadequate knowledge on ideal feeding practices and harmful cultural practices contribute to low intake of balanced diets in infants, and this eventually leads to stunting. To promote poverty reduction, targeted investments in human capital through social protection programs have an important role to play. Investments in social protection can also help scale up ECD interventions, which can have a positive impact on the health, nutrition, and development of infants. However, the effects are not automatic and depend on the design of the program. For instance, the coverage of social protection programs in Malawi (that is, social cash transfers [SCTs] and village savings and loans [VSL]) is limited and no single program reaches more than 15 percent of the population. Furthermore, expenditure on social protection in Malawi represents only 2.9 percent of the total Government expenditure or 0.8 percent of GDP, which is less than average for the Sub-Saharan African region. There are also inefficiencies in the targeting of potential beneficiaries. To address this problem, a social registry for social protection programs—the Unified Beneficiary Registry (UBR)—has been developed. With the registry in place, it is expected that beneficiary identification through the social protection program will be harmonized to make it more effective to achieve ECD outcomes. The World Bank-supported Malawi Social Action Fund (MASAF) IV Project (P133620) also provides an opportunity to expand SCTs nationwide. The VSL scheme under the MASAF IV Project also provides a catalytic entry point to spur links between ECD, nutrition, and social protection. Opportunities for Improving Child Development in Malawi 11. Improving ECD outcomes comprise critical investments in human capital that can contribute to reducing poverty and increasing economic growth and shared prosperity in Malawi. Early childhood care and experiences, especially in the first 1,000 days of life, have a profound impact on brain and cognitive development,22 including longer-term effects on learning, skills gain, and ultimately income. Global evidence shows that the first 1,000 days of a child’s life (from conception to the first two years of life) is the most critical window for addressing malnutrition as it is during this period that most physical growth, brain and psychosocial development, and human capital formation occur. Irreversible damage in child development takes place if a child does not receive proper nutrition during this period. Poor childhood nutrition leads to an increase in health care expenses and low labor productivity and costs Malawi US$597 million (2012 terms) or US$39 per capita per year.23 Globally, evidence suggests that every dollar invested in maternal and child nutrition interventions will deliver a return of US$16,24 while every dollar invested in ECD programs can yield US$6–US$17. However, as a share of total health spending, expenditure on nutritional deficiencies was only 10 percent on average per year between 2012/13 and 2014/15, which is very low given the high burden of stunting in the country. Equally important is early learning for children ages 3–5 years before they enter primary school. Therefore, for ECD to be successful, delivery of a 21 Heckman (2006). Skill Formation and the Economics of Investing in Disadvantaged Children. Science. 22 https://www.unicef-irc.org/article/958-the-first-1000-days-of-life-the-brains-window-of-opportunity.html. 23 United Nations and World Bank. 2015. Cost of Hunger. 24 Engle et al. (2011). Strategies for reducing inequalities and improving developmental outcomes for young children in low- income and middle-income countries. Lancet. Page 13 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) continuum of interventions for different age groups across various sectors including health, nutrition, education, agriculture, water and sanitation, and social protection is required. 12. Malawi has policies and institutional frameworks in place for implementing cost-effective interventions essential for optimal growth and development of young children. Malawi was one of the initial countries to join the global Scaling Up Nutrition movement in 2011 and developed a National Nutrition Policy 2012–2016, which has been revised and extended to cover 2017–2021. Malawi also has one of the oldest and most extensive early learning systems in Africa that began in the 1950s. 25 The first ECD policy was developed in 2003 and was revised in 2006, 2009, and 2017. Furthermore, ECD is high on the Government’s agenda and is one of the key strategies in the Malawi Growth and Development Strategy (MGDS) III. Malawi also formulated the National Agriculture Policy (2016–2021) aimed at increasing agriculture productivity and farm incomes. One of the key priority areas in the agriculture policy is food and nutrition security, aimed at increasing production and consumption of nutritious foods with specific focus on smallholder households, and thereby addressing stunting. Through the National Social Support Policy (2012) and the second Malawi National Social Support Program (2017–2022), the GoM has expanded its social protection programs. Emerging evidence on the performance of these programs shows positive results in reducing ultra-poverty by 14.2 percentage points, increasing consumption and investments in productive assets, and enabling resilience to seasonal shocks. 26 The VSL schemes also have a positive impact on household income and consumption. 27 13. Malawi is one of the 26 countries worldwide that is earmarked to receive financial and technical support from the Global Financing Facility (GFF) Trust Fund. The GFF is a grant financing mechanism for improving the health of children, adolescent girls, and women through the following pathways: (a) employing a multisectoral approach to address reproductive, maternal, newborn, child, and adolescent health and nutrition (RMNCAH-N) challenges; (b) strengthening prioritization and coordination of RMNCAH-N investments through implementation of Health Sector Strategic Plan (HSSP) II 2017–2022; (c) improving domestic resource mobilization through efficiency gains; and (d) placing a strong emphasis on results. The project will be aligned to the GoM GFF investment case which is under development. The resources from the GFF Trust Fund will be pooled with IDA resources and used to implement key activities under the project, such as strengthening monitoring and evaluation (M&E) systems and building the capacity of frontline workers in nutrition and early learning. 14. The platforms for implementing nutrition, reproductive, maternal, and adolescent health, early stimulation, and early learning interventions already exist in Malawi. Through these platforms (table 2), various interventions are being implemented by Government agencies, nongovernmental organizations (NGOs), development partners, and communities. A community-based platform—Care Groups (CGs)28— is used to deliver a wide range of nutrition-specific and sensitive interventions targeted at adolescent girls, pregnant and lactating women, and under-five children. Whereas the center-based platform, community- based childcare centers (CBCCs), is being used to deliver early learning interventions targeted at children 25 UNICEF. 2014. Assessment of Entry Points to Strengthen Child Protection within ECD in Malawi. 26 Handa et al. (2016). Can Unconditional Cash Transfers Lead to Sustainable Poverty Reduction? Evidence from two government-led programmes in Zambia. Unicef. 27 Ksoll et al. (2016). Impact of Village Savings and Loan Associations: Evidence from a cluster randomized trial. Journal of Development Economics. 28 CG—a group of 10–15 men and women volunteers in a village who are responsible for delivering nutrition-specific and nutrition-sensitive interventions to 10–15 households. They are supported by the respective line ministry extension workers. Page 14 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) ages 36–59 months. Furthermore, Malawi has a well-established network of rural health centers that deliver maternal, adolescent, and child health services that complement nutrition interventions delivered through CGs and CBCCs. These service delivery platforms for nutrition, early stimulation, and early learning are being supported by multiple development partners, including the European Union, U.K. Department for International Development (DFID), United States Agency for International Development (USAID), Norwegian Agency for Development Cooperation, Irish AID, Japan International Cooperation Agency (JICA), UNICEF, World Food Program, and the World Bank Group. Table 2. Existing Platforms and Target Groups for Delivering Nutrition and Early Learning Interventions Platform Target Group Intervention Community-based CGs Pregnant and lactating Identification of pregnant women and promotion of coordinated by DNHA and women ANC, maternal feeding, child spacing, and supported by local contraceptive use. government structures Children ages 0–35 Growth monitoring and promotion; infant young child months feeding promotion, including cooking demonstration; promotion of micronutrient powders (MNPs); deworming and vitamin A capsules; identification and referral of severe acute malnutrition (SAM) cases; and oral rehydration solutions/zinc for diarrhea treatment. Household Promotion of insecticide-treated bed nets; production of nutritious food and includes backyard gardening, promotion of legumes, biofortified crops, and small livestock; promotion of water, sanitation, and hygiene, fuel-efficient stoves, and solar drier; and VSL. Community-based CBCCs, Children ages 36–59 Early learning; basic health and nutrition services; coordinated by the months positive and responsive parenting education; and MoGCDSW and supported community gardens attached to CBCCs. by local government structures Health centres, Pregnant and lactating Reproductive, maternal, and child health services, coordinated by the MoHP women, children ages including ANC, postnatal care, distribution of iron- and supported by local 0–59 months, and folate tablets and contraceptives, immunization, government structures adolescent girls integrated management of childhood illnesses, and treatment of SAM; and youth-friendly services. Note: DNHA = Department of Nutrition, HIV, and AIDS; MoHP = Ministry of Health; MoGCDSW = Ministry of Gender, Children, Disability and Social Welfare. 15. The GoM, with support from the World Bank and abovementioned development partners, has been implementing the National Nutrition Strategic Plan which has been contributing to the institutionalization and strengthening of CGs with support from the local government entities. According to the national nutrition M&E system, managed by the MoHP’s DNHA and adopted by all districts, to date, the country has established 8,662 CGs through which 681,686 under-five children and 266,274 pregnant and lactating women throughout the country have been reached with a standard package of community-based nutrition interventions. Through the CG’s efforts, the following significant improvements in several key indicators have been documented: Page 15 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) x Percentage of children who recovered from SAM increased from 89.6 percent in 2014 to 93.6 percent in 2016. x Percentage of children who recovered from moderate acute malnutrition increased from 89 percent in 2014 to 91 percent in 2016. x Percentage of under-five children with diarrhea who received zinc supplements increased from 0.2 percent in 2010 to 28 percent in 2016. x Percentage of pregnant women who received iron-folate supplements increased from 67.6 percent in 2010 to 87.7 percent in 2016. x Percentage of pregnant women taking deworming tablets increased from 27.4 percent in 2010 to 51.6 percent in 2016. 16. The CBCCs have been established with active community participation and contribution, following support and guidelines provided by the MoGCDSW. Children ages 36-59 months are expected to attend preschool before joining the formal primary education. However, the quality of services provided through the CBCCs is generally poor. Most CBCCs suffer from lack of trained caregivers, poor infrastructure, and lack of basic supplies of learning materials. Furthermore, many communities in rural areas do not have access to the CBCCs, as they are mainly concentrated in urban and peri-urban areas. 17. A cluster randomized control study in Zomba District in Malawi suggests that the CBCCs can be an effective platform to deliver nutrition and early learning interventions to children ages 36–59 months.29 The study showed that the CBCCs can provide a platform for positive change on behaviors related to food production and consumption at the household level. Moreover, evidence from the study indicates that community contributions through the CBCCs had a protective effect during periods of high food insecurity and can be a sustainable option for improving ECD outcomes. In summary, the study concludes that CBCC-based activities, including demonstration and social behavioral change communication, can help achieve improvements in household food production and diversity, maternal knowledge of child nutrition, and preschool children’s diets. Implementation Gaps for Child Development in Malawi 18. While the institutional frameworks and service delivery platforms exist, there is limited coordination across ministries and financing constraints at the national and local government levels. Furthermore, due to limited program planning and implementation capacity, there is reliance on NGOs to deliver the interventions. This undermines institutional sustainability and accountability and is a missed opportunity to build capacity in country systems. High dependency on external assistance to finance key programs and interventions makes Malawi vulnerable to external shocks and reduces flexibility in resource allocation. 19. The current coverage of quality nutrition and early learning interventions at the community level is low and does not include early stimulation interventions. Access to home-based early stimulation and learning opportunities for children ages 0–35 months, estimated at 5 percent in 2017, is critically 29Gelli at al. 2017. Using a Community-Based Early Childhood Development Center as a Platform to Promote Production and Consumption Diversity Increases Children's Dietary Intake and Reduces Stunting in Malawi: A Cluster-Randomized Trial. Journal of Nutrition. Page 16 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) low.30 Only 32 percent of children ages 36–59 months receive early childhood education provided through the CBCCs31 partially due to the limited availability of CBCCs for most of Malawi’s population. Most of the CBCCs are overcrowded, the quality of services provided is poor, and only 49 percent of the caregivers are adequately trained.32 Other challenges include poor infrastructure and inadequate learning materials, insufficient feeding and cooking utensils, unhygienic sanitary facilities, and lack of gardens. 33 The expansion of ECD services should include early stimulation interventions at the CGs and focus on improving the quality of CBCCs. Existing World Bank Support in Nutrition and ECD-related Sectors 20. From 2012–2018, the World Bank supported the DNHA to deliver community-based nutrition interventions through the CGs in 14 out of the 28 districts in Malawi.34 The 14 districts were selected because they had the highest burden of malnutrition and stunting in the country. NGOs were contracted to oversee and coordinate implementation of a minimum package of nutrition-specific interventions targeting adolescent girls, pregnant and lactating women, and children ages 0–35 months in the 14 districts. There are no ongoing or pipeline World Bank education projects that support preschool and primary school level. However, complimentary ongoing World Bank-supported operations in the agriculture and social protection sectors are described in table 3. Table 3. Ongoing World Bank-supported Operations Relevant to the ECD Agenda Sector Intervention Scope Coverage Financing (US$, m) Social Strengthening Safety Nets Systems National, with emphasis on improved 177.9 Protection project- MASAF IV (P133620). household resilience and economic livelihoods to nutrition, maternal and child health, and early stimulation Agriculture Improving agricultural productivity, 12 districts, with emphasis on 55.0 market access and diversification productivity, diversification, and roads (Second Agriculture Sector Wide infrastructure. Approach Support Project [P164445]). Increasing Production and 2 districts with emphasis on nutritious Consumption of Nutritious Foods food production, consumption, and Among Adolescents (P163923). income generation 3.0 Agricultural Productivity Program for National, with emphasis on improving Southern Africa (P094183). research on nutritious crops and dissemination 30.0 21. Given the above context, including opportunities and constraints for change, the project will support the Government’s commitment to improving ECD outcomes through the implementation of the National Nutrition Policy 2017–2022 and the National ECD Policy 2017–2022. Specifically, the project 30 MoGCDSW ECD monitoring, 2017. 31 MoGCDSW ECD monitoring, 2017. 32 UNICEF. 2014. Assessment of Entry Points to Strengthen Child Protection within ECD in Malawi . 33 UNICEF. 2014. Assessment of Entry Points to Strengthen Child Protection within ECD in Malawi . 34 Malawi Nutrition and HIV/AIDS Project (P125237). Page 17 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) will finance nutrition-specific and nutrition-sensitive interventions and introduce early stimulation activities delivered through the CG and CBCC platforms. To enhance the quality of service delivery, in each district the project will upgrade 25 CBCCs,35 each referred to as a ‘model’; expand the number of CGs to ensure full coverage; train all frontline and extension workers on an integrated package of multisectoral nutrition, early stimulation, and early learning interventions; and equip the upgraded CBCCs and all CGs with basic resources and materials. The project will promote multisectoral collaboration at the national and district levels from the oversight function down to community-level implementation. Health system strengthening (for example, M&E) and capacity building at the district level (for example, planning and budgeting) will be critical, particularly given the recent decentralization of the sector. C. Relevance to Higher Level Objectives 22. The project is aligned to the Country Assistance Strategy (FY13–16) under theme 1 (promoting sustainable, diversified, and inclusive growth) and theme 2 (enhancing human capital and reducing vulnerabilities).36 The project is also linked with the World Bank’s corporate priority of ‘Investing in Early Years for Growth and Productivity’ to address early nutrition, early learning and stimulation, and provision of nurturing care and protection from stress in young children so that they can grow and thrive with full human potential. The project will contribute to the World Bank’s twin goals of ending extreme poverty and promoting shared prosperity and underscores its growing strategic investments in human capital to drive economic growth. Child development is a powerful mechanism for increasing economic growth as well-nourished children who are exposed to early learning activities are more likely to attend primary school and have greater cognitive capacity for learning, completing education, and actively participating in the labor force. 37 The project is also aligned to Sustainable Development Goals 1, 2, 3, 4, and 6. The project aims to strengthen human capital including by addressing gaps in ECD that lead to lost productivity and earnings. 23. The project is consistent with the MGDS III, the National Decentralization Policy 1998, the National Community Health Strategy 2017–2022, the National Nutrition Policy 2017–2022, and the National ECD Policy 2017–2022. The project is aligned to three of the five pillars in the MGDS III including: (i) Agriculture and climate change management - improved nutrition and food security and improved access to water resources; (ii) Education and skills development - improved access to quality and equitable ECD services; and (iii) Health and population - improved access and equitable heath service delivery, reduced disease prevalence, reduced prevalence of stunting and all forms of malnutrition; improved hygiene and sanitation practices; and increased maternal, neonatal, infant and child survival including family planning. 35 According to MoGCDSW guidelines an upgraded or model CBCC refers to (a) upgraded infrastructure along with permanent and hygienic learning spaces; (b) offering early learning programs for children ages 36–59 months by trained instructors; (c) a convening platform for other ECD services delivered by multisectoral teams at agreed regular intervals; and (d) being equipped with inputs that facilitate its effective learning as a model center, including a kit of play materials, instructors’ materials, a resource room, a food preparation kit, a gardening tools kit, and water points. 36 Report Number 74159-MW. 37 Jamison et al. 2013. Global health 2035: A World Converging Within a Generation . Page 18 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) II. PROJECT DESCRIPTION A. Project Development Objective 24. The PDO is to improve coverage and utilization of early childhood development services, with focus on nutrition, stimulation and early learning, from conception to 59 months in selected districts of Malawi. To contribute to this objective, the project will also focus on building the capacity and systems to strengthen national and district multisectoral coordination and management and citizen engagement; thus, contributing meaningfully toward enhancing the goal of child development in Malawi. 25. The term early child development considers a sequence of changes as children grow older, such as (a) prenatal development (that is, development of the fetus before birth), (b) nutrition and early stimulation especially in the first 35 months after birth, and (c) early learning from 36–59 months. The end goal of the project is to ensure that children reach their full potential with cognitive, language, physical, social, and emotional capacities to learn, earn, innovate, and compete. The project’s focus is on delivering short- and long-term changes in nutrition, early learning, and positive parenting behaviors and practices aimed at reducing stunting and improving cognitive ability among the children of Malawi. 26. Achievement of the PDO will be measured through the following outcome indicators: x Percentage of children 6–23 months who receive a minimum acceptable diet. x Percentage of children 0–6 months exclusively breastfed. x Percentage of children 36–59 months who completed one year of early learning in CBCCs. x Number of children 0–59 months, adolescent girls 11–19 years, and pregnant women who are beneficiaries of the project. 27. Progress toward achieving the PDO of improving coverage and utilization of ECD services will be monitored routinely through intermediate results indicators (IRIs), focusing on the project inputs, processes and outputs. (Section VI: Results Framework and Monitoring). B. Project Components 28. The project will support and contribute to the implementation of the GoM’s nutrition and ECD programs. The project comprises four components and a proportion of disbursements will employ a results-based approach using Disbursement Linked Indicators (DLIs). In the event of a future eligible crisis or emergency, the project is designed to provide immediate recovery support to the GoM through a Contingent Emergency Response Component (CERC). Component 1: Community-based nutrition and early stimulation interventions (US$26.2 million; of which US$17.3 million equivalent IDA, US$8.9 million GFF Trust Fund) 29. The primary objective of Component 1 is to consolidate and scale up the delivery of a comprehensive set of high impact and cost-effective nutrition and early stimulation interventions. In the project districts, the capacity of 3,000 CGs (300 per district) will be enhanced to deliver interventions aimed at achieving equity and gender equality through a multisectoral team of community-based Page 19 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) volunteers and extension workers.38 One of the priorities of this component will be to ensure that interventions on early stimulation and responsive parenting are incorporated into capacity building, service provision, and routine supervision and monitoring activities for the CGs and extension workers. This component will be financed through (a) two DLIs; (b) district grants; and (c) input financing at the national level. 30. This component will support the following activities which will be delivered by the CGs . (a) Nutrition-specific activities. These include carrying out monthly growth monitoring and promotion sessions for children ages 0–35 months with specific focus on weight-for-age to promote child growth; imparting social and behavioral change communication (SBCC) campaigns to improve maternal, infant, and young child feeding (MIYCF) practices, including promotion of exclusive breastfeeding and demonstration of complementary feeding best practices through organizing monthly cooking demonstration sessions; distributing MNP to children ages 6–35 months to enhance micronutrient contents of home-cooked complementary food; facilitating child health days, including the promotion of routine deworming and vitamin A supplementation; facilitating routine screening, referral, and follow-up of sick children ages 0–35 months, including those who suffer from severe and moderate acute malnutrition; and distributing, once a week, iron-folate supplements and deworming tablets to adolescent girls ages 11–19 years who are in and out of school. (b) Early stimulation activities. These include imparting responsive parenting education for caregivers of children ages 0–35 months complemented by promoting toys made with locally available materials for children ages 0–35 months. Skills to manufacture toys with locally available materials will be included in the CG training package and the trained CG promoters and cluster leaders will transfer the skills to caregivers of children ages 0–35 months along with education on responsive parenting skills. (c) Nutrition and gender-sensitive activities. These include identifying and mobilizing pregnant women and their male partners to promote ANC within 12 weeks of pregnancy from a nearby health facility with greater emphasis on those less than 19 years; promoting the utilization of insecticide-treated bed nets that are routinely provided through the health sector and nongovernmental providers to reduce malaria; mobilizing adolescent boys and girls ages 11–19 years to receive sexual and reproductive health education to prevent early childbearing and improve the uptake of reproductive and family planning services from nearby health facilities; promoting household and personal hygiene, including handwashing and the use of a safe latrine for all household members to prevent worm infestations and infections; promoting safe drinking water protocols, including the use of waterguard (a locally available water purifier) for all household members to prevent waterborne diseases, including cholera; and promoting production and utilization of nutritious foods, including 38Volunteers refer to Care Group promoters and Cluster Leaders. Extension workers refer to Health Surveillance Assistants (HAS), Child Protection Workers (CPW), Agriculture Extension and Development Officer (AEDO), and Water Management Assistant (WMA). Page 20 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) biofortified crops, and small livestock to enhance the intake of diversified and nutritious diets particularly by under-five children, adolescent girls, and pregnant and lactating women. In addition, the VSL scheme will be integrated in each CG as one of the approaches to sustain the activities of its promoters and cluster leaders. The UBR or social registry, which has been put in place by the GoM, will be used to prioritize the inclusion of social protection beneficiary households in the project. 31. Taking cognizance of gender inequities against girls and women, this component seeks to improve the capacity of CGs to promote community mobilization to deliver nutrition and early stimulation interventions as listed earlier. This includes (a) strengthening and/or setting up CGs in every group village in all project districts (each CG cluster leader covers a cluster comprising 10–12 households); (b) mobilizing target beneficiaries, including adolescent boys and girls ages 11–19 years, pregnant and lactating mothers, and children ages 0–35 months, including their parents; (c) conducting monthly home visits; and (d) organizing monthly village nutrition forums and group education sessions. To promote MIYCF good practices, the cluster leader will conduct cooking demonstrations using local ingredients, distribute MNP and provide counselling on appropriate nutrition and dietary practices during adolescence, pregnancy, lactation, infancy, and childhood. The cluster leader will also conduct door-to- door visits to reinforce the uptake of nutrition-specific and sensitive as well as early stimulation and responsive parenting interventions and identify sick children and those with moderate malnutrition and SAM for referral to a nearby health facility for treatment. Further, cluster leaders will follow up on acutely malnourished children, who have already been referred or discharged from health facilities after treatment to monitor progress. 32. There are two DLIs (described in annex 2) for this component, with a cumulative value of US$7.2 million over the project period. The component will require supply side support and technical and capacity building support; these costs are included in the cost of the program. x DLI 1: Percentage of CG cluster leaders and promoters delivering an integrated nutrition and early stimulation package (US$6.2 million). This DLI is linked to an IRI (care group cluster leaders and promoters that received an integrated training package) and will incentivize capacity-building activities to enhance skills of CG cluster leaders, promoters, HSAs, CPWs, AEDOs, and WMAs so that they can deliver a package of integrated nutrition and early stimulation interventions to achieve results. Project funds will be disbursed to the DNHA based on the verified achievement of targets (annex 2). x DLI 2: Percentage increase on exclusive breastfeeding practices for children from 0–6 months (US$1.0 million). This DLI is linked to a PDO indicator (children aged 0–6 months who were exclusively breastfed) and will incentivize the achievement of excusive breastfeeding results through imparting a set of CG-led SBCC activities. Project funds will be disbursed to the DNHA based on the verified achievement of targets (annex 2). Component 2: Center-based early learning, nutrition and health interventions (US$19.3 million; of which US$19.1 million equivalent IDA, US$0.2 GFF Trust Fund) 33. The primary objective of this component is to improve the coverage and quality of preschool education and reproductive, maternal, and adolescent health services. This component will support preschool or early learning interventions for children ages 36–59 months through ‘model’ CBCCs in the Page 21 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) project districts. In addition, this component seeks to address gender inequalities against girls and women by promoting health and nutrition for pregnant and lactating women as well as adolescent girls ages 11– 19 years. This will be achieved by enhancing the quality of services that are routinely delivered through health facilities in the project districts. This component will be financed through (a) two DLIs; (b) district grants; and (c) input financing at the national level. 34. The MoGCDSW has developed criteria for the selection of 25 existing CBCCs in each district, which will be upgraded to model CBCCs with financing support from the project. The selection criteria for model CBCCs include (a) uniform geographic distribution covering the entire district; (b) existence of a functional CBCC with at least 0.5 acres of conflict-free agricultural land to establish a nutrition-sensitive agriculture demonstration garden; (c) no previous record of conflict among the CBCC management committee members to avoid any potential fiduciary risk; and (d) written commitment of community contribution from the group village chief and the chair of the existing CBCC management committee. Subcomponent 2.1: CBCC interventions (US$17.7 million; of which US$17.5 million equivalent IDA and US$0.2 million GFF Trust Fund). 35. This subcomponent aims to enhance the coverage and quality of early learning delivered by CBCCs for children ages 36–59 months. Specific activities that will be financed under subcomponent 2.1 include (a) capacity building of the CBCC caregivers, mentors, and management committee members in 25 model CBCCs and 25 percent of the remaining CBCCs that are present in each selected district; this activity will be financed through DLIs 3 and 4; (b) upgrading and equipping the 25 model CBCCs in each district; (c) delivering a package of early learning interventions39 in each model CBCC; and (d) establishing a communal garden and integrating VSL in each model CBCC. 36. There are two DLIs (described in annex 2) for this component, with a cumulative value of US$3.0 million over the project period. The component will require supply side support and technical and capacity building support; these costs are included in the cost of the program. x DLI 3: Percentage of CBCC caregivers delivering an integrated early learning package (US$2.7 million). This DLI is linked to an IRI (CBCC caregivers and mentors that received an integrated training package) and will incentivize capacity-building activities of caregivers, mentors, and management committee members that are key to achieve early learning outcomes. Project funds will be disbursed to the MoGCDSW based on the verified achievement of agreed targets (annex 2). DLI 4: Average score achieved on the literacy and numeracy components of MDAT of children aged 48–59 months (US$0.3 million). This DLI is linked to a PDO indicator (children aged 36–59 months who attended at least one year of early learning in CBCCs) and will incentivize the achievement of a critical learning skills such as literacy and numeracy, which are needed to participate effectively and productively in society and are part of the MoGCDSW’s priorities. 39Package of interventions delivered at each model CBCC include (a) early learning, development, and stimulation materials complemented by an interactive radio instruction program; (b) nutrition services, including deworming, vitamin A supplementation, and establishment of the CBCC gardens; (c) health services (routine health checkups and referral of sick children) for children ages 36–59 months; (d) responsive parenting education for caregivers; (e) promotion of handwashing and personal hygiene; and (f) integration of VSL. Page 22 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) Project funds will be disbursed to the MoGCDSW based on the verified achievement of agreed targets (annex 2). Subcomponent 2.2: Health facility interventions (US$1.6 million equivalent IDA) 37. This subcomponent will support activities aimed at improving the quality of specific reproductive, maternal, and adolescent health and nutrition interventions, which are routinely delivered through health facilities and the HSAs in the catchment districts. Specifically, this subcomponent will finance activities aimed at (a) promoting an improved adolescent-friendly health service package, (b) revising and disseminating protocols to manage moderate and acute malnutrition that integrates early stimulation, (c) developing a comprehensive behavioral change communication strategy that will guide SBCC campaigns aimed at increasing the demand for family planning and general reproductive health services, and (d) providing iron- folate tablets for pregnant and lactating mothers attending ANC. 38. In Malawi, there is significant heterogeneity in sexual activity among adolescents, variations in marriage rates, use of contraception, and poverty rates.40 There is also restricted fiscal space and a host of competing priorities for investment in health and human development. Making strategic investments across RMNCAH-N that will not only deliver results but will also contribute to the efficient use of resources is a clear priority emerging in national discussions on the GFF and aligned to the recently launched National Strategy for Adolescent Girls and Young Women. Therefore, the project will support analytical work to guide community-based SBCC activities targeting determinants of adolescent fertility in this project and future multisectoral investments in support of the implementation of the National Strategy for Adolescent Girls and Young Women. This analysis will specifically focus on reducing adolescent fertility, which has a positive impact on gender equality for girls and women as well as child health and nutritional outcomes for human capital formation. Component 3: Multisectoral coordination, capacity and system strengthening (US$14.5 million; of which US$13.5 million equivalent IDA, US$1.0 million GFF Trust Fund) 39. The primary objective of this component is to support capacity-building activities from national to district levels to strengthen management, coordination and implementation of nutrition, and early stimulation and early learning interventions; enhance systems and service delivery at all levels; and improve citizen engagement. Subcomponent 3.1: Multisectoral coordination and capacity development (US$6.7 million; of which US$6.6 million equivalent IDA, US$0.1 million GFF Trust Fund) 40. This subcomponent has two objectives. The first objective is to support a range of high-level, capacity-building activities so that Malawi can plan and implement nutrition and ECD activities as well as sustain gains with a strong national leadership beyond the project period. The second objective is to strengthen management, coordination and implementation of nutrition, early stimulation and early learning interventions; enhance system and service delivery at all levels; and improve citizen engagement. 40 Malawi DHS 2015/16. Page 23 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) 41. In this regard, activities to be financed through Subcomponent 3.1 include (a) training of national- and district-level officials as well as community facilitators to plan, coordinate, and implement nutrition, early learning, and early stimulation activities; (b) annual joint planning and review of nutrition, early learning, and early stimulation activities at district and national levels to enhance coordination; (c) developing and operationalizing a comprehensive ECD and nutrition management information system to strengthen capacity to manage and sustain relevant processes as well as outcomes; and (d) providing customized short and long term courses including diploma and masters to national- and district-level officials to improve national capacity on ECD and nutrition. 42. There are two DLIs (described in annex 2) for this component, with a cumulative value of US$2.3 million over the project period. The component will require supply side support and technical and capacity building support; these costs are included in the cost of the program. x DLI 5: Number of districts disbursing at least 80 percent of funds allocated in District Implementation Plan (DIP) for ECD and nutrition (US$1.1 million). This DLI will incentivize activities ranging from strengthening the district council’s capacity in planning and budgeting to implementation of the district implementation plans (DIPs) that integrate ECD and nutrition to enhance local leadership and achieve greater sustainability building on the GoM’s ongoing decentralization efforts. Project funds will be disbursed to the MoLGRD based on the verified achievement of agreed targets (annex 2). DLI 6: Number of officers completing nutrition and ECD short- and long-term courses (US$1.2 million). This DLI will incentivize activities ranging from enhancing national capacity to develop short- and long-term courses including diploma and masters to production of new graduates in ECD and nutrition through building partnership with local academic institutions. Project funds will be disbursed to the MoGCDSW based on the verified achievement of agreed targets (annex 2). Subcomponent 3.2: Project management, learning, monitoring and evaluation, and citizen engagement (US$7.7 million; of which US$6.9 equivalent IDA and US$0.8 million GFF Trust Fund) 43. This subcomponent will support (a) day-to-day management of project activities at the national and district levels, which includes implementation of project activities, procurement, FM, and reporting; (b) learning and knowledge sharing, including process documentation and operational research; (c) independent verification agency (IVA) to verify claimed results pertaining to DLIs; (d) citizen engagement and Grievance Redress Mechanism (GRM); and (e) project M&E. To support multisectoral coordination and district-level implementation, this subcomponent will finance one full-time district financial management officer (DFMO) per district and community facilitators at traditional authority level.41 44. Citizen engagement will be supported to ensure that project activities are transparent, accountable, effective, and efficient. Through an active engagement of the relevant community organizations, citizen engagement will be mainstreamed in the project to enhance transparency and accountability, inclusiveness, and effectiveness for service delivery, finances, and results. The measures under citizen engagement include making information available to project beneficiaries, public consultations, and dialogues, as well as creating a stakeholders’ feedback loop system. As part of the 41Each district is subdivided into traditional authorities. The number of traditional authorities per district ranges from 2–8 depending on the size of the district. Page 24 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) feedback loop system, a comprehensive community scorecard will be used for assessing, planning, monitoring, and evaluating service delivery. The scorecard will be applied every six months and the findings will be disseminated to the relevant Government ministries, policy makers, legislators, media, and development partners. In addition, the Government is also expected to conduct third-party monitoring by an IVA, particularly for tracking progress on the renovation of the CBCCs and service delivery. Component 4: Contingent Emergency Response Component (US$0.0 million) 45. This CERC is included under the project in accordance with Bank Policy: Investment Project Financing, paragraphs 12 and 13, for situations of urgent need of assistance. This will allow for rapid reallocation of project proceeds in the event of a future natural or man-made disaster or crisis that has caused or is likely to imminently cause a major adverse economic and/or social impact during the life of the project. This component will have no funding allocation initially. In the event of a future emergency, this component would allow the Government to request the World Bank to recategorize and reallocate financing from other project components to cover emergency response and recovery costs, if approved by the World Bank. C. Project Beneficiaries 46. The direct project beneficiaries are children ages 0–59 months, adolescent girls ages 11–19 years, and pregnant and lactating women from 13 of the country’s 28 districts . In the 13 districts, the project is expected to benefit about 1.2 million children ages 0–59 months, 2.2 million adolescent boys and girls ages 11–19 years, and 370,500 pregnant and lactating women. The project will support a full package of interventions in seven districts, only nutrition and early stimulation interventions in an additional three districts, and only early learning interventions in the remaining three districts. This approach was adopted to ensure maximum complementarity with the support provided by other development partners. Ultimately, all the 13 districts will receive a similar set of comprehensive nutrition, early stimulation, and early learning interventions supported by the World Bank and other development partners. Therefore, the project will finance • Nutrition, early stimulation, and early learning interventions (seven districts): Rumphi, Mchinji, Ntcheu, Mangochi, Machinga, Neno, and Chikwawa • Only nutrition and early stimulation interventions (three districts): Zomba, Likoma, and Mwanza • Only early learning interventions (three districts): Dowa, Thyolo, and Chiradzulu 47. The district selection was done in close consultation with the GoM and development partners and aimed at ensuring complementarity with the ongoing efforts in nutrition, early stimulation, and early learning. The following criteria was used to guide selection of the districts for the project: (a) districts with low enrollment of children in the CBCCs, based on the coverage of eligible children for early learning; (b) high rates of malnutrition, as measured by stunting above the national average; and (c) presence of donor-financed projects supporting nutrition and early learning. Through a detailed mapping of nutrition and early learning activities, additional parameters such as availability of CBCCs, quality of CBCC infrastructure, attendance rate of children ages 36–59 months in the CBCCs, availability of CGs, and level of funding from development partners were added. Page 25 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) D. Project Instrument and Financing Financing instrument 48. The project will be financed through Investment Project Financing, which will also use a results- based approach, focusing on results with well-defined qualitative and quantitative targets. The project will use two disbursement modalities: a) traditional Statement of Expenditure; and b) reimbursement against the selected Eligible Expenditure Programs (EEPs), subject to the achievement of DLIs. 49. An estimated 21 percent of the projected disbursements will be linked to the verified achievement of disbursement-linked indicators, each of which is directly linked to the achievement of the PDO (annex 1). The use of DLIs shifts the focus of payments from inputs to outputs and outcomes and will support the GoM using country systems; thereby building capacity and linking disbursement to the achievement of results. Also, this financing approach will enhance the effectiveness of overall public spending and strengthen its results orientation. The project includes six DLIs with annual results from Year 1 to Year 4, totaling US$12.5 million. The DLI approach for financing is used under all project components as follows: DLIs 1 and 2 under Component 1, DLIs 3 and 4 under Component 2, and DLIs 5 and 6 under Component 3. Each DLI target is priced at a value that reflects its significance in the results chain and that incentivizes the achievement of the respective result. The World Bank Group’s Financial Management (FM) guidelines will apply to the selected Eligible Expenditures Program underlying DLI financing. Disbursements against DLIs will be (a) contingent on the satisfactory achievement of a set of targets, as verified by an independent verification agent and (b) against selected project budget line items, referred to as EEP. The EEP includes sizeable recurrent expenditures of mainly salaries and wages and includes other recurrent expenses of the budget allocated to the MoGCDSW, MoHP, Ministry of Local Government and Rural Development (MoLGRD), and their affiliated entities. Capital costs that can be incurred at district level will also be included as part of the EEP. Project Cost and Financing 50. The project will be implemented over five years, with an estimated total cost of US$60 million (table 4). This will be financed by an IDA Grant of US$50 million equivalent and a grant from the GFF Trust Fund (US$10 million) subject to its approval. Table 4. Project Costs by Component and Source of Financing (US$ millions) Project Component Project Cost IDA Financing GFF TF Financing % Financing Community-based nutrition and 26.2 17.3 8.9 100 early stimulation interventions Center-based early learning, 19.3 19.1 0.2 100 nutrition, and health interventions Multisectoral coordination, 14.5 13.5 1.0 100 capacity and system strengthening Contingent Emergency Response 0.0 0.0 0.0 100 Component Total Financing Required 60.0 50.0 10.0 100 Page 26 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) E. Results Chain 51. The theory of change in figure 2 depicts the proposed activities and expected results. It illustrates how the project will leverage Malawi’s existing service delivery platforms, notably, CGs and CBCCs as well as HSAs, CPWs, AEDOs, and WMAs to reach primary beneficiaries with a set of nutrition- specific and nutrition-sensitive, early stimulation, and early learning interventions to address multiple obstacles, ranging from lack of opportunity to develop responsive and positive parenting skills to inadequate health care and nutrition, minimal early stimulation and learning, and lack of protective environment. These obstacles affect the adolescent, child, and reproductive stages leading to a vicious cycle of poor health, nutrition, and learning outcomes. The project envisages that improving access to a set of nutrition-specific and nutrition-sensitive, early stimulation, and early learning interventions will contribute toward stunting reduction and cognitive improvement as critical components of the life cycle approach with a longer-term aim of child development. Figure 2. Theory of Change F. Rationale for Bank Involvement and Role of Partners 52. The rationale for the World Bank’s involvement hinges on its ability to build on experiences from the Malawi Nutrition and HIV/AIDS Project (P125237), work across sectors to support investments in ECD holistically, and draw on regional and global experiences. For example, in Malawi, the World Bank has been actively engaged in implementing multisectoral interventions to address malnutrition through the CG model, an approach that has been adopted in the country’s National Nutrition Policy. Therefore, the World Bank will rely on its convening power and expertise, that it has amassed over the years through Page 27 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) portfolio-wide investments in the country, to ensure complementarity of the World Bank’s investments across sectors and with other development partners. 53. There is considerable donor commitment to the nutrition and ECD agendas in Malawi. Development partners, including Irish AID, DFID, JICA, USAID, Germany, European Union, and the World Bank provide critical technical and financial support to a multisectoral response to address malnutrition. Approximately 80 percent of financing for nutrition in Malawi is provided by donors and is programmed outside the budget. The GoM’s contribution primarily includes the costs of personnel and infrastructure. Most donor funds to support nutrition are executed through UNICEF. The recently launched National Nutrition Policy 2017–2022 serves as a guiding document for national nutrition stakeholders, including development partners to promote evidence-based programming and strengthening of the national nutrition response, scale-up of evidence-based interventions, and realignment of nutrition interventions to the current national development strategy. The policy also provides the framework and context within which sectoral and other strategic plans and budgets are coordinated, formulated, implemented, and monitored. Development partners are active in all 28 districts and are coordinated through two key multisectoral platforms, that is, Donor Group on Nutrition and National Nutrition Committee, meeting monthly and quarterly, respectively. 54. Malawi’s ECD program is largely dependent on support from key development partners, including USAID and UNICEF. The ECD program is implemented through a network of national and international NGOs. UNICEF Malawi supported the implementation of the revised integrated ECD policy (2017–2022) and coordination across key ministries. For example, ECD was integrated in the national nutrition program, specifically in CGs, which support pregnant and lactating mothers. This was a major strategic shift as child development had been traditionally delivered through the CBCCs targeting children ages 3–5 years. G. Lessons Learned and Reflected in the Project Design 55. The project’s multisectoral approach draws on global evidence of what works to reduce stunting. In 2016, the Lancet identified 10 effective nutrition-specific interventions that would reduce the burden of stunting by one-fifth if all were delivered at 90 percent coverage. Implementing multisectoral nutrition-sensitive interventions that address the multidimensional causes of malnutrition simultaneously with nutrition-specific interventions would be expected to reduce the remaining 80 percent. Recent analysis of Malawi DHS 2015/16 data shows the multidimensional underlying factors that increase the risk for stunting. To this end, the project aims to scale up selected best-buy nutrition-specific and nutrition- sensitive interventions in districts with high stunting prevalence. 56. The project design reflects lessons learned from the implementation of and preliminary evaluation findings from the Malawi Nutrition and HIV/AIDS Project (P125237). Key lessons learned that were incorporated into the Investing in Early Years (IEY) Project design include the following: x Importance of recruiting fiduciary staff early so that the learning curve for the World Bank fiduciary requirements is substantially reduced. Further, capacity building for fiduciary staff should be more hands on than ‘workshop type’ training programs. x Greater local government ownership to sustain community-based nutrition activities. Although the CG model has been acknowledged as a good platform for implementing Page 28 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) interventions at the community level, its sustainability in the absence of donors needs to be considered. For instance, in areas where NGOs implemented community-based nutrition interventions without adequate engagement from district councils, the activities could not be sustained at the same level and intensity after they left. The use of NGO facilitators created a parallel system for the Government frontline workers, who were not as highly incentivized as NGOs. x Better planning for civil works. Ensuring the engagement and ownership of district health officials in routine quality checks of civil works is vital for the timely completion of activities in line with agreed quality guidelines. Also, having the required safeguards instruments (for example, Environmental and Social Management Plans [ESMPs]) developed early in project preparation can help avoid delays in implementation. Careful review of the existing infrastructure is also important in helping avoid unanticipated bottlenecks and planned additional works. 57. The CG model used in the Malawi Nutrition and HIV/AIDS Project has been successful in reaching hard-to-reach communities and served as a delivery platform for multisectoral interventions from health, nutrition, and agriculture. The success of the CG model as an implementation structure/platform will be replicated during the delivery of IEY interventions. Additional lessons learned from the Malawi Nutrition and HIV/AIDS Project that have been considered include: (a) involvement of multiple implementing partners improves multisectoral collaboration and ownership, but is best achieved with strong champions; (b) use of Government systems and structures strengthens staff capacity in program management, including planning and implementation, M&E, and procurement and FM, is good for promoting ownership and sustainability; (c) introduction of joint M&E activities into the project design enhances learning; and (d) integration of nutrition-sensitive agriculture is key to achieving food and nutrition security, and therefore, the project support needs to go beyond production by promoting the utilization and processing of foods. 58. The project also reflects lessons learned from other World Bank-supported projects in Malawi, including in social protection and labor and agriculture . The MASAF IV Project provides a potential service delivery platform for promoting maternal and child health, nutrition, and early stimulation at the household and community levels through a targeted approach reaching the bottom 50 percent of the rural poor. The agriculture sector remains critical in promoting food security, crop diversification, and utilization of nutritious foods and adequate diets. The Second Agriculture Sector Wide Approach Support Project (P164445) leverages resources through enhanced food security with a focus on diversification, nutrition-sensitive agriculture, food fortification, small-scale livestock farming, and promotion of functional gardens at the CBCCs. 59. The social protection program interventions, particularly SCTs and VSL groups have had significant impacts on income, poverty, and food consumption among poor households . Yet, these programs did not affect the health and nutritional indicators effectively. Strong links between social protection and nutrition/health-specific interventions can mutually reinforce objectives in both operations. Therefore, additional measures, including ensuring strong links with nutrition- and health- specific interventions should be put in place to ensure the impact on health- and nutrition-related indicators, especially among poor households. In addition, evidence shows that VSL schemes enabled Page 29 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) households to smooth consumption over the year, either through savings or access to credit.42 VSL groups, through diversification of income-generating activities, can also provide simple insurance products (mainly against illness and death) and thus function as risk coping devices, which can encourage households to discard inefficient ex ante coping strategies, such as low risk return activities. Finally, VSL group participation can improve social capital among members by enhancing trust, information flows, and joint decision making and create an environment conducive to socioeconomic activities. 60. Another lesson learned from the implementation of decentralized social protection operations in Malawi points to the need to incorporate institutional capacity building, citizen engagement, and fiduciary management into decentralized operations. Considering the capacity challenges at the subnational level, citizen engagement provides for better alignment of local service delivery with established procedures and standards and, to an extent, reducing abuses by local officials. It is equally important to consider having an additional structure of district-level project coordination and general oversight, for example, facilitation unit or project officers. To enhance the functions of these structures, there is need to have dual reporting lines; first to the district commissioner and second to the relevant line ministry/agency or department, for example, the role of project officers under MASAF IV who take up key district coordination and more importantly oversight roles for all key MASAF IV public works program activities before implementation and spending while reporting to both the district commissioners and local development fund-technical support unit. III. IMPLEMENTATION ARRANGEMENTS A. Institutional and Implementation Arrangements 61. The project will be implemented at the national, area, and community levels. The project’s Project Facilitation Team (PFT) will be anchored within the MoGCDSW and will be responsible for overall coordination and implementation. At the service delivery level, the CGs and CBCCs will implement nutrition, early stimulation, and early learning interventions in selected districts. The Project Implementation Manual (PIM) will describe the institutional and implementation arrangements at all levels and their roles and responsibilities. Formal adoption of the PIM is an effectiveness condition for the project. Figure 3 provides a simplified framework for the project implementation arrangement. 42Ksoll, Christopher, Helene Bie Lilleør, Jonas Helth Lønborg, and Ole Dahl Rasmussenc. 2016. Impact of Village Savings and Loan Associations: Evidence from A Cluster Randomized Trial. Journal of Development Economics, 120(C): 70–85. Page 30 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) Figure 3. Simplified Implementation Arrangements Project Steering Committee MoGCDSW, MoHP, MoAIWD, MoEST, MoLGRD, MoFEPD (Chaired by Secretary of MoGCDSW and Deputized by Secretary of MoHPP) ISPIC PFT MoGCDSW, MoHP, MoAIWD, (Housed in the MoGCDSW) MoEST, MoLGRD, MoFEPD (Chaired by Director DCA and Deputized by Director DNHA) District Project Team (DPT) (Headed by District Commissioner) Area Project Team (Headed by Area Executive Committee Chair) Note: MoAIWD = Ministry of Agriculture, Irrigation, and Water Development; MoEST = Ministry of Education, Science, and Technology; MoFEPD = Ministry of Finance, Economic Planning, and Development; ISPIC = Intersectoral Project Implementation Committee. National Level 62. Project Steering Committee. This committee will be established within 30 days of effectiveness and will provide strategic guidance and implementation oversight, review policy recommendations, and will facilitate interministerial coordination for nutrition, early stimulation, and early learning. This committee will be chaired by the Secretary of MoGCDSW and deputized by the Secretary of MoHP and will comprise the secretaries or designees of the MoFEPD, MoAIWD, MoEST, and MoLGRD. 63. ISPIC. The Intersectoral Project Implementation Committee (ISPIC) will be established before effectiveness and will review project progress, facilitate joint monitoring, identify challenges, and agree on actions to address implementation bottlenecks. This committee will be chaired by the Director of the Department of Child Affairs (DCA), MoGCDSW, and deputized by the Director DNHA, and will comprise the Director Reproductive Health Services, MoHP; Director DCA, MoGCDSW; Director Planning and Policy, MoLGRD; Director Agriculture Extension Services, MoAIWD; Director Basic Education, MoEST; Director Poverty Reduction and Social Protection, MoFEPD, and Director Debt and Aid, MoFEPD. Page 31 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) 64. PFT. The PFT will be established before effectiveness, housed in the MoGCDSW, and will be responsible for overseeing the overall implementation of the project. Specifically, the team will implement the day-to-day project operations, which includes procurement and FM, including timely disbursement of funds to the implementing entities based on approved annual work plans and budgets (AWPBs), monitoring, evaluation, and reporting. The PFT will also consolidate the AWPB from the DCA, DNHA, and districts. The PFT will be responsible for preparing technical and unaudited interim financial reports (IFRs) for the Designated Account (DA) and related project accounts. The technical report and IFR are to be produced on a quarterly basis and submitted to the World Bank within 45 days after the quarter end. The PFT will also ensure that the covenants are complied with and that the project is implemented in accordance with the approved PIM. The PFT will comprise the following project-financed positions: project coordinator (1), FM specialist (1), assistant FM specialists (2), procurement specialist (1), M&E specialist (1), and safeguard specialist (1). District Level 65. District council. All the project activities will be coordinated through the district council and the district commissioner will take primary responsibility for implementing the project activities. The district commissioner in each project district will organize a DPT with officers from health, social services, agriculture, and nutrition and will hire a project-financed, full-time DFMO who will be responsible for day- to-day implementation of the project with technical support from technical committees, including the District Nutrition Coordination Committee. The primary responsibility of the district council will be to approve the district annual work plan and budget (dAWPB). The district council will also ensure integration of project activities into the annual DIP. 66. The DPT will develop and oversee implementation of the project dAWPB. The DPT will meet regularly with the district council and provide activity and fiduciary reports. The DPT will be responsible for providing quarterly technical and financial reports to the PFT not later than 15 days following quarter end. These reports will include all project activities to be undertaken by the district, CBCCs, and CGs. To ensure the timely availability of funds, approximately six months of estimated funding will be available in the district account for access by relevant entities in the district as needed and justified. Area and Group Village Levels 67. At the area level, an Area Project Team (APT) will be formed headed by the Chair of the Area Executive Committee and will comprise an HSA, an AEDO, a CPW, a WMA, and a full-time project-financed Community Facilitator. The APT will assist in the development of a community annual work plan and budget (cAWPB) and provide coordination and technical support in the implementation of the project- financed activities by the CBCCs and CGs. 68. At the group village level, a cAWPB will be developed collectively by the model CBCC and its CGs with support from the APT, and will be submitted for the district council’s approval to the DPT. The cAWPB will be implemented at the group village level by the CBCC and its CGs and the necessary support will be provided by the respective model CBCC. Page 32 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) B. Results Monitoring and Evaluation Arrangements 69. Monitoring of project results will be based on sectoral activity and data under Components 1 and 2, reported through normal government systems, consolidated in quarterly reports produced by the M&E units of the DNHA and MoGCDSW, and complied by the PFT. The consolidated project M&E system will track progress and monitor effectiveness in implementing the project (inputs, activities, processes, outputs, intermediate outcomes, and PDO indicators). IRIs were identified to monitor progress in the chain of results expected to contribute to the PDO, including community-based nutrition and early stimulation interventions, center-based early learning, nutrition, and health interventions, multisectoral coordination, and capacity and system strengthening. The project will also monitor progress in gradual capacity enhancement of the local government structure from district to community levels with regard to delivering a comprehensive set of nutrition, early stimulation, and learning interventions. The Government monitoring systems will be strengthened and streamlined during the project with support from research partners, building on the existing in-country experiences using electronic data collection. 70. The DNHA has completed a national nutrition end line survey in all 28 districts . While the primary purpose of the survey was to provide end line data for the nutrition component of the Malawi Nutrition and HIV/AIDS Project, it was also designed to provide baseline data for the PDO and most IRIs for the IEY Project. All the PDO indicators will be updated every two years through mini surveys and IRIs twice a year through the project M&E. A comprehensive end line survey will be carried out toward the end of the final year of project implementation. 71. An impact evaluation will be conducted to evaluate the costs and benefits of alternative training packages on child development and growth and improvement of cognitive and learning abilities of targeted children. Important evidence gaps exist in the synergies and interactions between nutrition; water, sanitation, and hygiene; and child development during early childhood, particularly in the context of Government programs operating at scale. The impact evaluation will be designed in partnership with in-country universities and international research institutions. During the project planning stages options to randomize different elements of the training activities, as the project is scaled up, will be examined with support from evaluation experts, with the control group likely being the existing basic training package provided by the Government. The timing of the data collection and analysis will be designed to provide evidence to inform the planned scale-up of the project, as well as in other districts in Malawi, and contribute to the evidence base on the interactions across nutrition, water, sanitation and hygiene, early stimulation, and early learning. The evaluation will follow a theory-based approach, including the development of program impact pathways to better understand the mechanisms through which the intervention package operates. The evaluation will combine quantitative and qualitative methods and include a process evaluation to better understand issues related to quality of implementation. 72. An operational research agenda will be developed to support the learning agenda under the project. The learning agenda will focus on both impact- and process-related issues, including (a) gender sensitive nutrition-specific and early stimulation and learning interventions from continuum service provision viewpoints, (b) using community radio as an alternative behavior change communication and early learning approach, and (c) strengthening local government structures to enhance the quality and coverage of service delivery. The lessons learned from this operational research will be shared among districts and will inform the ongoing improvements in the design of the project and the national program. Page 33 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) C. Sustainability 73. The sustainability of activities supported under the project are considered likely from institutional and financial perspectives. The project focuses on training and capacity building at all levels, from parents, CGs, and CBCCs at the community level to line ministry extension workers at the group village/area level, district officials, and national stakeholders. The strengthened decentralized capacity to oversee, monitor, and coordinate multisectoral activities will bolster district institutional capacity. Enhanced knowledge and awareness of childhood stunting among parents, CGs, CBCCs, line ministry extension workers, and the public at large are expected to lead to behavior change that will go beyond the life of the project. In addition, the design leverages and builds on the existing decentralized institutional structures that have been in effect such as the district executive committee (DEC), area executive committee, village development committee (VDC), CG and CBCC platforms, and experienced PFTs at the national and district levels. Third, districts’ capacity to develop and finance DIPs will be supported through a DLI under the leadership of the Planning Directorate of the MoLGRD. Finally, the high-level political commitment will strengthen ownership of the nutrition and ECD agenda at all institutional levels facilitated by the high-level Project Steering Committee chaired by the principal secretary of the MoGCDSW and co-chaired by the secretary, MoHP. Sustainability also hinges on ensuring adequate levels of domestic financing in the medium to long term. While the nutrition and ECD agenda has been heavily dependent on donor financing, the GoM is making a concerted effort to allocate additional domestic financing and improve the efficiency of public spending. The World Bank will provide technical support to conduct expenditure reviews to explore additional ways to strengthen technical and allocative efficiency. IV. PROJECT APPRAISAL SUMMARY A. Technical, Economic, and Financial Analysis 74. The economic analysis for the project shows a strong economic rationale for the investment . The project is expected to contribute to (a) reduced stunting and (b) increased cognitive development for children ages 0–59 months in Malawi and the expected benefits justify the costs. The assumptions made to conduct the economic analysis are presented in box 1. Page 34 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) Box 1. Assumptions Used for the Economic Analysis The beneficiary population comprises 1.2 million children ages 0–59 months, 2.2 million adolescent girls and boys ages 11–19 years, and 370,500 pregnant and lactating women in 13 districts. The project is expected to expedite the reduction of stunting by 2.5 percentage points annually, which is higher than the rate of 1.79 percentage points that was observed during 2010–2016. For early learning and responsive parenting education, the total wage productivity increase is estimated at 10 percent based on empirical global evidence (World Bank 2007). The rate of return to schooling across countries is centered at about 10 percent, with returns higher for low-income countries, for lower levels of schooling, and frequently for women. Considering that official minimum wage applies only to the formal sector and that a large majority of workers operate in the informal economy, the minimum wage was not used. Thus, average wage estimates (US$705 in 2016 terms) were used. Further, to calculate the net present value, a discount rate of 10 percent is used (calculated by subtracting the inflation rate from the treasury bond rate). A sensitivity analysis was undertaken by changing estimates for the average annual rate of reduction (AARR) in three scenarios: historical, moderate, and optimistic. 75. To address the increasing number of stunted children in the 13 districts in Malawi, the project focuses on the community-based nutrition interventions targeting children ages 0–35 months, pregnant and lactating women, and adolescent girls and boys ages 15–19 years to accelerate progress in reducing stunting. Two scenarios are presented: (a) A strong performance scenario, which will lead to a reduction in stunting at an AARR of 4.3 percent. This estimate was obtained from the National Nutrition Policy 2017–2021. If Malawi’s performance is strong (AARR in stunting of 4.3 percent), the number of stunted children will reduce from 381,187 in 2019 to 264,747 in 2023 (figure 4). (b) A historical performance (2010–2016) scenario that involves sustaining the 1.79 percent AARR in stunting. If performance is sustained at the historical performance level (2010– 2016), the number of stunted children will increase from 381,187 in 2019 to 405,199 in 2023, because population growth will suppress the gains made with an AARR of 1.79 percent. Page 35 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) Figure 4. Comparing Baseline to Intervention Scenarios in Target Districts 410,000 400,000 Number of children stunted 390,000 380,000 370,000 360,000 350,000 340,000 2019 2020 2021 2022 2023 Base Scenario (1.79 AARR) 2.95 AARR 4.3 AARR Source: Author’s calculations 76. To enhance cognitive, language, social emotional, and motor development, center-based early learning interventions targeting children ages 36–59 months and community-based interventions on responsive parenting will be implemented. Children who benefit from nutrition and early learning interventions are expected to reap economic returns once they enter the labor market at age 15 and continue to do so until they exit the labor market at age 68. Empirical estimates of the negative effects of stunting on worker productivity and adult earnings range from 10 percent to 20 percent. The analysis assumes foregone wages of 10 percent. The analysis uses a wage productivity improvement ratio of 10 percent to estimate the average returns of early learning interventions and responsive parenting education. 77. Benefit-cost ratio and sensitivity analysis. The analysis assumes a 10 percent discount rate. 43 The 10 percent discount rate was computed by subtracting the inflation rate from the treasury bond rate for Malawi, which is a more realistic estimate than 3 percent (Ramsey Formula). With a 10 percent discount rate, investing US$60 million over a period of five years at a 4.3 percent AARR would yield a net present value of US$106 million, an internal rate of return of 13.8 percent, and a benefit-cost ratio of 2.4:1. This suggests that for every U.S. dollar invested in the project there is a yield of US$2.4. Taking the second scenario with an AARR of 2.95 percent, investing US$60 million over a period of five years would generate a net present value of US$40 million with an internal rate of return of 11.5 percent and a benefit-cost ratio of 1.92:1. This further strengthens the projects rationale; the project would be also viable even with a lower AARR than what is predicted in the National Nutrition Policy 2017–2021. 78. The analysis suggests that investing US$60 million in a package of proven high-impact interventions over a period of five years (AARR is 4.3 percent and discount rate is 10 percent) will ensure that 47,000 fewer Malawian children aged 0–35 months will be stunted, an additional 70,000 children ages 36–59 months will benefit from early learning interventions, and 31,000 adolescent girls who are 43 Discount rate calculation 1: Treasury bill rate (approximately 30 percent) - Inflation (20 percent in 2016) = 10 percent Page 36 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) pregnant or lactating will acquire responsive parenting knowledge and skills to promote maternal, adolescent, and child health and nutrition. Investing in this set of nutrition and early learning interventions will result in an estimated US$106 million in net present economic benefits over the lifetime of beneficiaries. This is, therefore, a strong economic rationale for the investment. 79. The project will be implemented using community-based platforms and formal public structures. The use of public resources to invest in nutrition in Malawi is justified on both equity considerations and market failures. The burden of stunting in Malawi falls disproportionately on poor households and rural residents. Malawian children from the bottom 40 percent of the population have experienced modest drops in stunting during the past 15 years (that is, from 60 percent in 2000 to 46 percent in 2015/16) compared to children from the top 40 percent (from 48 percent to 24 percent) with stunting rates remaining high in rural areas (39 percent). Public investment is critical to provide targeted support through both supply- and demand-side interventions. In addition, the Malawian Government owns 61 percent of all the major health facilities in the country (hospitals, health centers, and clinics), while the faith-based Christian Health Association of Malawi owns 37 percent, and private for-profit providers own 2 percent. However, health facilities owned by the Malawian Government do not fully cover the entire country (especially rural areas), and to address this problem, in 2002, the Government formed a partnership with the Christian Health Association of Malawi to complement the Government’s efforts to provide free health care to all citizens of Malawi. Henceforth, public sector provision of health services is justified in Malawi as it enhances equity in provision and utilization of health services. 44 80. Public investment in nutrition and early learning in Malawi are also justified on the grounds of market failure resulting from information asymmetries. Given such information gaps and information asymmetries,45 particularly among the poor and vulnerable, market forces do not suffice to improve nutrition. Investments in communications and awareness raising have a large public good element with benefits accruing to society at large, as improved nutrition reduces the impact of disease and improves national productivity.46 Technical Soundness 81. The project’s technical design is informed by multiple data sources, including national and globally accepted nutrition, early stimulation, and early learning findings and recommendations. This includes evidence from past initiatives by the GoM and development partners and evidence from the Lancet series on ECD which identified 10 nutrition-specific interventions that should be prioritized to 44 Chansa, Collins; Pattnaik, Anooj. 2018. Expanding Health Care Provision in a Low-Income Country: The Experience of Malawi. Universal Health Coverage Studies Series;No. 34. World Bank, Washington, DC. © World Bank. https://openknowledge.worldbank.org/handle/10986/29185 License: CC BY 3.0 IGO.”. 45 A critical reason for market failure in addressing malnutrition has to do with informational asymmetries of two kinds: people cannot tell when their children are becoming malnourished because healthy growth rates cannot be detected with the naked eye. And until micronutrient deficiencies are severe, they are impossible to detect without clinical tests. Thus, families do not know there is a nutrition problem until it is too late. Good nutrition is not intuitive: people do not always know what food or what feeding practices are best for their children or for themselves. Sometimes, food marketing and advertising change preferences in unhealthy ways, as is evident in the emerging epidemic of obesity and diet-related noncommunicable diseases in developing countries, driven by the increased availability of inexpensive, calorie-dense foods (World Bank 2005). 46 World Bank. 2005. “Repositioning Nutrition as Central to Development. A Strategy for Large-Scale Action.” In Chapter 1. Why Invest in Nutrition? http://siteresources.worldbank.org/NUTRITION/Resources/281846- 1131636806329/NutritionStrategyCh1.pdf. Page 37 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) reduce the burden of stunting. For example, a 20-year study of children in Jamaica by Nobel laureate James Heckman, Paul Gertler, and others showed that early stimulation interventions for infants are highly effective and can increase future earnings by 25 percent—equivalent to adults who grew up in wealthier households. Evidence suggests a potential return rate of 7 percent to 16 percent annually from high-quality preschool programs targeting vulnerable groups. The choice of implementation districts was made by overlaying the best available information with respect to stunting and poverty rates, access to CBCCs, and presence of donor support. B. Fiduciary (i) Financial Management 82. The MoGCDSW will lead the implementation of the project through its DCA, the DNHA of the MoHP, and the 13 selected district councils. A FM assessment47 of these proposed implementing entities was undertaken to determine if the entities will ensure that (a) the funds will be used for the purposes intended in an efficient and economical manner and the entities are capable of correctly and completely recording all transactions and balances related to the project; (b) the project’s financial reports will be prepared accurately, reliably, and on time; (c) the assets acquired under the project will be safely guarded; and (d) the project will be subjected to auditing arrangements acceptable to the World Bank. A final FM assessment of the selected districts will be undertaken before funds flow to the district to establish readiness. 83. The FM arrangements of the proposed implementing entities have been assessed as Moderately Unsatisfactory. The rating was due to: (a) lack of accounting systems for project accounting and reporting; (b) weak audit committees leading to ineffective internal audit function; (c) weak or absence of corruption and fraud deterrence mechanisms; (d) use of consolidated government bank accounts or district pooled fund bank accounts for project funds and delayed reconciliation; (e) delays in funds flow from the MoFEPD to the proposed implementing entities resulting in delays in implementation of some of the project activities; and (f) lack of dedicated FM staff working on project accounting and reporting resulting in delays in reporting, which affects timeliness of drawdowns on credits and grant. 84. To address these weaknesses, the following mitigation measures are recommended in the interim while the Government is strengthening its public FM systems : (a) The proposed project will have a PFT that will include dedicated FM staff who will be responsible for accounting and reporting for the project. (b) The project will acquire and install an accounting software acceptable to the World Bank to be used for transaction processing and reporting. The accounting software should be in place within six months of effectiveness. 47The assessment complied with the (a) World Bank Directive: Financial Management Manual for World Bank Investment Project Financing Operations (Catalogue number OPCS5.05-DIR.01) Issued (Retrofitted): February 4, 2015, and effective from March 1, 2010, and (b) World Bank Guidance: Reference Material-Financial Management in World Bank Investment Project Financing Operations (Catalogue Number OPCS5.05-Guid.02) issued and effective February 24, 2015. Page 38 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) (c) The project should have exclusive U.S. dollar and Malawi kwacha accounts at a commercial bank acceptable to the World Bank. The selected districts will also have exclusive Malawi kwacha accounts for the project. (d) The project will be required to submit unaudited IFRs, which will be reviewed and validated by the World Bank FM team. (e) The project will be visited at least twice a year for implementation support that will include dealing with FM issues. (f) The transactions will be internally audited at least twice a year to ensure that the proposed implementing entities’ audit committees are strengthened and functioning. (g) The project’s financial statements will be externally audited by the National Audit Office or private auditors under terms of reference (ToR) to be agreed with the World Bank. (h) The project will incorporate corruption prevention and reporting mechanisms through collaboration with the anticorruption bureau. 85. The abovementioned measures and other accounting requirements for the project should be clearly detailed in the PIM. 86. Funds will flow from IDA to the U.S. dollar account maintained by the PFT under oversight of the MoFEPD. The project will also have Malawi kwacha project accounts at both the Reserve Bank of Malawi (RBM) and a commercial bank acceptable to IDA. The selected districts will also open exclusive Malawi kwacha operating accounts for project operations. For community-level activities that require resources at the community, Malawi kwacha operating accounts will be opened by the model CBCCs and funds will be deposited from the district’s bank accounts. 87. Special commitments using irrevocable letters of credit as well as direct payments to suppliers for works, goods, and services may be used, upon the Recipient’s request. The project will also receive funds into the DA using the report-based disbursement method. IDA will make the initial disbursement to the project after receiving a withdrawal application with a six-month cash flow forecast. This withdrawal application should be prepared within one month after project effectiveness. Thereafter, IDA will disburse into the respective DA based on quarterly IFRs, which would provide actual expenditure for the preceding quarter (three months) and cash flow projections for the next two quarters (six months). The IFR will be reviewed by the World Bank’s FM specialist and will be approved by the task team leader before the request for disbursement is processed by the World Bank’s loan department. 88. The MoGCDSW, through the PFT, will produce quarterly unaudited IFRs for the DA and the related project account. The IFRs are to be produced on a quarterly basis and submitted to the World Bank within 45 days after the end of the calendar quarterly period. The MoGCDSW will agree with the World Bank on the format and content of the IFR. The reporting requirements will be incorporated into the accounting package to enable automatic generation of the IFRs. Reimbursements can be made from the DA or paid direct by the World Bank into the recipient’s bank account. These payments will also be Page 39 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) reported in the quarterly IFRs. The IDA Disbursement Letter will provide details about each of the abovementioned disbursement arrangements. (ii) Procurement 89. Procurement under the project will be carried out in accordance with the requirements in the Procurement Regulations for IPF Recipients: Goods, Works, Non-Consulting Services, and Consulting Services, dated July 1, 2016, revised November 2017 and August 2018; ‘Guidelines on Preventing and Combating Fraud and Corruption in Projects Financed by IBRD Loans and IDA Credits and Grants’, dated October 15, 2006 and revised in January 2011 and as of July 1, 2016; and provisions stipulated in the Financing Agreement. The DCA of the MoGCDSW, the DNHA of the MoHP, and the 13 selected district councils have jointly developed a Procurement Plan for the first 18 months to provide the basis for procurement/selection methods. The Procurement Plan shall be updated at least annually or as required to reflect the actual project implementation needs and every update shall require clearance from the World Bank before implementation. 90. A Project Procurement Strategy for Development (PPSD) has been agreed upon, setting out the market approaches and selection methods to be followed by the Recipient during project implementation in the procurement of goods, works, and non-consulting and consulting services financed by the World Bank. The PPSD shall be updated as required to reflect the actual project implementation needs and improvements in institutional capacity. 91. A procurement risk assessment of the capacity of the DCA of the MoGCDSW, the DNHA of the MoHP, and the 13 selected district councils to implement procurement activities under the project was carried out. The assessment included a review of the organizational structure, functions, staff skills and experience, and adequacy for implementation of the project. The assessment revealed several issues, including (a) A lack of staff dedicated to procurement records management; (b) Procurement staff lacking experience in undertaking procurement of goods and large-value consultancy services contracts through Open Competitive Procurement procedures; (c) Inefficiencies in processing procurement activities in terms of preparation of ToRs, specifications, bidding documents, request for proposals, and bids/proposals evaluations, due to delays from user/technical departments; (d) Weak procurement filing and record management system; and (e) Weak contract management. 92. The mitigation measures to the abovementioned risks include (a) Dedicating staff specifically for handling procurement records; (b) Ensuring that procurements are processed according to the time lines in the procurement plans, including timely preparation of ToRs and specifications by user departments; and Page 40 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) (c) Providing training to staff on procurement. 93. In addition, a competitively selected and dedicated PFT shall be set up under the MoGCDSW to facilitate implementation of the project. The PFT will be headed by a project facilitation coordinator and other staff will include an FM specialist, a procurement specialist, an M&E specialist, and other technical staff. The Internal Procurement and Disposal of Assets Committee of the MoGCDSW shall provide the procurement oversight on all activities undertaken by the PFT. 94. The project will use the Systematic Tracking of Exchanges in Procurement (STEP), a planning and tracking system, which would provide data on procurement activities, establish benchmarks, monitor delays, and measure procurement performance. The implementing entities shall be oriented and trained by the World Bank team on how to use STEP. 95. PIM. The MoGCDSW, DNHA, district councils, and other relevant stakeholders shall collaborate to prepare a PIM setting out implementation, organizational, administrative, M&E (including performance indicators and related targets), FM, disbursement, procurement, and environmental and social safeguards arrangements for purposes of project implementation. The draft PIM shall be reviewed and cleared by the World Bank before being adopted. The PIM provides step-by-step guidelines, tools, instruments, and systems for agencies responsible and involved in carrying out the implementation of the project components. Specifically, the manual will provide x A description of the project components and subcomponents; x A detailed implementation schedule and time line for achieving intermediate results and outcomes; x Roles and responsibilities of the implementing agencies; x Fiduciary responsibilities; x Social and environmental safeguards responsibilities (including gender, youth and vulnerable groups); x A detailed road map and framework for implementation based-results; x Steps and tools for establishing an M&E system; and x Any other specific reporting requirements as may be required by the World Bank. 96. The overall project procurement risk rating is assessed as Substantial. The risks identified, and the mitigation measures are detailed in annex 1. C. Safeguards (i) Environmental Safeguards 97. The project will enhance quality and coverage of early learning interventions through the CBCCs and links with surrounding communities. The project offers opportunities for citizen engagement and boosts the delivery of health and nutrition interventions at the CBCCs. The project will finance the rehabilitation of existing CBCCs to promote early learning. However, there is no other major construction or other civil works envisaged under the project. The project is thus not expected to have long-term significant negative environmental impacts. Hence, the project has been assessed as Category B (partial assessment) under the World Bank’s OP 4.01, Environmental Assessment, given the location specific and Page 41 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) manageable nature of the potential environmental impacts. The delivery of a set of health and nutrition interventions at the CBCCs to support health center-based interventions to promote maternal, adolescent, and child health and nutrition could generate incremental health care waste and may adversely affect the environment and local populations if not managed appropriately. It is anticipated that the incremental waste (that is, health care and general) attributed to the project activities will be adequately managed within the existing waste management mechanisms of the project-supported health centers. 98. In view of the above, a Health Care Waste Management Plan and an ESMP have been prepared and disclosed. The project locations were identified, hence the preparation of ESMPs was decided based on the screening and environment and social assessment reports. The World Bank Regional Safeguards Advisor advised the same. The safeguards instruments have been approved by the World Bank and are disclosed both in country (that is, through the Government websites) and through the World Bank. The implementation of the Health Care Waste Management Plan and the ESMP will be managed by a coordinated effort of the MoGCDSW under oversight from the Ministry of Environmental Affairs and Climate Change. While effective interagency coordination could be a challenge, there are developments within the GoM’s structure that have the potential to effectively implement the safeguards instruments of the project. In addition, Malawi has had good coordination mechanisms and platform for nutrition. The Ministry of Environmental Affairs and Climate Change has been enhancing its capacity at the district level through hiring of environmental inspectors who act as district focal persons. The implementation of the project safeguards instruments will benefit from the encouraging developments within the GoM’s structure, good coordination mechanisms for nutrition projects, and experience of other World Bank projects in Malawi on how to work with district environmental inspectors to strengthen the monitoring of safeguards implementation. (ii) Social Safeguards 99. The project integrates social safeguards considerations into its design. Successful implementation of the project interventions and activities is expected to have positive impacts on vulnerable children and pregnant and lactating women, who are the main beneficiaries of the project. No major negative social safeguard impacts are expected. The project is expected to attract no land acquisition as all civil works will be within the confines of the existing CBCCs. Appropriate management of other social risks in the rehabilitation of CBCCs are incorporated into the ESMPs. The project offers numerous opportunities for citizen engagement, such as home-based ECD centers, community sensitization programs, community outreach activities, and community dialogues. There are available governance structures to ensure adequate consultations with a broader stakeholder groups, including all relevant sectors, donors, community-based organizations, civil society groups, and other interest groups. In this respect, it is envisaged that community-based organizations and civil society groups will play a significant role in this project about citizen engagement and beneficiary feedback on implementation. It is therefore less likely that there could be serious, adverse, and unintended outcomes affecting other stakeholders. 100. GRMs. The proposed structure of the project GRM is to have village grievance redress committees at the group village level, where the CBCCs will be rehabilitated/constructed, and district grievance redress committee at the district level. Assessments will be made to explore the opportunity of using the existing district grievance redress committee of other World Bank projects, which are operated in the Page 42 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) same project districts such as the MASAF IV Project. The complaint will be recorded and evaluated to determine its merit. Unresolved grievances will be referred to a high-level committee until they are resolved or can be taken to the formal courts. Coordinating the implementation of the GRM will be the joint responsibility of the MoHP and MoGCDSW. In this regard, both ministries will provide human and financial resources for the successful implementation of the GRM. Effective implementation of the GRM will depend on several steps to be taken by the ministries. These include sensitization of communities in the project area on the availability of the GRM and how they can access it and orientation of the GRM committee members, at different levels, so that they fully understand the GRM and how it is supposed to operate. The project’s GRM could also benefit from traditional, formal, and informal decision making and social structures, including chiefs, district commissioners, family members, or religious leaders. Decentralized development structures such as VDCs and area development committees (ADCs) will also be used to help resolve grievances. 101. Communities and individuals who believe that they are adversely affected by a World Bank (WB) supported project may submit complaints to existing project-level grievance redress mechanisms or the WB’s Grievance Redress Service (GRS). The GRS ensures that complaints received are promptly reviewed to address project-related concerns. Project affected communities and individuals may submit their complaint to the WB’s independent Inspection Panel which determines whether harm occurred, or could occur, because of WB non-compliance with its policies and procedures. Complaints may be submitted at any time after concerns have been brought directly to the World Bank's attention, and Bank Management has been given an opportunity to respond. For information on how to submit complaints to the World Bank’s corporate Grievance Redress Service, please visit http://www.worldbank.org/en/projects-operations/products-and-services/grievance-redress-service. For information on how to submit complaints to the World Bank Inspection Panel, please visit www.inspectionpanel.org. V. KEY RISKS 102. Four key risks emerged from the systematic operations risk-rating tool that could affect the achievement of the PDO. The overall risk of the project is considered Substantial. The key risks and proposed mitigation measures are described below. 103. Political and governance risks. The project is exposed to high risks related to corruption and weak governance. Malawi is still recovering from the aftermath of the ‘cashgate’ scandal of September 2013, where around US$50 million in public funds were stolen by a group of individuals, some of whom were Government officials. Consequently, budget support (provided at the time by six development partners under a common approach) was suspended, leading to a sharp reduction in the share of official development assistance channeled through national systems and a significant deterioration in the Government’s fiscal position. The new Government committed itself to rebuilding trust in public institutions and correcting macroeconomic imbalances. However, this has proved to be challenging as the FM and accountability system was found to be even weaker than originally thought. This risk can be Page 43 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) mitigated by building broad public support for policy reforms—as public pressure to restore the credibility of Government institutions is high, and there is much greater public scrutiny of public sector performance. 104. Macroeconomic risks. The project is exposed to high macroeconomic risks caused by macroeconomic instability, currency fluctuation, and tight fiscal space which could undermine the achievement of project objectives. The macroeconomic outlook faces significant downside risks. These relate primarily to Malawi’s continued vulnerability to external shocks, amplified by the risks of fiscal slippages. The Government’s ability to contain public spending and increase domestic revenues is mixed and a restoration of donor budget support is dependent on visible gains in improving the control environment. Similarly, with its reliance on a few primary exports and a relatively undiversified economy, Malawi remains vulnerable to external demand and price shocks as well as weather-related disasters, as demonstrated by the flood in 2015 and drought in 2016. The volatility of aid flows in a heavily aid- dependent country should also be considered. With further external shocks, it may be hard for the Government to manage the fiscal gap and maintain macroeconomic stability and service delivery could also deteriorate further. These risks may be partially mitigated by continued close policy dialogue on macroeconomic and fiscal management issues, as well as deepened investment in disaster risk management and resilience. 105. Technical design of the project. Technical risks are assessed as Substantial. The overall technical design of the nutrition and ECD interventions are aligned with country priorities. The project is designed to primarily address priority areas to enable children to achieve full human potential and the proposed interventions are known to be impactful where they have been implemented in similar settings. However, risks still exist due to the complexity of the operation. There are several ministries and agencies expected to coordinate/implement activities at various levels. Considering that the activities in the various ministries/sectors will be implemented at national, district, and community levels, there is a risk that some activities could be implemented in silos and/or duplicated which would negate the anticipated opportunities offered by a multisectoral approach. To mitigate the risk, the project will involve national stakeholders, local authorities, communities, their leaders, and parents throughout implementation. Also, the World Bank will involve other development partners, ministries, and districts to continue to support an agreed and well-coordinated package of nutrition, early stimulation, and learning interventions. Further, the ministries and local authorities are at various levels of experience in implementing and managing World Bank-financed operations; thus, more technical assistance (TA) and capacity building will be provided. 106. Fiduciary. Detailed FM and procurement assessments have been undertaken and the fiduciary risk is considered high. This is because multiple ministries and agencies are involved, and because implementation will take place through national and decentralized structures, some of which have had limited or no experience in implementing World Bank-financed operations. Many of these structures have limited exposure to the World Bank’s fiduciary requirements. Furthermore, a substantial portion of the project activities will be implemented at the community level where fiduciary capacity is even lower. Because funds will flow to the district and the community, a comprehensive FM assessment was undertaken, and appropriate funds flows have been agreed upon. For procurement, the project will use the World Bank Procurement Regulations of July 1, 2016, (revised November 2017 and August 2018). The Government, with support from the World Bank, has prepared a PPSD where the market approach, Page 44 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) procurement and selection methods, risks and mitigation measures, including thresholds for the procurement plan have been determined. . Page 45 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) VI. RESULTS FRAMEWORK AND MONITORING Results Framework COUNTRY: Malawi Investing in Early Years for Growth and Productivity in Malawi Project Development Objectives(s) The project development objective is to improve coverage and utilization of early childhood development services with focus on nutrition, stimulation and early learning from conception to 59 months in selected districts of Malawi. Project Development Objective Indicators RESULT_FRAM E_TBL_PD O Indicator Name DLI Baseline End Target Improved nutrition Children aged 6-23 months receiving a minimum acceptable diet 35.00 46.00 (Percentage) Children aged 0-6 months who were exclusively breastfed DLI 2 60.00 81.00 (Percentage) Project beneficiaries who are children 0-59 months, adolescent 0.00 2,600,000.00 girls 11-19 years and pregnant women (Number) Improved early learning Children aged 36-59 months who completed at least one year of DLI 4 0.00 50.00 early learning in CBCCs (Percentage) PDO Table SPACE Page 46 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) Intermediate Results Indicators by Components RESULT_FRAM E_TBL_IO Indicator Name DLI Baseline End Target Component 1: Community-based nutrition and early stimulation interventions Households practicing integrated homestead farming (Percentage) 28.00 38.00 Children aged 6-24 months who received micronutrient powder 5.00 50.00 supplementation (Percentage) Pregnancies registered in the community (Percentage) 0.00 75.00 Adolescent girls aged 11-19 who received iron-folate 0.00 1,700,000.00 supplementation (Number) Care group cluster leaders and promoters who received an DLI 1 0.00 80.00 integrated training package (Percentage) Component 2: Center-based early learning, nutritoin and health interventions Model CBCCs upgraded and equipped (Number) 0.00 250.00 Model CBCCs in target communities engaged in VSL activities (Number) 0.00 250.00 Children aged 48-59 months achieved at least 50% score on 17.00 50.00 literacy and numeracy components of the MDAT (Percentage) CBCC caregivers and mentors that received an integrated training DLI 3 0.00 80.00 package (Percentage) Adolescent girls aged 15-19 years who have begun childbearing (Percentage) 29.00 21.00 Households where children 0-36 months play with toys made 43.00 58.00 from locally available materials (Percentage) Component 3: Multisectoral coordination, capacity and systems strengthening Councils that receive a satisfactory rating from women and caregivers whose children received nutrition interventions and 0.00 13.00 early learning and stimulation services (Number) Percentage of districts budget allocated for nutrition and early 0.00 10.00 Page 47 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) RESULT_FRAM E_TBL_IO Indicator Name DLI Baseline End Target learning in the project districts (Percentage) Councils that submitted a monthly report into the nutrition database on time (Percentage) 0.00 90.00 Staff completed short and long term courses including diploma and master programs (Number) DLI 6 0.00 100.00 Councils incorporated and implemented DIPs with ECD and DLI 5 0.00 13.00 nutrition (Number) IO Table SPACE UL Table SPACE Monitoring & Evaluation Plan: PDO Indicators Methodology for Data Responsibility for Data Indicator Name Definition/Description Frequency Datasource Collection Collection Baseline: Co mmunity Based Every two Children aged 6-23 months receiving a Malawi Community Based Nutrition Survey MoHP years minimum acceptable diet Nutrition Survey Survey 2018 Midline/Endli ne: Survey Baseline: Mal awi Every two Children aged 0-6 months who were Malawi Community Based Community Survey MoHP years exclusively breastfed Nutrition Survey Based Nutrition Survey 2018 Page 48 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) Midline/Endli ne: Survey Project beneficiaries who are children 0- Number of project Every 6 Project data Routine monitoring MoGCDSW, MoHP 59 months, adolescent girls 11-19 years beneficiaries in project months and pregnant women areas Numerator: Number of children aged 36-59 months who have completed at least one year of early Children aged 36-59 months who learning in CBCCs in project Annual Project data Routine monitoring MoGCDSW completed at least one year of early areas learning in CBCCs Denominator: Number of children aged 36-59 months who enrolled in CBCCs in project areas ME PDO Table SPACE Monitoring & Evaluation Plan: Intermediate Results Indicators Methodology for Data Responsibility for Data Indicator Name Definition/Description Frequency Datasource Collection Collection Baseline: Mal awi Numerator: Number of Community households practicing Based integrated homestead Households practicing integrated Annual Nutrition Routine monitoring MoHP farming. homestead farming Survey Denominator: Total number National of households in the project Nutrition districts. M&E System Page 49 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) Baseline: Mal Numerator: number of awi children aged 6-24 months Community who received micronutrient Based powder supplementation. Nutrition Children aged 6-24 months who received Annual Routine Monitoring MoHP Denominator: total number Survey micronutrient powder supplementation of children aged 6-24 months who received National micronutrient powder Nutrition M& supplementation E System Percentage of pregnant women who receive at least 2 home visits by a HSA Community- during their pregnancy based Numerator: number of maternal and pregnant women who Every six neonatal Routine monitoring MoHP Pregnancies registered in the community receive at least 2 home months care visits by a HSA register/Villa Denominator: total number ge health of pregnant women register recorded Numerator: number of adolescent girls aged 11-19 years who receive iron- National Every six Adolescent girls aged 11-19 who received folate supplementation in Nutrition Routine Monitoring MoHP months iron-folate supplementation project areas. M&E System Denominator: total number of adolescent girls aged 11- 19 years who receive iron- Page 50 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) folate supplementation in project areas. Numerator: Number of care group cluster leaders and promoters that received an Care group cluster leaders and promoters integrated training package Every six Project data Routine monitoring MoHP who received an integrated training in the project areas months package Denominator: Number of care group cluster leaders and promoters in the project areas Number of model CBCCs Every six Program data Routine monitoring MoGCDSW Model CBCCs upgraded and equipped that are upgraded and months equipped. Number of model CBCCs in each project district Every six Model CBCCs in target communities integrated VSL activities Program data Routine monitoring MoGCDSW months engaged in VSL activities participated by caregivers, mentors and management committee members. Numerator: number of children aged 48-59 months achieved at least 50% score on literacy and numeracy Children aged 48-59 months achieved at components of the MDAT in Annual MDAT MDAT questionnaire MoGCDSW least 50% score on literacy and numeracy project districts. components of the MDAT Denominator: total number of children aged 48-59 months took MDAT in project districts. Page 51 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) Numerator: number of CBCC caregivers and mentors that received an integrated training package in project Every six CBCC caregivers and mentors that districts. Program data Routine monitoring MoGCDSW months received an integrated training package Denominator: total number of CBCC caregivers and mentors in 25 model CBCCs and at least 25% of other CBCCs in project districts. Numerator: number of adolescent girls aged 15-19 years with first pregnancy in Every two Adolescent girls aged 15-19 years who the project districts.. Survey Survey MoH years have begun childbearing Denominator: total number of adolescent girls aged 15- 19 years in the project districts. Numerator: Number of Baseline: Mal households where children awi 0-36 months play with toys Community Households where children 0-36 months made from locally available Every two Nutrition Survey MoGCDSW play with toys made from locally available materials in project districts. years Survey materials Denominator: Number of Midline/Endli households with children 0- ne: Survey 36 months in the project districts. Councils that receive a satisfactory rating Number of District Councils from women and caregivers whose that receive a satisfactory Every six Citizen Engagement Program data MoGCDSW children received nutrition interventions rating from women and months Report and early learning and stimulation caregivers whose children services received nutrition Page 52 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) interventions and early learning and stimulation services Numerator: total budget allocated for nutrition and Percentage of districts budget allocated early learning in the project Annual Program data Routine monitoring MoGCDSW/MoHP for nutrition and early learning in the districts. project districts Denominator: total budget in the project districts. Numerator: number of project District Councils that submitted a monthly report Every six Councils that submitted a monthly report Program data Routine monitoring MoHP into the nutrition database months into the nutrition database on time on time. Denominator: total number of project districts. Number of government staff completed Diploma and Staff completed short and long term Every six Masters degree programs in Program data Routine monitoring MoGCDSW/MoHP courses including diploma and master months ECD and/or nutrition that programs have been approved and offered in Malawi. Total number of project District Councils Councils incorporated and implemented Annual Project data Routine monitoring MoHP/MoGCDSW incorporated and DIPs with ECD and nutrition implemented DIPs with ECD and nutrition. ME IO Table SPACE Page 53 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) Disbursement Linked Indicators Matrix D LI_TBL_M ATRIX DLI 1 Percentage of CG CLs and promoters delivering an integrated nutrition and early stimulation package Type of DLI Scalability Unit of Measure Total Allocated Amount (USD) As % of Total Financing Amount Intermediate Outcome Yes Percentage 6,214,000.00 10.36 Period Value Allocated Amount (USD) Formula Baseline 0.00 Y0 (at effectiveness) 0.00 1,554,000.00 US$1554000 x 1 Y1 (first fiscal year after 30.00 1,747,500.00 US$5825 x 30 x 10 effectiveness) Y2 (second fiscal year after 80.00 2,912,500.00 US$5825 x 50 x 10 effectiveness) Y3 (third fiscal year after 0.00 effectiveness) Y4 (fourth fiscal year after 80.00 0.00 effectiveness) D LI_TBL_M ATRIX DLI 2 Percentage increase on exclusive breastfeeding practices for children from 0-6 months Type of DLI Scalability Unit of Measure Total Allocated Amount (USD) As % of Total Financing Amount Outcome Yes Percentage 1,000,000.00 1.67 Period Value Allocated Amount (USD) Formula Baseline 0.00 Page 54 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) Y0 (at effectiveness) 0.00 0.00 0.00 Y1 (first fiscal year after 0.00 0.00 0.00 effectiveness) Y2 (second fiscal year after 0.00 0.00 0.00 effectiveness) Y3 (third fiscal year after 5.00 500,000.00 US$10000 x 5 x 10 effectiveness) Y4 (fourth fiscal year after 10.00 500,000.00 US$10000 x 5 x 10 effectiveness) D LI_TBL_M ATRIX DLI 3 Percentage of CBCC caregivers delivering an integrated early learning package Type of DLI Scalability Unit of Measure Total Allocated Amount (USD) As % of Total Financing Amount Intermediate Outcome Yes Percentage 2,660,000.00 4.43 Period Value Allocated Amount (USD) Formula Baseline 0.00 Y0 (at effectiveness) 0.00 632,000.00 US$632000 x 1 Y1 (first fiscal year after 40.00 1,014,000.00 US$1950 x 40 x 13 effectiveness) Y2 (second fiscal year after 80.00 1,014,000.00 US$1950 x 40 x 13 effectiveness) Y3 (third fiscal year after 80.00 0.00 0.00 effectiveness) Page 55 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) Y4 (fourth fiscal year after 80.00 0.00 0.00 effectiveness) D LI_TBL_M ATRIX DLI 4 Average score achieved on the literacy and numeracy components of MDAT of children aged 48-59 months Type of DLI Scalability Unit of Measure Total Allocated Amount (USD) As % of Total Financing Amount Outcome Yes Percentage 250,250.00 0.42 Period Value Allocated Amount (USD) Formula Baseline 0.00 Y0 (at effectiveness) 0.00 0.00 N/A Y1 (first fiscal year after 0.00 0.00 NA effectiveness) Y2 (second fiscal year after 0.00 0.00 NA effectiveness) Y3 (third fiscal year after 0.00 0.00 NA effectiveness) Y4 (fourth fiscal year after 50.00 250,250.00 US$385 x 50 x 13 effectiveness) D LI_TBL_M ATRIX DLI 5 Number of district disbursing at least 80% of funds allocated in DIP for ECD and nutrition Type of DLI Scalability Unit of Measure Total Allocated Amount (USD) As % of Total Financing Amount Intermediate Outcome Yes Number 1,060,000.00 1.77 Period Value Allocated Amount (USD) Formula Page 56 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) Baseline 0.00 Y0 (at effectiveness) 0.00 200,000.00 US$200000 x 1 Y1 (first fiscal year after 0.00 300,000.00 US$300000 x 1 effectiveness) Y2 (second fiscal year after 0.00 300,000.00 US$23070 x 13 effectiveness) Y3 (third fiscal year after 40.00 130,000.00 US$250 x 40 x 13 effectiveness) Y4 (fourth fiscal year after 80.00 130,000.00 US$250 x 40 x 13 effectiveness) D LI_TBL_M ATRIX DLI 6 Number of officers completing nutrition and ECD short and long-term courses including diploma and masters Type of DLI Scalability Unit of Measure Total Allocated Amount (USD) As % of Total Financing Amount Intermediate Outcome Yes Number 1,200,000.00 2.00 Period Value Allocated Amount (USD) Formula Baseline 0.00 Y0 (at effectiveness) 0.00 200,000.00 US$200000 x 1 Y1 (first fiscal year after 0.00 300,000.00 US$300000 x 1 effectiveness) Y2 (second fiscal year after 0.00 500,000.00 US$500000 x 1 effectiveness) Page 57 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) Y3 (third fiscal year after 0.00 0.00 0.00 effectiveness) Y4 (fourth fiscal year after 90.00 200,000.00 US$2222.22 x 90 effectiveness) Verification Protocol Table: Disbursement Linked Indicators DLI 1 Percentage of CG CLs and promoters delivering an integrated nutrition and early stimulation package HSA, AEDO, CPW, WMA, CG CL & promotors will be trained on an integrated nutrition and early stimulation module as Description follows: 30% in Y1 and up to 80% in Y2. Data source/ Agency MoHP/DNHA Verification Entity Independent Verification Agent Verify that in each of the 10 districts supported on nutrition activities by the project, HSA, AEDO, CPW, WMA, CG CL & promotors are trained on the integrated CG package. The percentage is not cumulative of districts. It is instead calculated for each district. Procedure The percentage for each district is calculated as the number of HSA, AEDO, CPW, WMA, CG CL & promotors who are trained on the integrated CG package divided by the total number HSA, AEDO, CPW, WMA, CG CL & promotors within the same district. DLI 2 Percentage increase on exclusive breastfeeding practices for children from 0-6 months Behavioral change messages and IEY services provided through care groups will induce adequate infant and young child feeding practices in project supported districts which will be measured by an increase on exclusive breastfeeding practices Description for children from 0-6 months as follows 5% in Y3 and 10% in Y4. The percentage is not cumulative of districts. It is instead calculated for each district, and is based on the percentage of exclusive breastfeeding practices for children from 0-6 months in Y0. Page 58 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) KAP surveys will be conducted in Y3 and Y4; and these results will be compared with Y0 data to generate the percentage increase on exclusive breastfeeding practices for children from 0-6 months. Data source/ Agency MoHP/DNHA Verification Entity Independent Verification Agent Verify that each of the 10 districts supported on nutrition activities by the project has achieved a 5% then a 10% increase of Procedure exclusive breastfeeding practices for children from 0-6 months, respectively from year 0 to year 3 and then year 0 to year 4. DLI 3 Percentage of CBCC caregivers delivering an integrated early learning package Percentage of trained CBCC caregivers, mentors and management committee members; and CPW who have been active in Description delivering early learning interventions based on an integrated ECD, stimulation and nutrition package Data source/ Agency MoGCDSW Verification Entity Independent Verification Agent Verify that in each of the 10 districts supported on ECD activities by the project, CBCC caregivers, mentors and management committee members; and CPW are trained on the integrated ECD, stimulation and nutrition package (2019 revision). The Procedure percentage is not cumulative of districts. It is instead calculated for each district. DLI 4 Average score achieved on the literacy and numeracy components of MDAT of children aged 48-59 months Early learning skills acquired from Y1 to Y3 by children attending CBCCs in project supported districts will be measurable in Description Y4 average literacy and numeracy score at 50% for children aged 48-59 months. The score is not cumulative of districts. It is instead calculated for each district. Data source/ Agency MoGCDSW Verification Entity Independent Verification Agent Verify that in each of the 10 Districts, the average literacy and numeracy score for children 48-59 months is at least 50%. In Procedure each district, 10 CBCC centers will be randomly selected; and the MDAT tool will be administrated to children aged 48-59 Page 59 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) months. DLI 5 Number of district disbursing at least 80% of funds allocated in DIP for ECD and nutrition By Y2 all the 13 district supported by the project have incorporated and budgeted for nutrition and ECD in their DIPs. By Y4 Description all districts have released at least 80% of operational funds budgeted for ECD and nutrition activities in DIP in previous FY. Data source/ Agency MOLGRD Verification Entity Independent Verification Agent Verify that all the 13 districts supported by the project have integrated and budget for nutrition and ECD in their DIPs. Verify that all 13 districts in Y4 have released at last 80% of operational funds budgeted for ECD and nutrition activities in Procedure DIPs. DLI 6 Number of officers completing nutrition and ECD short and long-term courses including diploma and masters Nutrition and ECD short and long term courses including diploma and Masters are developed and government officers Description enroll and complete these programmes. Data source/ Agency MoGCDSW Verification Entity Independent Verification Agent Verify that public tertiary schools have developed nutrition and ECD short and long term courses including diploma and Masters, which have been approved by competent authorities. Procedure Verify that 100 eligible government officers have been enrolled in the programs by Y2; and at least 90 governement officers have completed these programs by Y4. Page 60 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) ANNEX 1: IMPLEMENTATION ARRANGEMENTS AND SUPPORT PLAN Project Institutional and Implementation Arrangements 1. Overall project management. The MoGCDSW will house a PFT that will facilitate the day-to-day project implementation by the DNHA, MoHP; DCA, MoGCDSW; and the selected project districts. At the community level, the project-financed activities will be delivered primarily by the CGs and CBCCs. The PIM will describe institutional relationships at all levels and their roles and responsibilities. Formal adoption of the PIM will be an effectiveness condition for the project. The detailed institutional and implementation arrangements are summarized in figure 1.1. Figure 1.1. Coordination/Implementation Arrangements for Nutrition, Early Stimulation, and Early Learning National Level 2. Before effectiveness, a Project Steering Committee will be established to provide oversight to the project implementation, review the project progress, and facilitate interministerial coordination for nutrition, early stimulation, and early learning. This committee will meet semiannually. Chaired by the Principal Secretary, MoGCDSW and co-chaired by the Secretary, MoHP, the committee will include principal secretaries and/or high-level representatives from the MoHP, MoAIWD, MoEST, MoLGRD, and MoFPED. The committee may include other members as will be relevant to the implementation of the project. A detailed description of roles and responsibilities of the Project Steering Committee will be included in the PIM. 3. Also, before effectiveness, an ISPIC will be established. It will approve the AWPB and other tasks, facilitate joint monitoring, identify challenges, and agree on actions to facilitate the Page 61 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) implementation. This committee will meet once a month. Chaired by the Director DCA, MoGCDSW and co-chaired by the Director Nutrition, DNHA/MoHP, the committee will include the Director Reproductive Health Services, MoHP; Director Planning and Policy, MoLGRD; Director Agriculture Extension Services, MoAIWD; and Director Basic Education, MoEST. The committee may include other members as will be relevant to the implementation of the project. A detailed description of roles and responsibilities of the ISPIC will be included in the PIM. 4. A PFT will be established within the MoGCDSW before effectiveness and will be responsible for managing the project implementation with specific reference to FM, procurement management, and M&E. Specifically, the team will coordinate the day-to-day operations of the project which includes procurement; FM—including timely disbursement of funds to implementing entities based on an approved AWPB; monitoring; evaluation; and reporting. The unit will also ensure that covenants are complied with and that the project is implemented according to the PIM. Each quarter, the PFT will prepare a consolidated quarterly technical report and unaudited IFR. The PFT will also be responsible for preparing a consolidated project AWPB, which will be approved by the ISPIC and will include AWPBs developed by the DNHA, DCA, and districts. The PFT will comprise a project coordinator, an FM specialist (1), a procurement specialist (1), an M&E specialist (1), assistant FM specialists (2), and safeguard staff (1). Other staff/consultant positions may be considered as needed from time to time during implementation. The detailed ToRs for the PFT and its staff will be included in the PIM. District Level 5. At the district level, the project will be implemented through the existing local government structures. All project activities will be coordinated through the district council, chaired by the district commissioner. The district council is supported by the DEC which is the technical advisory body responsible for implementation of all aspects of the DIP. The district commissioner and district-level officials from line ministries, including district director of planning and development, district health officer (DHO), district agriculture development officer (DADO), and district social welfare officer (DSWO) will be responsible for overseeing the overall district-level implementation of project activities. The district council will approve the dAWPB, integrate them in the DIP, and submit it to the PFT at the national level. 6. Each district will establish a DPT which will be responsible for overseeing implementation of project activities, including all activities to be undertaken by the district, CBCCs, and CGs. The DPT will be headed by a district planning officer and will comprise the DHO, DSWO, DADO, and a full-time project- financed DFMO. The DPT will be responsible for developing the dAWPB. Each quarter, the DPT will prepare a district-level technical and financial report which will be shared with the PFT no later than 30 days following the quarter end. To ensure the timely availability of funds, approximately six months of estimated funding will be available in the district account for access by relevant entities in the district as needed and justified. The DPT will meet regularly with the district council and provide activity and fiduciary reports. Area and Group Village Level 7. The ADC is responsible for coordinating implementation of project activities at the area level. The ADC comprises all the VDCs under the jurisdiction of a traditional authority. Like the district council, the ADC is supported by an area executive committee, which is a group of extension workers responsible Page 62 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) for providing technical support to the ADC. The project will finance one community facilitator per traditional authority, who will work alongside line ministry extension workers and support development and implementation of each cAWPB. 8. Each VDC will be responsible for coordinating support and supervising activities with support from the community facilitators and line ministry extension workers from health (HSAs), gender (CPWs), and agriculture (WMAs and AEDOs). The cAWPB will be implemented by the model CBCCs and its surrounding CGs. Community Level 9. All project activities will be delivered primarily through 3,000 community-based CGs, and 250 model CBCCs. Figure 1.2 illustrates the project-supported key interventions by sector-specific district- level officials and extension workers. In addition to these service delivery platforms, the project will support key maternal-, adolescent girl-, and children-focused nutrition-sensitive health interventions through primary-level health centers. The project activities will be delivered through these platforms with periodic support from line ministry extension workers as mentioned earlier and community facilitators. Figure 1.2. Project-supported Key Interventions by Sector-specific District-level Officials and Extension Workers Page 63 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) Financial Management 10. A FM assessment of the MoGCDSW, the DNHA/MoHP, and the selected district councils was undertaken, and the FM arrangements of the proposed implementing entities have been assessed as Moderately Unsatisfactory. This assessment is because of the following: (a) The proposed implementing entities do not have appropriate accounting systems for project accounting and reporting. The accounting systems used by the entities have several weaknesses (for example, forensic audit revealed massive bank transactions that were not processed in the Integrated Financial Management Information System [IFMIS]). The control environment around the IFMIS has been assessed as weak, which undermines the integrity of the system. The weak control environment is worsened by weak and mostly nonexistent remedies for noncompliance. (b) Weak audit committees leading to ineffective internal audit function. (c) Weak or absence of corruption and fraud deterrence mechanisms. (d) The proposed implementing entities use the consolidated government bank account for project funds. The bank reconciliations are not done on time and for those that are done the reconciling items are not resolved on time. The districts also use a pooled fund bank account which is not promptly reconciled and there have been incidences of funds of one project being used on another project. This means that the accounting and reporting may neither be accurate nor complete. (e) Delays in funds flow from the MoFEPD to the proposed implementing entities result in delays in implementation of some of the project activities. (f) The lack of dedicated FM staff working on project accounting and reporting result in delays in reporting, which affects the timeliness of drawdowns on credits and grants. 11. Because of the weaknesses in the FM arrangements of the implementing entities the following mitigation measures have been recommended: (a) The proposed project should have an independent PFT which will include dedicated FM staff who will be responsible for accounting and reporting for the project. The staff will be trained in FM and disbursement for World Bank-funded projects. (b) The project will acquire and install an accounting software to be used for transaction processing and reporting. (c) The project should have exclusive U.S. dollar and Malawi kwacha accounts at a commercial bank acceptable to the World Bank. The selected districts will also have exclusive Malawi kwacha accounts for the project. (d) The project will be required to submit unaudited IFRs, which will be reviewed and validated by the World Bank FM team. Page 64 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) (e) The project will be visited at least twice a year for implementation support that will include dealing with FM issues. (f) The transactions will be internally audited at least twice a year to ensure that the proposed implementing entities’ audit committees are strengthened and functioning. (g) The project’s financial statements will be externally audited by the National Audit Office or private auditors under ToR to be agreed with the World Bank. (h) The project will incorporate corruption prevention and reporting mechanisms through collaboration with the anticorruption bureau. This should include social accountability mechanisms covering public reporting and use of community volunteers and civil society organizations in social audits and disclosure of project information. The use of whistle blowers is proposed to further combat corruption and other forms of fraudulent activities. (i) The abovementioned measures and other accounting requirements for the project should be clearly detailed in the PIM. 12. Funds will flow from IDA to the U.S. dollar account maintained by the PFT under oversight of MoFEPD. The project will also have Malawi kwacha project accounts at both the RBM and a commercial bank acceptable to IDA. The selected districts will also open exclusive Malawi kwacha operating accounts for project operations. For community-level activities that require resources at the community, Malawi kwacha operating accounts will be opened by the model CBCCs and funds will be deposited from district’s bank accounts. Figure 1.3. Funds Flow Page 65 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) 13. Special commitments using irrevocable letters of credit as well as direct payments to suppliers for works, goods, and services may be used, upon the Recipient’s request. The project will also receive funds into the DA using the report-based disbursement method. IDA will make the initial disbursement to the project after receiving a withdrawal application with a six-month cash flow forecast. This withdrawal application should be prepared within one month after project effectiveness. Thereafter, IDA will disburse into the respective DA based on quarterly IFRs, which would provide actual expenditure for the preceding quarter (three months) and cash flow projections for the next two quarters (six months). The IFR will be reviewed by the World Bank’s FM specialist and approved by the task team leader before the request for disbursement is processed by the World Bank’s loan department. 14. The MoGCDSW, through the PFT, will produce quarterly unaudited IFRs for the DA and the related project account. The IFRs are to be produced on a quarterly basis and submitted to the World Bank within 45 days after the end of the calendar quarterly period. The MoGCDSW has agreed with the World Bank on the format and content of the IFR. The reporting requirements will be incorporated into the accounting package to enable automatic generation of the IFRs. Reimbursements can be made from the DA or paid direct by the World Bank into the recipient’s bank account. These payments will also be reported in the quarterly IFRs. The IDA Disbursement Letter will provide details about each of the above disbursement arrangements. Procurement 15. Procurement under the project will be carried out in accordance with the Procurement Regulations for Investment Project Financing (IPF): Goods, Works, Non- Consulting and Consulting Services, dated July 1, 2016, revised November 2017 and August 2018; ‘Guidelines on Preventing and Combating Fraud and Corruption in Projects Financed by IBRD Loans and IDA Credits and Grants’, dated October 15, 2006 and revised in January 2011 and as of July 1, 2016; and the provisions stipulated in the Financing Agreement and the Public Procurement and Disposal of Public Assets Act, 2016. As the project will be using the IPF, it is a mandatory requirement for the project to prepare a PPSD, which is a strategy to be prepared by the DNHA and MoGCDSW that describes how procurement in IPF operations support the PDOs and deliver value for money. The PPSD addresses how procurement activities will support the PDOs and deliver the best value for money under a risk-based approach. The World Bank’s core procurement principles of value for money, economy, integrity, fit for purpose, efficiency, transparency, and fairness must be observed throughout the procurement process. The project has prepared a simplified PPSD as there are no complex contracts to be undertaken by the project. The PPSD provided adequate justification for the selection methods in the Procurement Plan and the level of detail and analysis is proportional to the risk, value, and complexity of procurements. 16. The agreed PPSD together with the Procurement Plan has been incorporated, through reference, in the Financing Agreement making it legally bidding on the Government. A Procurement Plan that outlines the procurement procedures to be used and helps plan and monitor implementation of investment activities will be prepared and agreed upon. The Procurement Plan for the IEY Project will provide (a) a brief description of the activities/contracts for the goods, works, non -consulting services, and/or services, (b) the selection methods to be applied; (c) the estimated cost of each individual contract; (d) time schedules; (e) World Bank review requirements; and (f) any other relevant procurement information. The DNHA and MoGCDSW shall update the Procurement Plan annually, or as needed, Page 66 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) throughout the duration of the implementation of the IEY Project and implement it as has been agreed upon and approved by the Government and the World Bank. 17. Procurement under the project will be carried out and led by the DNHA and MoGCDSW and a dedicated Project Facilitation Management Unit will be created and will be responsible for all procurements. Both the DNHA and MoGCDSW have internal procurement committees, which are responsible for award of contracts and these committees will be responsible for award of contracts under the project. For each contract to be financed under the project, various procurement or consultant selection methods, the need for pre-qualification, estimated costs, prior review requirements, and time frames have been agreed between the MoGCDSW and the World Bank in the PPSD and Procurement Plan. The PPSD and Procurement Plan will be updated at least annually, or as required, to reflect the actual project implementation needs and improvements in institutional capacity. 18. An open, competitive approach to the market is the World Bank’s preferred approach as it provides all eligible bidders/proposers with timely and adequate advertisement of project requirements and provides equal opportunity to provide the required goods or services. The use of World Bank standard procurement documents for contracts under Open International Bidding Procedures beyond thresholds defined in the Procurement Plan will be mandatory. For procurements involving national competition below the defined thresholds, the GoM’s Procurement Law and associated bidding documents, which have been reviewed and found acceptable by the World Bank, will be used. 19. Public Procurement in Malawi is governed by the Public Procurement and Disposal of Public Assets Act, 2016 which decentralized to the ministries and departments who are responsible for award of contracts. Under the project, the MoGCDSW, DNHA, and selected districts will be responsible. 20. All procurements below US$7 million for works and below US$1 million for goods and non- consulting services will use National Procurement Procedures as agreed in the Procurement Plan and will be carried out in accordance with the Public Procurement and Disposal of Public Assets Act, 2016. However, activities under the CERC shall not be prior reviewed, once the activities and their estimated costs have been agreed with the World Bank through the Contingent Emergency Response Implementation Plan (CERIP). The requirements for national open competition shall include the following: (a) open advertising of the procurement opportunity at the national level; (b) the procurement being open to eligible firms from any country; (c) the request for bids/request for proposals that will require presenting a signed acceptance at time of bidding to be incorporated in any contract confirming compliance with the World Bank’s Anti-Corruption Guidelines, including the World Bank’s right to sanction, inspection, and audit rights; (d) contracts with appropriate allocation of responsibilities, risks, and liabilities; (e) publication of contract awards; (f) rights for the World Bank to review procurement documentation and activities; (g) an effective complaints mechanism being in place; and (h) maintenance of records of the procurement process. The other national procurement arrangements such as limited/restricted competitive bidding, request for quotations/shopping, and direct contracting are consistent with the World Bank’s Core Procurement Principles, Anti-Corruption Guidelines, and Sanctions Framework. 21. All procurement of goods and non-consulting services above US$1 million will use International Competitive Procurement, except for goods under the CERC, whose procurement procedures have been outlined in the PPSD and details shall be finalized in the CERIP for each crisis or emergency. Goods to be Page 67 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) procured will include vehicles, computer equipment, nutrition commodities, and equipment for ECD. All items to be procured are in the Procurement Plan. 22. An Open Competitive Procurement approach to market is the preferred method for selection of consulting services, including advertisement of expression of interest , as it provides all eligible prospective firms or individual consultants with adequate time to participate in the process of bidding for providing project requirements, equal opportunity, and fairness to all eligible firms. Consulting services to be procured have been defined in the PPSD. All ToRs for selection of consultants, regardless of value, will be reviewed by the World Bank before start of an assignment. 23. The World Bank sets mandatory prior review based on project procurement risk levels and this may include contracts below mandatory thresholds if it is determined that the contract is risky and includes negotiations in a competitive procurement process for goods, works, non-consulting services, best and final offer, competitive dialogue, and sustainable development. In cases where the risk is assessed as low, the World Bank may determine that such procurements be subject to post review and be included in the Procurement Plan and such procurements shall use the World Bank’s standard procurement document. 24. An independent consultant may be hired to do the prior review clearances on behalf of the World Bank. Prior review contracts will include (a) all contracts estimated to cost the equivalent of US$7 million or more for works and US$1 million or more for goods and non-consulting services; (b) consulting service contracts provided by a firm estimated to cost the equivalent of US$200,000 or more; (c) each contract for the employment of individual consultants estimated to cost the equivalent of US$100,000 or more; and (d) cases of direct contracting or single-source selection of contractors, firms, or individual consultants as determined by the Procurement Plan. 25. The DNHA and MoGCDSW shall publish the Procurement Plan, its updates and all awarded contracts on the World Bank’s website, its own website, and in at least one newspaper with national circulation. The details of contract awards through International Competitive Approaches shall be published though STEP in accordance with the World Bank regulations and using World Bank templates. In addition, the details of the contract awards, including those through National Procurement Procedures shall also be published on the relevant Government website and in at least one local newspaper with national circulation. Procurement monitoring reports shall be submitted on a quarterly basis. 26. The DNHA, MoGCDSW, PFT, and all implementing agencies under the project shall maintain contract registers and adequate records of all procurement processes—contract by contract. Each contract file shall contain the complete paper trail of the procurement process. 27. The World Bank’s system (Systemic Tracking of Exchanges in Procurement (STEP)) will be used to prepare, clear, and update Procurement Plans and conduct all procurement transactions for the project. As part of the preparation, staff from the relevant implementing agencies shall undergo STEP training. 28. The World Bank undertook a procurement capacity and risk assessment of the DNHA and MoGCDSW and selected districts of Chikwawa, Blantyre, Chiradzulu, Machinga, Dowa, Mchinji, Nkhata Bay, and Rumphi during January 2018 to check their readiness and capacity to undertake procurement Page 68 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) under the project. The procurement risk rating using the Procurement Risk Assessment and Management System is Substantial as staff are not familiar with the Procurement Regulations which the project will be using, record keeping is poor, and in some districts the procurement processes are not properly handled. The risks that have been identified under the project and mitigation measures that have also been proposed are as shown in table 1.1. Table 1.1. Identified Procurement Risks and Proposed Mitigation Measures S. Risk Risk Factor Mitigation Measure Time Responsible No Impact Likelihood Frame Entity 1 Record-keeping and Major Unlikely x All implementation Life of Government documentation not agencies will maintain project maintained all procurement records 2 Existing manual Major Unlikely x All implementation Life of Government requires updating to agencies maintain and project be useful for use the manual on a guidance under the regular basis as project. required by the Financing Agreement 3 Evaluation reports Major Likely x Quality of evaluations Life of Government and awards of and awards of contracts project contracts do not requires enhancing. always contain all x Staff to be trained in information good evaluation necessary for practices which base approvals, including decisions on pre- adequate disclosed criteria justification for decisions taken during evaluation such as rejection of bids. Wrong award decision may be made because of inadequate information and due diligence not being routinely carried out 4 Inadequate Major Likely x Improve procurement Life of Government participation by implementation project technical experts in capacity by acquiring bid preparation and and assigning the evaluation leading to necessary potential/inadequate procurement expertise. bidding process, x Involve technical staff contract awards, and and users in implementation preparation of delays specifications or agree Page 69 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) S. Risk Risk Factor Mitigation Measure Time Responsible No Impact Likelihood Frame Entity to hire competent consultants to draft technical specifications and ToRs during evaluation of bids and proposals. 5 Inadequate Major Unlikely x Experienced Life of Government procurement procurement project capacity due to lack staff/consultant shall of experienced staff be positioned to guide and work overload implementing agencies due to x Attend training in implementation of World Bank new regulations procurement x Conduct training on new World Bank procurement procedures x Regular supervision support and monitoring 6 Inefficiencies and Major Likely x Regular monitoring Life of Government delays in the through the project procurement process Procurement Plan especially x Timely preparation of preparation of ToRs ToRs/bid specifications and bid x Train staff in specifications preparation of ToRs/bid specifications 7 Insufficient Major Likely x Aggregation of smaller Life of Project competition in contract packages project Implementation procurement wherever feasible Unit 8 Contract Major Likely x Disclosure of all Life of Project management contracts awards in project Implementation United Nations Unit/Government Development Business for prior review contracts and post review contracts in local newspapers and website of Office of Director of Public Procurement 9 Probability of Major Likely x Continue dialogue with Life of Government procurement staff the Government to project leaving the retain trained staff project/being transferred Page 70 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) S. Risk Risk Factor Mitigation Measure Time Responsible No Impact Likelihood Frame Entity 10 Fraud and corruption Major Likely x Disclosure of Life of Government risks, including Procurement Plan project collusion and outside x Disclosure of contract interference in the awards contracting process x Creating awareness on effects of fraud and corruption x Regular reviews such as Portfolio Performance Review, internal audit, and external audit 11 Weak complaint Major Likely x Disclosure of complaint Life of Government redress system redress procedure project through Office of Director of Public Procurement x Biannual report of complaints received and action taken 29. Based on the risks identified earlier the following procurement arrangements are proposed: (a) Approach to market. Based on previous experience, and available local market, the threshold as shown in table 1.2 will be used for open national/international and request for quotation bidding. Table 1.2. Thresholds for Procurement Approaches and Methods (US$, millions) Works Goods, IT, and Non-Consulting Services Short List of National Consultants Open Open Request Open Open Request Consulting Engineering International National for International National for Services and ≥ < Quotation ≥ < Quotation ≤ Construction ≤ ≤ Supervision ≤ 7 7 0.2 1 1 0.1 0.2 0.3 (b) For consultancy services, open international advertisement shall be done for all cases equal to and above US$300,000. (c) Selection method. For goods, works, and non-consultancy services, request for bids, request for quotations, and Direct Contracting will be used as appropriate. For consultancy services, the preferred method would be Quality- and Cost-Based Selection; however, other methods, including Direct Selection would be used, as stipulated in the Procurement Plan. For National Open Competitive Procurement, National Procurement Procedures will be used, subject to conditions as laid down in the Procurement Plan. Page 71 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) (d) Contract strategy. Goods, services, and civil works will be packaged in economical packages to attract bidders who are qualified and can offer good prices and complete contracts within the stipulated period resulting into value for money. 30. A Procurement Plan has been developed, that includes the summary of the procurement arrangements for each contract in the project, covering the first 18 months of implementation. Under the project no contract has been identified that will require a mandatory contract management plan. Implementation Support Plan 31. The proposed implementation plan is based on lessons learned from the implementation of past and ongoing projects in Malawi, as well as the project’s specific challenges and risks. Project implementation rests under the responsibility of the MoGCDSW and MoHP, with targeted and continuous implementation support and technical advice from the World Bank. The World Bank’s implementation support will broadly consist of x Capacity-building activities to strengthen the ability to implement the project, covering the technical, fiduciary, and social and environmental dimensions; x Provision of technical advice and implementation support geared to the attainment of the PDOs; x Ongoing monitoring of implementation progress, including regularly reviewing key outcome and intermediate indicators and identifying bottlenecks; x Reviewing and verifying DLI protocols; x Monitoring risks and identifying the corresponding mitigation measures; and x Close coordination with other development partners to leverage resources to ensure coordination of efforts and avoid duplication. 32. The World Bank’s implementation support team will consist of a Health, Nutrition, and Population Global Practice task team leader; an Education Global Practice co-task team leader; an Agriculture Global Practice co-task team leader (to ensure continued cross-practice collaboration); and country-based and headquarters-based staff in the areas of health, FM, procurement, safeguards and operations. Team members will be responsible for supporting the implementation of project-specific elements in their areas of expertise. 33. During implementation, fiduciary and other specialists will work with the Recipient to identify underperforming areas (if any) and address the constraints. Fiduciary support will include review of financial and progress reports prepared by the Recipient and audit reports prepared by internal and external auditors. Additional implementation support will include review of implementation progress and achievement of project results and DLIs; providing support for implementation issues and institutional capacity building; and monitoring changes in risks and, as relevant, compliance with legal covenants. Page 72 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) Table 1.3. Focus of Implementation Support Time Focus Skills Needed Resource Estimate First twelve Technical advice to Technical, 2 implementation support visits by technical months support project fiduciary, specialists focused on capacity building, TA, implementation operational, and monitoring environment, and social 2 implementation support visits by environment and social specialists focused on capacity building and reviewing/strengthening effectiveness of redress mechanism 12–24 months Continued institutional Technical, 2 implementation support visits by technical capacity fiduciary, and fiduciary specialists focused on fiduciary enhancement to environment, support and strengthen and social implementation support implementation capacity 2 implementation support visits by social/environmental specialists focused on Implementation review of model CBCCs, strengthening local monitoring capacity, and implementation support Technical advice to support program Implementation Implementation Implementation Technical, 1 implementation support visit including midterm progress review and fiduciary, technical, fiduciary, identification of environment, social, environment, M&E, and operational necessary midcourse social, and specialists adjustments operational 24–48 months Implementation Technical and 2 implementation support visits by technical M&E fiduciary and fiduciary specialists focused on implementation and fiduciary support Technical advice to support program 2 implementation support visits by Implementation social/environmental specialist focused on review of upgrading CBCCs, strengthening local capacity, and implementation support Table 1.4. Task Team Skills Mix Requirements for Implementation Support Skills Needed Number of Staff Weeks per Fiscal Year Program management (Task team leader x 3) 15 Health specialist 8 FM specialist 3 Procurement specialist 3 Operations officer 6 Social and environmental safeguards specialist 4 Administrative support 2 Page 73 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) ANNEX 2: DLI AND DLR MATRIX DLI FY 2019 FY 2020 FY 2021 FY 2022 FY 2023 FY 2024 TOTAL DL 1 1.6 1.7 2.9 — 6.2 Percent of CG CLs and DLR 1.0 Approved DLR 1.1. 30% of all DLR 1.2. 80% of all HSA, promoters delivering training module HSA, AEDO, CPW, AEDO, CPW, WMA, CG an integrated nutrition available WMA, CG CL and CL and promoters are and early stimulation promoters are trained trained on the package on the integrated integrated nutrition nutrition and early and early stimulation stimulation training training module module DLI 2 0.5 0.5 — 1.0 Percentage increase DLR 2.1 5% increase DLR 2.2 10% on exclusive on exclusive increase on breastfeeding breastfeeding exclusive practices for children practices for breastfeeding from 0–6 months children from 0–6 practices for months children from 0–6 months DLI 3 0.7 1.0 1.0 — 2.7 Percentage of CBCC DLR 3.0 Approved DLR 3.1 40% of all DLR 3.2 80% of all CBCC caregivers delivering training module CBCC caregivers, caregivers, mentors, an integrated early available mentors, and and management learning package management committee members committee members are trained on the are trained on the integrated CBCC integrated CBCC caregiver training caregiver training package package 0.3 — 0.3 Page 74 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) DLI FY 2019 FY 2020 FY 2021 FY 2022 FY 2023 FY 2024 TOTAL DLI 4 DLR 4.1 Average score Average achieved on the numeracy literacy and numeracy and literacy components of MDAT score for of children aged 48–59 children 48– months 59 months is at least 50% DLI 5 0.2 0.3 0.3 0.1 0.1 — 1.1 Number of districts DLR 5.0 DLR 5.1 DLR 5.2 100% districts DLR 5.3 40% of DLR 5.4 80% disbursing at least 80% Approved Approved guidelines have incorporated ECD operational funds of of funds allocated in decentralization on integration of ECD and nutrition activities budgeted for ECD operational DIP for ECD and policy and nutrition in DIP in their annual DIP and and nutrition funds nutrition empowering and budget funded activities in DIP in budgeted for councils to previous fiscal year ECD and implement and released for each nutrition budget for district activities in nutrition and ECD DIP in activities previous fiscal year released for each district DLI 6 0.2 0.3 0.5 0.2 1.2 Number of officers DLR 6.0 DLR 6.1 DLR 6.2 DLR 6.3 completing nutrition ECD and nutrition Nutrition and ECD 100 officers are 90 officers and ECD short- and short and long- short and long-term enrolled in short and completed long-term courses term courses courses including long-term courses short and including diploma and needs assessment diploma and masters including diploma and long-term masters report is available are developed and masters courses approved including diploma and masters programs TOTAL 2.7 3.4 4.7 0.6 1.0 — 12.4 Page 75 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) ANNEX 3: TEAM LIST Name Role Title Unit Anthony Aggrey Team Member Consultant GGOPA Msendema Blessings Nyanjagha Botha Team Leader Agriculture Economist GFA13 Chipo Msowoya Team Member Social Protection Specialist GSP01 Collins Chansa Team Member Senior Economist GHN01 Edith Ruguru Mwenda Counsel Senior Counsel LEGAM Fisseha Tessema Abissa Safeguards Specialist Senior Operations Officer GCCCI George da Silva Finance and Accounting Finance Officer WFCAS Gertrude Mulenga Banda Team Member Senior Program Assistant GHN01 Innocent Kibira Najjumba Team Leader Senior Education Specialist GED01 Mulinda John Bosco Makumba Team Member Senior Operations Officer GHN01 Julita Manda Team Member Consultant GHN01 Katelyn Jison Yoo Team Member WBG Analyst GHN01 Lawrence Mumbe Team Member Consultant GHNGF Mercy Chimpokosera- Team Member Environmental Specialist GFA13 Mseu Phoebe M. Folger Team Member Operations Officer GHN01 Steven Maclean Mhone Procurement Specialist (ADM Senior Procurement Specialist GGOPA Responsible) Tinyade Neffie Kumsinda Team Member Team Assistant AFMMW Toni Lee Kuguru Team Member Health Specialist GHN01 Trust Chamukuwa Financial Management Financial Management GGOAE Chimaliro Specialist Specialist Ziauddin Hyder Team Leader (ADM Senior Nutrition Specialist GHN01 Responsible) Page 76 of 77 The World Bank Investing in Early Years for Growth and Productivity in Malawi (P164771) ANNEX 4: MAP Page 77 of 77