Document of The World Bank Report No. 13869-CD STAFF APPRAISAL REPORT REPUBLIC OF CHAD POPULATION AND AIDS CONTROL PROJECT MARCH 3, 1995 Population and Human Resources Operations Division Central Africa and Indian Ocean Department Africa Region CURRENCY EQUIVALENTS Currency Unit = CFA Franc (CFAF) / US$1 = 512.25 CFAF 100 CFAF = IFF WEIGHTS AND MEASURES Metric System Im = 1.09 yd I m2 = 10.76 sq ft FISCAL YEAR January 1 - December 31 ABBREVIATIONS AND ACRONYMS AIDS - Acquired Immunodeficiency Syndrome APMS - Appui psycho-medico-social ASTBEF - Association 7chadienne du Bien-Etre F-amilial (Chadian Association of Family Welfare) CERPOD - Center for Research on Population and Development CILONG - Centre dInformation et de Liaison des ONG (NGO Liaison Group) CILSS - Comite inter-etats de lutte contre la s&heresse dans le [Sahel CIP - Carriage and Insurance Paid CNLS - Comite National de Lutte contre le SIDA CNPHR - (ommission Nationale pour la Population et les Ressources Ifumaines CPR - Contraceptive Prevalence Rate CSM - Condom Social Marketing CST - Conseil Superieur de Transition CTLS - Comite 7echnique de Lutte contre le SIDA DHS - Demographic and Health Survey DPP - Declaration de Politique de Population DPDR - Direction de la Planification, du Dlveloppement et de la Reconstruction DSEED - Direction de la Statistique et des Etudes Economiques et Demographiques DSIS - Division in charge of the health information system (Division du .svsteVne d'information sanitaire) FOSAP - Fonds de Soutien auxActivites en matiere de Population (Support Fund for Population Activities) FP - Family Planning GDP - Gross Domestic Product HIV - Human Immunodeficiency Virus IEC - Information, Education, Communication IPP - Priority Indicators of Prevention (indicateurs prioritaires de prevention) IUD - Intra-uterine device KAP - Knowledge, Attitude, and Practice MCH - Maternal and Child Health MOPC - Ministry of Plan and Cooperation MOPH - Ministry of Public Health MTP - Medium-Term Plan NGO - Non-Governmental Organization NRH - National Referral Hospital PADS - Social Action Development Project (projet d'action sociale pour le developpement) PCT - Project Coordination Team PFIE - Programme de Formation et d'Information sur l'knvironnement PMA - Basic Package of Services (Plaquet minimum d'activites) PNLS - Programme National de Lutte contre le SIDA SSA - Sub-Saharan Africa STD - Sexually Transmitted Disease TFR - Total Fertility Rate USAID - United States Agency for International Development WHO - World Health Organization STAFF APPRAISAL REPORT REPUBLIC OF CHAD POPULATION AND AIDS CONTROL PROJECT TABLE OF CONTENTS Page CREDIT AND PROJECT SUMMARY I. INTRODUCTION II. SECTORAL CONTEXT1 A. Background B. Macro-Economic Context 2 C The Population Sector 2 D. The HIV/AIDS Situation 6 E. Government Strategy I I 1. Population and Family Planning Strategy I1 2. HlV/AIDS/STDs Strategy 12 F. The Bank Group's Role 13 111. THE PROJECT 1 5 A. Project Objectives and Scope I 5 B. Project Dcscription 15 1. Reinforcing the National Capacity to Implement the National 1I Population Policy 2. Strengthening the National Capacity to Contain the Spread of I8 HIV/AIDS/STDs 3 Putting in Place a Social Marketing Program for the Promotion of Condoms 2() 4 Promoting the Participation of the Private Sector and NGOs in Population. 22 Family Planning, and HIV/AIDS/STD Programs C. Project Cost and Financing Plan 24 IV. PROJECT IMPLEMENTATION 25 A. Status of Project Preparation and Readiness 25 B. Project Coordination and Management 25 C. Monitoring and Evaluation and Reporting 27 D. Procurement 27 E. Disbursements, Accounting and Auditing 3 0) F. Environment 32 This report is based on the findings of a pre-appraisal mission in May 1994 and an appraisal mission that visited Chad in October-Novcmber 1994 comprising Nimes Eva Jaravsan, Mission Leader (AF3PH); Michele Lioy, IEC/Population Specialist (AF3PHI); Gabrielle Rooz, Project AXssistant (A15P1I); and Mr. Mohsen Farz.a, Epidemiologist Consultant. Report processing was finalized with assistance from Mimes Gabriellc Rooz, Rosclivc Leroy, Bilingual Staff Assistant (AF3P}1) and Anne Anglio, Language Staff Assistant (AF13PH). Mr. Francisco Aguirre-Sacasa and NIr. D)avid l3erk are the Department Director and Managing Division Chief, respectively, for the operation. Mrs. Maryse Pierre-Louis (MIN I P11) aid NMr. liLliacl Porter (ASTHIR) are the peer reviewers. V. PROJECT BENEFITS AND RISKS 32 A. Benefits 32 B. Risks 32 VI. AGREEMENTS REACHED AND RECOMMENDATION 33 TABLES: Table I: Expected Evolution of the AIDS Epidemic Indicators, 1994-1999 10 Table 2: Estimated Project Costs and Financing Plan 24 Table 3: Procurement Arrangements 28 Table 4: Allocation and Disbursement ofthe IDA Credit 31 ANNEXES: Annex 2-1 Socio-Economic Indicators Annex 2-2 Health and Safe Motherhood Project: Credit/Project Summary and Role of the Health and Motherhood Project in Reinforcing AIDS Control Activities Annex 2-3 Population Action Plan and Monitoring Indicators Annex 2-4 AIDS Action Plan and Monitoring Indicators Annex 3-1 Training Program Annex 3-2 Cost Tables Annex 4-1 Supervision Plan Annex 4-2 Procurement Arrangements/Project Implementation Schedule Annex 4-3 Project Disbursement Profile Annex 4-4 Documents in Project File MAP: IBRD 26775, February 1995. REPUBLIC OF CHAD POPULATION AND AIDS CONTROL PROJECT CREDIT AND PROJECT SUMMARY Borrower: Republic of Chad Beneficiaries: Ministry of Plan and Cooperation Ministry of Public Health Association Tchadienne du Bien-Etre Familial (ASTBEF) Poverty: Program of Targeted Interventions Amount: SDR 13.9 million (US$ 20.4 million equivalent) Terms: Standard, with 40 years maturity Commitment Fee: 0.50% on undisbursed credit balances, beginning 60 days after signing, less any waiver Project Description: The project would assist the Government in implementing its long-term strategy in population and family planning (FP) and its medium term plan 1995-1999 for AIDS control. Its overall objectives are to advance the onset of fertility decline by increasing the use of modem methods of contraception, and slow the spread of HIV infection by promoting behavioral change. To attain these objectives, the project would support policies and investments designed to: 1. Reinforcing the national capacity to implement the national population policy by: (a) strengthening the national capacity for undertaking population-related activities; (b) implementing a community awareness program and dissemination of the population policy; and (c) supporting population-related research. 2. Strengthening the national capacity to contain the spread of HIV/AIDS/STDs by: (a) institutional strengthening of the Ministry of Public Health; and (b) supporting epidemiological, operational, and socio-economic research. 3. Putting in place a social marketing program for the promotion of condoms; and 4. Promoting the participation of the private sector and NGOs in population, FP, and HIV/AIDS/STD programs by setting up a social fund. ii REPUBLIC OF CHAD POPULATION AND AIDS CONTROL PROJECT Estimated Project Costs and Financing Plan (Net of Taxes and Duties) Estimated Project Costs Local Foreign Total ----(US$ million)--------- A. Reinforcing the national capacity to implement the 2.5 4.5 7.0 national population policy B. Strengthening the national capacity to contain the spread of 3.7 2.2 5.9 HIV/AIDS/STDs C. Putting in place a social marketing program for the promotion 2.1 4.3 6.4 of condoms D. Promoting the participation of the private sector and NGOs 2.8 2.7 5.5 in population, FP, and HlV/AIDS/STDs programs Total Base Costs 11.1 13.7 24.8 Physical contingencies 0.4 0).6 1.0 Price contingencies 0.7 0.7 1.4 Total Project Costs 12.2 15.0 27.2 Financing Plan Financiers Local Foreign Total *--------(US$ million)--------- IDA 9.0 11.4 20.4 KfW 0.9 3.5 4.4 UNFPA 0.0 0.1 0.1 Government 1.3 0.0 1.3 Communities 1.0 (.0 1.0 Total 12.2 15.0 27.2 Estimated Credit Disbursements (in US$ million) -------------------------------------IDA Fiscal Years--------- FY96 FY97 FY98 FY99 FY2000 FY2001 Annual 0.4 2.4 3.2 5.0 6.6 2.8 Cumulative 0.4 2.8 6.0 11.0 17.6 20.4 iii Benefits and Risks: By assisting the Government in implementing its population policy, the project would help incrcase community awareness of the legitimacy of FP activities. It would facilitate the integration of FP into the public health system and encouragc the private sector to work in this area. The overall population program including efforts supported by the IDA-financed Health and Safe Motherhood project and NGOs, is expected to increase the contraceptive prevalence rate from lcss than 2% to about 10% by the year 2000. The wvider practice of FP would have a particularly beneficial effect on the health of women and children. The project would help slow the spread of the HIV infection and alleviate the burden of HIV/AIDS on about 12.000 AIDS patients, 21,000 families, 45,000 orphans, and the nation. The project would have significant returns in terms of years of healthy life saved and would hold down the indirect economic cost of AIDS -- the losses of productivity and human capital, which threaten the long-term cconomic development of Chad. The project would also help prevent the transmission of STDs, which is one of the most effective strategies to inhibit the spread of HIV. By the end of the project, multisectoral IEC activities and the social marketing of condoms are expected to produce behavioral changes among the 415,000 sexually- active persons at high risk and reduce or prevent the transmission of HIV infection and STDs. By contributing to reducing the number of infections transmitted to women, the project would help reduce neonatal infection. There are three main risks: First, the implementation of the population policy may be hampered by the unstable political conditions in the countrv. This risk would be addressed by closely monitoring the implementation of this policv through supervision of the project as well as through the Bank's general dialogue with the Government. Second, the Government's weak capacity may result in poor implementation. This risk would be addressed through the strengthening of the public institutions involved in project implementation, and through the use of NGOs as well as the private sector. Third, the Government's chronic financial constraints may affect counterpart funding, particularly for salary payments. This risk would be mitigated through the successful implementation of the Economic Recovery Program and careful monitoring of performance indicators. Environmental Risks: No environmental risks are foreseen Economic Rate of Return: Not applicable Map: IBRD 26775, dated February 1995 REPUBLIC OF CHAD POPULATION AND AIDS CONTROL PROJECT 1. INTRODUCTION I The Government of Chad has requested IDA's assistance in financing a project designed to assist in the implementation of its population program and its AIDS control program. Total project cost is estimated at about US$27.2 million equivalent, net of taxes and duties, with a foreign exchange component of US$15.0 million. IDA would finance US$20.4 million of total project costs. The Government of Chad would contribute about US$1.3 million equivalent and local communities US$1.0 million. Parallel cofinancing of about US$4.4 million and US$0.1 million is expected from KfW (Germany) and the United Nations Fund for Population Activities (UNFPA) respectivelv. 1.2 The proposed project would be IDA's second free-standing operation in Chad in the health and population sectors. The first involvement in the health sector was through the ongoing Social Action Development project (PADS, Cr. 2156-CD) which includes a component supporting the improvement of primary health care and social services in the capital N'djarnena and, to a limited extent, in the Tandjile area. IDA has recently approved the first free-standing operation in the sector -- the Health and Safe Mothcrhood project (Cr. 2626-CD) which became effcctive February 24, 1995. There is a significant degree of complcmentary between the proposed project and the Health and Safe Motherhood project and their preparation has been closely coordinated. Originally, one operation -- Health and Population -- was being prepared. However, to ensure simple and tightly-focused projects, it was decided to split the Health and Population project into two: Health and Safe Motherhood, and Population and AIDS Control. This has also helped reduce the risk of overloading the Ministry of Public Health's (MOPH) limited project coordination capacity as the Ministry of Plan and Cooperation is responsible for the proposed project. Both projects reflect the priority given by the Bank to maintaining the emphasis on human resources development in Chad. 11. SECTORAL CONTEXT A. Background 2.1 Chad is one of the poorest countries in the world with a per capita GNP of US$210 in 1993. Subsistence farming is the mainstay of 85% of the population and generates 35- 40% of GDP. The industrial sector includes a large cotton parastatal, public and para-public medium-scale enterprises, and informal micro-enterprises. The service sector (40-45%) includes a large informal trading sector. 2.2 In 1992, an estimated 30% of all adults and 18% of adult women were literate, compared with 49% and 38% for Sub-Saharan Africa (SSA). Available data suggest that the health situation in the country is precarious. Life expectancy at birth is estimated at 47 years (compared to 52 years for SSA), and the infant mortality rate is about 122 per 1,000 live births. The principal causes of mortalitv and morbidity are infectious and parasitic diseases (including most of the tropical diseases), pregnancy-related conditions, and malnutrition. AIDS is increasing rapidly with the number of reported cases having practically doubled each year from 1986 to 1992. 2.3 Maternal mortality relatcd to childbirth is the main causc of dcath among women of reproductive age. It is one of the highest in the world. A study of N'djamena National Rcferral Hospital (NRH) has rcported an average matcrnal mortality ratio of 8X 1 pcr I 00,000 livc births for thc vears 1986-1989 As tlhcsc arc hospital data, they arc in all likelihood an undcrcstimate of national figures. Major dircct causcs of maternal mortality are hemiiorrhage/anicmia. eclamiipsia. and post-partum and post-abortion infcctions. Adolcsccnt pregnancy. difficult access to hcalth care, clandestine abortions, and low literacy among womcn are amonig the many indirect causes of maternal mortality and an indication of the unfavorable situation of women. Basic socio-cconomic indicators for Chad and comparator groups of countries are in Annecx 2-1. B. Macro-Economic Context 2.4 Until the end of 1993. Chad's cconomy was scvercl hampercd by a combination of armed conflicts, political turmoil, an overvalued rcal cxchange ratc, detcriorating tcrms of tradc and wcakcncd cconomic and financial managcmcnt. Thc dcpletionl of the formal base of the economy was accompanied by a growing liqifidity crisis and drastic cuts in investment. 2.5 In the wvakc of the 50% dcvaluation of the C FA franc (in forcign currcncy tcrms) on Januarv 12, 1994, Chad embarked on a 12-month stabilization program supported by an IMF stand-by arrangement and an IDA Economic Rccovcry Credit (ERC). This program aims at restoring equilibrium in public financcs and addrcsscs somc key issues among which the necessity to restore an operative administration appcars paramount. Undcr the program, the effect of the devaluation on priccs has been passed through to the tradable sector, notably livcstock and cotton. The program includes a scrics of social measures to alleviate the impact of devaluation on vulncrable groups. In addition, the Bank portfolio was restructurcd to includc new or supplemcntal job-crcating projects and incrcascd supply of lowN-cost. gencric drugs. 2.6 The implementation of the stabilization program has suffcrcd from delays due to pervasive administrative weakness and lack of coordination. After the mid-tern review and supervision of the ERC, the government has optcd to replacc the cxisting stand-by program with a Fund-monitored program. This has becn dcsigncd with rcviscd performancc targcts for Deccmber 1994 and for March and June 1995. If the Decembcr targcts are met, it can be expccted that this would lead to early negotiation of a policy framework paper w ith the IMF and the Bank and to a subsequcnt considcration of Chad's access to the ESAF. In the longcr term. Chad's cconomic prospects will rest upon sustaincd political stability. (iven increascd and durable security, the cxploitation of the country's most promising rcsourcc. pctrolcum. could scrvc dcvclopment purposcs and markedly improve living conditions. C. The Population Sector 2 7 Demographic Characteristics. Chad's population. which stood at roughly 3.0 million in 1960, has more than doubled in the past thirty years and was reportcd by the first population census in April 1993 to be about 6.8 million. At prcsent, the average annual growth rate is 2.5% (3% for SSA). The country's birth rate has remained at 45 per thousand since 1965, while the crude death rate has decreased from 28 to 19 pcr thousand (compared to 16 per 1,000 in SSA). Although the estimated total fertility rate (TFR) in Chad (5.7 live births per woman) is very high by world standards, it is among the lowest in the rcgion, wherc the average is 6.6. The prevalence of sexually transmitted diseases (STDs) is very high and the partly consequent prevalence of sterility might explain the country's lower fcrtility. Improved health and socio- 3 economic conditions arc likely to exert upward pressure on the fertility rate in the short-run, a concern which underscorcs thc importancc of a strong family planning effort. 2.8 Chad is morc urbanizcd than most other countrics in the Sahel sub-region. The pressures of drought, Nvar, and political instability, coupled with deteriorating economic conditions are rapidly increasing this pattern. Although data on internal migration are virtually non-existent, rural to urban flows have becomc a recognized phenomenon in Chad. The population of N'djamena has increased five-fold between 1960 and 1990 to reach more than half a million inhabitants; and the pcrcentagc of the urban population nationwide is 21% according to the 1993 census, one of the highest in the Sahel. While this urbanization trend might have a positive impact on the population's attitudes with rcgard to family sizc, its impact on lowering fertility rates would remain minimal in the foresecable futurc given the early age at marriage, polygamy, and low literacy among wvomen. 2.9 Implications of Population Growth. Three scts of population projcctions have been selected to illustratc the implications of Chad's rapid population growth: constant fertility rate, gradual and rapid fertility dccline Although it would not bring about a major change in the total population during this dccade, a gradual decrcasc in fertility under the standard variant is achievable and could reducc the population growth rate towards the end of the next decade. Given its poor cconomic and social indicators, it is important for Chad to lower its fertility rates and bring about the necded demographic transition. In addition to the positive impact it would havc on the health of mothers and children, declining fertility would also have a significant impact on education, employment, environmental protection and overall povcrty reduction. 2.10 Family Planning Following rcorganization of the Ministry of Public Health in 1991. and the crcation of a thrce-ticred health system with a district focus, Chad has moved in servicc delivery from the vertical, project-based approach, towards an integrated approach. Accordingly, a health care provider is expected to link preventive and curative care, and to provide health, nutritional and FP services at the same facilitv. A minimum packagc of health services is expected to be delivered at each level of the svstem and should include FP services. Moreover, contraceptives are now part of the official list of cssential drugs. Howcver, with the cxception of a few hcalth centers, this transition has becen slow. In 1993, thcre werc reportedly only eleven public health facilities. out of about 400. providing contraccptive information and services. All arc located in urban arcas and are directly supported by donors, particularly UNFPA and USAID. FP activitics are also provided to a limited cxtent by: (i) the Ministry of Social Affairs within social ccnters in urban areas; and (ii) a fewv NGOs and religious organizations in their respective health centers. As cxpected. modern contraceptive prevalence is verv low (less than 2%) although it has clearly increased in areas where FP services arc availablc. In N'djamena, the estimatcd contraccptive prevalence rate (CPR) has incrcased from 2.9% in 1992 to 4.0% in 1993 (Division du systLme d'information sanithaire - DSIS - MAinistlre de la Sante I)ublique). The actual rate for N'djamcna is highcr as contraccptivcs sold in privatc pharmacies are not accounted for. However, other rcgions like the Logone Occidcntal have very low CPR (0.3%). Oral contraceptives are the method preferred by women; injcctables and condoms rank second and third respectively. The utilization rate of I.U.D. and female barrier methods is insignificant due to socio-cultural factors and lack of public awareness of risk behavior. 2.11 External Aid. Many donors have been active in the population/FP sector, with UNFPA. USAID, and IDA providing the largest support IPPF supports the activities of its affiliate. the Association 7chadienne du Bien-FA en Afrique de VIH/MST/SIDA. l'Ouest. i0 i o -2- ACTIVITES BENEFICES ATTENDUS 1995 1996 1997 1998 1999 3. Fonnation Locale * Medecins (pnse en charge * Generalisation de l'utilisation * 30 medecins fonnes dans la prise * 30 medecins formins dans -- MST). d'algorithmes adaptes au Tchad pour la en charge des MS1. la pnse en charge des MST prise en charge des MST. * lnfirmiers (prise en charge * Generalisation de lutilisation * 75 infinmiers des districts fonnes * 100 infirmiers des MST). d'algorithtnes pour la prise en charge dans la prise en charge des MST. districts forrn6s dans la des MST. prise en charge des MST. * Mddecins (clinique SIDA). * Amelioration des capacites de * 30 medecins fornmes en clin iqtue * 30 m6cdecins recyclks en diagnostic et de prise en charge du SIDA. clinique du SIDA. clinique du SIOA. * hIfirmiers et assistants sociaux * Developpernent dans cinq centres * 30 techniciens (15 intinniers et en appui psychosocial. prefectoraux des competences en 15 assistants sociaux) forTnes en appui psychosocial pour les conscils psychosociaux. seropositifs avec ou sans SIDA. * Cadres prefectoraux (en * Amelioration des capacites de * 15 cadres des 15 prefecturcs gestion de programme du SIDA) gestion des activites li&es aux sanitaires formes en gestion de MST/SIDA dans toutes les programme. prefectures. * Personnel de sante des * Ameliorer la qualite des prestations * 7 medecins et 2 fonnateurs * 7 inedccins et prefectures du Logone Occidental des soins relatives aux MST/SIDA prefectoraux Ibormes. 2 foniatetirs et du Logone Oriental, en ciniquie dans les centre de sante et h6pitaux recycles MST/SIDA. des detix prlefctures. * 180 infinniers et techniciens * 60 innirmiers et * 90 infinniers * 90 iifirmiers Ionies. techniciens formi s. recyclks recycles. 4 Organisation d'un atelier * Evaluation anntielle des progres * Elaboration d'utn rapport de Idern Idern Idem Idem annuel pour la revue et la r6alisds, des contraintes rencontrees et I'atelier et diffusioii a toties les reprogrammation des activites du des resultats des etudes et enquetes parties int&erssces. programme national de lutte par tous les intervenants. contre le SIDA. * Exarnen des strategies du PMT2. * Recommandations et reprogramnation des activites pour I'annee suivanite. CD -3- ACTIVITES BENEFICES ATTENDUS 1995 1996 1997 1998 1999 B) Appui i la recherche pideninologique, operation- neDe et socio-econondque. . I Developpement do * Armelioration de la qualite * 14 enquetes * 14 enquetes sentinelles * 14 enquetes senti- * 14 cnquetes senti- * 14 enquetes senti- systeme de surveillance des donnees pour le suivi des sentinelles r6alis&es (7 realis6es (7 X 80() femmes nelles realisees (7 X 800 nelles realisees (7 X 800 nelles realises sur (7 sentinelle du tendances de la prevalence des X 800 enceintes et 7 X enceintes et 7 X 400 feimnes enceintes et 7 X Ieninmes enceintes et 7 X X 800 femmes encein- VIl/MST/SfDA Vl I/MST par site sentiiielle 400 porteurs de MST). porteurs de MST). 400 porteurs de MST) 400 porteurs de MST) tes et 7 X 400 poneurs de MST). 2 Realisation d'etudes de * Disposer d'informations sur * Une enquEte de * tine enquete de * Jne enquete de * Une enquete de * Une enquete de prevalence du VIH/MST les cornelations entre prevalence aupres des pr6valence aupres des prevalence aupres des prevalence aupres des prevalence aupres des aupres de groupes cibles comportements de certains Jeunes routiers iilitaires prostitu6es jeunes specifiques groupes et niveaux de _revalence des MSI /VI l. 3 R&alisation de deux * Connaissance et suivi de * lJrie enqiijtc ('Al' * nce 1 l nqeicte CA I' enquites CAP 1'6volution des profils socio- nationiale realisde naitioriale realisee. comportementaux relatifs aux VIHI/MSTI 4. Realisation d'uwe etude * Caract&risation de la * Etude de mesure des sur la mesure des [PP situation en termes d'adoption 11'1' ralisee. de mesures preventives Ptromues par le PNIS S. Realisation des ctudes * Elaboration d'algoritflues, * Uiie etude pour * tJIi etudc pour Iclabo- op&rationnelles pour le MSTI et le SIDA, et d'un I'adoption des iationl d'un ii otocolC poUr protocole pour I'APMS algorithnies pour les I'APMS realisde Evaluation de la capacitk MST predictive positive de la * tJne etude pour l'eva- definition clinique du SIDA et * Une etude pour lualion de la definition adopter apres e~valuation le I'adoption des clinique du SIDA realise. schema therapeutique chez les algorithmes pour Ie tuberculeux VIIf positifs. SIDA * Une etude pour la relation VlirfIubcrcuilose realisee. 6. Appui a l'etude de * Analyse de limpact socio- * Economiste l'impact socio-economique economique du SIDA au niveau iteiiatiotial recrute (3 du SIDA individuel, familial, perso nales/ntois) conununautaire et macro- * Etude de l'impact economigue. realisee. 0 X - 4 - OBJECTIF 4: PROMOUVOIR LA PARTICIPATION DU SECTEUR PRIVE ET DES ONGS ACTIVITES BENEFICES ATTENDUS 1995 1996 1997 1998 1999 Developpement de * 415,000 1chadienis * 2 prefectures sonit * 4 prelectures soil * 6 prefectures sont * 10 prefectures sont * 14 prefectures sont projets pour l'IEC el devront benreficier de chaciie couverte par un chacuiie couverte par ul chacune couverle par un chacune couverte par an chacunc couverte par un I'appui psycho-medico- contacts educatifs, projet IEC/jeunes. projet LEC/jeunles projet IEC/jeunes. projet IC/jeunes. projet IFC/jeunes. social informatils, et preventifs (usage de preservatifs) pour . 3 prOfecturcs sont * 3 prd'ectures sont * 4 prefectures sont * 5 prefectures sont * 7 prdekctures sonti eviter 27 a 29,000 nouvelles chacune couverie par tn chacune couverte par un chacune couverte par un chacune couverte par un chacune couverte par un infections par le VIli. projet IEC/fenunes libres projet lEC/fenunes projet IEC/feimies projet 11C/Iemmes projet FEC/femmes libres libres. libres libres 21,000 familles devraient . 4 secteurs sociaux sont * 5 secteurs sociinix * 6 secleurs sociaux * 7 secteurs sociaux * 7 sectetirs sociauix beneficier d'une assistance chacun couvert par un projct soilt cliacIIn colvert pal soil1 chIacuin cotivert palr soil( ch.lcoln couvert par soni chactin couivert par medico-sociale a base [ltC/SII)A ulii projet IlEC/SII)A. um projet IEC/SIDA uon projet II (/SII)A on projet IEC/SU)A communautaire pour reduire 'imnpact du SIl)A a leur * Un centre d'APMS * Un centre d'APMS . Un ccntre APMS . Un centre d'APMS * UJn centre d'APMS niveau. commwuautaire ou comxiimaulaire est coilnitiiiatalire est coiinuLiautaire es( comounuiautaire est fonctionnel dans une Ibnctionnel dans deux tonctionnel dans 3 fonctionnel dans 4 fonctionnel dans 5 prc-fecture. pr6fectures. prefectures. prefectures prefectures. n * Jn projet IEC/mnigrants/ * Un projet IlEC/ * 2 projets * 2 projets * 3 projets routiers est en cours inigrants/routiers est en IEC/inigrants sont en ElC/migrants sont en IEC/migrants sont en d'execution cours d'execution. cours d'extension. cours d'extension cours d'extension. * 2 projets dynamiiisateurs * 3 projets * 4 projets * 4 projets * 4 projets sont oprationnels dynamisateurs sont dynamnisateurs sont dynainisateurs sont dynamisateurs sont operationnels. operationnels. operationnels. operationnels. 0 CIIAI) POIltJLA'l'ION ANI) AI)S CON'I'ROI, PROJFCT [RAINING lPR(XiRAM Component/Sub-Coniponent Plarticipants Training Activity 4 of Participanits SW Executing Agency A POPULAIlON COMPONENT 1) Institutional Strengthening of the D)ivision Stalf Statistical data analysis 2 48 CERPOD) Dlivision of Population - Population/Development 2 24 CERPOD - P'opulation/l)evelopment 1 24 IfP/Dakar - Popiilation progiams 1 30 CIl)EP/Louvain Dreniogriphy I 8 CERPOI) - Eclloxkship on demography I 108 Pans/13cigium -SUdy 'lour i other counitries to I 1(0 Abroad gaiii 1rom experience in populationi piogramns Project Team - Procurement 2 20 Abroad - i'roject maniagemileint 2 8 Abroad - Participate in int'l conferences 3 41 Abroad , 2) Raising Public Awareness Mass media 7Seminar 30 30 Plopulation Division - Opinion leaders Seminar 50 50 Population Division - Government and CST Seiiinar 50 50 Population Division - Prefects and other officials Seminiar 25 25 Population Division - NGOs Seminar 40 40 Population Division Union representatives Seminar 30 30 Population Division - Youths, women - Seminiiar 50 50 Population Division - Represeintatives of the medical Seinimimar 50 50 IPopulation Division prolession - Fanners S Seminar 5() 50 Population Division B. AIDS COMPONENT I) Institutional Strengthening of the - Regional physicians STD/AIDS clinical training 8 8 District Trainer PNLS and the DSIS - Nurses and technicians STD/AIDS clinical training 232 232 District Trainer - INLS Staff - Fellowship in MPII I 36 Abroad > -[EC I 12 Region x -Epideniiology 1 16 Region tm~ - Epidemiology and statistics 2 72 Abroad - 2) Social Marketing - Unit Staff - Study tours to observe other social 1 6 Abroad o markeling programs - Procurement and MIS 1 3 Abroad - Promotional activities 1 2 Region CHAD POPULATION AND AIDS CONTROL PROJECT % % Total Components Project Cost Summary (CFAF '000) (USS '000) Foreign Base Local Foreign Total Local Foreign Total Exchange Costs A. Reinforce the national capacity to implement the national population policy 1 Strengthening the national capacity to undenake population-related activities 1,043,608 9 893 364 5 1 936 973 4 2 037 3 1 744 0 3 781 3 46 15 2 Implementing a public awareness program and dissemination of the population policy 31,886 0 1.331 100 0 1 362 986 0 62 2 2 598 5 2 660 8 98 11 3 Supporting population-related studies and research 237.018 4 73 837 5 310 855 9 462 7 144 1 606 8 24 2 Subtotal 1 312 513 3 2 298 302 0 3 610 815 3 25623 4,486 7 7 048 9 64 28 B. Strengthen the national capacity to contain the spread of HIV/AIDSISTDs 1 Institutional strengthening of MOPH 630 491 9 706.247 5 1 336,739 4 1 230 8 1 378 7 2 609 5 53 11 2 Supporting epidemiological operational, and socio-economic studies and research 1,269 815 8 395,581 3 1,665.397 1 2 478 9 772 2 3 251 1 24 13 Subtotal 1,900 307 7 1101,828 8 3,002,136 4 3709 7 2r151 0 5,860 7 37 24 C. Promote the participation of the private sector and NGOs In population, Family Planning, and HIVIAIDS/STDs 1 Population Activities 307,500 0 307 500 0 615 000 0 600 3 600 3 1.200 6 50 5 00 2 AIDS Activities 1,120,970 0 1,101 080 0 2,222 050 0 2,188 3 2,149 5 4,337 8 50 17 Subtotal 1,428,470 0 1,408,580 0 2 837 050 0 2.788 6 2,749 8 5,538 4 50 22 D. Put in place a social marketing program for the promotion of condom use 1,064,324 3 2.203 904 4 3 268 228 7 2,077 7 4,302 4 6,380 1 67 26 Total BASELINE COSTS 5 705.615 3 7,012,615 1 12,718,230 4 11,138 3 13 689 8 24 828 2 55 100 Physical Contingencies 196,247 0 296,820 9 493,067 9 383.1 579 4 962 6 60 4 Price Contingencies 378,643 5 371,424 1 750,067 6 739 2 7251 1,464 3 50 6 Total PROJECT COSTS 6,280,506.8 7,680,860.1 13,961,366.0 12,260.6 14,994.4 27,255.0 55 110 CrD< _ CHAD POPULATION AND AIDS CONTROL PROJECT Project Components by Year - Investment/Recurrent Costs (US$ '000) Totals Including Contingencies 51I96 96/97 97;98 98/99 99100 Total A. Strengthen the national capacity to implement the national population policy 1. Strengthening the ntl capacity to undertake population-related activities investment Costs 962 5 379 4 478 9 327 0 407 5 2,555 1 Recurrent Costs 359 5 3241 307 7 334 6 316 9 1 642 7 Subtotal 1322 0 703 4 786 5 651 6 724 3 4197 8 2. Implementing a public awareness program and dissemination of the population policy Investment Costs 403 8 523 0 635 3 733 6 854 3 3 150 0 3. Supporting population-related studies and research Investmne'it Costs 480 6 218 7 - 69 3 Subtotal A 2 206 3 1445 2 1 421 9 1 395 2 1 578 6 8,0471 B. Strengthen the nt'l capacity to contain the spread of HIVIAIDSISTDs 1. Institutional strengthening of MOPH Investment Costs 763 5 307 0 141 6 155 4 96 3 1 463 7 Recurrent Costs 285 2 270 2 274 4 278 3 282 3 1 390 5 Subtotal 1048 7 577 2 416 0 433 7 378 6 2,854 3 en 2. Supporting epid., operational, and socio-economic studies & research Investment Costs 738 0 7031 755 5 822 0 712 4 3,731 0 Subtotal B 1786 7 1,280 3 1 171 5 1 255 7 1,091 0 6 585 3 D. FOSAP I Population activities investment Costs 2401 2401 2401 2401 2401 1 200 6 2. AIDS activities Investment Costs 5191 6584 8532 1047 8 1 2703 43488 Subtotal D 759 2 898 6 1093 3 1.287 9 1510 4 5 549 4 C. Put in place a social marketing program for the promotion of condom use Investment Costs 1512 2 956 2 1,011 0 898 0 904 7 5 282 1 Recurrent Costs 3401 350 4 358 9 366 8 374 9 1,791 1 Subtotal C 1852 3 1306 6 1.369 9 1 264 8 1,279 6 7 073 2 Total PROJECT COSTS 6,604.6 4,930.7 5,056.5 5,203.6 5,459.5 27,255.0 Total Investment Costs 5 619 8 3 986 0 4 115 5 4 223 8 4 485 4 22 430 6 Total Recurrent Costs 984 8 944 7 941 0 979 8 9741 4 824 4 o 0 CA CHAD POPULATION AND AIDS CONTROL PROJECT Components by Financler Local (USS '000) Government IDA KiW UNFPA Communttles Total (ExCI. Amount X Amount % Amount X Amount X Amount X Amount X For. Exch. Taxes) A Reinforce the national capaity to Implement the national population pollcy 1 Strengthening the national capacity to undertake populaton-related actMhes 6110 146 35235 839 - - 634 15 - - 4,1978 154 19401 2,2577 2 Implementing a public avareness program and drsseminat,on of the population pocicy 0 0 31341 99 5 - - 15 0 5 - 3,150 0 116 3 078 7 713 3 Supporting populabtion-related studies and research - - 699 3 100 0 - - 699 3 2 6 162 7 536 6 Subtotal 611 0 7 6 7 357 0 914 - 79 2 1 0 - - ,047 1 29 5 5,1S1 5 2. 657 B. Strengthen the national capacity to contain the spread of HIVIAIOSISTDs 1 Institutonal strengthening of MOPH 524 6 18 4 2.329 7 81 6 - - - - - 2,854 3 10 5 1 510 2 1,344 0 2 Supporting epidemiological, operational, and socio-econon,c studies and research 00 6 3,731 0 10 3,731 0 13 7 866 3 2,864 7 Subtotal 524.6 6.0 6.060 7 92 0 - - 6.585 3 24 2 2.376 5 4,208 7 C. Promote the participatlon of the private sector and NGOs In population, Faimly Planning, and HIVIAIDSJSTDs 1 Population Actrviies - - 995 6 82 9 - - - 205 0 17 1 1,200 6 4 4 600 3 600.3 2 AiDS Actities 0 0 - 3,638 2 83.7 - - - - 710 6 16 3 4,348 6 16 0 2.151.7 2,197 1 Subtotal 0 0 - 4,633 8 835 - - - - 915 6 16 5 5,549 4 20 4 2,751.9 2,797 4 D. Put in placa social marketing progrm forthe promotion of condom use 1424 20 2,4157 34.2 4,397.7 622 - - 1174 17 7,073 2 260 4,6844 2,388.8 Total Disbursement 1,277 9 4 7 20.467 2 751 4,397 7 16.1 79 2 0 3 1,033 0 3 8 27,255 0 100 0 14,994 4 12,260 6 o X CHAD Population and AIDS Control Project Disbursement Accounts by Financiers Local (USS 000) Government IDA KfW UNFPA Communities Total (Excl. Amount % Amount % Amount % Amount % Amount % Amount % For. Exch. Taxes) A. Civil Works 0 0 - 160 188 69 2 81 2 85 2 0 3 63 1 22 0 B.Goods 1 Equipment - - 510 18 3 227 6 81 7 - - - - 278 6 1 0 278 6 2 Materials and furnture 00 167 5 100 0 - - - - - 167 5 06 122 0 45 4 3 Vehicles - - 577 9 65 2 308 4 34 8 - - - - 886 3 3 3 886 3 Subtotal Goods 0 0 796 4 59 8 536 0 40 2 - - - 1,332 4 4 9 1,286 9 45 4 C. Condoms - - 904 5 55 0 740 0 45 0 - - - 1,644 5 6 0 1,644 S D. Contraceptives - - 3,0480 1000 - - 3,0480 11 2 3,0480 E. Other Consuhants'Services 1. National Court terme 0 0 455 9 100 0 - - - - - - 455 9 17 115 6 340 3 Long term 0 0 - 84 9 100 0 - - - - - - 84 9 0 3 19 7 65 2 Subtotal National 0 0 - 540 8 100 0 - - - - 540 8 2 0 135 3 405 5 2. Intemational Shortterm 00 - 1,1861 956 550 44 - - - - 1,241 1 46 1,0515 1896 Long term -0 0 -0 0 217 8 19 0 928 5 81 0 - - - - 1,146 3 4 2 1,146 3 Subtotal International -0 0 -0 0 1,403 9 58 8 983 5 41 2 - - - - 2,387 4 8 8 2,197 8 189 6 3. Contractual Personnel - - 869.4 67 7 414 7 32 3 - - - - 1,2841 4 7 - 1,2841 Subtotal Other Consultants' Services -0 0 -0 0 2,814 2 66 8 1,398 2 33 2 - - - 4,212 4 15 5 2,3331 1,879 2 F. Tralning Local 00 - 1846 816 411 182 06 03 - - 2262 08 397 1866 Abroad - - 513 3 93 4 - - 36 4 6 6 - - 549 7 2 0 5497 - SubtotalTraining 00 - 6979 899 41 1 53 370 48 - - 7759 28 5893 1866 G. Studies & Research 00 - 4,4303 1000 - - - - - - 4,430 3 163 1,029 0 3,401 3 H. FOSAP Population ActMties - - 995 6 82 9 - - - - 205 0 171 1,200 6 4 4 600 3 600 3 H. FOSAP _ 3,5533 833 - 7106 167 4,2639 156 2,131 9 2131 9 Sub Population Actrvities - 4,548 9 83 2 - - - 915 6 16 8 5,464 4 20 0 2,732 2 2,732 2 I. IEC 00 4581 391 6964 595 158 1 4 - - 1,1704 43 5550 6154 J. Recurrent Costs 1. Operating Costs O&M of vehicles, matenals, & eq 258 2 12.4 1,169 6 56 3 558 0 26 9 188 0 9 71 5 3 4 2,0761 7 6 979 2 1,096 9 Consumables 27 8 2.1 879 4 66 8 358 8 27 3 4 8 0 4 46 0 3 5 1,316 8 4 8 430 6 886 2 Subtotal Operating Costs 286 0 8 4 2,049.0 60 4 916 9 27 0 23 6 0 7 117 4 3 5 3,392 9 12 4 1,409 8 1,983 1 2. Supervision missions 15 8 4 3 353 8 950 - - 2 8 0 8 - - 372 4 1 4 78 3 294 1 Subtotal RecurrentCosts 3018 80 2,4028 638 9169 244 264 07 1174 31 3,765 3 138 1,4881 2,2772 K. Ministry Personnel 9761 100 0 - - - - - - - - 9761 3 6 - 9761 L PPF - - 3501 100 0 - - - - - - 3501 1 3 225 0 1251 Total 1,277.9 47 20,467.2 751 4,397.7 161 79.2 03 1,033.0 38 1000 14,9944 12,2606 o X CHAD Population and AIDS Control Project Expenditure Accounts Breakdown (USS '000) Base Cost Physical Contingencies Price Contingencies Total Incl. Cont. Local Local Local Local (Excl. For. (Excl. For. (Excl. (Excl. For. Exch. Taxes) Total Exch. Taxes) Total Exch. Taxes) Total For. Exch. Taxes) Total I. Investment Costs A. Civil Works 60.7 20 7 81A4 1 2 0 4 1.7 1.2 0.9 2 1 631 22.0 85 2 B.Goods 1 Equipment 2505 - 250.5 22.8 - 22.8 5 4 - 5A4 278.6 - 278.6 2. Materials and furniture 126.2 437 1699 122 43 16.5 33 2.9 6.2 141 8 508 192.6 3. Vehicles 816.1 - 816 1 35.9 - 35.9 34.2 - 34.2 886.3 - 886.3 SubtotalGoods 1,1928 43.7 1,2365 70.9 4.3 75.2 42.9 2.9 459 1,306.7 50.8 1,357.5 C.Condoms 1,521.7 - 1,521 7 - - - 122.8 - 122.8 1,644.5 - 1,644.5 D.Contraceptives 2,571.0 - 2571.0 2571 - 257.1 219.9 - 219.9 3,048.0 - 3048.0 E. Consultants' Services 1. National Shortterm 101.2 290.0 391.3 51 14.5 19.6 71 30.0 37.1 113.4 3345 447.9 Long term 17.6 564 74.0 0.9 2.8 3.7 1 3 6.0 7.3 19.7 65.2 84 9 Subtotal National 118 8 346.4 465.2 5.9 17.3 23.3 8.4 36.0 44 3 133.1 399.7 532.8 2. International Shortterm 1,121.1 232.1 1,353.2 45.2 8.7 53.9 51.2 12.8 64.0 1,217.5 253.6 1,471 1 Long term 1,030.7 - 1,030 7 51.5 - 51.5 64.1 - 641 1,146 3 - 1,146.3 Subtotal International 2,151.8 232.1 2,3839 96.8 8.7 105.5 115.3 12.8 128.1 2,363.8 253.6 2,617 4 3. Contractual personnel - 1,113.4 1,113.4 - 72.5 72.5 - 118.2 118.2 - 1,3041 1,3041 SubtotalConsultants'Services 2,270.6 1,691.9 3,9625 1027 98.5 201.2 1236 167.0 290.6 2,4969 1,9574 4,454.4 F. Training Local 353 161 9 197.2 1.8 81 9.9 26 166 192 39.7 186.6 226.2 Abroad 500.8 - 500 8 25.0 - 25.0 23.9 - 23.9 549 7 - 549.7 Subtotal Training 536.1 161.9 6980 26.8 81 34.9 26.4 16.6 43.0 5893 186.6 775.9 G. Studies & Research 9164 2,941.6 3,858.0 53.0 170.2 223.2 59.6 2895 349 1 1,029.0 3,401.3 4,430.3 H. FOSAP Populaton Actvities 600.3 600.3 1,200 6 - - - - - - 600.3 600.3 1,200 6 AIDS Activibes 2,131.9 2,131.9 4,263.9 - - - - - - 2,131.9 2,131.9 4,263.9 Subtotal FOSAP 2,732.2 2,732.2 5,464.4 - - - - - 2,732.2 2,732.2 5,464 4 I. IEC 521.2 559.7 1,080.8 1.4 3.1 4.5 32.4 527 85.1 555.0 615.4 1,170.4 TotallnvestmentCosts 12,322.7 8,1516 20,474.3 5132 284.7 797.8 628.9 529.6 1,1585 134647 8,965.9 22,430.6 II. Recurrent Costs 1. Operating Costs O&Mofvehicles, materials, &eq 903,7 9800 1,883.8 436 474 91.0 633 101.0 164,3 1,010.7 1,1284 2.1391 Consumables 393.6 776.3 1,169.9 192 383 57.5 278 816 1094 4406 896.2 1,3368 2 Supervision missions 69.8 254.3 324.1 3.5 12.7 16.2 5.0 27.1 32.1 78.3 294.1 372.4 Subtotal RecurrentCosts 1,3671 2,010.6 3,377.8 66.3 98.5 164.7 96.2 209.6 305.8 1,529.6 2,318.7 3,848.3 K. Ministry Personnel - 976.1 976.1 - - - - - - - 976.1 976.1 Total Recurrent Costs 1,367.1 2,9867 4,353.8 66 3 98 5 164.7 96.2 209.6 3058 1,529.6 3,294 8 4,824 4 Total 13,689.8 11,138.3 24,828.2 579.4 383.1 962.6 725.1 739.2 1,464.3 14,994.4 12,260.6 27,255.0 r, = ° 1> 63 Annex 4-1 Page I of 2 REPUBLIC OF CHAD POPULATION AND AIDS PROJECT Project Monitoring and Supervision Plan 1 .1 IDA Supervision Input. Regular supervision needs are described in Table I of this Annex. In addition, specific tasks such as review of progress reports, terms of reference, annual work plans and audits, and procurement and disbursement actions are estimated to require eight staffweeks of various specialist inputs a year which are not included in Table 1. Borrower's Contribution to Supervision (a) Progress reports would be submitted twice a year, in April and October. They would include a summary of implementation under each project component, financial statements on project expenditures, updated project implementation and procurement schedules, as well as the status of contract advertising, bidding, awards and completion dates and compliance with aggregate limits on specified methods of procurement. The PCT would collect inputs from each responsible MOH Directorate and other implementing agencies and prepare the reports. (b) Joint annual reviews. Once a year, no earlier than October, and no later than December 31, the PCT will organize a joint IDA/Government review of project implementation based on: (i) the progress report in the above paragraph which, for the purposes of the annual review, would also include an annual work program and budget for the next project year; (ii) the AIDS budget of each of the lead ministries for the next year; (iii) a status report of the FOSAP projects, and (iv) the status of monitoring indicators. (c) Mid-Term Review. In addition, the PCT would carry out, jointly with IDA, and, to the extent available with other donors affiliated with the project, not earlier than October 1 and not later than December 31, 1997, a mid-term review of the progress made in carrying out the project. The review would cover all aspects of the project, and will be made on the basis of a report prepared 45 days earlier by the PCT. Based on the review, the MSP shall promptly prepare an action plan, acceptable to IDA, for the further implementation of the project and shall thereafter implement such action plan. (d) The PCT would be responsible for coordinating IDA supervision missions and participating in them. (e) Project Completion Report. Within six months of the Credit closing date, a project completion report, and a plan for the future operation of the project, prepared in accordance with terms of reference satisfactory to IDA, would be transmitted to IDA. 64 Annex 4-1 Page 2 of 2 SUPERVISION PLAN II)A FISCAIL Yl-AR (FY) STAIF ANI) APPROX AC'I'IVI'I'Y SKILL REQUIREMENTS WI'EKS FY 96 CONI)IT'ION OF EIFFECTIVENESS. I)ROCURJ'ME'N''/IMPlIEMIEN'I'A'I'ION, 6 JILY 95 PROJECTL AUNCII WORKSHOP AND I)ISI3URSEMI'NT, POPULATION, FIRST SUPE'RVISION MISSION 'O AIDS, ANI) I'ROJEI'C'I' MANA(iIEME.N'I'. REVIEW PROJECT START-UP AND PROCIURI MEINT I SI' OIN'I' ANNI JAI REVIEW MISSION: 6 OCT. - NOV. REVIEW PROGRESS OF PAST SIX POPULATION, AI)S, 1995 MON'I' IS, WORKPILAN ANI) 3UDGI,T I'OCURE.ME.N'FT/MPI.lEMEFN'I'A''ION, FIOR NEXT YEAR TRAINiNG, IFC SUPERVISION MISSION 4 APR -MAY SAME AS AB3OVE 1996 6 FY 97 2NI) JOINT ANNUAI RE,VIEW MISSION: POIPULATION, AIDS, OCI. -NOV. RE.VIEW PROGRESS OF) PAST SIX PR1OCURIEMlENTI'IMPLEMENTFATI'ION, 1996 MONTI IS, WORKPLAN AND BUDGET T'RAINING, ITC FOR NEXT YEAR 4 APR. - MAY SIII'ERVISION MISSION SAME AS ABOVE 1997 6 I'Y 98 MID-'IERM REVIEW: COMPRE.1E1NSIVE' SAME AS ABOVE' + FINANCIALI OCT. - NOV REVIEW OF PROJECT INPUTS, ANALYST 1997 OPERAI'IONS AND OUTCOMES AND RESTRIJCTU'. PROJECT IF NECESSARY 4 AP'R. - MAY SUPERVISION MISSION SAME AS ABOVE' 1998' 6 FY 99 3RD) JOINT ANNUAI. RI`V-i.W MISSION SAME AS ABOVE OC'I' -NOV 1998 4 APR] - MAY SUPERVISION MISSION SAME AS ABOVE 1 999 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 6 FY 200() 4I-1 JOINT ANNIIAI, REVIEW MISSION SAME AS ABOVE OCI. - NOV 1 999 4 APR. - MAY SUPERVISION MISSION SAME AS ABOVE 2000 6 FY 20() I PROJECI COMI'I.ITION MISSION TO BE DETERMINED NOV. - DEC, 2000 CHAD OPUJtATION AND A106 CONTFo)L PROJCT PROCUREMENT ARRANGEMENTS I PROJECT IMPLEMENTATION SCHEDULE Prn-prol.ct Pr olct Yost Total Procure Finn -Ing 1 °t__ 1 °DS__ 1994 199" 1998t 19991/9 199991 00 P.rrne -4nl Alloc.tlon Quarers t. 2 L 2 L 4 3 t4 112t.2. 1 3.14.. ..L.t..2At.3.. 1 L4. 1..2 -3..L4.. ..1.t2.L.3.. L4 USS0 Method Iutr ooo Board Slgfletur.ISIIactlo.n.aaIClo.lng KK ______.__ _-_________ A. G0ODS 1,334 1. 0fke EquIprmnt & Supptlo- 44t 11 Office e qiprrn A &supple ddbzearr~w 281 LCBflA - MPH program _ 32 OTH IDA IEC w 3 OTH IDA - Epidemiokogy w 4 OTH IDA Masters in Epidlstist 65 es 0TH IDA - Other tninng for DSIS ea1 0 OTH IDA C. SOCIAL MARKETING PROGRAM 13 - Training for Marketing Unit stal 1 NBF NBF Local 226 A. POPULATION POtlCY 55 1. Insttutional Stngthening of the 55 Populaton Division - Seminar on integrabng demog variables w w w 31 OTH IDA into planil programs - Seminar on Populabon & Delopment w w 24 OTH IDA B. HlVIAIOSISTDO 110 1. InsftrtlonaI Strengthening of the PNLStDSIS Worsiops on Nabonal AIDS Pogram w w w w w 67 OTH IDA - Worshop on STD/AIOS clinic w 3 OTH IDA - Woslhop on ST70AIDS clinic w w w w 0 OTH IDA C. SOCIL MARKETING PROGRAM - Training hr Marketing Unit stall 55 NBF KIW 0 1 1-h N) Prm-project ________Project Year ________Total Procure Finvanclng 1994 II995196 1996197 11997198 19913199 11999)00 Payment ..entn Allocation Qualrters ..1.I.2.1I.3.1.I. .1i..2.4-.3-11A4.. ...I..2-3..I. 4 I 1 4 . tI..I.... ..2..I..3.1.4.. USS-000 Method (SOO F. STUDIES & RESEARCH ______________ _______4430 ____ LOITfORs/Sh L br Appr,' ddb AwiirdtConeci re.,I ~byIDA eec___________ A. POPULATION POLICY69 *MignifionfJUrtanlzalon 216 OTH IDA *Cents.4 enalysis 58 OT-I IDA * en,og srn"y w~m423 OTH IDA S. HIVIAIC)S/STDs 3.735 0TH IDA *Sentinel system w.w#w VW652 0Th IDA *Sursys tronswmsales 2727 OTh IDA *KAP ww~153 OTH IDA *Priority prewention indicators measures so 0ThA IDA -STDs algoxithms a 0TH IDA *AIDS algornthmns 6 0TH IDA -APMS protocol a 0TH IDA * llAuberculo. relaionship 6 0Th IDA *Epidem. research w~w6 01Th IDA -I-Jealth centers mnanagerment lv 24 O0TH IDA B eneficiaries ass iment of1 heath centems 12 0TH IDA in the sLahelian zore 51 0Th IDA *Dislri hospitals mnanagemrent a________'A 0TH I IDA 13. IEC I I70 A. POPULATION POLICY 11. Public Awareness-Ralslrrg Program 102 -Seminars on National Populabion Poiscy -73 OTIAJUNFPA IDA 8 2, UNFPA 1 i1 -RadoroTV ectr"ties ~ ~ w w ~ ~ * ~ ~ ~~28 OTI-IJNPA IDA = 24; UNFPA 5 C. SOCIAL MARKETING PROGRAM Bel - Pmr.omaonal actretres ________881 NBF K(1W H. FOSAP 5__ _ _ _ _ ___ _ _ _ _ _ _,465 I. Population ActIvtIes vwnv1we1wnww~ vw% VfV*frN%W~WVW wa1-w Vey^w*wffww 1,201 0Th/Commiu IDA = 1.0, Corn =201 2. AIDS ActlItIes ~w w w ~ w w w w w4,284 OTHI-Comnru IDA = 3,500. Corn =784 I OPERATING COSTS _______ ______________ 5,650, )DA w w w~we ~ W W #4.451 OTH UJNFPA 51 NBF commurrntres v ~ ' 117 NBF GOVT ____________ lwwwwww lwwwswwwm Iw-4www iw ww.w 1.279 NBF J. PPF REFINANCING ____________________________________________ 5 0Th Total IDA 1 9,440 Not BanIk-fintancedl: .1(1W 4.220 - ovt 1,264 * Communities i,oso -UNFPA 70 TOTAL COST 27 2551_____________ id,TORs- b b.ddingpernod.- .evluation -A.SankinGoxI appr. c: contrac signature - w. execution eq services CAD 0I-L CHAD POPULATION AND AIDS CONTROL PROJECT Disbursement Profil Disbursements Profile 100% IPopulation ard A.ds Control Project IDA fiscal years Regiooal - Regional Sector Profile and quarters By Quarter Cumulative Creddt Sector 90% (US$ -irlion) US$ I011o 1%) I%E 80% 1996 1 0% 0% 2 0% 0% 3 0.2 0 2 1 % 3% et 70% 0 4 4 0 2 0 4 2% 6% 1997 1 0 5 0 9 5% 6% t 60% 2 05 1 4 7% 6% 3 0.7 2.1 11% 6% trL 0 2 4 4 07 2 8 14% 6% e 50%0 1998 1 0a9 3 6 19% 8% 2 0.8 4 4 23 % 10% d4% 3 0 8 5 2 27% 12% 40% 3.2 4 08 6.0 31% 14% 1999 1 10 7 0 36% 16% ?L 30% 2 10 890 41S% 18% 3 1 5 9 S 49% 24% . 20% 5 0 4 15 1 1 0 57% 30% .2 20% 2000 1 15 125 64% 36% E 2 15 140 72% 42% Q 10% 3 1.3 15 3 79% 48% 5 6 4 1 3 16 6 86% 54% 2001 1 1 1 177 91% 60% 0% 2 07 184 95% 66% 1996 1997 1998 1999 2000 2001 3 05 18.9 97% 70% 128 4 0.S 19 4 100% 74% Fiscal Year (Exercice) o -4 dist, els~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 69 Annex 4-4 Page l of3 REPUBLIC OF CHAD POPULATION AND AIDS CONTROL PROJECT Documents in the Project File "Plan d'activites 1995-1999", PNLS, Tchad, 1995. Rapport de Mission "Interventions multisectorielles: I'approche par projets dynamisateurs", N'Djamena, 1994. "Programme Travail/Budget r6vise de l'ASTBEF suite a la devaluation du Franc CFA", N'Djamena, 1994. "Projet de lettre de politiques sectorielles", Gouvernement du Tchad, 1994. "Statuts revises"de 1'ASTBEF, N'Djamena, 1994. "Le CILONG en bref', N'Djamena, 1994. "Arrete No. 205/PM/MSP/94 portant adoption du Plan a Moyen Terme de lutte contre le SIDA (1995-1999)", Republique du Tchad, Ministere de la Sante Publique, N'Djamena, 1994. Rapport final de la "Reunion de mobilisation des ressources pour le financement du Plan a Moyen terme de lutte contre le SIDA 1995-1999", Republique du Tchad, Ministere du Plan et de la Cooperation, N'Djamena, Octobre 1994. "Activity Report 1993" CERPOD, Bamako, Aout 1994. "Loi No. 025/PR/94 portant adoption de la declaration de politique de population du Tchad", Republique du Tchad, Presidence de la Republique, N'Djamena, 22 juillet 1994. "Accord de projet: Appui a l'Unite de Population pour la mise en oeuvre de la Declaration de Politique de Population", N'Djamena, Juillet 1994. "Accord de projet: Education a la vie familiale et en matiere de population a l'ecole entre le gouvernement de la Republique du Tchad et le Fonds des Nations Unies pour la Population (FNUAP)", N'Djamena, Juin 1994. 70 Annex 4-4 Page 2 of 3 "Note technique relative a l'etude de prevalence des MST/VIH au Tchad", rapport de consultant, Juin 1994. "Plan a moyen terme de lutte contre le SIDA (1995-1999), Republique du Tchad, N'Djamena, Avril-Mai 1994. "Dossier technique sur la situation de la lutte contre les MST et le SIDA au Tchad", rapport de consultant, Mars 1994. "Rapport Annuel d'activites 1993", PNLS, Tchad, Janvier 1994. "Projet de declaration de la politique de population", Republique du Tchad, Ministere du Plan et de la Cooperation, N'Djamena, Novembre 1993. Rapport final de la "Mission d'examen de programme et de developpement de strategies en matiere de population en Republique du Tchad - Juin 93", N'Djamena, Septembre 1993. "Recensement general de la population et de l'habitat 1993, r6sultats provisoires", Republique du Tchad, N'Djamena, Juillet 1993. "Ordonnance No. 008/PR/93 portant reglementation de la contraception au Tchad", R1publique du Tchad, Pr6sidence de la R6publique, N'Djamena, Avril 1993. "Seminaire de sensibilisation sur les problemes de population au Tchad", Republique du Tchad, Ministere du Plan et de la Cooperation, N'Djamena, Janvier 1993. "Arret& No 0003IMPC/SE/DG/DPDRI93 portant creation d'un comite technique interministeriel sur la population", N'Djamena, Janvier 1993. "Note circulaire a l'attention des ministres, des responsables des ONG, des responsables des associations", Republique du Tchad, Ministere du Plan et de la Cooperation, N'Djamena, Janvier 1993. "Arrete No. 083/MPC/SE/DG/PDDR/92 portant creation d'une unite de coordination des activites en matiere de population", Republique du Tchad, Ministere du Plan et de la Cooperation, N'Djamena, Decembre 1992. "Rapport de Mission CERPOD de coordination de la formulation de la politique de population du Tchad", N'Djamena, Decembre 1992. "Programme Travail/Budget de l'ASTBEF 1993", N'Djamena, Octobre 1992. 71 Annex 4-4 Page 3 of 3 "Seminaire national en vue de definir un programme national de sante maternelle et infantile et de bien-etre familial", Commission pr6paratoire au seminaire, N'Djamena, Avril 1992. "Programme national de la sante maternelle et infantile et du bien-etre familial", N'Djamena, Avril 1992. "Arrete No. 193/MSPAS/SECASPF/DG/DPF/91 portant creation d'un Comite National pour l'Integration de la Femme au Developpement", Republique du Tchad, Ministere de la Sante Publique, N'Djamena, Novembre 1991 "Arrete No. 57/MSPAS/SE/DG/PNLS/91 fixant la composition, les attributions et les modalites de fonctionnement de la commission technique de lutte contre le SIDA", Republique du Tchad, Ministere de la Sante Publique, N'Djamena, Mai 1991. "Family planning data collection project in N'Djamena", Republique du Tchad, Ministere de la Sante Publique, N'Djam6na, n.d. MAP SECTION IBRD 26177 Thy boundaries, corors ~~~~' ~ ~ ~~~~ / ~~~~~~~~~~~' ~~~~~den n1otnaon s or t cws d , yornr numops do, orf impliy or) t,h pdg ,enh Or) irre9 stotus of any te-r,h;y o, anry crndorsc,uerri CHAD ! s or acceptance of soLB CHAD boun~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~hcrdaries POPULATION AND AIDS CONTROL PROJECT K Main Roads ( ~' Secondoary Roads Rivers Prefecture Boundaries j | Intertiational Boundaries t F Nokou / A|,,B It ne r f oo Mo,,,SS0 ef Bo,'--~ )t^usr ~~' ~ . SALMA \, '23 1jAl M'1~~u Konmia At n Mags m \ D aEasszc rM/Mssen. / \ > ~~~~~~Bousso Ame< A iBongo, -> | % /M SALAMAT9j J BonGorz ) JX k~~~ ~ ~~~~~~~~~e|/ er > K~~~~~~~~ounn,a / Sail , . I \. * ,X, ) ,.1 ~~~~~~~~~CĒMo'ssala> / ~~~~~~Bo bakoum\ MARCH 1 995