The World Bank Implementation Status & Results Report Maternal and Child Nutrition and Health Results Project (P143650) Maternal and Child Nutrition and Health Results Project (P143650) AFRICA | Gambia, The | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2014 | Seq No: 11 | ARCHIVED on 28-Jun-2019 | ISR37772 | Implementing Agencies: The Republic of The Gambia, National Nutrition Agency (NaNA) Key Dates Key Project Dates Bank Approval Date: 21-Mar-2014 Effectiveness Date: 20-May-2014 Planned Mid Term Review Date: 31-Jan-2018 Actual Mid-Term Review Date: 02-Feb-2018 Original Closing Date: 31-Jul-2019 Revised Closing Date: 30-Jun-2020 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) A. Proposed Development Objective The development objective of the project is to increase the utilization of communitynutritionand primary maternal and child health services in selected regions in the Recipient’s territory. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Community mobilization for social and behavior change:(Cost $4.31 M) Delivery of community nutrition and primary health care services:(Cost $12.37 M) Capacity building for service delivery, results-based financing, food and nutrition security and cash transfers:(Cost $4.00 M) Ebola preparedness and control:(Cost $0.50 M) Contingent Emergency Response Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating Substantial Moderate Implementation Status and Key Decisions Implementation is going well and the project is likely to fully achieve its development objectives. The project has scaled up to all five rural health regions, with all health centers and hospitals in these regions being covered. This has led to an increase in the delivery of community nutrition services, an increase in the number of communities being directly contracted through the community RBF scheme, and social and behavior change communication and community mobilization tools being implemented. The implementation of the RBF activities is successful and led to greater uptake in service utilization. The Project was restructured in March 2019 and the following changes were effected: (a) adjustment of the closing 6/28/2019 Page 1 of 10 The World Bank Implementation Status & Results Report Maternal and Child Nutrition and Health Results Project (P143650) date from July 21, 2021 to June 30, 2020; (b) reallocation between disbursement categories and (c) revision the results framework (such as clarifying the indicator formulation and definition, revising baseline and endline values, revising two of the PDO-level indicators from outputs to outcomes, introducing the new corporate results indicators, and including data sources for PDO-level indicators). The Ministry of Health (MOH), Ministry of Finance and Economic Affairs (MOFEA) and the National Nutrition Agency (NaNA) jointly developed an RBF Sustainability Roadmap in September 2018 which proposed a National RBF institutional framework with details on institutional sustainability, financial sustainability, and operational sustainability. A Program Operational Manual has been developed to help institutionalize the RBF approach in the health sector. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance -- Moderate Moderate Macroeconomic -- High High Sector Strategies and Policies -- Moderate Moderate Technical Design of Project or Program -- Moderate Moderate Institutional Capacity for Implementation and Sustainability -- Moderate Moderate Fiduciary -- Moderate Moderate Environment and Social -- Low Low Stakeholders -- Moderate Moderate Other -- -- -- Overall -- Substantial Moderate 6/28/2019 Page 2 of 10 The World Bank Implementation Status & Results Report Maternal and Child Nutrition and Health Results Project (P143650) Results PDO Indicators by Objectives / Outcomes Increased utilization of community nutrition IN00720467 ►Children 0-6 months exclusively breastfed (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 47.00 69.30 69.30 60.00 Date 21-Mar-2014 31-Dec-2018 21-Jun-2019 30-Jun-2020 The latest data source for the PDO-level indicators is 2018 multiple indicator cluster survey (MICS). Thus, the progress values will remain the same until the findings for the forthcoming 2019 DHS is released Comments: sometime in 2020. IN00720469 ►Children age 6-23 months consuming at least four out of seven food groups (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 7.60 22.20 22.20 20.00 Date 21-Mar-2014 31-Dec-2018 21-Jun-2019 30-Jun-2020 Comments: Increased utilization of primary maternal and child health services IN00720468 ►Deliveries in health facilities (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 43.00 75.70 75.70 60.00 Date 21-Mar-2014 31-Dec-2018 21-Jun-2019 30-Jun-2020 IN00720470 ►Women using modern contraceptives (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 3.50 15.00 15.00 15.00 Date 21-Mar-2014 31-Dec-2018 21-Jun-2019 30-Jun-2020 Overall Comments PDO The latest data source for the PDO-level indicators is 2018 multiple indicator cluster survey (MICS). Thus, the progress values will remain the same until the findings for the forthcoming 2019 DHS is released sometime in 6/28/2019 Page 3 of 10 The World Bank Implementation Status & Results Report Maternal and Child Nutrition and Health Results Project (P143650) 2020. Additionally, the progress values for some of the intermediate results indicators remain unchanged since the data is reported by calendar year. Intermediate Results Indicators by Components Component 1: Community Mobilization for Social and Behavior Change IN00720496 ►Pregnant women referred by village health workers and community birth companions for delivery and complication management (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 27,530.00 27,530.00 28,500.00 Date 21-Mar-2014 31-Dec-2018 21-Jun-2019 30-Jun-2020 The progress values for some of the intermediate results indicators remain unchanged since the data is Comments: reported by calendar year. IN00720501 ►Hand washing stations/points established (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 23,067.00 23,067.00 10,000.00 Date 21-Mar-2014 31-Dec-2018 21-Jun-2019 30-Jun-2020 Component 2: Delivery of Community Nutrition and Primary Health Care Services IN00720500 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 752,412.00 1,145,497.00 375,834.00 Date 21-Mar-2014 31-Dec-2018 21-Jun-2019 30-Jun-2020 IN00720502 People who have received essential health, nutrition, and population (HNP) services - Female (RMS requirement) (Number, Corporate Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 50.00 50.00 50.00 50.00 IN00720505 Number of women and children who have received basic nutrition services (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 498,722.00 1,050,762.00 904,719.00 Date 21-Mar-2014 31-Dec-2018 21-Jun-2019 30-Jun-2020 IN00720507 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) 6/28/2019 Page 4 of 10 The World Bank Implementation Status & Results Report Maternal and Child Nutrition and Health Results Project (P143650) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 85,850.00 94,735.00 87,115.00 Date 31-Mar-2014 31-Dec-2018 21-Jun-2019 30-Jun-2020 IN00720508 ►New acceptors of modern contraception (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 12,925.00 135,181.00 135,181.00 90,000.00 Date 21-Mar-2014 31-Dec-2018 21-Jun-2019 30-Jun-2020 IN00720511 ►Children between the age of 6 and 59 months receiving Vitamin A supplementation (number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 70,000.00 -- 540,759.00 475,000.00 Date 31-Jan-2014 -- 21-Jun-2019 30-Jun-2020 IN00720513 ►Pregnant women receiving iron and folic acid (IFA) supplements (number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 9,000.00 -- 204,978.00 18,000.00 Date 31-Jan-2014 -- 21-Jun-2019 30-Jun-2020 IN00720515 ►Children under the age of 24 months benefiting from improved infant and young child feeding (IYCF) practices (number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 0.00 Date 31-Jan-2014 -- 21-Jun-2019 30-Jun-2020 This was dropped at restructuring in March 2019 Comments: IN00720517 ►Children under age five treated for moderate or severe acute malnutrition (number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 200.00 -- 12,792.00 11,400.00 Date 31-Jan-2014 -- 21-Jun-2019 30-Jun-2020 IN00720518 ►Post-partum mothers supplemented with VAS in the preceding year (cumulative) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 22,200.00 134,585.00 134,585.00 145,000.00 Date 21-Mar-2014 31-Dec-2018 21-Jun-2019 30-Jun-2020 6/28/2019 Page 5 of 10 The World Bank Implementation Status & Results Report Maternal and Child Nutrition and Health Results Project (P143650) IN00720519 ►Pregnant women coming for ANC in the first trimester (cumulative) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 2,342.00 47,731.00 47,731.00 26,000.00 Date 31-Dec-2013 31-Dec-2018 21-Jun-2019 30-Jun-2020 IN00720520 ►Children age 12-59 months dewormed (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 6,461.00 315,295.00 315,295.00 143,500.00 Date 21-Mar-2014 31-Dec-2018 21-Jun-2019 30-Jun-2020 IN00720521 ►Households supported with Food and Nutrition Security (FNS) inputs (small ruminants, poultry and back yard garden and labor serving devices. (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 900.00 900.00 1,500.00 Date 21-Mar-2014 31-Dec-2018 21-Jun-2019 30-Jun-2020 Comments: IN00720522 ►Communities supported in establishing child food banks (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 50.00 45.00 90.00 Date 21-Mar-2014 31-Dec-2018 21-Jun-2019 30-Jun-2020 IN00720523 ►Communities implementing BFCI activities (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 633.00 827.00 720.00 950.00 Date 21-Mar-2014 31-Dec-2018 21-Jun-2019 30-Jun-2020 IN00720524 ►Selected recipients who receive all cash transfers according to the payment plan (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 80.00 Date 15-Nov-2016 31-Dec-2017 31-Dec-2017 31-Jul-2021 This was dropped at restructuring Comments: IN00720525 6/28/2019 Page 6 of 10 The World Bank Implementation Status & Results Report Maternal and Child Nutrition and Health Results Project (P143650) ►Selected recipients who meet the targeting criteria (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 80.00 Date 21-Mar-2014 31-Dec-2018 31-Dec-2018 31-Dec-2019 The indicator shows the performance at the beginning of the roll out of the activity. The performance is likely to shows some ups and downs as implementation expands to other communities. Comments: Source: Health Management Information System and Project Monitoring System IN00720526 ►Recipients of UCT (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 897.00 897.00 2,300.00 Date 21-Mar-2014 31-Dec-2018 21-Jun-2019 30-Jun-2020 IN00720527 ►Community registers updated quarterly (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 341.00 2,333.00 2,333.00 2,110.00 Date 21-Mar-2014 31-Dec-2018 21-Jun-2019 30-Jun-2020 Component 3: Capacity Building for Service Delivery, Results-Based Management, Food and Nutrition Se IN00720499 ►RBF adopted in the revised health financing policy (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 21-Mar-2014 16-Nov-2018 16-Nov-2018 30-Jun-2020 IN00720503 ►Health facilities receiving Client Tracer and Satisfaction Survey Feedback at least 3 times during the Calendar year (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 70.00 100.00 70.00 Date 21-Mar-2014 16-Nov-2018 21-Jun-2019 30-Jun-2020 IN00720504 ►Health facilities scoring at least 75% on the Quality Checklist (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 85.00 86.50 85.00 Date 21-Mar-2014 31-Dec-2018 31-Dec-2018 30-Jun-2020 IN00720506 6/28/2019 Page 7 of 10 The World Bank Implementation Status & Results Report Maternal and Child Nutrition and Health Results Project (P143650) ►Health personnel receiving training (number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,975.00 1,975.00 1,715.00 Date 21-Mar-2014 31-Dec-2018 21-Jun-2019 30-Jun-2020 IN00720509 ►Health workers (including central and regional level managers) trained on RBF management (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 38.00 996.00 996.00 610.00 Date 21-Mar-2014 31-Dec-2018 21-Jun-2019 30-Jun-2020 Component 4: Ebola Virus Disease Preparedness and Control IN00720498 ►Health personnel trained on Ebola prevention and management (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 305.00 305.00 100.00 Date 11-Nov-2014 31-Dec-2018 21-Jun-2019 31-Jul-2019 Component 5: Contingent Emergency Response IN00720497 ►No indicator required (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value None None None None Date 21-Mar-2014 16-Nov-2018 16-Nov-2018 31-Dec-2019 No indicator assigned Comments: Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P143650 IDA-56230 Effective USD 2.48 2.48 0.00 2.48 0.08 97% P143650 IDA-59420 Effective USD 3.20 3.20 0.00 0.85 2.47 26% 6/28/2019 Page 8 of 10 The World Bank Implementation Status & Results Report Maternal and Child Nutrition and Health Results Project (P143650) P143650 IDA-D0500 Effective USD 2.53 2.53 0.00 2.53 0.00 100% P143650 IDA-D1600 Effective USD 4.30 4.30 0.00 4.54 0.00 100% P143650 IDA-H9230 Effective USD 3.68 3.68 0.00 3.35 0.00 100% P143650 TF-16640 Effective USD 5.00 5.00 0.00 5.00 0.00 100% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P143650 IDA-56230 Effective 24-Apr-2015 04-Jun-2015 30-Nov-2015 31-Jul-2019 30-Jun-2020 P143650 IDA-59420 Effective 09-Jan-2017 03-Feb-2017 06-Apr-2017 31-Jul-2021 30-Jun-2020 P143650 IDA-D0500 Effective 24-Apr-2015 04-Jun-2015 30-Nov-2015 31-Jul-2019 30-Jun-2020 P143650 IDA-D1600 Effective 09-Jan-2017 03-Feb-2017 06-Apr-2017 31-Jul-2021 30-Jun-2020 P143650 IDA-H9230 Effective 21-Mar-2014 09-Apr-2014 20-May-2014 31-Jul-2019 30-Jun-2020 P143650 TF-16640 Effective 09-Apr-2014 09-Apr-2014 20-May-2014 31-Jul-2019 31-Jul-2019 Cumulative Disbursements 6/28/2019 Page 9 of 10 The World Bank Implementation Status & Results Report Maternal and Child Nutrition and Health Results Project (P143650) Restructuring History Level 2 Approved on 18-Dec-2014 ,Level 2 Approved on 07-Dec-2017 ,Level 2 Approved on 22-Mar-2019 Related Project(s) P154007-GM Maternal and Child Nutrition and Health Results Project ,P159693-AF Maternal and Child Nutrition and Health Results Project 6/28/2019 Page 10 of 10