The World Bank Report No: ISR12873 Implementation Status & Results Ethiopia Ethiopia Nutrition (FY08) (P106228) Public Disclosure Copy Operation Name: Ethiopia Nutrition (FY08) (P106228) Project Stage: Implementation Seq.No: 12 Status: ARCHIVED Archive Date: 04-Jan-2014 Country: Ethiopia Approval FY: 2008 Product Line: IBRD/IDA Region: AFRICA Lending Instrument: Specific Investment Loan Implementing Agency(ies): Key Dates Board Approval Date 29-Apr-2008 Original Closing Date 07-Jan-2014 Planned Mid Term Review Date 21-Nov-2011 Last Archived ISR Date 18-Jun-2013 Effectiveness Date 10-Sep-2008 Revised Closing Date 07-Jan-2014 Actual Mid Term Review Date 29-Nov-2011 Project Development Objectives Project Development Objective (from Project Appraisal Document) To improve child and maternal care behavior, and increase utilization of key micronutrients, in order to contribute to improving the nutritional status of vulnerable groups. Has the Project Development Objective been changed since Board Approval of the Project? Yes No Component(s) Component Name Component Cost Component 1: Supporting Service Delivery 14.00 Component 2: Institutional Streghtening and Capacity Building 16.00 Overall Ratings Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Public Disclosure Copy Overall Implementation Progress (IP) Satisfactory Moderately Satisfactory Overall Risk Rating Implementation Status Overview This ISR reflects the outcomes of the October 28, 2013 implementation support mission which sought to propose concrete actions to accelerate implementation progress in view of the closing date of January 7, 2014, and to start preparation for the Implementation Completion and Results Report. The overall progress towards the development objectives related to promoting nutrition interventions (Growth Monitoring and Promotion sessions and exclusive breast feeding for children under 6 months) and increasing utilization of key micronutrients, e.g., Iron Folic Acid (IFA) tablets for pregnant women and Vitamin A capsule for children aged 6-59 months is satisfactory. The Monthly CBN monitoring data collected by Health Extensions Workers (HEWs) suggests that the overall under-two children Growth Monitoring and Promotion (GMP) participation rates are 46%, exceeding the target of 40%. However, there are regional variations with Oromia, Amhara and Tigray, reporting coverage ranging from 20% to 50%, while the SNNPR reaching almost 80%. Most Page 1 of 5 The World Bank Report No: ISR12873 recent national data show 52% of infants 0-5 months are exclusively breastfed, 41% of pregnant women received IFA tablets, and 94% of under-5 children received two doses of vitamin A capsules. All Intermediate Results indicators showed satisfactory progress towards the planned targets, including: percent of salt iodized at the production site (95%); number of health staff who received Masters of Science (MSc) in nutrition degrees (30); percent of CBN woredas providing monthly GMP data to the Federal level (87.6%); completion of all planned operational research projects, and establishment of a Universal Salt Iodization policy. The two Legal Covenants (registration of zinc tablet and establishment Public Disclosure Copy of the National Nutrition Coordination Body - NNCB) were met. Since the last mission, disbursement of the IDA grant has increased from 60 to 81 percent. One major remaining component of disbursement is the outstanding procurement of IFA tablets (US$3.3 million). An extension of the project closing date has been requested to accommodate this outstanding procurement. The JSDF grant, piloting Community based Management of Acute Malnutrition (CMAM) (TF 93946) implemented by Concern Worldwide, is scheduled to close on January 7, 2014. The implementation has improved significantly in the last six months, with a strong focus on community level innovative approaches with potential to be scaled up across the health system. The average Therapeutic Feeding Program score for all health facilities covered by the project increased from 58% in 2010 to 74% in 2013. The Infant and Young Child Feeding (IYCF) training was provided to Health Workers (HWs), Health Extension Workers (HEWs) and Health Development Armies (HDAs). Enhanced IYCF-CMAM trainers’ guides and job aids were developed. A Ready to Use Therapeutic Food (RUTF) storage assessment was finalized and RUTF cabinets were distributed to 90 health posts and additional 89 cabinets are being manufactured and will be distributed by end of the year. Concern Worldwide had obtained an approval for a no cost extension until 7 January 2014 (current closing date) to finalize and disseminate an operational research report, after delays in release by the Tigray Regional Health Bureau. Two operational research studies on the project were completed by five national universities and will be ready for dissemination. The evaluation of the JSDF project is underway with the draft report likely to be completed by mid- December 2013. Locations No Location data has been entered Results Project Development Objective Indicators Indicator Name Core Unit of Measure Baseline Current End Target Percentage of children 0-23 months Percentage Value 0.00 46.00 40.00 participating in monthly GMP sessions Date 29-Apr-2008 10-Dec-2013 07-Jan-2014 Comments Source: Routine CBN data, Source: Routine CBN data, Source: Routine CBN data, FMOH (new indicator ) FMOH FMOH Percentage of infants 0-5 months exclusively Percentage Value 51.00 52.00 56.00 breast fed (source DHS survey, project Public Disclosure Copy Date 01-Oct-2009 10-Dec-2013 07-Jan-2014 baseline and endline surveys; baseline from Comments Source: National Nutrition Source: EDHS 2011 Source: NNS 2013 2005 DHS) Survey (NNS) 2009 Percentage of pregnant women receiving iron Percentage Value 17.00 41.10 25.00 and folate supplementation Date 01-Oct-2009 10-Dec-2013 07-Jan-2014 Comments Source: National Nutrition Source: EDHS 2011 Source: NNS 2013 Survey (NNS) 2009 (baseline value and data source revised Page 2 of 5 The World Bank Report No: ISR12873 Number of people with access to a basic Number Value 0.00 29750000.00 44125000.00 package of nutrition services (CBN), % female Date 29-Apr-2008 10-Dec-2013 07-Jan-2014 Comments Source: Routine CBN data, Source: Routine CBN data, Routine CBN data, FMOH Public Disclosure Copy FMOH FMOH (revised indicator definition, baseline value and data source) Number and percentage of children 6-59 Number Value 10200000.00 10700000.00 11300000.00 months receiving a dose of Vitamin A every 6 Sub Type Date 29-Apr-2008 10-Dec-2013 07-Jan-2014 months Breakdown Comments UNICEF EOS 2008 data Source: FMOH 2010-11 data Source: Routine CHD/EOS (revised indicator definition reports, FMOH and baseline value) Intermediate Results Indicators Indicator Name Core Unit of Measure Baseline Current End Target Health Extension Workers trained on revised Percentage Value 0.00 85.00 85.00 curriculum: percentage out of a target of Date 29-Apr-2008 10-Dec-2013 07-Jan-2014 30,000 to be achieved by project completion Comments Source: Policy and Planning Source: Policy and Planning Source: Policy and Planning (source: HMIS, Annual NNP Reports; baseline 2007) Directorate, Ministry of Directorate, FMOH Directorate, FMOH Health, FMOH (revised indicator definition ) Universal Salt Iodization policy adopted and Text Value Not yet achieved Achieved Achieved put in force, supporting Proclamation 200/2000 Date 29-Apr-2008 10-Dec-2013 07-Jan-2014 Comments The universal salt iodization policy legislated on February 18, 2011, came into force on April 13, 2011 Establishment of inter-sectoral National Text Value Not yet achieved Achieved Achieved Nutrition Coordination Body (source: Terms of Date 29-Apr-2008 10-Dec-2013 07-Jan-2014 Reference for body, Annual NNP Program Public Disclosure Copy Comments FMOH Administration reports FMOH Administration reports, Reports, project evaluations; baseline 2007) NP Report Percentage of national salt production iodized Percentage Value 0.00 80.00 50.00 in previous year Date 28-Apr-2008 10-Dec-2013 07-Jan-2014 Comments FMOH routine reports Source: HSDP IV Annual Source: FMOH routine reports (revised indicator definition Performance Report and baseline value) 2011/2012 Page 3 of 5 The World Bank Report No: ISR12873 Number and percentage of health personnel Number Value 0.00 12380.00 12000.00 (health center to federal level) receiving Date 29-Apr-2008 10-Dec-2013 07-Jan-2014 training on CBN Comments Source: Routine reports, Source: Routine reports, Of a target of 1412 in 353 Public Disclosure Copy FMOH FMOH woredas. Source: Routine reports, FMOH Percentage of CBN woredas providing monthly Percentage Value 0.00 87.60 50.00 nutrition data to federal level Date 29-Apr-2008 10-Dec-2013 07-Jan-2014 Comments FMOH Administration reports FMOH Administration reports FMOH Administration reports (new indicator ) Percentage of NNP operational research Percentage Value 0.00 100.00 80.00 studies completed and disseminated (of a Date 29-Apr-2008 10-Dec-2013 07-Jan-2014 target of 10) Comments FMOH Administration reports FMOH Administration reports Percentage of health personnel trained to Percentage Value 0.00 100.00 80.00 masters level in nutrition (of a target of 30) Date 29-Apr-2008 10-Dec-2013 Comments FMOH Administration reports FMOH Administration reports FMOH Administration reports, NP Report Zinc registered as essential drug and included Text Value Not yet achieved Achieved Achieved in Health Post package Date 29-Apr-2008 10-Dec-2013 07-Jan-2014 Comments FMOH Administration reports FMOH Administration reports Data on Financial Performance (as of 17-Dec-2013) Financial Agreement(s) Key Dates Project Ln/Cr/Tf Status Approval Date Signing Date Effectiveness Date Original Closing Date Revised Closing Date P106228 IDA-H3760 Effective 29-Apr-2008 13-Jun-2008 10-Sep-2008 07-Jan-2014 07-Jan-2014 P106228 TF-10247 Closed 11-Aug-2011 16-Aug-2011 16-Aug-2011 30-Sep-2012 30-Sep-2012 P106228 TF-93946 Effective 16-Jun-2009 14-Aug-2009 14-Aug-2009 14-Aug-2013 07-Jan-2014 Public Disclosure Copy Disbursements (in Millions) Project Ln/Cr/Tf Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P106228 IDA-H3760 Effective USD 30.00 30.00 0.00 23.37 5.69 78.00 P106228 TF-10247 Closed USD 0.65 0.62 0.03 0.62 0.00 100.00 P106228 TF-93946 Effective USD 1.81 1.81 0.00 1.28 0.53 71.00 Disbursement Graph Page 4 of 5 The World Bank Report No: ISR12873 Public Disclosure Copy Key Decisions Regarding Implementation n/a Restructuring History Level two Approved on 10-Apr-2012 Related Projects There are no related projects. 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