Public Disclosure Copy The World Bank Implementation Status & Results Report Pilot to Improve the Development and Nutrition of Young Children in Poor Rural Areas in Guatemala (P145410) Pilot to Improve the Development and Nutrition of Young Children in Poor Rural Areas in Guatemala (P145410) LATIN AMERICA AND CARIBBEAN | Guatemala | Social Protection & Jobs Global Practice | Recipient Executed Activities | Investment Project Financing | FY 2015 | Seq No: 5 | ARCHIVED on 25-Jun-2019 | ISR37247 | Implementing Agencies: ChildFund Guatemala, ChildFund International - Guatemala Key Dates Key Project Dates Bank Approval Date:07-Nov-2014 Effectiveness Date:18-Mar-2015 Original Closing Date:07-Nov-2018 Revised Closing Date:30-Jun-2019 Project Development Objectives Project Development Objective (from Project Appraisal Document) The Development Objective is to strengthen the capacity of parents and communities to improve and monitor child development outcomes (physical, cognitive, socio-emotional and linguistic skills) for children under two in project intervention areas. Has the Project Development Objective been changed since Board Approval of the Project Objective? No PHRPDODEL Components Name Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO  Moderately Satisfactory  Moderately Satisfactory Overall Implementation Progress (IP)  Satisfactory  Satisfactory Implementation Status and Key Decisions This Grant financed the piloting of the Reach Up Early Childhood Parenting Program, which is a program based on a Jamaican operation which had proven successful at improving cognitive outcomes, school achievement and labor market outcomes over the long run. The Reach Up program was used in a subset of the Project communities, while the group modality (Ventana de la Vida) developed by ChildFund, is being used in the rest. In order to measure impacts. After a period of testing the Reach Up modality and materials in local indigenous settings in Guatemala, the project has 6/25/2019 Page 1 of 10 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Pilot to Improve the Development and Nutrition of Young Children in Poor Rural Areas in Guatemala (P145410) successfully adapted both methodologies to the Guatemalan context, including the curriculum, guidelines for training, and learning materials, which are all developed considering the Quiche and Mam languages and cultures. The indicators that will measure children’s development outcomes at the community level, have also been tested and are currently being regularly updated by the two Non-Governmental Organizations (NGO) sub-grantees selected by Childfund, Cooperación para el Desarrollo Rural de Occidente (CDRO) and Asociación de Cooperación al Desarrollo Integral de Huehuetenango (ACODIHUE). The Grant is also carrying out an impact evaluation, along with a thorough operational assessment that will measure the effects of both interventions. The IE will assess the impacts of providing psychosocial stimulation through home visits and group meetings to increase child development by promoting play, parent-child interactions, and generally improve parent practices, and will compare that with territories where none of the modalities were rolled out. In addition, it will include a cost-effectiveness analysis of the two modalities of service delivery on home environment, parental behavior and child development and nutritional outcomes. Preliminary results of the IE are expected to be ready by July 2019. As confirmed during the last missions, both local sub-grantees, Acodihue and CDRO, have continued early stimulation and parenting sessions at the community level using both type of parenting modalities: “Ventana de la Vida” (group sessions) and “Reach-up” (home visiting). Children and mothers have been enrolled and registered for attending both. In addition, the project is currently preparing the actions needed to undertake an end- line survey for evaluating the effects of both modalities. The project has concluded a costing analysis of both modalities, which would be useful for potential scale up plans. Local sub-grantees have begun the process of gradual phase-out in the communities. Closing activities include community fairs and graduation events for caregiver mothers. Fairs include two areas: a) community consultation and b) presentation of ECD outcomes (barrilete). ChildFund has two partner organizations: CDRO and Acodihue, and both partners organize plenary sessions in which recognition is given to the madres guías (mother guides), caregivers and children of the project. Community authorities participate in the closing activities, and in many cases have expressed their commitment to continue with the activities of the project. The project has also concluded an assessment of the implementation of the methodologies by the madres guías, identifying positive and negative aspects and suggestions for improvement. Between the two implementing partners, almost 700 madres guias have been trained in early stimulation modalities, and other local actors have been sensitized, such as community leaders, and Government local staff from the Secretaría de Seguridad Alimentaria y Nutricional (SESAN), Ministerio de Agricultura, Ganadería y Alimentación (MAGA), Ministerio de Desarrollo Social (MIDES), Ministerio de Salud Pública y Asistencia Social (MSPAS) and Ministerio de Educación (MINEDUC). The evaluation team has worked on the design and implementation of the impact evaluation, as well as assured the cultural and linguistic adaptation of the MDAT instrument that has been used in the end-line data collection to test language and fine motor skills. The team prepared a draft of the household questionnaire, reviewed and approved the full questionnaire with feedback from the survey firm and ChildFund. It held meetings with the survey firm (INCAP) and ChildFund personnel; coordinated survey operations with ChildFund, the Bank, and the survey firm. The evaluation team coordinated the adaptation of the MDAT instrument and provided training to the enumerators from the survey firm. To assure that the data collected will be high quality and that attrition will be minimal, the evaluation team conducted two pilots in Guatemala (to culturally adapt the MDAT instrument) prior to hiring the survey firm. Then, it conducted a general training and pilot with the survey firm, as well as three additional site visits to oversee the work of the firm. The evaluation team has been providing constant feedback to INCAP regarding data programing, data collection, and data collection report. After the survey firm delivers the final dataset, the team will be ready to conduct the analysis of the data. On the other hand, a thorough systematization of the project is being implemented and will include lessons learned on the community approach implemented by ChildFund to ensure participation and full collaboration of indigenous leaders, adaptation of the curricula to Quiche and Mam areas, and the involvement of Madres Guias as key actors to promote childhood development in their communities. Progress on each component includes: Component 1: 3379 children continue to participate, 2140 in the ‘Ventana de la vida’ modality and 1239 in the Reach Up. During this period, 210 CEOs (Casas de Evaluacion y Orientacion – Centers for evaluation and orientation) providing training in the areas of physical, cognitive, social, emotional and language development. Likewise, positive deviation sessions (desviacion positiva) were carried out by Acodihue in 2 communities, with the participation of 73 caregivers, who shared their experiences. In addition, 691 madres guías have participated in monthly meetings to update and strengthen their knowledge in both modalities (285 in level 1 and 406 of level 2). Of the CEOs, 210 are still functioning, and 58 communities remain implementing project activities; exit activities have been carried out in 34 communities, 16 in level 1 (Ventana de la Vida) and 18 in level 2 (Reach Up) in 7 municipalities of 3 departments. Component 2. Following activities have been completed in component 2: Community fairs focusing on child development: 81 closing community fairs were held with 2,879 people participating, including: madres guías, members of COCODE, mothers and fathers, caregivers and health and nutrition personnel, MIDES, SESAN and MAGA. Midwives. 1473 midwives continue to participate in training events and the development of early stimulation, addressing the following topics: i) importance of the game with infants (0 to 2 years), ii) quality of maternal time, iii) appropriate referral to health services of pregnant women, iv) Signs 6/25/2019 Page 2 of 10 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Pilot to Improve the Development and Nutrition of Young Children in Poor Rural Areas in Guatemala (P145410) of danger during pregnancy, and v) Clean and safe delivery -the last three with guidance from health workers. Community Development Councils. The Community Development Councils (COCODE) have been informed of the results of ECD activities carried out in their communities, so they can continue providing support to the madres guías to carry out of early stimulation. With regards to the Municipal Development Councils (COMUDE), 1062 members have participated in 10 monthly meetings held in the same number of municipalities. As for the Municipal Councils for Food and Nutritional Security (COMUSAN), 176 members have participated in monthly meetings in 9 municipalities. In these meetings, information has been provided on the importance of the community fairs and the monitoring of outcomes to improve the wellbeing of families and children. Municipal Health Districts (DMS) have participated in training processes to reinforce early stimulation, including 126 health personnel (nurses, doctors, educators, administrative staff, assistants, etc.). The project’s methodology was also transferred, and the importance of vaccination and GMP services was highlighted. Component 3: ChildFund has provided technical and financial support to the local partners to ensure the achievement of the project objective. The technical teams of CDRO, ACODIHUE and ChildFund continue to dialogue with Government on the new Early Childhood strategy, along with UNICEF, PAHO, Plan International, and Save the Children. ChildFund continues to share its project experience with international organizations including PAHO. An agreement has been signed with the Ministry of Education (MINEDUC) to contribute with the implementation of the “Acompañame a crecer” program. Risks Overall Risk Rating Risk Category Rating at Approval Previous Rating Current Rating Overall  --  Moderate  Moderate Results Project Development Objective Indicators PHINDPDOTBL Percentage of children achieving the expected development level for their age (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 40.00 64.00 60.00 Date 18-Mar-2015 01-Jul-2018 30-Mar-2019 30-Jun-2019 PHINDPDOTBL Percentage of participating households with enhanced early stimulation practices (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 32.00 40.00 6/25/2019 Page 3 of 10 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Pilot to Improve the Development and Nutrition of Young Children in Poor Rural Areas in Guatemala (P145410) Date 18-Mar-2015 19-Dec-2016 30-Mar-2019 30-Jun-2019 PHINDPDOTBL Number of children that are direct beneficiaries of the Project (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 4,020.00 4,506.00 5,500.00 Date 18-Mar-2015 31-Dec-2017 30-Mar-2019 30-Jun-2019 Overall Comments Intermediate Results Indicators PHINDIRITBL Diagnostic of early childhood development beliefs and practices in beneficiary communities is completed (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 18-Mar-2015 15-Jun-2018 15-Jun-2018 30-Nov-2015 PHINDIRITBL Monitoring tool to track child development is developed (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 18-Mar-2015 15-Jun-2018 15-Jun-2018 01-Apr-2016 6/25/2019 Page 4 of 10 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Pilot to Improve the Development and Nutrition of Young Children in Poor Rural Areas in Guatemala (P145410) PHINDIRITBL Number of project communities implementing Level 1 (Ventana de la Vida) and Level 2 (Reach Up) activities (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 94.00 94.00 100.00 Date 18-Mar-2015 15-Jun-2018 30-Mar-2019 30-Jun-2019 Comments 94 is the historical maximum of communities reached by the project. Gradually as the intervention phases out, this number will drop. Six (6) out of 100 communities decided not to participate in the project. PHINDIRITBL Percentage of COCODES (Consejos comunitarios de Desarrollo) implementing activities in favor of childhood in their communities (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 48.00 76.00 70.00 Date 18-Mar-2015 15-Jun-2018 30-Mar-2019 30-Jun-2019 PHINDIRITBL Number of community fairs implemented with an ECD approach (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 169.00 230.00 188.00 Date 18-Mar-2015 15-Jun-2018 30-Mar-2019 30-Jun-2019 PHINDIRITBL Baseline survey conducted (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 20-Oct-2015 01-Mar-2017 01-Mar-2017 01-Jun-2016 6/25/2019 Page 5 of 10 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Pilot to Improve the Development and Nutrition of Young Children in Poor Rural Areas in Guatemala (P145410) PHINDIRITBL Quarterly progress reports completed (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 13.00 14.00 16.00 Date 18-Mar-2015 15-Jun-2018 30-Mar-2019 30-Jun-2019 Comments The remaining two progress reports are being reviewed/produced and will be approved before the closing date. PHINDIRITBL Mass events hosted for departmental health systems (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1.00 2.00 2.00 Date 18-Mar-2015 15-Jun-2018 30-Mar-2019 30-Jun-2019 PHINDIRITBL Final Impact Evaluation survey conducted (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No No Yes Date 18-Mar-2015 15-Jun-2018 30-Mar-2019 30-Jun-2019 PHINDIRITBL Number of Madres Guias trained to apply level 1 methodology (Ventana de la Vida) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 320.00 371.00 595.00 Date 18-Mar-2015 15-Jun-2018 30-Mar-2019 30-Jun-2019 Comments Target was not met since the project prioritized some Reach-Up communities (home visits) adding Madres Guias there, as they were operating in areas with difficult access to the homes. 6/25/2019 Page 6 of 10 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Pilot to Improve the Development and Nutrition of Young Children in Poor Rural Areas in Guatemala (P145410) PHINDIRITBL Number of Madres Guias trained to apply level 2 methodology (Reach Up) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 396.00 523.00 450.00 Date 18-Mar-2015 15-Jun-2018 30-Mar-2019 30-Jun-2019 PHINDIRITBL Number of children participating in level 1 activities (Ventana de la Vida) within CEO's strategy (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 2,040.00 2,833.00 4,480.00 Date 18-Mar-2015 15-Jun-2018 30-Mar-2019 30-Jun-2019 Comments Since prioritization was given at some point to methodology 2, this target was not met. PHINDIRITBL Number of children participating in level 2 activities (Reach Up) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,406.00 1,673.00 1,920.00 Date 18-Mar-2015 15-Jun-2018 30-Mar-2019 30-Jun-2019 Comments Even with the prioritization of these areas (adding more Madres Guias), it was difficult to keep some of the children regularly participating, for this reason the target was not met. 6/25/2019 Page 7 of 10 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Pilot to Improve the Development and Nutrition of Young Children in Poor Rural Areas in Guatemala (P145410) PHINDIRITBL Percentage of Madres Guias with quality implementation of level 1 and level 2 activities (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 49.00 47.00 70.00 Date 18-Mar-2015 15-Jun-2018 30-Mar-2019 30-Jun-2019 PHINDIRITBL Percentage of CEOs implemented (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 64.00 79.00 80.00 Date 18-Mar-2015 15-Jun-2018 30-Mar-2019 30-Jun-2019 Comments The indicator is measuring the percentage of CEOs that effectively implement activities out of the maximum number (target) of CEOs in communities where the project is being implemented. Denominator is 373 (CEOs in communities of intervention). Number of CEOs operating by March 2019: 295. PHINDIRITBL Number of midwives in the catchment areas of the project, trained in exclusive breastfeeding and oportune stimulation by the social workers (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,473.00 1,473.00 900.00 Date 18-Mar-2015 15-Jun-2018 30-Mar-2019 30-Jun-2019 6/25/2019 Page 8 of 10 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Pilot to Improve the Development and Nutrition of Young Children in Poor Rural Areas in Guatemala (P145410) Overall Comments Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed Disbursed P145410 TF-17709 Effective USD 2.75 2.75 0.00 2.71 0.04 99% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P145410 TF-17709 Effective 07-Nov-2014 07-Nov-2014 18-Mar-2015 07-Nov-2018 30-Jun-2019 Cumulative Disbursements Restructuring History 6/25/2019 Page 9 of 10 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Pilot to Improve the Development and Nutrition of Young Children in Poor Rural Areas in Guatemala (P145410) Level 2 Approved on 21-May-2018 Related Project(s) There are no related projects. 6/25/2019 Page 10 of 10 Public Disclosure Copy