Argentina - Maternal and Child Health and Nutrition Project

Document of The World Bank FOR OFFICIAL USE ONLY Report No. 11790-AR STAFF APPRAISAL REPORT ARGENTINA MATERRAL AND CHILD HEALTH AMD NUTRITION PROJECT JULY 14, 1993 MICROGRAPHICS Report No: 11790 AR Type: SAR Human Resources Operations Division Country Department IV Latin America and the Caribbean Region Office lTis document has a restricted distnbution and may be used by redpients only in the performance of their offical dutes. Its contents may not otherise be disclosed without World Bank authoization  CURRENCY UNrr - PESO (AS) EXCHANGE RATE (as of March 15, 1993) US$1.00 = A$1.00 F[SCAL YEAR January 1 - December 31 WEtIGIIS AND MEASURES The metric system has been used tbroughout the report.  FOR OICAL USE ONLY GWSSARV OF ACRONYMS APIS Snmia and Finac niea Subq CDC Chid Dvelomen Cetr CNMN Natioa Maternal ad Ch Pmgia (Compmmis Nacional A avr do la Madre y el Nd) R40 Food nd Agticu FSC Fde Sg Co_ GDP Gws Domestc Pnduct ( do" Infeino BEuo) GNP Guss National Product (Producto Nacidonal Bruto) RS Federal Healt Secrsariat IDB Inter-Ameran Delpmett Bank IND1C Natonal Instit of Stastcs and Census ([sdtuto Nail de Es1ska y Cww) MCH Matrna and Child Ealth MCEN Maera and Child Healh and Nutiton Services NW Municipal Eecuting Unit MSAS Miistryof Heakh and Socil Actio (M ro de Salud y Acci6n Social) NGO Non-Govemental O n PAHO/WHO Pan A n eakh Health BagsInsurance Fund PAN Naonal Food Piogmm (ln Nacional de PCU pruject Coriain Ui PEU pwincial Executing Unit PMH PQwinca Ministres of Heal EMTS P t Ma -nagmenfomao Subystem OO z for Economic Coopeqtion ad Deveopen OS Social Inme Funds (Obras Socales) SAMCS hged s Pubic Health Ara Services SDMIS Service Delvery Montrn and Infrmation Subsystem SSAL Social Sector Ma e Thic Ascstne lam TPS Ibhnical Pmjects Secetrat UNDP Unitd Nato Development Pwgmmme UNCEF United Nations Ckild's Fbnd i document has a rstd distibuton and may be used by cipient only in the peromane of thei offil dutis Its contents may not otherwi be dsclosed witout Wor D authorizton.  ARGENTINA M1ATERNAL AND CECLDPWALTH AND UTRITION PROJECT TABLE OF CONTENTS LOAN AND P!ROJECT SUUAMARY ................................ i 1.BACKGROUN ............ 4......... .......... A. Ilonoi Sefti g ............................. 1 B. SocblConidon . ..................... *... ......... } C. Womeni Developmen ................................. 2 2. SECTORAL CONTEXT ................................... 3 A. EqlXeat and Nutdion Stas ............................ 3 B. 7h ef aeSyt .........................I...... 0. S C. HedthCan andFianciago iSw .............................. 7 D. EHealthCanRsucs andUtization ................................... 8 fI a m an"Ld Child Heah andNutM*k Serices and Pw s ........................... 11 P. PmshxilSerices andPedoranc ................................... 12 3. SUbBlURY OF$EICTOR LESUES AND GOVER3eET STRATEGY ................................. 13 A. issus ........................................................................ 13 B. 8oenW utg .................................................................. 14 C. Avaibbeand PbndResourcs forMat nd ChildHealh .................................... 16 4. E XENAL ASSISTANCE FOR TBEESECTOR ........... ...o ......................... 16 A. 8ar Rol an sdW Satg ............................................. 16 B. 7URoleo Odier Donor .................... ....................... .... is C. Lesn of E.....pe...e..ce...................................... 18 S. TEEP ROECO..............C....T.. 0. 20 A. Pqect Orgi ........................... .. ..** *...............20 B. PfgojetObjcdvs,R * s6Sw and Area ........................................ 21 C.M NP"a Fas of thePn-je .............................................. 23 D. DeMilW PlqeDescdpdo ................. 0... *.................. ...... 23 6. VS IMUTED COSTS AND FINANCING PLAN ......................................... 34 A.Coss .................................................... *34 D. Fhldng Phn .................................... * .*..*..36 C. Reounn C ss adk nbdy ......................................... 38 7. pRojECT BPpLEMENTAIION ............... . ............................ 38 A.it Oqnaknnyed Coordinton ......................................... 38 B.PKeo ............................................ C. ad Accountsds ................ ..,46 D.AxegAig ....  . Stus of PzgjectPouwa ..... ............ ...... . 47 F. Monhoigangd S%rvisin ........................... 48 G. id-Te,nNReview .................... . * ... . .. .. 49 B. Risks. * *om ntal. .pa ............... ....... . ........ . .o 49 9.A Ih4aton Women ................ .................... 549 n. Pr: EJEct AND P...... .......................... 42 A. BondsX ..................... ........... 49 D. RAie ....................P.... SO 9.nex C: OrganREIzIoNaS.Cbarts . . .. ..... .. .............. . ..... 5SO Anex : PSrojeco C land Pai tniias......... ....... ...... . S2 Anma B: PngeaCosts ..............................o 53 Annex C: opzb ChuU ............................ S8 AnnexD: Sdpn-eo Cycl a lic4dd okn CdWda ..... ....... o....... 60 A ex B P and Disb Cycle . .......... ....... . 65 Armex F: MonitoringIdit .. .................... 66 Anmx G: SupevisionPlarn ......................... . ........... 78 AnmexH: Docunmesin Phoet's WodnFieandGb Q= Fie ................ 80 MAP. IBRD # 24782 lis repot is based on th fndinp of pawraisal and api missions tat visied Argntn in OctoberNovember 1992, and March 1993, rqpecbv. Msion membes ibludd Mi/Mm. JOsB Adsu (Mission aTnd Sr. Projet Officer, LA4HRA ; Patrio V. M(bc Heat Seia and A na Mission Coordinator, LA4WI; Fncic Mardon_e (Nutri Seist, LAT ; Juan Giacoli (Public Healt Specst, Consan); Edmond Andrews nformai SYsms Specialit Conua); Vita Didonet (Child Devdop t Specialst, Consant); d Anit Au (Opeaio Assista Consulta). Ms. Jewnif r Feande (Staff Milant, LA4WR) provided a oms in th poducton of this report. Task _naor. Jose Ank= (A4H; DMsi C . hif: an S*weie (LA4R; Director Pg-eung Loh (LA4); Powr R1fr : Jane (bow (ASMI; SaHm Hab (SA2P; ad Alan Brg (P DR). Mr. Wllim Mayvle (LA4DR) edotd th report  ARGENTINA MATERNAL AND CIHD REALTH AND NPlITON ROJECT LOAN ND !ROJECM SUMMARY Borrower Aitine Repubic B _: Ptovince andMu b Amount: US$100 million, eqivalet T,nV: Repayment in 15 yeas, iluding a 5 year gmcr pedod, with intrest at the ks sandatd variable re. Project Objecties: Th prposed project would assist the Goverment in mwoving the heat and natrXit stu of poor mothes and chklden and pCO cn can and devlpmn of