Niger - Population Project

Document of The World Bank FOR OFFICIAL USE ONLY Report No. 17762-NIR IMPLEMENTATION COMPLETION REPORT REPUBLIC OF NIGER POPULATION PROJECT (Credit 2360-NIR) May 1, 1998 Human Development III Africa Region This document has a restricted distribution and may be used by recipients only in the performance of their official duties. Its contents may not otherwise be disclosed withoui World Bank aujthorization.  CURRENCY EQUIVALENTS Currency Unit = CFA franc (CFAF) The CFAF is tied to the French Franc (FF) in the ratio of FF I to CFAF 100 following the January 12, 1994 devaluation of the CFAF from a ratio of FF I to CFAF 50. The French Franc is currently floating. 1993 US$ = 270 CFA francs 1993 CFAF 1 million = US$3,703.70 1994 US$ = 470 CFA francs 1994 CFAF I million = US$2,127.66 1995 US$ = 490 CFA francs 1995 CFAF 1 million = US$2,040.82 1996 US$ = 550 CFA francs 1996 iCFAF I million = US$1,818.18 1997 US$ = 590 CFA francs 1997 CFAF I million = US$1,694.92 SDR I - US$1.34442 (February 1998) WEIGHTS AND MEASURES Metric System FISCAL YEAR OF BORROWER January I - December 30 ABBREVIATIONS AND ACRONYMS AIDS Acquired Immune-Deficiency Syndrome CAS Country Assistance Strategy CCPP Cellule de Coordination du Projet Population (Population Project Coordination Unit) CONAPO Commission Nationale de la Population (National Commissioii on Population Activities) GDP Gross Domestic Product ICR Implementation Completion Report IDA International Development Agency IEC Information, Education and Communication MCH/FP Maternal and Child HealthlFamily Planning MSD/P/WD/CP Ministry of Social Development, Population, Woman's Development and Child's Protection MOPH Ministry of Public Health MTR Mid-term review NGO Non Governmental Organization NIGETIP Agence Nigerienne de Travaux d'Interet Public pour I'Emploi (Niger's Public Works and Employment Agency) PDS Plan de Developpement Sanitaire (Health Sector Development Plan) SAR Staff Appraisal Report SIP Sector Investment Program STD Sexually transmitted disease TOR Terns of Reference UNDP United Nations Development Programme UNFPA United Nations Fund for Population Activities UNICEF United Nations Children's Fund USAID United States Agency for International Development Vice President: Jean-Louis Sarbib Director: Theodore Ahlers Sector Manager: Helena Ribe Task Team Leader: Denise Vaillancourt  TABLE OF CONTENTS FOR OFFICIAL USE ONLY PREFACE ..................................................................... i EVALUATION SUNIMARY .................................................................... i PART 1: PROJECT IMPLEMENTATION ASSESSMENT .................................................................... I 1. INTRODUCTION .....................................................................1 A. Macroeconomic Setting .................................................................... I B. The Bank's Role in the Country and in the Sector .................................................................... 2 11. PROJECT OBJECTIVES .................................................................... 2 A. Original Project Objective ...............................................................-..... 2 B. Project Components .................................................................... 3 C. Credit Covenants and Special Agreements ..................................................................... D. The Risks .................................................................... 4 E. Evaluation of Project Objectives .................................................................... 5 III. IMPLEMENTATIC)N EXPERIENCE AND RESULTS .................................................................... 5 .4. Assessment of Project's Outcome and Sustainability .................................................................... 5 B. Summary of Costs .................................................................... 7 C Financing Arrangements .................................................................... 7 D. Implementation Schedule .................................................................... 8 E. Analysis of Key Factors Affecting Implementation ................................................ .................... 8 F. Assessment of the Bank 's Performance .................................................................... 10 G. Assessment of the Borrower's Performance .................................................................... I I V. SUMMARY OF FINDINGS, FUTURE OPERATIONS AND KEY LESSONS LEARNED ................. 12 A. Findings of Project Implementation Experience .................................................................... 12 B. Sustainability and Future Operations .................................................................... 13 C. Lessons for Future Projects in the Sector in Niger .................................................................... 15 PART 11: STATISTICAL TABLES .................................................................... 18 TABLE 1: SUMMARY OF ASSESSMENTS .1.........9.... .. ............................................... 19 TABLE 2: RELATED BANK LOANS/CREDITS.......................................................... ....20 TABLE 3: PROJECT TIMETABLE ............. 21 TABLE 4: CREDIT DISBURSEMENTS: CUMULATIVE ESTIMATED AND ACTUAL ............................................ 2 1 TABLE 5A: KEY INDICATORS FOR PROJECT IMPLEMENTATION AND OPERATION .......................................... 22 TABLE 5B: PROBLEMS RELATED TO THE QUALITY OF INFRASTRUCTURES/LESSONS LEARNED .................... 29 TABLE 6: STUDIES INCLUDED IN THE PROJECT ......................................................... 3 1 TABLE 7A: PROJECT COSTS ......................................................... 32 TABLE 7B: PROJECT FINANCING ......................................... 33 TABLE 7C: PROJECT EXPENDITURES BY COMPONENT BY YEAR .34 TABLE 8: ECONOMIC COSTS AND BENEFITS .35 TABLE 9: STATUS OF LEGAL COVENANTS .36 TABLE 10: COMPLIANCE WITH OPERATIONAL MANUAL STATEMENTS .39 TABLE 1 1: BANK RESOURCES: STAFF INPUTS .39 TABLE 12A: BANK RESOURCES: MISSIONS .40 TABLE 12B: BANK RESOURCES: SUPERVISION MISSIONS. 41 APPENDICES: A. Mission's Aide Mdmoire B. Borrower's Contribution to the ICR C. Loan Status (Active and inactive) for Niger, as of March 16, 1998 D. Map IBRD No. 23562 This document has a restricted distribution and may be used by recipients only in the performance of their official duties. Its contents may not otherwise be disclosed without World Bank authorization.  IMPLEMENTATION COMPLETION REPORT REPUBLIC OF NIGER POPULATION PROJECT (Credit 2360-NIR) PREFACE 1. This is the Implementation Completion Report (ICR) for the Population Project in Niger, for which Credit 2360-NIR, in the amount of SDR 12.9 million (US$17.6 million equivalent in 1992) was approved on April 30, 1992 and made effective on December 1, 1992. The Credit was closed on December 31, 1997, 6 months after the original closing date of June 30, 1997. Final disbursement took place on April 27, 1998, and a balance of SDR 5.3 million (US$ 7.2 million equivalent) was canceled on May 1, 1998. 2. The ICR was prepared by a team led by Ms. Denise Vaillancourt (Task Team Leader, AFTH3) and composed of several members of the final evaluation mission: Hugues Agossou (Financial Analyst), Johanne Angers (Operations Analyst, AFTH3). Rougui Diallo (Program Officer. AFMNE), Celine Gavach (Team Assistant, AFTH3). Belkis Giorgis (Consultant/Family Health Specialist) and Jacques Waechter (Consultant/Architect). Aboubacar Magassouba (Consultant/Implementation Specialist) and Ross Pfile (Project Assistant) also contributed to the preparation of Annexes. The report was reviewed by Nimes/Messrs. Theodore Ahlers (Director, AFC13), Helena Ribe (Sector Manager, AFTH3) and Jerome Chevallier (Manager, AFTS3), as well as key members of the Niger Country Team and population and reproductive health advisers. 3. Preparation of this ICR was initiated during the Bank's supervision missions of November 1996 and January 1997. Following a change in task team leaders and a 6- month postponement of the original closing date to accommodate a more meaningful and participatory evaluation process, ICR preparation was further supported through the Bank's supervision mission of September/October 1997. In addition to its analysis of documents in the project file, and interviews with former task team leaders and other members of previous teams, this ICR draws heavily on extensive, independent field visits carried out by the task team, covering all regions and districts touched by the project. This ICR also draws heavilv on the products and outcomes of the evaluation process carried out by the Govermnent. Culminating in a national final evaluation workshop. held in Niamey during the period February 9 -14, 1998 and attended by the Bank's team during its final evaluation mission, Government's evaluation encompassed the points of view of key actors and stakeholders (including beneficiaries), as well as an independent evaluator. The Borrower's contributions to this ICR include: the production of internal and external evaluation reports, discussion of the Bank's final evaluation Aide Memoire, and submission to the Bank of its own chapter of the ICR document.  IMPLEMENTATION COMPLETION REPORT REPUBLIC OF NIGER POPULATION PROJECT (Credit 2360-NIR) EVALUATION SUMMARY BANK'S ROLE IN THE COUNTRY AND SECTOR 1. Niger is one of the poorest countries in the world with some 60 percent of its population living on less than a dollar a day. Social indicators are correspondinglv low. Dismal statisristics on child mortality, life expectancy. literacy and primary school enrollment give Niger the rank of last in the world in the UNDP's human development index. Nigeriens are, moreover, much poorer than they were 30 years ago -- GDP growth has been negligible, while the population has more than doubled. Finally, given Niger's extremely poor natural resource base and low- levels of human capital investment, growth prospects are not good. Sound economic management has been further complicated by political instability throughout much of the 1990s. The past efforts of both the government and multilateral and bilateral development institutions have failed to reach their objectives -- as witnessed by slow economic growth and increased poverty. This performance is mirrored in the IDA portfolio where more than half of closed projects have been rated unsatisfactory. 2. The Government is fully aware of the country s poor economic performance, increasing poverty and daunting development challenges. An economic reform was adopted at the end of 1995 and implemented satisfactorilv through 1997. Broad poverty reduction, private sector development and capacity building programs have also been prepared. Implementation experience with programs has, however, been episodic and weak implementation capacity is further strained by unresolved political tensions. 3. The first Health project (Credit 1668-NIR) marked the beginning of the Bank's involvement in Niger's health sector. Its direct assistance to population activities included support to family planning services and information and cofinancing of the 1998 Population Census. The Population project (Credit 2360-NIR, declared effective on December 1. 1992) was designed to build on achievements of the Health project. The Health Sector Development Program (Credit 2915-NIR. which becamne effective on July 29, 1997) supports implementation of Niger's Health Sector Development Plan, including the support of reproductive health services as an integral part of the minimum package of activities at all levels of the health system.  - 11 - PROJECT OBJECTIVES AND COMPONENTS 4. Original Project Objective. The project was designed to assist the Government in implementing an effective national population program, with the primary objective of accelerating the onset of fertility decline by increasing the contraceptive prevalence raite as rapidly as possible, reducing maternal mortality, promoting attitudes favoring a reduction in family size norms, and enhancing the capacity of women to participate effectively in socioeconomic development. 5. Project Components. The project consisted of three components: (1) strengthening maternal health and family planning services through improvements to the efficiency, effectiveness and coverage of family planning and safe motherhood interventions in three selected Departments (Zinder, Tahoua and Tillabery); (2) promotion of family welfare and women 's status through information, education and communication (IEC) activities, efforts to improve economic opportunities for women and nutrition interventions; and (3) strengthening population policy analysis, research and coordination through activities to build public sector capacity in these areas and to encourage private sector and NGO initiatives in population and family planning. 6. Credit Covenants and Special Agreements. After two extensions of the limnit date for effectiveness, all conditions of effectiveness (itemized in para. 7 of the main text) were complied with and the credit was declared effective on December 1. 1992. No substantial changes were introduced to the project description or to the implementation arrangements during the life of the project. nor were any amendments made to the Development Credit Agreement. 7. Evaluation of Project Objective. The project's objective were -- and remain -- consistent with the Bank's and Niger's strategies for economic recovery and development. They are also consistent with the international consensus on the approach to population and reproductive health reached at the 1994 International Conference on Population and Development in Cairo. At the same time, project objectives -- and the consequent project design -- were very ambitious, covering a wide range of challenges and sectors in a country with very limited management and institutional capacity, where the Bank had limited operational experience. Project targets were also ambitious given the five-year time span of the project and given considerable pockets of resistance of initiatives to limit family size and improve the status of women.  - Inl - IMPLEMENTATION EXFPERIENCE AND RESULTS 8. Assessment of Project's Outcome and Sustainability. While the project succeeded in providing most inputs and in carrying out most activities envisaged, its overall success in achieving its stated objectives is unsatisfactory. This being said, however, project inputs and activities, particularly those supporting health sector development, are likely to contribute in the coming years to the realization of program/project objectives. The sustainability of project investments varies from component to component and is discussed in detail in Section V.B. of this report. Major outcomes of the various components are summarized as follows. 9. Under the first component, strengthening maternal and child health services, project inputs contributed to the upgrading and equipment of first-referral services and of selected primary level facilities. Completion of works and procurement of equipment transferred to the new health project are already underway and should provide the necessary complement for making the district hospitals functional. IEC training and equipment provided under the second component, promotion of family welfare and women's status, must be more fully exploited through a needed review and revision of Niger's communication srxategy. Also under this second component, investments in the establishment and suppoM of 53 women's groups (about 3000 women) have shown their potential to give women The capacity, income and opportunity to care for themselves and their families more effeciively. as well as to participate more effectively in communal initiatives. However, there is substantial scope for reducing the costs and cost- effectiveness of such initiatives in the future. The last component, strengthening population policy analysis. research and coordination, contributed to improvements in vital statistics. Capacity strengthening efforts are still needed, however, to improve program coordination. A Population Fund financed about 30 projects with NGO and private sector involvement. but was closed at the mid-term review because it was insufficiently decentralized and participatory, and because of inadequate financial management. 10. Summary of Costs and Financing Arrangements. At appraisal, the total cost of the project was estimated at US$24.1 million equivalent (net of taxes and duties) and its financing was projected as follows: IDA: US$17.6 million equivalent; Govermnent: US$2.7 million equivalent; NGO/private sector: US$0.2 million equivalent; communities: US$0.1 million equivalent; the Belgian Cooperation: US$2.5 million equivalent; and UNICEF: US$1.0 million equixalent. Actual total project cost was US$12.6 million, financed as follows: IDA: USS10.9 million equivalent; Government: US$1.4 million equivalent; communities: US$0.1 million equivalent; NGO/private sector: US$0.1 million equivalent; UNICEF: US$0.1 million equivalent; and Belgian Cooperation: nil. Differences in planned vs. actual costs and financing were due essentially to: (1) the effect of the 1994 devaluation of the CFA franc on local component expressed in foreign curTency; (2) the transfer of significant civil works and equipment to the new health project that could not be completed before the closing date; and (3) the  - iv - decisions of the Belgian Cooperation and UNICEF to channel their respective support through parallel financing arrangements. 11. Implementation Schedule. The project was prepared over a period of two years, with the first identification mission taking place in May 1990 and the Board Presentation and signature of the Development Credit Agreement taking place on April 30, 1992 and May 22, 1992, respectively. The credit became effective on December 1, 1992 and closed five years later on December 31, 1997 after one six-month extension of the original closing date of June 30, 1997. Disbursements against commitments under the project were made until April 27, 1998. An outstanding balance of SDR 5.3 million (about US$ 7.2 million) was canceled on May 1, 1998. 12. Key Factors Affecting Implementation. The project was implemented during a period of severe political instability and economic hardship. A long period of political instability following the National Conference in 1991 and a political deadlock in 1995 culminated in a military coup in January 1996. Legislative elections were boycotted by opposition parties; and the unresolved and continuing political instability in Niger has had a negative impact on project implementation. Among the most detrimental results of this situation were: (1) the high turnover of Ministers and key technical staff; and (2) suspension of significant donor assistance to population and reproductive health in protest of the military coup, some of which has never been reinstated. In addition, the dire public finance situation in Niger left civil servants without salaries for extended periods of time, creating conditions of low morale and lack of motivation. 13. Organizational and managerial constraints were also formidable. Government capacity to implement a project of this magnitude and complexity was inadequate. MSDIP/WD/CP was a new, sparsely staffed, relatively weak Ministry with a very small budget and a broad, somewhat unclear mandate, which changed over the life of the project and which tended to compete with, and even duplicate, the efforts of other Ministries. The project coordination unit (CCPP) lacked basic capacity in project management and coordination, most particularly in: planning and programming, procurement, financial management, supervision, monitoring and evaluation. During the course of project implementation, the CCPP exceeded its mandate to manage and coordinate project activities and assumed an increasing role in implementation, as Well as increased autonomy and decreased accountability. The performance of NIGETIP as contractor for the health civil works component was unsatisfactory. 14. Assessment of the Bank's and the Borrower's Performance. Bank's performance during project development was mixed. The sector dialogue was good, focusing on a holistic approach to addressing population issues. While the project objectives were pertinent, project design and complexity underestimated institutional capacity to carry out a project of this nature and magnitude. A number of risks should have been cited and addressed as a part of the design process. Project design could. have benefited greatly from the setting of baseline indicators at the level of the 9 arrondissements and from more involvement of beneficiaries and decentralized decision-  - v - makers and technical staff of the various implementing Ministries. Bank's performance during implementation was unsatisfactory. Problems raised in Aide Memoires were not addressed and resolved in subsequent missions, reporting on 590s was overly optimistic and overly focused on inputs vs. impact, and mission composition was not always responsive to project issues. The mid-term review was not exploited as an effective vehicle for reviewing and revising project objectives and design or for improving implementation performance and impact. 15. Considering that this Population project was the first of its kind in Niger and that family planning and women's status were extremely sensitive topics, Government performance during project development was satisfactory in general. The existence of a national population policy provided an enabling framework for program and project implementation. On the whole, Government performance on project implementation was unsatisfactory, however. MSD/P/WD/CP was unsuccessful in effectively coordinating other Ministries responsible for implementing different components of the project. Despite its mandate, this Ministry did not link strategically its own overridinQ social objectives to those of the project, nor did it forge links between the program project objectives and the expressed needs of the population it was serving. The CCPP's performance in project coordination and management was also unsatisfactory. Lack of respect of Bank procedures persisted through the end of the project. Management and supervision of the contract with NIGETIP were not adequately carried out resulting in infrastructure of marginal quality. FINDINGS OF PROJECT IMPLEMENTATION EXPERIENCE 16. The Population project was implemented during a period when Niger was facing very considerable constraints -- socio-political, economic and financial. While fully appropriate to Niger's development and population agenda, project objectives wvere too ambitious for a five-year project to implement successfully. The project's outcome vis-a- vis its stated objectives has, therefore, been rated unsatisfactory. This being said, however, the project comnpleted a considerable portion of the investments and activities envisaged in the project, and it is anticipated that much of this investment and effort, particularly that supporting health sector development, will be sustained and will, in the medium-term, make some contribution to the realization of program and project objectives. Sustainability of the women's groups will need a concerted effort on the part of Goverrnent to apply lessons of project implementation and to find the right institutions, the most cost-effective approaches and the cheapest, most available financing for supporting efforts in this regard. Support of mass communications for population and efforts to strengthen capacity for data collection and analysis and research has been disappointing.  - vi - FUTURE OPERATIONS 17. The Government and the Bank reached general consensus on the ways and means to consolidate and sustain project investments in the health sector (itemized in Section V.B and in the final evaluation mission Aide Memoire shown in Appendix A). Agreed actions include the assumption under the Health Sector Development Program (Credit 2915-NIR) of most major investments that could not be implemented before the Niger Population closing date, as well as support to the functioning of health facilities strengthened under the Population project, in line with reform implementation envisaged under Niger's Health Sector Development Plan for the period 1994-2000. In addition, during the final evaluation mission, the Bank and MOPH committed themselves to devoting greater effort to ensuring the availability, quality and access of the full range of reproductive health services that constitute an important part of the minimum package of services that has been defined for each level of the health svstem. It was also agreed that the strengthening ofpartnerships in health component of the new health project would be used as an effective vehicle for continued efforts to exploit alternative (non- govemmental) channels for family planning services and information and also for linking with women's Croups supported under the Population project in an effort to promote safe motherhood and extend preventive and promotional activities for improved family health. While the Bank emphasized its recognition of the potential contributions of women s groups to poverty alleviation and to the stimulation of desire for smaller family size, it noted that the overhead costs of support to these groups under the Population project we-re not sustainable and recommended that Government: (a) incorporate lessons of implementation experience so as to decrease significantly the costs and improve the cost- effectiveness of such efforts and to use more efficiently the comparative advantages and mandates of the multiple Government and non-aovermental structures in Niger to this end; and (b) exploit IDA financing immediately available through IDA's ongoing portfolio of projects under supervision -- worth some USS135 million -- for support of these groups, as many of these projects support objectives commensurate with such initiatives. The Country Director and senior members of the country team representing key sectors and initiatives committed themselves at the final evaluation workshop to meeting and pursuing how they can collaborate among themselves and with Government to address more effectively Niger's population agenda. LESSONS FOR FUTURE PROJECTS IN THE SECTOR IN NIGER 18. A number of lessons of project design and development emerged from the evaluation process. Project objectives should be realistic so as to be feasible within the established timeframe of the life of the project. And they should be based, to the extent possible. on a sound knowledge of the existing situation. Reliable baseline data are essential in this regard. Complex projects implemented through various Ministries require well-defined monitoring and supervision systems with a capacity to address and resolve constraints in a flexible, pro-active manner. Involvement of key stakeholders (including beneficiaries and decentralized personnel) increase ownership and sustainability. A more comprehensive and rigorous assessment of institutional capacity  - vii - would have modified project design and introduced interventions to streamline and strengthen that capacity. The objective of achieving sustainability of project investments should have been a driving force in the project, from its very conception, and throughout implementation. 19. The most salierLt of all of the implementation lessons is the importance of embracing a learning approach. The project's design and complexity, weaknesses in capacity and cumbersome institutional arrangements, political and economic factors affecting project implementation -- all of these could have been proactively addressed and minimized, had supervision missions constantly questioned the viability of project objectives and implementation arrangements and been in constant pursuit of ways and means to finetune implementation effectiveness and maximize impact. Greater adherence to the annual programming and evaluation process, envisaged in the project design, would have accommodated both more rigor and more flexibility during project implementation to take into account and to manage opportunities and constraints emerging from implementation experience. In short, opportunities should have been more fully exploited to address and quickly resolve project implementation issues. The mid-term review process and the special financial and operational audits should have been more fully exploited in this regard.  IMPLENIENTATION COMPLETION REPORT REPUBLIC OF NIGER POPULATION PROJECT (Credit 2360-NIR) PART I: PROJECT IMPLEMENTATION ASSESSMENT I. INTRODUCTION' A. MACROECONOMIC SETTING 1. Niger is one of the poorest countries in the world and ranks last in the world in the UNDP's human development index. One out of five children die before the age of five, which is double the average for low-income countries. Four out of five adults are illiterate, two and a half times the average for low-income countries. Fewer than one out of three children attend primary school, less than one third the average for low-income countries. Per capita income is estimated at US$200 in 1996, and more ihan 60 percent of the population lives on less than a dollar a day. Overall economic performance has been dismal since the 1960s and poverty has increased steadily over the last 30 years. GDP has hardly grown -- the 30-year real growth rate is 0.3 percent, while the population has more than doubled. Agricultural GDP has actually declined over the same period. During the last 30 years there have been only two relatively brief occasions when GDP growth wvas positive for more than two consecutive years. The first was the 1977-80 uranium boom and the second was the 1993-97 period when rainfall was relatively favorable and the CFAF was devalued. Poor economic and social performance is mirrored in weak implementation of development projects. 2. Progress on stabilization and economic reform has been episodic. Niger abandoned its economic reform efforts in ithe early 1990s with.consequent disarray in public finances. Critical problems were low revenue mobilization due in large measure to tax evasion, an unaffordable wage bill and public enterprise mismanagement. The Government adopted a stabilization and reform program in December 1995 and has executed it satisfactorily through 1997. Public finance management in 1996 and 1997 was particularly encouraging as it began to address long- standing problems. In particular the Government raised revenue collection by 16 and 15 percent, respectively, in one year, cut the wage bill by 11 percent in 1997, and launched a major privatization program, including for the water, power and telecommunication utilities. A long period of political instability constitutes a major risk for sound economic management. Although there is a broad consensus on the reform agenda of fiscal stabilization, privatization and market liberalization, privatization and wage bill issues are highly political and remain a focus of Govenment opposition. Source: Niger Country Assistance Strategy (CAS), November 1997.  - 2 - B. THE BANK'S ROLE IN THE COUNTRY AND IN THE SECTOR 3. As of March 1998. 50 IDA credits have been approved for Niger for a total of US$785 million equivalent (Appendix C). The Bank's current portfolio of 10 projects under supervision supports structural adjustnent, social sector development, agriculture and rural development, natural resources management and urban infrastructure. Total uindisbursed amount is about US$135 million equivalent (Appendix C). The Bank's CAS for Niger emphasizes that significant improvement in the well-being of the Nigerien population w ill depend on major long- term investments in human capital, a reduction in the population grovth rate, and regional, rather than national, growth opportunities. Future Bank assistance would. therefore, take a long-term view, recognize that Niger will require external assistance for the foreseeable future, and focus on three things: (1) improvements in access and quality of basic education and health services; (2) increased access to safe water and improved water use in agriculture: and (3) promotion of open economic policies and regional linkages to take advantage of external growth opportunities. 4. The first Health Project (Credit 1668-NIR, which became effective on November 3, 1986) marked the beginning of the Bank's involvement in Niger's health sector and was designed to support the government's structural adjustment objectives at the sectoral level: (a) more efficient use of resources: (b) mobilization of resources through cost recovery; and (c) policy reform to improve overall efficiency and effectiveeness in the health sector. Direct sLupport to population activities included: support to familx- planning services and information; and cofinancing of the 1988 Population Census. Policy and program objectives were substantially met and prospects for sustainability of investments are proving to be good. The Population Project (Credit 2360-NIR) was designed to build on achievements of the Health project. The Health Sector Development Program (Credit 2915-NIR, which became effective on July 29. 1997) is a sector investment program (SIP). This investment is designed to support implementation of Niger's Health Sector Development Plan. It supports health reform implementation and has carefully incorporated lessons of experience of both the first Health and Population projects. Among other priorities, this investment is supporting reproductive health services as an integral part of the minimum package of activities at all levels of the health system. II. PROJECT OBJECTIVES A. ORIGINAL PROJECT OBJECTINE 5. The project was designed to assist the Government in implementing an effective national population program, with the primary objective of accelerating the onset of fertility decline by increasing the contraceptive prevalence rate as rapidly as possible. reducing maternal mortality. promoting attitudes favoring a reduction in family size norms, and enhancing the capacity of women to participate effectively in socioeconomic development.  B. PROJECT COMPONENTS 6. The project consisted of three components. The first aimed at strengthening maternal healtlh and family planning services. Designed to complement activities of other aid donors (particularly USAID and UNFPA), this component focused on improving the efficiency, effectiveness and coverage of family planning and safe motherhood interventions at the departmental, district and village levels in three selected Departments (Zinder, Tahoua and Tillabery) through two subcomponents: (a) support of health policy reform in the areas of essential drugs and cost recovery and strengthening departmental and district capacities in strategic sector management; and (b) improving the quality and access of maternal and child health and family planning (MCH/FP) services through investments in infrastructure and training. The second component, promotion offamily welfare and women 's status, was designed to support activities encouraging behavior favoring a reduction in family size norms and improvements in the status of women through three subcomponents: (a) development of a nationwide information, education and communication (IEC) program; (b) promotion of the status of women; and (c) improvements in nutrition interventions. The third and last component aimed at strengthening population policy analysis, research and coordination through activities to (a) improve data collection, research and analytical capacities at the central level; (b) strengthen the institutional capacity to facilitate and coordinate the national population program at the central level; and (c) encourage private sector and NGO initiatives in population and familv planning programs through a Population Fund. C. CREDIT COVENANTS AND SPECIAL AGREEMENTS 7. Special covenants or agreements were included to help promote achievement of project objectives (Table 9). Conditions of effectiveness were as follows: (a) publication of the arrete defining the structure of thLe regional health system, including the roles and functions of the departments and districts in the administration and management of the decentralized health system; and adoption of the policy document defining the personnel recruitment and redeployment plan for 1993-95; (b) adoption of the action plan establishing guidelines for the extension of the drug distribution network, as well as procedures for the introduction of the national essential drugs list; (c) adoption of the revised departmental in-service training modules for MCH/FP and nutrition, including a detailed in-service training plan for the first two years of project implementation; (d) adoption of the statute governing the proposed interregional family health center in Zinder and giving details of the center's organizational structure, role and functions, as well as a proposed staffing plan; (e) publication of the arretj defining the norms and standards for provision of MCH/FP at each service delivery level; (f) publication of an arrete (i) authorizing newly recruited village health workers to provide refills for hormonal contraceptives, as well as supplies of barrier methods and (ii) defining the revised checklist to be used to screen new family pLanning acceptors and other modalities for its utilization; (g) adoption of the by-laws and regulations governing the administration of the Population Fund, together with a procedures manual and a standard contract to be entered into with the would-be beneficiaries of the Fund; and establishment of the committee for the selection of sub-projects to be financed under the Fund; (h) publication of the arrete establishing the Interministerial IEC  - 4 - Technical Committee; (i) submission to IDA for review and comment, of draft bidding documents for all bid packages for the first year of the project; (j) finalization and signature of the contract with the selected auditor; and (k) conclusion of appropriate agreements with other cofinanciers in view of securing all complementary financing required for execution of' the project. After two extensions of the initial limit date for effectiveness, all conditions of effectiveness were complied with and the credit was declared effective on December 1, 1992. 8. Agreed Changes and Amendments. No substantial changes were introduced to the project description or to the implementation arrangements during the life of the project, nor were any amendments made to the Development Credit Agreement. It is worth noting, however, that at the mid-term review it was agreed that all remaining project investments in the health sector would have to be in conformity with Niger's recently issued health sector development plan and with newly established norms and standards for the sector. The credit's original closing date of June 30, 1997 was extended once by six months to December 31, 1997 to accommodate a more in-depth and participatory final evaluation process. D. THE RISKS 9. The SAR identified three main risks: (a) persistence of the unstable political situation that might threaten the attention and visibility of the population and family planning programr; (b) slow implementation of the decentralization strategy at departmental and district levels; and (c) non-respect or ineffective implementation of the plan for redeployment of health personnel from the central to the regional and district levels. All three of these risks proved to be real and ef."forts envisaged under the project to mitigate them had some, albeit marginal, impact. There were other, more pressing, risks. however, that should have been anticipated and effectively addressed at the project design stage. These risks were mainly institutional and socio-political in nature. There was considerable risk that Government did not have sufficient capacity to implement such an ambitious and complex project. The Ministry of Social Development, Population, Woman's Development and Protection of the Child (MSD/P/`D/CP) was given the overall responsibility for project coordination and management, yet it was newly established and its human and budgetary resources were extremely limited. Risk was also considerable that coordination of the inputs and actions of five different Ministries responsible for implementation of different components and subcomponents under the project would prove too difficult, especially for a brand new Ministry with an unclear mandate, weak capacity and weak standing in the hierarchy of Government. USAID and Canadian capacity building efforts were ongoing but insufficcient to prepare MSD/P/WD/CP for this responsibility. The risk of probable turnover of' key Ministers. and other key actors, who were strong leaders and proponents of the population program, should have been anticipated. These risks could have been mitigated at the design stage by, among other things, efforts to: strengthen MSD/P/WD/CP and/or scale back project complexity; clearly define roles and responsibilities, as well as systems and procedures, in project management, coordination and implementation; build project success more around institutions vs. individual leaders; and employ consultative and participatory approaches during project design and implementation that would have broadened and deepened understanding and ownership of the project and program.  -5 - E. EVALUATION OF PROJECT OBJECTIVES 10. The project's objectives were -- and remain -- consistent with the Bank's and Niger's strategies for economic recovery and development. The objectives are also consistent with the international consensus on the approach to population and reproductive health reached at the 1994 International Conference on Population and Development in Cairo, which encompasses efforts to: bridge the gender gap in education, promote equity for women, reduce maternal mortality and morbidity, increase child survival, provide universal access to reproductive health and family planning services and information, and integrate the population agenda into all national policies and strategies. At the same time, project objectives -- and the consequent project design -- were very ambitious, covering a wide range of challenges and sectors (health sector reform, improvements to quality and coverage of health services, essential drugs policy, nutrition interventions, income generation for women, literacy and numeracy initiatives, institution building, vital registration, population analysis, research, monitoring and coordination) in a country with very limited management and institutional capacity, where the Bank had limited operational experience. Project targets (especially those aimed at reduction of fertility and increasing contraceptive prevalence rates) were also ambitious given the 5-year time span of the project and given considerable pockets of resistance of initiatives to limit family size and improve the status of women. The mid-term review of the project should have been seized as an opportunity for the review and revision of project objectives in light of the progress in implementation and lessons of experience and in light of evolutions in policy, institutional arrangements and socio-political and religious attitudes towards family planning and women's status. III. IMPLEMENTATION EXPERIENCE AND RESULTS A. ASSESSMENT OF PROJECT'S OUTCOME AND SUSTAINABILITY 11. The lack of region-specific baseline data in the 9 arrondissements covered by the project and the lack of an adequate, decentralized monitoring system with clear performance indicators make it difficult to quantify and qualify any gains made in achieving the main objectives of the project: increasing the contraceptive prevalence rate, reducing maternal mortality, promoting attitudes favoring a reduction in family size norms, and enhancing the capacity of women to participate effectively in socioeconomic development. This assessment is thus based on all elements of the national evaluation process and on the mission's own independent field visits, reviews and discussions. In summary, while the project succeeded in providing most inputs and in carrying out most activities envisaged under the project (planned vs. actual inputs and activities are itemized in Table 5), its overall success in achieving its stated objectives is unsatisfactory. This being said, however, project inputs and activities, particularly those supporting health sector development, are highly likely to contribute in the coming years to the realization of program/project objectives. The sustainability of project investments varies from component to component and is discussed in detail in Section V.B. of this report. In summary, sustainability of health sector investments, which constitute the bulk of project investments, will be assured thanks to the support envisaged in the context of the Health Sector Development  - 6 - Project (Credit 2915-NIR). On the other hand. the sustainabilitv of women's groups is in jeopardy until certain steps are taken to: improve the cost effectiveness of such initiatives; define and exploit more fully the mandates and comparative advantages of the various Ministries involved, most particularly MSD/P/WD/CP, and of the small, but growing, network of NGOs; and draw on grant monies and funds available through IDA's existing portfolio of projects xvhose objectives accommodate such initiatives. 12. Major outcomes of the various components are summarized as follows. Under the first component, strengthening maternal and child health services, project inputs contributed to the upgrading and equipment of first-referral services (now called district hospitals under the new sector development plan), and of selected primary level facilities (see Table 5A for itemization). Completion of works and procurement of equipment transferred to the new health project are already underway and should provide the necessary complement for making the district hospitals functional. Training of staff at all levels of the system should render them more capable of delivering reproductive health services and of sector management. Construction of housin g for health personnel is helping to curtail high mobility of service providers. Under the second component, promotion offamily welfare and uwomen 's status, IEC training and equipment were provided to the department of health education of the Ministry of Public Health (MOPH) at the central and departmental levels. Fuller exploitation of this assistance must be pursued through a needed review and revision of Niger's communication strategy. Local level social workers were trained iP interpersonal communication. Listening clubs at the village level were provided with radios and cassettes but this material remains to be fully exploited. Also under this second component, 53 women's groups (about 3,000 wvomen) benefited from training in literacy and management and from microproject funds, which have allowed them to undertake income generation activities. These interventions show the potential of women's groups in giving women the capacity, income and opportunity to care for themselves and their families more effectively. They have also given women more weieht in decision-making in their families and in their communities; and they have created greater solidarity among women. The timeframne of support to these women's groups was too short to have had any discernible effect on changing attitudes in desired family size. It must also be said that the overhead costs for this component were high and would need to be scaled back significantly in the future. The last component, strengthening population policy analysis, research and coordination, contributed to improvernents in vital statistics registration. A number of studies were also produced under this component (itemized in Table 6) that might be better exploited. Niger's National Population Commission (CONAPO) received equipment and material to enable it to carry out its mandate more effectively, but it is still in need of other support to enable it to facilitate and coordinate the national population program at the central level. The recent transfer of this entity to the office of the Prime Minister may give it the weight and credibility to improve its performance and irmpact. Finally, the Population Fund supported NGO and private sector involvement in population activities. While the idea is excellent, the operation of this fund suffered from being insufficiently decentralized and participatory, and from poor financial management. After 45 projects were funded, this Fund was closed at the mid-term review.  B. SUMMARY OF COSTS 13. At appraisal, the total cost of the project was estimated at US$24.1 million equivalent (net of taxes and duties) with a foreign exchange component of US$12.3 million (51%). Base cost estimates were in February 1992 prices. Actual total project cost was US$12.6 million, of which US$2.7 was in foreign exchange. 14. The difference between projected and actual total project cost is significant. Table 7A itemizes these differences by cost category, bv project component and by local vs. foreign components. The 1994 devaluation is an important factor in explaining the difference between the projected vs. actual costs of the local component (US$11.8 million equivalent vs. US$9.9 million equivalent): the value of the local component after devaluation, expressed in US dollars, is half of that estimated at appr aisal, given that the CFAF was devalued by 50 percent vis-a-vis the French franc. On the other hand, the difference in the projected vs. actual costs of the foreign component (US$12.3 million equivalent vs. US$2.7 million equivalent) is attributable to other factors, most notably: the transfer of unfinished investments in civil works and equipment to the new health project (paragraphi 30); the underutilization of international technical assistance programmed under the project; and, in view of the nature of many the activities, the overestimation at appraisal of -he foreign component for the project. In addition, the actual costs of project coordination and management were much higher than anticipated. This cost category consumed 20 percent of total project costs vs. the 5 percent estimated at appraisal. While the local component of this expenditure should have been low -er due to the devaluation effect, actual local costs for project coordination were four times the amount estimated at appraisal C. FINANCING ARR-ANGEMENTS 15. Table 7B shows the planned vs. actual financing plans for the project. At the time of Board presentation it was estimated that the total project cost of US$24.1 million equivalent would be financed as follows: IDA: US$17.6 million equivalent; Government: US$2.7 million equivalent; NGO/Private Sector: US$0.2 million equivalent; communities: US$0.1 million equivalent; the Belgian Coop,ration: US$2.5 million equivalent; and UNICEF: US$1.0 million equivalent. The actual financing of this project was somewhat different. IDA financing was US$10.9 million equivalent, some US$6.7 million equivalent less than planned when compared at appraisal exchange rate of the US dollars with the SDR. This difference is due to the project's inability to complete a number of key investments prior its closing date (paragraph 30). Government financing, at USS 1.4 million equivalent was half of the appraisal estimate, but this shortfall can be explained in large part by the devaluation effect; and its contribution as a percentage of total project cost is fully consistent with the appraisal estimate of 11 percent. Actual community contributions matched projections. NGO contributed 100 percent of contributions to local costs, but did not finance the US$0.1 million worth of foreign costs, as projected. After Board presentation, Belgium chose not to cofinance the Population project, but, rather, to provide assistance through its bilateral channels. To compensate for this change, the Population project financed three UN Volunteers to carry out the tasks initially slated for Belgian technical assistance: the training and backstopping of district hospital surgical staff. UNICEF  - 8 - only contributed US$0.1 million equivalent to nutrition activities (vs. US$1.0 million equivalent planned), because it also chose ultimately other vehicles for channeling its support to nutrition activities. D. IMPLEMENTATION SCHEDULE 16. The project was prepared over a period of two years, with the first identification mission taking place in May 1990 and the Board Presentation and signature of the Development Credit Agreement taking place on April 30, 1992, and May 22, 1992, respectively. The credit became effective on December 1. 1992 and closed five years later on December 31, 1997 after one six- month extension of the original closing date of June 30, 1997. While the mid-term review should have been scheduled for the end of 1994 (two years before the December 1996 completion date), it did not actually take place until April 1996. and the exercise wasn't completed until a second phase mid-term review mission and workshop took place in October 1996. Disbursements against commitments under the project were made until April 27, 1998. An outstanding balance of SDR 5.3 million (about US$ 7.2 million) was canceled effective May 1, 1998. Because of substantial delays in the implementation of various project components, a number of investments in health sector infrastructure and equipment were not able to be undertaken in the context of the population project. but were ultimately shifted to the ongoing Health Sector Development Program (Credit 2915-NIR). Suppon to the promotion of women and family health was only initiated during the last two years of the project curtailing both the number of women's groups reached and the timeframe of such assistance. Major reasons for the delays in implementation are summarized below. E. .A-NALYSIS OF KEY FACTORS AFFECTING IMIPLENIENTATION 17. Political and Economic Situation. A long period of poliiical instability following the National Conference in 1991 and political deadlock in 1995 culmninated in a military coup in January 1996. Legislarive elections in November 1996 were boycotted by opposition parties and the unresolved and continuing political instabilitvy in Niger has had a negative impact on project implementation. The high turnover of Ministers of Social Development, Population, Woman's Development and Child s Protection and of Public Health (with a new Minister appointed every 8-9 months on average for each Ministry throughout the life of the project),. and the accompanying, frequent changes in Secretary General and other key positions, have also disrupted project implementation, as each new Minister revisited and questioned project objectives and implementation progress. Significant donor assistance to populatiorL and reproducitive health was lost as donors suspended aid in protest of the military coup. Substantial USAID support to population (including contraceptive procurement and the support of non- governmental channels of service delivery) has never been reinstated. In addition, the dire public finance situation in Ni2er has left civil servants without salaries for extended periods of time, creating conditions of low morale and lack of motivation. This prompted pressure on the project to supplement salaries through the financing of overtime, training costs and per diems. Finally, widespread sensitivities to issues of women's status. coupled with the highly volatile political situation, caused the family code to be shelved.  - 9 - 18. Organizational/Managerial Constraints. Govermment capacity to implement a project of this magnitude and comrplexity was inadequate. Lack of progress in implementing Niger's decentralization policy, particularly decentralization of budgets and financial responsibilities, impeded the decentralized thrust of this project. MSD/P/WD/CP was a new, sparsely staffed, relatively weak Ministry with a very small budget and a broad, somewhat unclear mandate, which changed over the life of the project and which tended to compete with, and even duplicate, the efforts of other Ministries. Despite the fact that the bulk of funds under this project were direct investments in health sector development, MOPH involvement in implementation of the health component was impeded by the complex institutional arrangements and inadequate definition of roles and responsibilities of the various actors: MSD/P/WD/CP as coordinator; MOPH as implementor (encompassing central, departmental and local level managers and technical staff); NIGETIP as contractor of civil works investrnents. These deficiencies were clearly illustrated in the inadequate communications and monitoring of the health civil works component, which culminated in less than satisfactory quality of works under the project (Table 5B). 19. The project coordination unit (CCPP) lacked basic capacity in project management and coordination, most particularly in: planning and programming, procurement, financial management, supervision, monitoring and evaluation. During the course of project implementation, the CCPP exceeded its mandate to manage and coordinate project activities and assumed an increasing role in implementation, as well as increased autonomy and decreased accountability. Rather than relying on line Ministries for implementing various components, CCPP on a number of occasions requested financing to hire technical staff to oversee implementation. This was a phenomenon of a number of factors, including: CCPP's attachment to a relatively weak and under-resourced Ministry, fast tumover of Ministers and Secretary Generals for MSD/P/WD/CP, and CCPP's enormous financial clout, being the channel for all financial resources of the project during a time of severe public finance and budgetary constraints. The Government's chapter notes that it was CCPP's autonomy that allowed it to function during a period of political and economic instability. It must also be noted that, however, this autonomy was inhibiting of capacity building of line ministries and too expensive to be sustainable. Financial mismanagement was raised in annual audits as well as in the special financial audit undertaken prior to the mid-term review. Neither these nor the operational audit, also prepared prior to the mid-term review, led to any concrete action by Govermment or by the Bank to correct these serious flaws in project management. 20. The performance of NIGETIP (Niger's Public Works and Employment Agency), as an executing agency for the health civil works component was unsatisfactory. The elements of this poor performance, the reasons behind it, as well as actions to avoid repeating the same mistakes in the future were discussed and agreed with this contractor in a tripartite meeting (Government of Niger, World Bank, NIGETIP), recorded in the mission's Aide Memoire and summarized in Table 5B.  - 10- F. ASSESSMIENT OF THE BANK'S PERFORMANCE 21. Bank's perfornance during project development was mixed. The sector dialogue was good, focusing on a holistic approach to addressing population issues, encompassing the need to improve the supply and quality of health services with a particular emphasis on reproductive health; stimulate demand for family planning services and information through investments to improve the status and opportunities of women; and incorporate quality population data, analysis and research into national macroeconomic and sector policy and strategy. The essence of this dialogue remains commnensurate wNith the thrust of the CAS and, as well, with the recommendations of the 1994 Cairo Population Conference on which an international consensus was reached (para. 10). This dialogue should also be appreciated in light of the fact that there was still widespread resistance to efforts to limit family size and to improve the status of women. While the project objectives were pertinent, project design and complexity underestimated institutional capacity to carry out a project of this nature and magnitude. A number of risks should have been cited and addressed at this stage (para. 9). Performance indicators were itemized for use during the mid-term review (MTR), but indicators and baselines for monitoring of implementation progress as well as impact at the level of the nine arrondissements were not defined. Project design could have benefited greatly from more involvement of beneficiaries and of decentralized decision-makers and technical staff of the various implementing Ministries. During the design phase, coordination with MOPH was good, given that the same Bank team worked on both population and health. 22. Bank's performance during project implementation was unsatisfactory. Supervision was inadequate from a number of perspectives. Supervision missions focused too heavily on tasks in Niamey and visits to subregions in the three departments covered under the project were too infrequent and cursory. Problems raised in Aide M6moires were not addressed and resolved in subsequent missions. Reporting on 590s was overly optimistic, minimizing issues associated with implementation performance, impact and respect of covenants. Supervision reporting focused too much on project inputs and not enough on project outcome and impact, and did not include ongoing validation of project objectives in light of implementation progress, issues and constrairts and evolutions in relevant policy and strategy. Skills mix of supervision missions did not accommodate the need to address and resolve crucial technical issues: civil works, procurement, organization and management/institutional development, accounting and financial managemrrent. The team's performance in handling procurement matters was weak: there were long delays in communicating the Bank's non-objections; and the team's review of procurement files was in many cases not sufficiently comprehensive or rigorous. The MTR, carried out in two phases, was not exploited as an effective vehicle for putting the project back on track, in spite of the results of the operational and special financial audits carried out prior to the MTR. Neither did the MTR culminate in a set of lessons to apply immediately for improved project performance or in a detailed planning of the remainder of project activities that could have provided a credible basis for seeking an extension of the project. 23. Quality of the Bank's supenrision work suffered considerably as a result of rapid turnover of task teams and task tearn leaders and a lack of clarity of roles and responsibilities. During the 5-year life of the project there were four different task managers. The second and third task team  - Il - leaders were assigned exclusively to work on population issues in Niger; and communication and coordination between this team and the team responsible for health in Niger was inadequate, resulting on occasion in conflicting messages to Government. While field staff would have been well placed to reconcile and resolve such internal disagreements, their roles and responsibilities were unclear and they were not fully used to their potential. Disagreements and conflicts in approach across the four successive population task managers and their teams were also evident. Changes in Country Directors, Sector Managers and Resident Representatives during this period only exacerbated this situation. Corrective measures have been taken: the recently appointed task team for this project works across both health and population, and this is also the case now for the responsible field staff. Current managers have been brought into the dialogue to reconcile and resolve outstanding conflicts in messages. G. ASSESSMENT OF THE BORROWER'S PERFORMANCE 24. Considering that this Population project was the first of its kind in Niger and that family planning and women's status were extremely sensitive topics, Govemment performance during project development was satisfactory in general. This was due in significant part to the vision and leadership of the Ministers of Social Development, Population, Woman's Development and Child's Protection and Public Health, who worked well with the Bank and with each other. Also, the existence of a national population policy provided an enabling framework for program and project implementation. There were some weaknesses in project development, the most noteworthy of which are: inadequate assessment of institutional capacity for project coordination, implementation and management; inadequate incorporation of sociological and political dimensions and risks in project design; and insufficient solicitation and incorporation of stakeholders' points of viewv into project design. 25. On the whole. Government performance on project implementation was unsatisfactor,. for reasons itemized in Section E, above. MSD.P/WD/CP was unsuccessful in effectively coordinating other Ministries responsible for implementing different components of the project; and it did not wield enough authority and quality control over the CCPP. which was placed under its overall responsibility. Despite its mandate, this Ministry did not link strategically its own overriding social objectives to those of the project, nor did it forge links between the program/project objectives and the expressed needs of the population it was serving. Until recently this Ministry had no representation at the departmental level and so was far removed from its stated grassroots orientation. Neither did it exploit the opportunity to forge stronger links with the small, but growing network of NGOs in pursuit of project activities, although this was a stated objective of the project. The Ministrv did not take advantage of the opportunity it had under the project for building its capacity; the technical assistance programmed under the project was not fully utilized. In addition, Government failed to comply fully with a number of key covenants of the Development Credit Agreement (Table 9). 26. The CCPP's performance in project coordination and management was also unsatisfactory. It lacked critical skills and experience in project management, and took little or no action to address and correct problems raised in Bank mission Aide Memoires. During the  -12 - course of the project life, CCPP gained more autonomy and power than had been envisaged and gradually took on more of an implementation (vs. coordination) role. Management and supervision of the subcontract with NIGETIP (executing agency for health civil works) was not adequately carried out with the result being that infrastructure constructed/rehabilitated under the project was of low quality and not fully responsive to technical requirements of the health sector. CCPP's lack of respect of Bank procedures persisted through the end of the project: the Bank was unable to give its non objection to a number of studies envisaged under the evaluation process (including a beneficiary assessment) because terms of reference, budget, contract, and choice of consultants did not meet minimum requirements even after Bank had transmittecl its comments on preliminary drafts. V. SUMMARY OF FINDINGS, FUTURE OPERATIONS AND KEY LESSONS LEARNED A. FINDINGS OF PROJECT IMPLEMENTATION EXPERIENCE 27. The Population project was implemented during a period when Niger was facing considerable constraints, among which are: poor economic performance and poor prospects for economic development, a crisis in public finance, high and increasing poverty, political instability, high turnover of Ministers and lead technical specialists, weak, overly centralized institutions and poor performance in virtually all key development sectors (health, education, agriculture), waning donor assistance, and limited involvement of non-governmental sector in social sectors. In addition, the development and implementation of the Population project was also challenged by the fact that the population issue is complex and multisectoral in nature and it touches on the most personal aspects of the lives of Nigeriens and addresses issues that are sensitive and highly volatile, such as limitations in family size and women's status. Despite this difficult context, this Population project was developed to support a national population program. 28. While fully appropriate to Niger's development agenda and to the population agenda, project objectives were too ambitious for a five-year project to implement successfully. The project's outcome vis-a-vis its stated objectives has therefore been rated unsatisfactory. This being said, however, the project completed a considerable portion of the investments and activities envisaged in the project, and it is anticipated that much of this investment and effort, particularly that supporting health sector development, will be sustained and will, in the medium- term, make some contribution to the realization of program and project objectives. Implementation delays ultimately resulted in an underutilization of IDA funds and, after a six- month extension of the closing date, the cancellation of a part of the Credit in the amount of US$ 7.2 million equivalent. Completion and sustainability of the health investments will be ensured through su.pport of the ongoing health project. Sustainability of the women's groups will need a concerted effort on the part of Government to apply lessons of project experience and to find the right institutions, the most cost-effective approaches and the cheapest, most available financing for supporting efforts in this regard. Support of mass communications for population and eifforts to strengthen capacity for data collection and analysis and research has been disappointing.  - 13 - 29. Both the Bank's and the Borrower's performances have been mixed and a number of steps are suggested to improve them. By far the two most importanm themes of this evaluation process -- both to Government and to the Bank -- were: the consolidation and sustainability of achievements made under the project; and lessons learned. These were exhaustively addressed and discussed throughout the evaluation process and there is full consensus that responsibilities for following up on both of these themes rests with both parties. The following two sections on "Sustainabilitv and Future Operations" and on "Lessons for Future Projects in the Sector in Niger" provide, in practical form, the essence of findings of project imDlementation experience. B. SUSTAINABILITY AND FUTURE OPERATIONS 30. The Government and the Bank reached general consensus on the ways and means to consolidate and sustain project investments in the health sector (recorded in final evaluation mission Aide Memoire shown in Appendix A). In summary, the Health Sector Development Program (Credit 2915-NIR) has already assumed the responsibility for financing most major investments that could not be implemented before the Niger Population closing date, most notably: construction and equipment of radiology facilities and equipment of surgical facilities for district hospitals consmicted under the Population project, construction and equipment of the nine office facilities for the nine district health teams. Furthermore, of the nine districts supported under the Popuiaation project, three (Fillingue and Say in the Department of Tillaberi, and Mirriah in the Departnent of Zinder) were already targeted under the new health project for intensive support in implementing their district health plans, in line with national health sector reform. With reference to provisions agreed between Government and the Bank in June 1996 during negotiation of the new health project, and in light of significant reduction in committed donor assistance to health sector operations since that time (particularly the closing down of USAID office and operations in late 1996), the Bank- and the MOPH confirmed their agreement to support the functioning of health facilities and health reform implementation in the remaining six districts included in the Population project subject to certain conditionalities and principles that all target health districts are subject to under the new health project (itemized in attached Aide Memoire). During the final evaluation mission, the Bank and the MOPH committed themselves to devoting greater effort to ensuring the availability, quality and access of the full range of reproductive health services that constitute an important part of the minimum package of services that have been defined for each level of the health svstem. Past experience has shown all too clearly that these services can be easily neglected in favor of curative services. Finally, it was acknowledged and agreed that the strengthening of partnerships in health component of the new health project can and should be used as an effective vehicle for continued efforts to exploit alternative (non-governmental) channels for family planning services delivery and promotion, and also for linking with women's groups established and supported under the Population project in an effort to promote safe motherhood and extend preventive and promotional activities for improved family health. 31. There were also a number of points of disagreement between Government and Bank on the consolidation and sustainability of other outputs of the Population project. While Government requested financing under the new health project of the equipment and functioning  - 14 - of the Zinder Center for Reproductive Health, constructed under the Population project, the Bank kept its position on this issue as discussed and recorded in Aide Mdmoires of the final evaluation mission as well as those of previous missions. In summary, in light of a number of evolutions since its conception over 9 years ago, the Bank questions the viability of this Center and recommends a review and revision of its mandate, before it would consider the financing of its equipment and functioning, based on a number of criteria discussed during the last several missions and itemized in the mission's final evaluation Aide Memoire (attached). 32. Perhaps Government's greatest concern was for the future of the women's groups established under the microproject fund. Having only been established and supported ovei the last two years (or less) of the project, these groups were seen as fragile and almost certain to disintegrate unless added support (continued training and support of women's groups, continued financing of salaries of rural animatrices and of the costs of supervision of decentralized MSD/P/WD/CP staff) is provided. The Government presented to the Bank a request for " interim" financing aimed at: supporting existing women's groups; extending the fund to establish and support additional groups; and developing a second Population project. While the Bank emphasized its recognition of the potential contributions of these groups to poverty alleviation and to the stimulation of desire for smaller family size. it noted that the overhead costs of support to these groups under the Population project were excessively high and recommended that Government: (a) exploit IDA financing immediately available through IDA's ongoing portfolio of projects under supervision -- worth some US$135 million -- for support of these groups, as many of these projects support objectives commensurate with such initiatives; and (b) incorporate lessons of implementation experience so as to decrease significantly the costs and cost-effectiveness of such efforts and to use more efficiently the comparative advantages and mandates of the multiple Governnent and non-governnental structures in Niger to this end. 33. More broadly speaking, the Bank seized the occasion of the final evaluation of the Population project to communicate to Government its strong commitment to addressing population issues in the context of its overall development strategy for Niger. The Country Director and senior members of the country team representing key sectors and initiatives, attended a special session of the final evaluation work-shop devoted to the topic of sustainability and future operations and specified that Bank's future support to population will be determined in large part by the Cairo agenda (para. 10). This agenda is clearly multisectoral in nature and highlights the need to draw on the potential contributions of all sectors and development initiatives. This requires a clear and holistic national vision on population issues, strategy and priority interventions that will both mobilize and render accountable key actors and institutions. In the context of Niger's severe public finance constraints, it also requires a concerted effort to minimize the costs of carrying out activities -- particularly the overhead costs -- as well as efforts to achieve greater cost effectiveness. 34. Any future support to population activities that the World Bank might consider will also take into full account the achievements, shortfalls, lessons and perspectives emanating from program implementation -- both those activities financed by IDA through the Population project and those financed by others. It will also take into consideration the need to streamline cumbersome institutional arrangements that are both costly and inefficient. The Director  - 15- committed the country team to a meeting to explore how best it can support Niger in its efforts to address population issues. This meeting will review the Bank's portfolio of ongoing projects with a view to exploiting its full potential for contributing to Niger's population agenda. It will also review its menu of lending and non-lending instruments and their adequacy for addressing any priority areas that cannot be effectively covered under the existing portfolio. This approach is fully consistent with the draft population strategy that is currently being developed by the Bank for eventual presentation to the Bank's Board of Executive Directors. C. LESSONS FOR FUTURE PROJECTS IN THE SECTOR IN NIGER 35. The following lessons were gleaned from the evaluation process. They are annexed to the final evaluation mission's Aide Memoire and were reviewed jointly with Government with a view to ensuring their application in the implementation of the Health Sector Development Project. These are lessons that both the Bank and the Government must learn and apply. 36. Lessons of Project Design and Development. The lessons of project design and development are: (a) project objectives should be sufficiently modest so as to be feasible within the established timeframe of the life of the project. And they should be based. to the extent possible, on a sound knowledge of the existing situation. The compilation of reliable baseline data is verv important in this regard. Clear targets and indicators should be set at the outset; (b) conditions for effectiveness should be limited to only a few key actions, as most critical actions should be implemented during project preparation; (c) complex projects implemented through various Ministries require well-defined monitoring and supervision systems with a capacity to address and resolve constraints to smooth implementation in a timely and efficient manner. Such systems should also continually examine strategies. modify or revise objectives, reorient priorities in order to respond to an environment where external and internal forces are dynamic and changing; (d) key stakeholders, including the beneficiaries, service providers, local authorities. NGOs and key donors involved in the sector, should be identified at the outset and involved in all stages of project desian and development: needs assessment, design, setting of targets and indicators, implementation, management and evaluation; (e) a more comprehensive and rigorous assessment of institutional capacity would have modified project design and introduced interventions to steamline and strengthen that capacity. Project complexity should not exceed institutional capacity. A least cost approach should drive the project design and costing exercise, with a particular emphasis on fully accounting for and minimizing the recurrent cost implications of project/program investments; and (f) the objective of achieving sustainability of project investments should have been a driving force in the project, from its very conception, and throughout implementation, rather than emerging as a crisis at the project's closing. 37. Lessons of Project Implementation. In order to improve Government's effectiveness in its efforts to address population issues, more effort must be devoted to develop capacity: in coordination of activities; in management of resources; in decentralized strategic sector management; and in decentralized implementation. Future support to social development initiatives should not only inform and involve local actors and stakeholders. Its very conception should be initiated at the local level and primary responsibility for its implementation should also  - 16- be assigned to the local level. This will serve to make interventions more commensurate with local priorities and needs. It will also serve to elicit greater ownership of project goals and activities and will significantly enhance prospects for sustainability. The roles and responsibilities of the various institutions within Government for the coordination and implementation of population activities are not clearly defined and have been proven through project experience to be inefficient. The recent decree placing CONAPO (National Commission on Population Activities) in the office of the prime minister is a positive step in raising the prominence of the population issue and in facilitating its mandate to coordinate activities across Ministries. However, considerably more effort must be devoted to clarifying the roles and responsibilities for defining and implementing a population agenda for Niger, that would be commensurate with the comparative advantages of the various institutions in Niger. The support of future activities that would be implemented through this MSD/P/WD/CP must be grounded1 in a revised mandate. mission objectives, strategy and program of that Ministry that would exploit its relative strengths vis-a-vis other Ministries in addressing population and gender issues and that would eliminate duplication or competition with other Ministries. 38. Institutional arrangements for project implementation should have been reviewed and revised during the life of the project to correct the trend of the CCPP assuming increasing power, autonomy, executing (vs. coordination) responsibility and consuming considerably more of project resources than initially planned. Greater adherence to the annual programming and evaluation process. envisaged in the project design, would have accommodated both more rigor and more flexibility during project implementation to take into account and manage opportunities and constraints emerging from implementation experience. Opportunities should have been more fully exploited to address and quickly resolve project implementation issues. The mid-tern review process and the special financial and operational audits could have been more full)y exploited in this regard. Routine (quarterly or semi-annual) reporting on project execution should have been more instrumental in identifying and resolving implementation issues effectively and efficiently. The credit's original closing date of June 30, 1997, negotiated and agreed and clearly stated in the Development Credit Agreement, should not have come as a surprise to project implementors and beneficiaries. The decision to close the credit after a six- month extension and to integrate unfinished health investments into the new health project was the outcorne of extensive discussion of Government's request for credit extension in which all key actors in the Bank participated: Management, the resident representative, technical advisors and members of the population and health teams, encompassing both HQ and field-based staff. This decision was immediately communicated to Government by field staff. 39. Investments in service quality improvements were not fully exploited or consolidated due to a lack of technical support and follow-up that should have been provided through the implementation of a well-designed supervision program. Likewise, a lack of follow-up and evaluation of training investments left MOPH and MSD/P/WD/CP incapable of ensuring optimal utilization of newly acquired skills and of assessing the utility of training to guide future investments in human resources development. Greater emphasis on both of these -- supervision and training evaluation -- would have contributed to enhance service quality. More emphasis should also have been placed on the preventive aspects of reproductive health and on issues of service quality. The adoption of Niger's Health Sector Development Plan (PDS) in 1994,  - 17- including a clear definition of the full range of reproductive health services within the context of the minimum package of activities, should have been a springboard for the project: to verify that the package of reproductive health services is complete and commensurate with the needs and demands of clients; and to consolidate and reinforce efforts to respond fully to this agenda. This would have been an opportlnity to review the quality of care in family planning and reproductive health, with particular emphasis on: prevention and promotion; on quality enhancement at the primary health care level; and on adequate attention to STDs/AIDS, adolescent reproductive health, sterility and sub-fecundity. Finally, although gender is a critical aspect of the population agenda, all sectors and development initiatives should be held responsible and accountable for poverty alleviation and for improving the lives and prospects of women.  - 18- PART II: STATISTICAL TABLES Table 1: Summary of Assessments Table 2: Related Bank Loans/Credits Table 3: Project Timetable Table 4: Credit Disbursements: Cumulative Estimated and Actual Table 5A: Key Indicators for Project Implementation and Operation Table 5B: Problems related to the quality of infrastructures/lessons Table 6: Studies Included in the Project T'able 7A: Project Costs Table 7B: Project Financing Table 7C: Project Expenditures by Component by Year Table 8: Economic Costs and Benefits Table 9: Status of Legal Covenants Table 10: Compliance with Operational Manual Statements Table 11: Bank Resources: Staff Inputs Table 12A: Bank Resources: Missions Table 12B: Bank Resources: Supervision Missions  - 19 - TABLE 1: SUMMARY OF ASSESSMENTS A. Achievement of Objecives Substantial Partial Negligible Not applicable National Population Policy FL i Financial Objectives Institutional Development [] (II Physical Objectives l LI iii Poverty Reduction Li Gender Issues L L0 Other Social Objectives Environmental Objectfi-es L Public Sector Managerient n L Li Private Sector Develorment II I Li B. Proiect Sustainabilitv Likely Unlikehv Uncertain L Ei Highl] C. Bank Performance Satisfactory Satisfactory Deficient Identification nl Preparation Assistance Appraisal CO Supervision [J Li Highly D. Borrower Performance Satisfactory Satisfactory Deficient Preparation EL Li Implementation Li Li Covenant compliance n Li Operation (if applicable) I L G Highly E. Assessment of Outcome Satisfactory Satisfactory Unsatisfactony Oi Li E  - 20 - TABLE 2: RELATED BANK LOANS/CREDITS Credit Purpose J Year of approval | Status Preceding operations Cr. 1668-NIR First Health Project: The project aimed at 1986 Closed improving the efficacy of the public health sector through (a) the adoption of an appropriate mechanism for investment planning; (b) development and implementation of policies for demographic planning, nutrition, mother and child health. control of communicable diseases, including. among others, malaria and diarrhea; and (c) implementation of health personnel training programs. Following operations Cr. 2915-NIR Health Sector Development Program: The project aimed at improving the population's 1997 Ongoing health status through improving (a) the quality and coverage of basic health services: (b) the population's access to essential generic drugs; and (c) sector effectiveness and efficiency through (i) strengthening and decentralizing strategic sector management and management of resources: and (ii) efforts to appreciate more fully and to utilize more effectively the capacity of various partners active in the health sector in implementing national and district programs.  -21 - TABLE 3: PROJECT TIMETABLE j | Date actual/ Steps in Project. Cycle Date Planned | latest estimate Identification (Executive Project Summary) 05/90 Preparation 10/90 Appraisal 07/89 06!91 Negotiations 03/92 Letter of development policy (if applicable) Board presentation 11/91 04/92 Signing 05/92 Effectiveness 05/91 12/92 Mid-Term Reviews (in two phases). 04/96 and 09/96 Project completion 12/96 12/97 Credit closing (one extension) 06/97 12/97 TABLE 4: CREDIT' DISBURSEMENTS: CUMUL-ATIVE ESTIMATED AND ACTUAL (US$ Million) FY1993 FY1994 FY1995 FY1996 FY1997 FY1998 Appraisal estimate 0.8 2.8 8.3 13.3 16.3 17.6 Actual 1.7 2.8 5.7 8.2 9.8 10.9 Actual as % of estimate 213 100 69 62 60 62 Date of final disbursement: April 27, 1998 Source: Actual data are taken from the Loan Database of May 1, 1998.  - 22 - TABLE 5A: KEY INDICATORS FOR PROJECT IMPLEMENTATION AND OPERATION Components SAR Planned Actual I. STRENGTHENING OF MATERNAL AND CHILD HEALTH (MCH) AND FAMILY PLANNING (FP) SERVICES A. Sectoral reforms and s.engrhening technical and managenment training caps.ities: Originally programmed a.:ivities: a) Implementation of a pe:sonnel recruitment/redeployment plan 50% b) Implementation of an a:tion plan regarding drug distribution and application of the essential drugs list 0% c) Implementation of a cos recovery system (during the first year of the project) 0% d) Implementation of a deailed training plan for health personnel (1993-94 plan was prepar.-d) 20% e) Five-year plan for finan.-ing health operations at the department and district levels. 0% 1. Equipment: a) Vehicles 3 3 b) Office materials for the departments of Zinder, Tahoua and Tillabery and their distric-s 3 3 c) Computer equipment for the three departments 3 3 2. Technical assistance and Training: a) National and intemational specialists to develop, launch and evaluate the training pro-ram. 5 5 b) Health management training of health administration personnel in the departments and districts. 18 15 c) Training in programming and using data to establish a supervision and reference svstem. 6 5 d) Technical assistance financed by I 'Agence Generale de la Cooperation au D6veloppement, Belgium (AGCD) (one doctor specializing in health management and one doctor gynecologist for each of the three depa-tments) $2.500,000 $0 B. Improving the quality of and access to MCH/FP services Originally programmed activities: a) Elimination of the vertical supervision system by transferring follow-up and supervision responsibilities to the nurses 0% b) Participation of village committees in the selection of and support to the Village health teams (VHT) 50%  - 23 - Components SAR Planned Actual c) Establishment of supervision teams for the dispensaries. 0% d) Placing in rural dispensaries of two nurses trained in MCH/FP who will be responsible for supervising the VHT 100% e) Training modules developed by the MSDPPF with the support of USAID/INTRAH 100% 1. Civil works, equipment and other goods a) Provision of contraceptives (barrier and hormonal) $500,000 $500.000 b) Equipping operating blocks at the medical center level in the 9 districts surveyed. 2 9 0 c) Equipping laboratories at the medical center level in the 9 districts surveyed. 2 9 0 d) Construction of 9 operating blocks and rehabilitation of 9 laboratories. 2 9 0 e) Housing construction 15 1 5 f) Construction of the National Reproduction Center in Zinder I I g) Rehabilitation of rural dispensaries 30 0 h) Rehabilitation of other housing for supplementary personnel 12 8 i) Equipping the lodgings (constructed and rehabilitated) 27 27 i) 4X4 Vehicles and trucks I I 17 j) Mopeds 63 63 k) Bicycles 54 54 l) Provision of a medical kit for each mid-wife, nurse and doctor at the completion of training. 225 225 2. Technical assistance and Training: a) Training of doctors in obstetrics/gynecology and minor surgery 18 18 b) Specialized training of an OB/GYN doctor for a period of three years. 1 c) Training of mid-wives and nurses 45 68 d) Training of nurses in FP anid MCH 108 108 e) Training of traditional birth attendants 300 144 f) Training of first-aid workers 300 144 II. PROMOTION OF FAMILY WELL-BEING AND WOMEN'S STATUTE A. National IEC Program: Originally programmed activities: a) Development of an annual media production plan 50% 2 The procurement process for the construction/rehabiliation and equipping of operating blocks and laboratories was initiated under the Population Project but in view of the Project's closing date, these items were financed at 100%/c, under the Health ll Project.  - 24 - Components l SAR Planned Actual b) Expanding central production facilities of the DFEPS 50% c) Production of mass communication (radio, television and written press) 100% d) Preparation of a series of audio-visual and printed messages based on the results of research on family health and FP. 50% e) Development and production of the messages 50% f) Development instruments to monitor the impact of IEC activities 0% g) Development of a plan for visits to listening clubs by the agents responsible for interpersonal communication 0% l ~~~~~ 1. Civil works! equipment and other a) Expansion of the DFEPS office I I b) Furnishing of audio-visual material for the 9 medical centers 9 9 c) 4X4 Vehicles 3 3 d) Mass communication production (radio and television) 1 I e) Printed and audio-visual material production 1 0.5 f) Equipping of listening clubs 700 247 2. Technical assistance, Training and other a) Journalist training (first and third years of the project) 40 50 b) Training of interpersonal communication facilitators for "Women in Development" interventions at the village level c) Training of moderators for youth groups 20 0 d) Training of IEC facilitators (interpersonal communication in 8 8 the departments) e) Training of mid-wives (annually) 200 169 f) Training of nurses (annually) 50 50 g) Training of auxiliary health workers (annually) 200 200 h) Organization and implementation of listening clubs 140 140 i) Technical assistance for the preparation and production of the 700 269 messages (national and international: manmonths) 68 n.a. B. Community Initiatives: Originally programmed activities: a) Identification/selection of micro-projects using impact and viability as selection criteria 60 53 1. Technical assistance and training a) Principal facilitator and programmer specialists (manmonths) 24 24 b) Management training for one member of the management committee 60 53  - 25 - Components J SAR Planned ] Actual c) Training for the facilitators recruited for the component Community initiatives, development and evaluation of micro- projects 5 10 d) Management training of the members of the women's groups n.d. 506 C. Functional Literacy Progranm: Originally programmed activities: a) Development of literacy programs in collaboration with the relevant ministries 50% b) Development and production of the pedagogical supports 50% c) Implementation of a post-literacy and reading program 0% 1. Technical assistance and training a) International specialists for training material and program (manmonths) 10 0 b) National specialists for research on the post-literacy and training programs (manmonths) 16 0 c) Training in use and maintenance of pedagogical materials 60 45 d) Training for trainers and instructors e) Study tours to learn of positive experiences in functional literacy (Niger and regional) 6 0 f) Recruitment and training of facilitators 9 9 g) 45-day rapid training in functional literacy for women in the 16 women's groups n.d. 270 2. Rehabilitation and equipment a) Rehabilitation of the buildings for women's groups (three 6 2 departments) 6 6 b) Didactic materials for the women's groups 6 3 c) Equipment for the women's groups D. Strengthening of nutrition interventions: Originally programmed activities: a) Monitoring of the nutritional status of babies (managed and financed by UNICEF through the Agreement under the Population Project) $115,000 $140,000 1. Equipment a) Material for monitoring infants growth (financed by UNICEF): computers 2 2 vehicle I 1  - 26 - Components SAR Planned Actual 2. Training a) Training of health workers in planning, coordination, monitoring and evaluation of the nutrition programs (25 per district) 200 200 D. Institutional Strengthening: Originally programmed activities: a) Strengthen the institutional capacity of the MDSPPF by training select workers at the central and departmental level to improve their knowledge and efficiency 0% 1. Training a) Training departmental workers of the DCF in management, planning and monitoring 8 8 b) Study tours on the experience in organizing women's groups in income-generating activities 2 2 2. Equipment a) Office furniture and computers 3 3 b) Vehicles (central and departmental) 4 4 III. STRENGTHENING THE ANALYSIS, RESEARCH AND COORDINATION IN POPULATION POLICY MATTERS A. Data collection, research and analytical capacity Originally programmed activities: a) Motivation and awareness campaigns aimed at local administrators, opinion leaders and communities (number of villages) 1 6 b) Visits by awareness teams 100% c) Quarterly awareness campaigns to the nomads (dropped for security reasons) 0% d) Production of registration forms, posters, and advertising at the village level (written in local languages) 100% 1. Technical assistance and training a) Translator (manmonths) for the translation of the civil status formns destined for the nomadic population 3 0 b) Train:ing of civil status workers in the Ministry of the Interior during the first years of the project 1800 1800 c) Thematic seminars (workshops and discussions in Niarney) n.d. 2 d) Computer training for workers n.d. 13  - 27 - Components [_SAR Planned Actual 2. Research and documentation a) Development of two regional monographs 2 2 3. Equipment a) Vehicles 3 3 B. Integration of demographic variables. Originally programmed activities: a) Strengthen the capacity of the directorates of studies and programming (DEP) of the key ministries (economy and finance, education, social development, population and women's promotion, interior and agriculture) at the central and departmental levels to use the demographic data in their sectoral plans 0% 1. Training a) Training of the DEP employees in collaboration with the CERPOD (central and departmental levels) 80 80 b) Workshops at the central level to sensitize directors and executive secretaries on the importance and use of the demographic data 1 C. Strengthening the institutional capacityfor population planning and coordination (CONAPO): Originally planned activities: a) Support the creation of the National commission on population activities (CONAPO) which will coordinate, monitor and evaluate the national population program. 100% 1. Equipment a) Computers and software 2 3 b) vehicle I I 2. Technical assistance a) IEC specialist (manmonths) 12 0 b) Lawyer (manmonths) 2 2 c) Training workshop for communication technicians on population questions 40 30 d) Training seminarfor Islantic preachers andpopulation 30 30 e) Studies: thematic and n.d. 7 demographic projections n.d. I f) Training for computer worlcers n.d. 3  - 28 - Components | SAR Planned | Actual D. Population Funds: Originally programmed activities: a) Furnish grants for activities and programs contributing to the implementation of a population program. $500.000 $400,000 IV. Coordination and project management Originally programmed activities: a) Responsible for administration of the population fund 0% b) Responsible for the coordination and management of project activities. 50% 1. Equipment a) 4x4 Vehicle and truck 2 2 b) moped 1 c) computers 3 2. Technical assistance and training a) Management specialist (manmonths) 24 24 b) Audit (manmonths) 8 10 c) Implementation of compatible software (manmonths) 4 4 d) Procurement specialist (manmonths) 3 3 e) Monitoring, evaluation, studies (manmonths) 10 10 f) Study tours 2 2  TABLE 5B: PROBLEMS RELATED TO THE QUALITY OF INFRASTRUCTURES/LESSONS LEARNED Problems Possible origins Possible solutions Health 2 Project Plans de nmasse .Fragmented operationis in terms of priorities .standards (package of activities, locaux) .standards to be comipleted (Cu-D Diffa) Poor distribution of and/or opportunities .functional needs .users + BET + architect buildings on the sites Finiancing .establishliment of master plans .establishiment of master plans .Site constraints whiich provide a guide for progressive restructurinig or global interventions Unexpressed fiutCtional requirements .Absence of an overall vision Poorly conceived .Unexpressed requiremenits witl regard to .improving the archlitectural programminig .arch. + users buildings functional aspects, and problems of comfort, security, maintenance and stanidards for savings .expression and ranking of needs .arch. + users .qualification of the consultinig firimis .morc rigorous selection .Inadequate architectural proposals .improving the monitoring/ supervision of the .arch. + users architectural studies .Insufficient recourse to the users to validate .use of different chaniels for conductinlg the studies the studies .Doubtful programiniiig (abuinidancc of' .useaid respeci olfthIC standards buildings) .Lost space, unadapted plans, improper or .expression of needs and monitoring of the studies .arch. + users useless materials and equipment .arch. + users .Poor ventilation of the roofs and the expression of needs and monitorinig of the .arch. + users btuildinigs, Uiiadapted protectionls againlst stiun sttidics and dust Poorly constructed .Architectural plan unadapted to the area .qualification and monitoring of the consulting .arch. + users buildings (materials, knowledge) firms .Technical/financial capacities of the .qualification of the enterprises .qualification criteria in agreemenit witi enterpr-ises the conistructioni standards .Framing failure - .monitoring/supervision of the worksites .use of different cliannels for realization .technical audit  Problems Possible origins Possible solutions Health 2 Project Deteriorating Buildings .Poor conception (roof collects water) . qualificalion and monitorinig of thc conisultinig .arch + users firms .Poor quality implementation . qualification of tihe enterprises, supervision arch + users .Ignorance of site constraints .quality and respect of the preliminary technical arch + users studies (Soil quality, water, rain, and drainage, erosion) .Absence of buildings protection .adapted conception, treatment of the approach arch + users (roof, gallery, water collection,) .Absence of adequate mainitenianice .nunininial mainitcinanice outside conceptioni arcih + uscrs .decentralization of the responsibility .budget and decision making at the district level .strengthening of the appropriation by the .support to the partnership component beneficiaries (installations, maintenance) 0 lO  -31 - TABLE 6: STUDIES INCLUDED IN THE PROJECT Purpose as defined at Study appraisal/redefined Status Impact of study Thematic Studies on: Population Published in Used as a reference guide Fertility February but with limited capacity Mortality 1994 in view of the limited Population-Health timeframe and scope Population-Employment covered. Population-Agriculture Population and Development in Niger Legal Study on the implementation of the Population Completed The National Population National Population Policy in 1995 Policy document exists but recommendations are not implemented, therefore legal study has little use. Furthermore, the study does not address the main problems of population. that is the acceptance of the Code de lafamille (e.g.. women _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _rri g hts) Study on the impact of Population funds Community Initiatives Completed The study w;as completed and micro-realizations in 1996 after the Mid-term review and never had an impact on the management and implementation of the Population Funds and micro-realizations. Analysis of the Etat Civil data 94-95 Legal Status Completed Possible reference guide in 1996 for historical research due to the fact that the data are obsolete. Guide to informing the population about Population and Legal Status Completed Guide was translated in the Etat Civil in 1996-97 several local languages et distributed. but current practice shows that vital registration system has not __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _ __ ____ im proved. Survey on youth needs and aspirations Youth Completed Data was unfortunately in 1995 not used during the two phases of the Mid-term review in 1996. This is the only activity that benefitted the Ministry of Communication, Culture, Youth and Sports. Brochure on Women's Associations and Women in Development Completed The pamphlet was NGO in 1994-95 distributed but had limited impact.  -.32 - TABLE 7A: PROJECT COSTS a) By Category of Expenditures (US$ Million) Categorv Appraisal estimate Actual/latest estimate Local Foreign Total Local Foreign Total I. Civil Works 1.3 2.0 3.3 2.5 0.0 2.5 2. Office Furniture, Vehicles, Equipment, and Materials 0.7 3.7 4.4 0.5 2.2 2.7 3. Service Contracts 0.5 0.3 0.8 0.4 0.0 0.4 4. Consultant Services 1.1 2.6 3.7 1.5 0.5 2.0 5. Training 3.0 0.0 3.0 1.2 0.0 1.2 6. Population Funds 0.3 0.3 0.6 0.4 0.0 0.4 7. Micro-projects 0.4 0.4 0.8 0.3 0.0 0.3 8. Operating Expenses 2.9 1.0 3.9 2.7 0.0 2.7 9. PPF 0.1 0.3 0.4 0.4 0.0 0.4 10. Unallocated 1.5 1.5 3.0 0.0 0.0 0.0 TOTAL 11.8 12.3 24.1 9.9 2. 12.6 b) By Components (USS Million) Component _ _Appraisal estimate Actual/latest estimate IL______________________________ ILocal Foreign Total % Local Foreign Total 04 1. STRENGTHENING DELIVERY OF MCH AND FP SERVICES 4.5 6.5 11.0 46 5.0 1.1 6:11 49) 2. PROMOTING FAMILY WELFARE AND THE STATUS OF WOMEN l ________________________________ 4.4 2.6 7.0 29 1.8 0.7 2.5 20 3. REINFORCING POPULATION POLICY ANALYSIS. RESEARCH AND COO]RDINATION 0.6 0.8 1.4 6 0.9 0.1 1.0 8 4. PROJECT COODINATION AND MANAGEMENT 0.5 0.6 1.1 5 2.0 0.6 2.6 20 5. PPF 0.1 0.3 0.4 2 0.2 0.2 0.4 3| 6. UNALLOCATED 1.5 1.5 3.1 13 _ _ TOTAL 11.8 12.3 24.1 100 9.9 2.7 12.6 100 Source: Ministry of Social Development, Project Coodination Unit. February 1998; and Loan Database of May 1. 1998.  -33 - TABLE 7B: PROJECT FINANCING (US$ Million) Source Appraisal estimate Actual/latest estimate Local Foreign Total Local Foreign Total IDA 8.0 9.6 17.6 8.2 2.7 10.9 NGO/Private Sector 0.1 0.1 0.2 0.1 0.0 0.1 Communities 0.1 0.0 0.1 0.1 0.0 0.1 Belgium 0.5 2.0 2.5 0.0 0.0 0.0 UNICEF_ 0.5 0.5 1.0 0.1 0.0 0.1 Government of Niger 2.7 0.0 2.7 1.4 0.0 1.4 TOTAL 11.8 12.3 24.1 9.9 2.7 12.6 Source: Ministry of Socia Development, Project Coordination Unit. February 1998: and Loan Database of May 1, 1998.  TrABLE 7C: PROJECT EXPEND)ITURES UY COMIONEN'I' BY YEAR (US$ Million) Component 1993 1994 1995 1996 1997 Total % 1. STRENGTHENING DELIVERY OF MCII ANI) 1'P SERVICES 0.07 1.30 2.37 1.43 0.90 6.07 49 - Services Extension 0.07 1.12 1.38 1.15 0.73 4.44 - Sectoral Reforms 0.00 0.18 0.99 0.28 0.17 1.63 11. PROMOTING FAMILY WELFARE AND THE STATUS OF WOMEN 0.14 0.97 0.77 0.35 0.21 2.45 20 - IEC Program 0.13 0.50 0.39 0.07 0.03 1.12 - Community Initiatives 0.00 0.17 0.25 0.18 0.05 0.64 - Functional Literacy 0.00 0.01 0.04 0.06 0.00 0.12 - Institutional Restructuring 0.00 0.24 0.(9 0.04 0.13 0.50 - Nutrition Support 0.01 0.04 0.01 0.00 0.00 0.07 111. REINFORCING POPULATION POLICY ANALYSIS, RESEARCI-I AND COORDINATION 0.11 0.40 0.32 0.10 0.10 1.03 8 - Vital Registration System 0.05 0.20 0.06 0.06 0.05 0.41 - Integrating Demograpic Variables 0.07 0.05 0.02 0.01 0.03 0.19 - CONAPO 0.00 0.06 0.00 0.01 0.02 0.09 - Population Fund 0.00 0.09 0.23 0.03 0.00 0.35 IV. PROJECT COORDINATION AND MANAGEMENT 0.64 0.55 0.48 0.36 0.57 2.59 20 V. REFINANCING PPF 0.40 0.00 0.00 0.00 0.o0 0.40 3 TOTAL 1.37 3.21 3.94 2.25 1.78 12.55 100  -35 - TA13LE 8: ECONOMIC COSTS AND BENEFITS No attempt was made at appraisal to estimate net present value (NPV) or economic rate of return (ERR) and therefore there is no baseline against which to judge a re-estimate for evaluation purposes.  TABLE 9: STATUS OF LEGAL COVENANTS - - __________ 4~~~~~.. _ Agreement Section Covenant Present Original Revised Description of Comments type status fulfillment fulfillment covenant date date Cr. 2360- 3.01 (a) 10 ( 05A)01 1/(6 01/23/97 13oriower declares comiti entiliili to Itie objectives ol'fle Inmplemenlation impeded dtic to the lack of NIR Project as set loritl in Schedtile 2 to Ihis Ag,retiiiii and to counterpart funids. (i) Delays in executitig this end, shall crry out Part A of the Project through MSP and Parts A and B. Activities not completed MDSPPF, Part B of the Project through MDSPPF, MEF, and under the Population Project transfered to Mi, with due diligence and efliciently and in coniformity with the Ilealth 11 project (Cr. 2915-NIR); (ii) appropriate admlinistrative, Financial, techniical aind public buildings constructed do not always Iieiiltli piiicIices aiid piovitde as Iiee(ldel r1espild Io locill niceds; 1ictciii ic costs iiiil funds/facilities/services, etc. as requ iredl for the Project. locally sustainable, efficiency of the __________ ____________ iv estm ent is un certain. 3.01 (b) 10 CP 05/01/96 Without limitations upon the provisions of paragraph (a) of Actions 1, 2, 5, and 6 under Schedule 4 this Section and except as the Borrower and the Association have been partially achieved with delays. shall otherwise agree, the Borrower shall canry out the Project Actions 3 and 4 will be addressed under the in accordance withi the Implementation Program set forth in new Health If Project. Sclhedule 4 to this Agreemenit. 3.02 10 NC 05/01/96 Except as the Association shall otherwise agree, procurement Long delays in procurement of equipment of thie goods, works and consultanits' services requir eld for the due to hlie lack of a procuieimieint plan. project and to be financed out of the proceeds of lie Credit P'roceduiies to reciruit consultalits do not shall he gover-nied( by tlie provision ot'Scled(uiIle 3 to tIlis always loiolow Iaink's procedures. '1'Ii is has Agreement. caused somlle stud(lies planned flor the ICR . _______ _______ _______ process to be canceled. 3.03 (a) I0 CD 05/01/96 10/26/96 Borrower and Association shall, no later thaii Oct. 31, 1993 MTR delayed by coup d'e(at--completed in and, tlhereafter, no later than Oct. 3 1. of each subsequent October 1996 year, undertake a joint rev. to be undertaken no later than 00. 1. 1.'95, Ilalid-lerill review lo ext'll:inge v % jew 111 matters re.: progress ol'the Project and thie Plerformaiice by tlie ltoi-rower- ol' its ob)jefives und(ler Ii is Agreciiient and il part (i) evaluate the activities of the Project for the current FY. 3.03 (a) 10 NC Consolidate the proposed work program for the forthcoming Project coordination and managemenit unit (ii) fiscal year. has focused almost exclusively on the .aninual evaluation process rather than also _ _____ _ on the planning of activities. 3.03 (a) 1(0 NC In the case of the MTR, review the instittitionial arrangemilenits The responisibility for MCI-I/FP had been (iii) governlilig M('l 1/1:1' services, assess tleir elflicienicy and, if' move(d back toMO(I' I at the timne of'thie nieed be agree on any corrective actions reictir-ed to remedy M'l'R. Instittitionial arrangement was l I I ___________ I isliortcoiiiings iltat may have become apparenlt in this regard. revisited during the M'l'R but due to  Agreement Section Covenant Present Original Revised Description of Comments type status fulfillment fulfillment covenant date date resistance from the Ministry of Social Development, this arrangement has never been modified. 3.03 (b) 9 C 05/01/96 Nol later tlhani oniC m1onitlh prior to cacli such review, tlle Borrower shall funishi to the Association, for its commenits, a report, in such detail as the Association shall reasonably request on the progress and status of the Project, and on all I______ other related amtters due to be addressed during each review. 3. c)io C05/01/96 Fo!lowing each suc!l review, fhe Borrower undertakes to act Audi: repor.s l;ave highlighted um esolved promptly and diligently, in order to take any corrective action management problems which led to deemed necessary to remedy any shortcoming noted in thie implementation difficulties. implementation of the Project, or to implement such other measures as may have bceii agrecd upon between the parties in futheranice of the objectives of the Project. 3.03 (d) 9, 10 CP 05/01/96 Without limitations to the preceding paras. (a), (b), and (c) of Submission of reports has been inconsistent this Section, borrower shall, throtighiout the period of during the life of the project. implemenitation of the lProject, subimiit to the Associatiotn for its review; (a) serniannual reports on the progress of implementation of the Project; and (b) not later than the end of each fiscal year, the final draft duly approved by MVDSIPF, for activitics lo be underwaken dturing Ihe .________ ._______ fortlhco ming FY. 4.01 (a) I CP pro jcct lifc pro cC lire Borrower shiall maintain or cause to be mainitainied records Problems of accountinig and expenditures and accountis adequtate to rcllect in accordancc willh sounld rccords throtuglhotit Ihc lifc of tihe pojicc'il accountinig practices the operation, resources, and have been identified in aniual reports and expenditures in respect of the Project or the departments or audit reports. agencies of the Borrower responsible for carrying out the I_Project or any part thereof. The Borrower shall: (i) have records and accounts referred to 4.01 (b) I C pr.ject life project life in paras. (a) of this Section includinig those for the Special Account for each financial year audited, in accordance ith appropriate auditing principles consistently applied, by I______ _independent auditors acceptable to the Association. 4.01 (1) I C prlQicL lilc' prqjeCt lile (ii) furn,isl to tilhe Associatioii, as soon as available, but in any Final audit reporit for FY97 is being (ii) . . case not later thani six monithis after the end of each such year, prepared aiid is expected shortly. a certified copy of the report of such audit by said auditors of such scope and in such detaail as the Association shall have reasonably requested.  ~-- . - Agreement Section Covenant Present Original Revised Description of fComments type status fulfillment fulfillment covenant date date 4.01 (b) I C project life project life Furnish to the Association such other infonnation concerning 4.01i (b) l C proJect llSe proJect life said records, accounts and the audit thereof as the Association shall fromil time to time reasonably request. 4.01 (c) l C' project lilc lFor all cxpendiliuies wilh rcspecl to whicih witlihidawals fromil (iii) tistially comiplic(l witil. I lowevcr, thc 4.01 (c) I prlject lithe Credit Account were made oni the basis of statements of October 97 mission was informed that expenditures, the Borrower shall: (i) Maintain or cause to be certain documents were unavailable after maintained, in accordance with para. (a) of this Section, the departure of the acting coordinator in records and accounts reilecting stich expendittires; (ii) etain, September 1997. until at least one year after the Association has received the audit report for the fiscal year in which the last withdrawal from the Credit Account or payment out of the Special Account was made, all records (contracts, orders, invoices, bills, receipts, and other documents) evidencing such expenditure; and (iii) enable the Associations representative to examinie such records; and (iv) ensure that the said accounts and records shall be audited on a semi-aninual basis by said auditors, who shall prepare audit reports accordingly w and furnisi themii to the Association, not later than 3 months co after tlie ci(l oftlhsc s ien-annual atiudit period, along with an opinioni as to whelitle the statemenlt of expenditures sub. (lurintg suclh period, logellhel wilh Ithc procuremcnt and internial controls involved in preparationl. Covenant types: 1 - Accoumntsaudits 8 - Il,gvmv,n peopkl 2. - Financial peformrncdrevennegeneration frombeneficiaries 9. = Mo=Ntring. re6e, and reporting 3 I Flow ,nd atiliktjion o'project funds 10 = Projct inpl-cr n 4 (Conute,pnrt fimding I - Sectotal I,, cross-noctorul bslglovty vs s,rhcr rune,,cc nll,,c,tivn 5 = Management aspect, of the projecl or sec-cting agency 12 - Sectoal o>r cte P'sal fsrlicy/ regulatiory/hci.trtitt wil act,i,l, 6 = Environmentai covenans 13. Other 7 = Involuntary resettlement Present Staius C - covenanl complied with CD = wmplied with after delay Cr - complied silt pmttilly NC - not wmplied with  - 39 - TABLE 10: COMPLIANCE WITH OPERATIONAL MANUAL STATEMENTS Statement Number and Title Description and comment on lack of compliance 1. O.D. 13.05 Project Supervision (para. 4) The Bank did not allocate sufficient Bank staff and other resources commensurate with the nature. complexity and size of the project. 2. O.D. 13.05 Project Supervision (Annex D, para. 29) A few legal covenants were not complied with. Refer to Table 10, Status of Legal Covenants and Development Credit Agreement, Sections 3.02, 3.03 (a) (ii) and (iii). TABLE 11: BANK RESOURCES: STAFF INPUTS Stage of Planned Actual Project Cycle Staff Weeks US$ Staff Weeks US$ ('000) ('000) Preparation to appraisal n.d. n.d. 70.5 156.3 Appraisal n.d. n.d. 48.9 113.7 Negotiation through Board n.d. n.d. 7.5 19.2 approval Supervision n.d. n.d. 182.2 362.7 Completion 28.7 68.7 28.5 37.4 TOTAL n.d. n.d 337.6 689.3 n.a.: not available Source: Costs Accounting System (FACT, March 12, 1998)  -40 - TABLE 12A: BANK RESOURCES: MISSIONS Performance Rating Stage of Month/ Number Days Specialized Implemen. Develop. Types of project cycle year of in staff skills Status objectives problems persons Field represented __ A. To Appraisal: Identification 06/90 6 19 ED, PH. D, PF, WID. RM Preparation 11/90 3 13 ED, D. RM Pre-evaluation 04/91 7 18 D, POP/IEC, MGT. N, PH, _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ W ID . R M_ _ _ _ _ B. Appraisal through Board Approval: Evaluation 07/91 8 21 D, POP/IEC, MGT. PH, WID, NT, A. RM Post-evaluation 11/91 2 12 D. POP/IEC C. Board Approval 06/92 3 18 D, POP. A through Effectiveness 11/92 4 10 D, PH. WID. _ _ _ _ _ _ _ ~~~~~RM Supervision 06/93 to 76 167 A, D. E. ED, PDO, PMP 10/97: HE. EP, FA. HS, 16 missions IEC, IS. PR, LTA. MGT, Ml, PH. POP, RM, POP/WID | Completion 02/98 9 10 A, FA, PH, POPJWID, RM, - = - = -QOA. PR. LTA . Specialization: A: Architect; CIE: Civil Engineer;D: Demographer; E: Economist; ED: Principal Education Planner: FA: Financial Analyst; HE: Health Economist; HNP: Health and Population Specialist; HS: Health Specialist; lEC: IEC Specialist; IS: Implementation Specialist; MC: Malaria Control Specialist; MCH: Matemal and Child Health Specialist; N: Nutritionist; PEV: EPI Specialist; PF = Family Planning Specialist; PR: Procurement Specialist; MGT: Project Management Specialist; OA: Operations Analyst; PG: Planning Specialist: PH: Public Health Specialist; PO: Project Officer; POP: Population Specialist; PR: Procurement Specialist: RM: Resident Mission staff; SOO: Sr. Operations Officer; TRG: Training Specialist Types of problems for performance: AOF: Availability of Funds; CLC: Compliance with Legal Covenants; DL: Disbursement Lag; OS: Overall Status; PDO: Project Development Objectives; PMP: Project Management Performance; PF: Procurement Progress: SP: Studies Progress; TAP: Technical Assistance Progress; TP: Training Progress  Appendix A REPUBLIQUE DU NIGER PROJET POPULATION (CR. 2360-NIR) MISSION D'EVALUATION FINALE PROJET SANTE II (CR. 2915-NIR) MISSION DE SUPERVISION AI)E MEMOIRE ler - 20 fevrier 1998 I. Une mission cle la Banque mondiale a s6journe au Niger du ler au 20 f6vrier 1998. Elle avait deux objectifs: (a) participer a l'6valuation finale du Projet Population (Cr. 2360-NIR), et (b) superviser le Programme de D6veloppement du Secteur de la Sante (Cr. 2915-NIR). Elie 6tait composee des personnes suivantes: Mmes/Messrs. Denise Vaillancourt (Chef de Mission, Spdcialiste en Gestion), Hugues Agossou (Analyste Financier); Johanne Angers (Analyste d'Op6rations); Asha Ayoung (Specialiste en Passation des March6s), Rougui Diallo (Chargde de Programmes), Celine Gavach (Assistante), Belkis Giorgis (Consultante/Expert en Santd Reproductive), Abdul-Wahab Seyni (Charg6 des liaisons avec les ONG) et Jacques Waechter (Consultant/Architecte). La mission a aussi ben6fici6 de l'appui de M. Edward Brown (Repr6sentant Rdsident de la Banque mondiale au Niger). 2. La mission tient a remercier Leurs Excellences Mme Mariama Abdoulaye Sambo, Ministre du D6veloppement Social, de la Population, de la Promotion de la Femme et de la Protection de I'Enfant, et M. Almoustapha Illo, Ministre de la Sante Publique, ainsi que tous leurs collaborateurs, et plus particulierement le personnel des Unit6s de Coordination des Projets Population et Sante pour leur disponibilit6 ainsi que pour la nature franche et dynamique des discussions. 3. La mission a bleaucoup apprdci6 la semaine passee sur le terrain. Elle souhaite remercier tres sincerement le personnel des DDS et les membres des Equipes Cadres de District, le personnel de sant6 et les populations des- departements de Tahoua, Zinder et Diffa, ainsi que les membres du groupement f6minin de Dan Alla (Arrondissement de Bouza) pour leur hospitalit6 et pour la richesse des discussions auxquelles elle a etd conviee. A. PROJET POPULATION 4. La mission a assist6 a l'Atelier National d'Evaluation Finale du Projet Population qui s'est deroule a Niamey du 9 au 14 fevrier, et souhaite f6liciter le Gouvernement pour son succ6s. Les objectifs fixes par l'Equipe Nationale d'Evaluation ont et6 atteints. Suite aux discussions, aux debats et aux rapports d'evaluation interne et externe de cet atelier, une compilation des lecons a tirer de I 'ex6cution du projet Population a ete elaboree par la mission et se trouve enAnnexe 1. La mission souhaite que ces lecons soient pleinement prises en compte lors de la mise en oeuvre du Projet Sante 11. 5. Au cours de l'Atelier, les participants ont pu exprimer leurs opinions et poser des questions a M. Theodore Ahlers (Directeur des Operations pour le Niger), qui 6tait accompagnd des principaux membres de son 6quipe: Mme Antonella Bassani (Economiste, Responsable des dossiers de r6forme 6conomique), Mme Denise Vaillancourt (Responsable du Secteur Sante), M. Makha Ndao (Responsable du Secteur Education), et M. Madani Tall (Responsable du Secteur Agriculture et Ddveloppement rural). Ces discussions ont pertnis d'elever le dialogue sur les questions relatives a la population i un plus haut niveau, et ont contribue a sensibiliser tous les  2 acteurs sur la nature multisectorielle de ce domaine et sur les problemes de population. Les declarations de M. Ahlers et de Mme Vaillancourt au cours de l'Atelier se trouvent en Annexe 2. 6. Un des principaux themes discute tout au long de I'Atelier et souleve pendant la session avec M. Ahlers etait la consolidation et la perennisation des acquis du projet. Les participants ont demande a l'IDA de considerer le financement d'une phase int6rimaire. M. Ahlers a assur6 les participants de la volonte de P'IDA de s'attaquer aux problemes de population, et a indiqu6, qu'6tant donnd la nature multisectorielle de ces problemes, il conviendrait d6sormais de les integrer dans les operations en cours dans les autres secteurs. Dans les mois a venir, 1'6quipe de la Banque mondiale travaillant sur le Niger reverra son portefeuille de projets en vigueur en vue d'exploiter tout son potentiel. 7. La mission Sante a pr6cise les mesures deja prises pour assurer la p6rennisation du volet sante. Le projet Sante If a pris en charge plusieurs investissements qui ne pouvaient pas etre acheves avant la date de clbture du projet Population, notamment la construction de blocs de radiologie et de bureaux d'Equipes Cadres de District, et l'achat des equipement pour les blocs operatoires. De plus, le projet Sante II pourra 6ventuellement appuyer la mise en oeuvre des reformes dans tous les 9 districts qui b6n6ficiaient de financements sous le projet Population. En plus de Mirriah (Departement de Zinder), Filingue et Say (Departement de Tillabery), deja prevus darts le projet Sante 11, ce projet pourrait appuyer la mise en oeuvre des r6formes dans les 6 districts restants: Matameye, Magaria (Ddpartement de Zinder), Bouza, Konni et Madaoua (Departement de Tahoua) et Ouallam (Departement de Tillab6ry). Cependant, les etapes suivantes devronlt etre suivies pour permettre la prise en charge de ces districts par le projet Sant6 ll: (a) I'elaboration d'un PDS et d'un plan d'actions pour la premiere annee d'exdcution; (b) la mise a jour des donnees sur l'aide prevue et actuelle, et, en fonction des resultats de cette mise a jour, la description de I'assistance demand6e a l'IDA en tant que "bailleur de demier recourt"; et (c) P'approbation par l'IDA du PDSD et des plans d'actions. S. Afin de consolider les acquis du projet Population en matiere de sante reproductive (y compris la planification familiale), le projet Sante 11 s'assurera de la disponibilite et de la qualit6 de toute la gamme de services et d'activites de sante reproductive dans le cadre du paquet minimum d'activit6s. 9. La mission a reconnu les resultats positifs de l'appui consenti aux groupements feminins, et a tire des lecons de cette experience. Malgre l'int6ret porte a de telles initiatives, elle recommande l'all6gement du cadre institutionnel et la reduction des frais g6neraux relatifs a de telles activites dans le futur. Avant de demander de nouveaux financements dans ce domaine, la mission recommande que le Ministere du Developpement Social, de la Population, de la Promotion Feminine et de la Protection de l'Enfant (MDSPPFPE) considere les 6l6ments suivants: (a) la revision du mandat du MDSPPFPE afin de faire ressortir sa compl6mentarite et d'eviter les duplications avec les autres ministeres techniques; (b) la rationalisation du cadre institutionnel afin de le rendre plus efficace et de faciliter un partenariat solide avec les ONG; et (c) la recherche d'appuis financiers qui devrait en priorite exploiter les opportunit6s offertes par le portefeuille de projets finances par l'IDA, se montant a plus de 70 milliards de FCFA, ainsi que la recherche de dons eventuels provenant d'autres partenaires au developpement. 10. Situation financiere et comptable. Dans le cadre de l'evaluation finale du projet population. et pour appr6cier la situation financi6re en fin de projet, la mission cherche a appr6cier les differentes ressources financieres mobilis6es pour les differentes composantes du projet tous bailleurs de fonds confondus et de s'assurer que les biens acquis sur le projet ont 6te inventories pour 6ventuellement etre verses dans ie patrimoine du projet population ou des Ministeres techniques. Deux tableaux refletant I'evolution financiere du projet du ler janvier 1993 au 31 ddcembre 1997 sont prdsentds en Annexe 3.  3 11. L'audit des comptes du projet pour l'exercice 1997 a ete r6alise par le cabinet ivoirien Pannel Kerr Forster. Le rapport d'audit n'est pas encore parvenu au projet. Les audits des anines antdrieures ont etd realises par le meme bureau d'etudes et presentent de fa9on detaillde la situation financiere du projet par bailleurs. Aussi dans le cadre de l'evaluation finale du projet population et -en attendant le rapport de l'auditeur pour fin fevrier, la mission a pris connaissance du rapport du cabinet SEKOU et Associes, consultant charge de l'6valuation exteme du projet dont les resultats peuvent etre exploites. 12. La mission rappelle a l'emprunteur que les pieces comptables relatives au projet doivent etre archivees au sein du MDSPPFPE pour une pdriode d'un an a partir de la date de cl6ture, en vue d'une verification eventuelle ult6rieure. 13. Le projet a rernis a la mission le tableau d'immobilisations de tous les biens inventori6s, leurs emplacements et leurs etats pour appreciation. 14. Le statut des clauses de l'Accord de Credit de Developpement se trouve en Annexe 4. 15. Les prochaines etapes. Selon les directives soumises au Gouvemement et discutees au cours des missions precedentes, un Rapport Final d'Evaluation sera presentd au Conseil d'Administration de la Banque mondiale le 30 avril 1998. Ce document sera compose de 2 chapitres: un dcrit par l'IDA, et l'autre prepare par le Gouvemement. Chaque chapitre ne devrait pas excdder 10 pages. Le calendrier a suivre A cet effet est presente en Annexe 5. La mission soulig,ne l'iimportance pour la Banqie de recevoir la contribution du Gouvemement nigdrien au Rapport Final le 13 mars 1998, au plus tard. C. SUPERVISION DU PROJET SANTE IL 16. Fonds de contrepartie. Les engagements pris par le Gouvemement en matiere de fonds de contrepartie n'ont pas ete satisfaits. La decision de mandatement a ete remise au projet, mais les fonds ne sont pas dispcnibles au niveau du Tresor National. 17. Ressources htimaines. Le MSP a confirme, qu'en mai 1997, 260 agents de sante ont AtA recrutes, dont la plupart ont ete assignes dans les zones du projet. Ce recrutement a pennis au MSP de reduire le deficit en ressources humaines dans ces zones. 18. La mission a ete informe que la DFGP a demande A toutes les DDS d'executer leurs plans de redeploiement interne avant fin fevrier. La DFGP entreprendra ensuite une mission de sensibilisation, au cours de la seconde moitie du mois de mars, pour inforner les autorites locales sur le bien-fonde de ce redeploiement et pour obtenir leur appui. La DFGP prevoit egalement de mener un exercice de reconversion de 285 auxiliaires (matrones, filles de salle, etc.), afin d'en faire des agents polyvalents. Cette tache ddbutera par une enquete qui evaluera les besoins en formation A cet egard. Suite au redeploiement interne, un etat precis des besoins et des deficits en personnel sera etabli et servira de base au plan de reconversion des cadres techniques. 19. La mission et le Gouvemement ont rappeld la condition de decaissement dans I'Accord de Credit de Developpement (paragraphe 3 (b) de l'annexe I de l'Accord de Credit). Cette condition exige qu'avant le financement par le projet de toute nouvelle construction, un plan d'actions pour pourvoir ces bitiments en personnel soit soumis et juge satisfaisant par l'IDA. La mission recommande que le MSP developpe un plan d'actions pour entreprendre le renforcement des capacites du ministere en matiere de gestion des ressources humaines. Ce plan d'actions devrait etre remis A l'IDA avant le ler avril 1998. La mission a notd, au cours des discussions, les problemes lies a la mise a jour des fichiers personnel au niveau central. Elle recommande que ce plan d'actions sus-citd se penche sur cette question particuliere pour degager les mesures  4 necessaires pour avoir un fichier fiable. De plus, la mission propose l'utilisation d'un assistant tecihnique apres l'exercice de redeploiement afin d'etablir un nouveau fichier des ressources humaines qui tienne compte de la nouvelle repartition du personnel. Le MSP s'est engage a sournettre a l'IDA, avant juin 1998, un plan d'actions refletant les besoins reels du personnel des formrations sanitaires, toutes regions confondues. 20. Les discussions de la mission avec le Gouvernement et les autres partenaires du secteur sante ont soulign6 l'importance d'etablir une capacite viable et perenne de lormation des medecins en chirurgie d'urgence. Un tel-systeme decentraliserait la formation au niveau des CHD et representerait un processus de fornation continue qui perrnettrait la prevision et la prise en charge des besoins locaux dans ce domaine. Un plan de formation revise en chirurgie d'urgence sera prepare d'ici mai 1998 et soumis a l'IDA. Ce plan devrait egalement etre soumis aux bailleurs participant a la formation en chirurgie d'urgence. 21. La mission a e inform6e que la DFGP mene presentement une reflexion sur le probleme de mise a disposition des aide-anesthesistes et manipulateurs radio dont la premiere promotion n'achevera sa formation qu'en 1999. Entre-temps, il y aura un d6ficit de personnel dans ce domnaine. La DFGP a precise que le resultat de ces r6flexions fera l'objet d'un document qui sera remis a la mission avant son depart. 22. Indicateurs d'ex6cution et d'impact. Des discussions ont eu lieu sur l'etablissement des donnees quantitatives pour chaque indicateur du programme de d6veloppement du secteur de la sante relatif a son execution et a son impact. Cependant, il conviendrait de souligner qu'une decision devrait etre prise en consultation avec la DEP quant aux dispositions a prendre vis-a-vis de l'indicateur d'iimpact sur la transformation du PDS en un programme pluriannuel qui servirait d'instrument pour la gestion strategique du secteur et de la coordination de l'aide. Les tableaux joints en Annexe 6 presentent la liste de ces indicateurs. 11 avait 6t6 convenu que le ministere se chargerait d'identifier ces donnees quantitatives au demarrage du projet (a sa mise en vigueur au 29 juillet 1997) et de veiller a ce que les niveaux central, d6partemental et district projettent les donnees quantitatives qu'ils souhaitent atteindre d'ici l'6valuation a mi-parcours du programme prevue pour la fin de l'annee 1999. La mission aimerait recevoir ces tableaux remplis d'ici la fin mars pour son appreciation. Elle propose que les tableaux des indicateurs fassent partis du processus de planification et de programmation lors des reunions trimestrielles, semestrielles et annuelles et qu'ils soientjoints au plan d'actions a l'issue de ces reunions. 23. Les dtudes socioculturelles et dpidemiologiques prevues par le Projet Sante 11 serviront de base de mesure de l'impact au cours de la revue i mi-parcours. II a ete convenu que les personnes qui feront ces etudes coordonneront entre elles afin de realiser une analyse globale des facteurs sanjitaires et socioculturel pertinents dans Ies zones du projet. II a egalement ete convenu que la d6finition des taux pour les differents indicateurs de performance sera clarif,ie et utilis6e de facon consistante pour assurer l'exactitude et la validit6 des donnees generees. De plus, sur la base de ces etudes, le systeme de gestion informatis6 devrait etre revis6 afin d'appuyer les districts sanitaires. Ce systeme sem utilis6 pour suivre et superviser des activites, determiner des tendances, des changements de comportement, et aussi pour modifier les objectifs et les interventions pendant la v ie du projet. 24. Produits pharmaceutiques. Le dossier d'appel d'offres relatif a l'achat de produits phaLrmaceutiques sera confie a un sp6cialiste en produits pharmaceutiques, afin d'obtenir son avis technique. Le Gouvemement devrait transmettre a l'IDA le dossier d'appel d'offres avant le ler mars 1998, pour avis de non objection. 25. Processus d'approbation des plans d'actions. Le MSP et-la mission ont convenu d'une procedure pour revoir et approuver les plans d'actions annuels pour les districts et les DDS  5 finances par le Projet, ainsi que ceux du niveau central. Les deux parties ont reconnu l'urgence de cette tfiche, etant donne que ceux-ci sont deja a la fin du deuxieme mois de leur execution. La DEP a informe ia mission clue seuls 2 des 7 districts et I des 3 DDS lui ont soumis un plan d'actions. La DEP a convenu de ccntacter les personnes concemres afin de permettre la soumission des plans manquants a l'UCP avant le ler mars 1998. Apres avoir revu ces plans, le MSP/UCP les soumettront a l'IDA pour avis. Le MSPIUCP et l'IDA reverront ces plans a deux niveaux: programme et projet. C'est a dire que, conformement a l'approche sectorielle, le MSP/UCP et l'IDA reverront toutes les activites inclues dans les plans d'actions, toutes sources de financement confondues, pour assurer leur conformit6 avec les refonnes et priorit6s exiges par le PDS. L'IDA examinera egalement les activites pr6vues dans les plans d'actions pour financement par le cr6dit IDA afin de donner son avis de non objection qui sera bas6 sur le respect-des conditions et du programme d'activites specifie dans l'Accord de Credit de Developpement. La mission fera part de son avis dans un delai de 3 semaines suivant leur reception. 26. Les principaux crit&res utilises pour l'evaluation des plans d'actions des districts comprendront: leur concordance avec les 6 indicateurs de performances et les 6 indicateurs d'impact (Annexe 6) negocies A Washington et specifi6s dans la lettre suppl6mentaire de l'Accord de Credit de D6veloppement; leur faisabilit6 (etant donn6 les r6les et responsabilites des DDS et du niveau central et les d6lais de passation des marches); la concordance des cofits unitaires entre les districts; et la p6riodicit6 des actions cles (tourn6es de supervision, reunions de coordination, etc.). Ces plans seront aussi revus et r6vises avec l'idee d'assurer une bonne planification et une mise en oeuvre des rsformes essentielles a la bonne mise en oeuvre du PDS (assurance de la qualite, systeme de recouvrement des couts). Un des principaux criteres d'evaluation des plans d'actions du niveau central et des DDS sera leur appui effectif au fonctionnement des districts sanitaires. La mission a tenu a rappeler au Gouvernement la procedure de revue et de revision des plans d'actions telle qu'envisagee dans le PDS et decrite dans l'Accord de Credit de D6veloppement: r6unions trimestrielles au niveau des districts, reunions semestrielles au niveau des DDS, reunions annuelles au niveau national. 27. La mission a developp6, en tenant compte des commentaires du Gouvernement, un projet .de fiches qui permettront la presentation d'un plan d'actions sur 12 a 18 mois pour les bourses, les formations A l'etranger, les conferences et les voyages d'6tudes (Annexe 7). Elles seront utilisees pour gerer le plan de formation, a tous les niveaux. Le Gouvernement etudiera ces fiches et fera part de ses commentaires a l'IDA afin de permettre leur amelioration eventuelle. Les diff6rentes fiches remplies par les ,divers responsables seront ensuite regroupees au niveau central et soumises A l'IDA pour son avis de non objection, en meme temps que les plans d'actions des 7,districts, des 3 DDS et du niveau central. 28. Passation des march6s. La mission a rencontre les personnes responsables de la passation des marches pour le Projet Sante II (Unit6 de Coordination/DAF/DEP) et a revu avec elles le plan de passation des march6s 6labore au cours de la mission d'octobre 1997. La mission a constate que les responsables ont fait un effort pour respecter les delais pr6vus. Cependant, en raison de la complexit6 et du volume du travail necessaire, un retard a et6 constate. Aucune actualisation dcs calcndriers de passation dc marchcs, dont Ics richicrs informatiqucs sonIt disponibles a l'UCP, n'a 6te effectu6e depuis la derniere mission. 11 est imperatif que, compte tenu des contraintes de coordination existant entre les differentes activites, ces calendriers soient regulierement actualis6s et utilises comme outils de gestion et communiques trimestriellement aux responsables des differentes composantes et a l'IDA. Comme souligne et recommande dans l'aide-m6moire de la mission de septembre/octobre 1997, la mission a insist6 sur la necessite de recruter un sp6cialiste en passation des marches, familier avec les procedures de la Banque mondiale, pour coordonner et suivre de pres les activites. Cependant, I'UCP a affinnr ses activites, actuellement r6parties au scin des services techniques du MSP, devraient continuer a etre assum6es par ces memes services, et que le coordonnateur-adjoint pourrait assumer toutes ies  6 rcsponsabilites inhdrentes a la gestion des activites de passation des marches au sein de l'UCP. Par consequent, en plus de ses fonctions de coordonnateur-adjoint, cette personne assumera la fonction de "coordonnateur des activites de passation des marches". 11 sera responsable d'assurer la conformite de toutes les activites de passation des marches pour le projet. Ainsi, parmi les tiaches qui lui seront imparties, il devra mettre en place un systeme de suivi pour veiller ia ce que les montants globaux specifids dans l'Accord de Credit de Developpement pour chaque type de passation des marches, autres que I'Appel d'Offres International, soient respectes. 11 se chargera du classement adequat des documents de passation des marches permettant aux missions de l'IDA d'operer des controles a posteriori pour tout marche n'ayant pas ete soumis a un examen prealable de l'IDA. 29. La mission a et6 informrn de depart et de mutation au sein de la DAF/M, division de P'equipement. Pour faire face i cette situation critique, la mission n'a pas d'objection au principe de recruter, sur les fonds du projet, les services d'un ingenieur genie civil i plein temps, loge a la DAFIM, et dont la mission principale serait de contribuer a la preparation et de coordonner i'avancement des dossiers relatifs au genie civil et d'en superviser leur bon avancement. If est convenu que le recrutement de ce contractuel se fera de facon ouverte, en suivant les procedures de la Banque mondiale en matiere de services de consultants. La manifestation d'int6ret sera sollicitie via un avis dans la presse nationale. Les TDR de cet ingenieur sont joints en Annexe 8. 30. La mission a revu des dossiers de passation des marches: vehicules, mobilier de bureau et mat6riel informatique. Les commentaires de la mission ont ete remis au Projet et se trouvent en Annexe 9. La mission demande au Projet de bien vouloir lui renvoyer les documents modifi6s selon ses instructions, y compris les quantitds et les spdcifications techniques. La mission a partagd avec le Projet la menace qui pese sur les systemes informatiques qui risquent de ne pouvoir g&er correctement le passage a l'an 2000 du calendrier gregorien. La mission enverra ulterieurement de la clocumentation complimentaire. 31. Une reunion a eu lieu entre le MSP (en pr6sence du Ministre de la Sant6), NIGETIP et la mission. Cette reunion a et l'occasion de soulever diverses defaillances de travaux ex6cut6s par NIGETIP, et d'insister sur l'importance de la clart6 et du respect des circuits de communication, la clarte des responsabilite et le respect des procedures concernant les etapes-cl6s de la mise en oeuvre, le recours i une s6lection et a un suivi plus rigoureux des BET et des entreprises qui tienne compte des lerons de l'experience. NIGETIP a assure ses interlocuteurs que les problemes mentionnes ne se reproduiraient plus, et que l'Agence communiquerait plus fr6quemment avec le ministere. 11 a et6 convenu que toute correspondance serait envoyee au Ministere qui la retransmettrait aux DDS et aux districts concernes. 32. La mission a ulterieurement eu une session de travail avec NIGETIP. Les deux parties se sont mises d'accord'sur la convention NIGETIP a etre signee. Apres intdgration des commentaires dc la mission ct dc NIGETIP, Il mission a fait part de Ia non objection de l'IDA sur cette convention. La mission a egalement remis a NIGETIP des modeles types de "demande de proposition" et de "contrat-type pour services de consultant - remuneration forfaitaire" pour le recrutement des BET. Des son retour a Washington a la mi-mars, la mission enverra i NIGETIP un modele type d"'Appel d'Offres National pour travaux". 11 a ete convenu que NIGETIP utilisera ces documents et ex6cutera les activites de passations de march6s exclusivement conformement aux procedures de l'IDA. 33. NIGETIP a remis son Manuel de Proc6dures ia la mission. 11 a ete convenu que ce document (et plus particuli6retiient les chapitres relatifs i la passation des marches et aux documents d'appels d'offres) sera tudie i Washington, et que des commentaires seront envoyes i NIGETIP dans un effort d'aider l'agence i am6liorer ses procedures de passation des marches.  7 34. La mission a ete inform6e de la creation d'une Commission Fiscale charg,e de se prononcer sur la validlite des calculs des droits et taxes, et a rencontre le President de cette commission. Cette comimission aura pour tache principale de recueillir toutes les offres concernant les marches publics afin d'en deduire les droits de douane apres 1'evaluation de ces offres. En cas de difference entre le nnontant indique par le soumissionnaire et celui calculd par la commission, c'est ce dernier qui fera foi et qui figurera sur le contrat signe. Bien que cette commission n'ait pas encore commenc6 ce travail, la mission peut deja prevoir quelques problemes qui surgiront des sa mise en oeuvre. Tout d'abord, toutes les offres passeront par cette commission, apres leur evaluation par les commissions primaires de march6s, ce qui aura pour effet de rallonger les d6lais d6ja importants dans le processus de passation des marches. Ensuite, dans l'Accord de Credit de Developpement, les pourcentages des montants finances par l'IDA s'appliquent aux contrats T.T.C. Or, si les contrats sont desormais signes sur la base de montants H.T.IH.D., la Banque continuera d'appliquer De meme pourcentage; le montant finance sera donc inferieur a ce qui etait prevu lors de l'6valuation du projet, ce qui signifie que plus de fonds de contrepartie devront etre mobilises. Ce probleme sera discut6 au siege de la Banque mondiale d&s le retour de la mission a Washington. L'UCP devrait informner l'IDA des developpements de cette question. L'IDA continuera a suivre de pres cette question afin de s'assurer qu'elle ne gene pas la bonne execution du projet. 35. La mission souhaite rappeler a l'UCP qu'elle n'a pas besoin de soumettre a la non objection de l'IDA les documents dont les montants sont au dessous des seuils prevus dans l'Accord de Credit de Developpement pour examen prealable. Ces dossiers seront examines par des missions de supervision qui r6aliseront des revues a posteriori. 36. Genie Civil. Unie revue de l'etat d'avancement des diffbrents dossiers a et effectuee au cours de la mission. Des commentaires detaill6s de cette revue sont presentes en Annexe 10. 37. Situation financiere et comptable. La mission est ravie de constater que le systeme comptable infornatise est op6rationnel et que sa mise en oeuvre a ce jour est satisfaisante. Elle s'est entretenue avec les comptables aux niveaux central et peripherique et a constate un niveau satisfaisant d'appropriation et de maitrise des outils de gestion. La mission a donne son avis de non objection a la recommandation du MSP d'attribuer le marche concernant la mise en place du systeme comptable informatise du LANSPEX am cabinet Auditeurs Associes en Afrique (representant Arthur Andersen). L'Annexe 11 presente de plus amples details sur les aspects de gestion comptable et financiere du projet. 38. Le statut des clauses de l'Accord de Credit de Developpement se trouve en Annexe 12. Niamey, le 20 f6vrier 1998 Denise Vaillancourt Charg6e des Projets Sante et Population Banque Mondiale  Appendix B Niger Population Project Summary of the Government's Report The population project, which began in 1992 and closed in 1997, was the beneficiary of the participatory approach which included all actors involved in all stages of project exectution. The final internal evaluation was the responsibility of a team composed of administration representatives from all levels: central, regional, and sub-regional. Additionally, an external evaluation was completed by independent consultants. The project was developed over a two-year period, from 1990-92, in the context of social and economic crisis. It was designed to support the government of Niger in its efforts to implement a national population program. During the life of the project, Niger underwent a number of political changes which had a negative impact on project implementation. These political difficulties were aggravated by social unrest in the country, including strikes, a recession and irregular salary; and counterpart payments from the State further hindered project implementation. However, the management autonomy of the project allowed for completion of project obligations, despite the uneabling environment in the country. Internal problems were not the only hurdles which had to be overcome, as the implementation occasionally suffered from difficulties with Bank procedures, especially procurement procedures and the change in Task Managers. Also, the devaluation of the FCFA in 1994 further hindered implementation progress. RESULTS AND GAINS Overall the project dispensed 92.3% of the proposed budget.' The project also afforded the opportunity for the different sectors to collaborate on the national population policy. The task still remains to transform the work of the project into permanent dynamics. Specific improvements were seen in the following areas: * MCH/FP: execution rate was relatively high due in part to the project's flexibility. Health sector reforms were effective due in part to the redeployment of health personnel. Additionally, construction and rehabilitation of infrastructures and health personnel training added to the success of this component. World Bank Qualifying Footnote: Government's financial data on the project are calculated and presented in CFA francs which are not adjusted for the various exchange rates over the life of the project, including the 1994 devaluation. As such, they are not thus fully coherent with financial statements included in the Bank's chapter of this report or with the Bank's official disbursement statements.  * Family well-being and women's rights: 147 women's groups established of which 70 benefited from financing, establishment of 53 micro-realisations benefiting 3,600 families, and training of 4,158 women. LESSONS LEARNED * It is necessary to include the beneficiaries and agents in the design and management of the project. * Performance and impact indicators should be established at the beginning of the project, and monitored on a regular basis. * Training programs should include a monitoring and evaluation plan. * Decentralization rnust take into account the following: operationalization of the current structure; mranagement decentralization; and training. * Donors must be more flexible and adaptable to the context and capacity of the structures responsible for project implementation. * An appropriate maintenance plan is necessary to ensure longevity of equipment and materials. * Project Coordination Units should be have appropriate technical competencies. * Project/program actions must be coherent in order to improve efficiency and impact. Finally, the project objectives are perfectly integrated with the national interests in MCHIFP, family well-being, women's rights, and the overall national population policy.  Appendix B REPUBLIQUE DU NIGER MINISTARE DU DEVELOPPEMENT SOCIAL, DE LA POPULATION, DE LA PROMOTION DE LA FEMME ET DE LA PROTECTION DE L'ENFANT PROJET POPULATION IRAPOT :Dre STIMTHiEM. DM VC--VALUIATHCH FNIAR-e: ' - . - .DU: lpftoj .& popuu-0ol Prisente Dar le Modrateur: Mr. MAINA BOUKAR MOUSSA Analyste de I'Eneoncii, Dodceur is Sciences Ecoomiques Mars 1998  SOMMAIRE 1. INTRODUCTION.___ 1 1. 1. CoNEc DE LLARATION Du PROJET POP ..AT.ON ..................................... I 1.2. PROJEr 1..... . ............... 1 1.2.1. Obiectifs et straties .......................... 2 1.2.2. Zones dintervention .......................... 2 1.2.3. Dure. Budet etesfion .......................... ... ... 2 2. tVALUATION FINALE DU PROJET POPULAONI_ 3 2.1. OaIwECS DE LVALUATON A ...................................F.NA. 3 3. CADRE D'EXACUTION ET DE GESTION DU PROJET 3.1. CADRE DVUXECLTTON DLU PROJT ................................ 4 3. 1.1. Faceurs exogbees. avant affecti la mise en oeuvre du proLet ............................ ..................... 4 3.1. 2. Caractere multi-sectoriel du proie .................................................. 5 3.2. CADRE Di. GEBSriON DU PROJET ............................. , . 5 3.2. 1. Cellue de coordlination ........................S 3.2.2. Gestion des activiles dans les r6eions el sous-reions ............................................ 5 3.2.3. Raprorls avec le bajileur de fondzs ........................................... 6 4. REALISATIONSIRRSULTATS ET ACQUIS ------- 6 4.1. R;AISSATnONS}T RkSULTATS .......................................... 6 4 .2. Acotns ............................................ 9 4.2. 1. Acauis rre nral ............................................. 9 4.2.2. cauissecifigues aur dilerentescomposantes ............................................. 9 S. LES LECONS A TIRER POUR LE FUTUR.. .___._______. __________1- 6. CONCLUSION {GENERELE.I ._ __- __ 1 7. RECOMMANDATIONS EN VUE DE LA CONSOLIDATION ET LA PERENNISATION DES ACOUIS DU PROJETO. ....___2 7.1. R.COMMANDATIONS EN VUE DE LA CON OUll)A11ON/PlRF.NNISATnON DES ACS DU PROjET POPULATION.... 12 7.2. RcOMMANDATONS SUR LmS STRATtOlES FurmFs ..................................... 13 7.2. /. Stra"gies ,our rehoasser Ic niveau de revenus e tla aulfiM de We de la po2mation nigmrtenne ....... 13 7.2.1.1. PorsWuitc et cmnsolidatiou des micro.nilisatioam ct iniiatives conunautrs .............. ............................ 13 7.2.1.2. Mise n nlace deun fonds d*mui aux ONG. wnatjons et auX oclits actW= du scdeu r . ................... 14 7.3. RENIVRCF,MFN rINSTTrloNNI. FTTFcHNiUE DU MDS/P/PF/PE ........................................................... 14 ANNEXES  1. Introduction Le projet population qui a demarre en 1992 est arrive a son terme. Le gouvenemnent a engage le processus d'effectuer son evaluation finale. Celle-ci a et abord6e suivant tne approche participative englobant aussi bien les beneficiaires que les prestataires des services et autres partenaires et ce a travers rorganisation des ateliers aux diffirents niveaux d'execution. Une equipe composee de representants de radministration aux differents niveaux: central, r4gional et sous regional, a Wte cbargee de l'6valuation interne qui a retrace la contribution et le bilan des diff6rents travaux. En plus de l'evaluation inteme, une evaluation exteme a e conduite par des consultants ind6pendants et a eu pour objectif une appreciation externe des resultats du projet. Le present rapport presente les resultats issus de l'ensemble du processus de 1'6valuation finale, et en particulier de ceux des evaluations interne et externe. 1.1. Contexte de I'eIaboration du Droief DoDulation Le projet population a ete e1abore en 1990-92 dans un contexte de crise econoTnique et sociale profonde qui se caracterise par des indicateurs de developpement et des indicateurs socio-sanitaires parmi les plus faibles du monde: un reve:nu moyen par tete de 290 dollars, un taux de mortalite-matemelle d'environ 7 pour mille (70/c); un taux d'alphabetisation des adultes de 14% (le taux le plus bas au monde); un taux de scolarisation au niveau pfimaire de 30