Madagascar - Food Security and Nutrition Project

Document of The World Bank FOR OFFICIAL USE ONLY Report No. 19282 IMPLEMENTATION COMPLETION REPORT REPUBLIC OF MADAGASCAR FOOD SECURITY AND NUTRITION PROJECT CREDIT 2474-MAG May 17, 1999 Human Development IV 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 without World Bank authorization.  CURRENCY EQUIVALENTS Currency unit: Malagasy Franc (FMG) (Period average) 1989: US$ 1.00 = FMG 1603 1994: US$ 1.00 = FMG 3067 1990: US$ 1.00 = FMG 1494 1995: US$ 1.00 = FMG 4266 1991: US$ 1.00 = FMG 1835 1996: US$ 1.00 = FMG 4061 1992: US$ 1.00 = FMG 1864 1997: US$ 1.00 = FMG S091 1993: US$ 1.00 = FMG 1914 1998: US$ 1.00 = FMG 5441 WEIGHTS AND MEASURES Metric system FISCAL YEAR January 1 - December 31 ABBREVIATIONS AND ACRONYMS ACN Community nutdtion Worker (Agent Communautaire de Nutrition) BPS SECALINE Project Office (Bureau d'execution du Projet SECALI.NE) CICS Interministerial Coordination Committee (Comite Interministeriel de Coordination du Projet SECALINE) CRT Nutrition Rehabilitation Center (Centre de Rehabilitation Therapeutique) DCA Development Credit Agreement EMSAP/ PASAGE Economic Management and Social Action Project (Projet des Actions Sociales et Appui a la Gesfion Economique) EWS Early Warming System (Systeme d'Alerte Precoce) FARITANY Province (groups about 20 fivondrononana) FID Social Fund (Fonds d'Intervention pour le Developpement) FIRAISANA Local Government Grouping of Villages orNeighborhoods FIVONDRONANA District (includes several Fraisana) FOKONTANY Village or Neighborhood IDA International Development Association IEC Information, Education and Comnunmication (Informafion, Education et Communications) IDD/TDCI Iodine Deficiency Disorders (Troubles Das aux Carences en Iode) ILO/BIT Intemational Labor Organization/Bureau International du Travail KAP Knowledge, Attitude and Practice NGO Non Govenmnental Organization (Organisation Non Gouvernementale) PCN Community Nutrition Program (Programme Communautaire de Nutrition) PNSAN National Food Security and Nutrition Monitoring System (Programme ANafional de Surveillance Alimentaire et Nutritionelle) SAR Staff Appraisal Report SECALINE Food Security and Nutrition Project (Securite Alimentaire et Nutrition Elargie) UNICEF United Nations Intemational Children Emergency Fund UNDP United Nations Development Program WFP/PAM World Food Program (Programme Alimentaire Mondia) Vice-President: Mr. Callisto Madavo Country Director: Mr. Michael Sanis Sector Manager: Mr. Arvil Van Adams Task Manager: Ms. Eileen Murray  FOR OFFICIAL USE ONLY IMPLEMENTATION COMPLETION REPORT REPUBLIC OF MADAGASCAR FOOD SECURITY AND NUTRMTION PROJECT CREDIT 2474-MAG TABLE OF CONTENTS PREFACE EVALUATION SUMMARY Introduction. i Project Objectives ................................................ Implementation Experience and Results ...............................................ii Summary of Findings, Future Operations, and Key Lessons Learned ................................................ 1. PROJECT IPLEMENTATION ASSESSMENl.._...._... Project Objectives . . . . Achievement of Project Objectives . .............................................. .3 Implementation Record and Major Factors Affecting The project .......................................... . . 4 Project Sustainability ................................................7 Bank Performance ................................................. Borrower Performance . . . . . Assessment of Outcome ................................................ . Future Operation ................................................ 13 Key Lessons Learned ................... .. . l.4 2. STATISTICAL EX............... .....................-_ .16 TABLE 1: SUMMARY OF ASSESSMENTS ............................................................... l TABLE 2: RELATED BANK LOANS AND IDA CREDITS .19 TABLE 3: PROJECT T ABLE .............................................................. 2) TABLE 4: CREDIT DISBURSEMENTS: CUMULATIVE ESTIMATED AND ACTUAL ........................... 20 TABLE 5: KEY INDICATORS FOR PROJECT IMPLEMENTATION .......................................................... 21 TABLE 6: KEY INDICATORS FOR PROJECT OPERATION .............................................................. 23 TABLE 7: STUDIES INCLUDED IN PROJECT............................................................... 2.4 TABLE 8: PROJECT COSTS ............................................................... 27 TABLE 9: PROJECT FINANCING .............................................................. 28 TABLE 10: ECONOMIC COST AND BENEFITS .............................................................. 28 TABLE 11: STATUS OF LEGAL COVENANTS IN THE CREDIT AGREEMENT ..................................... 29 TABLE 12: STATUS OF LEGAL COVENANTS IN THE PROJECT AGREEMENT .................................. 35 TABLE 13: COMPLIANCE WITH OPERATIONAL MANUAL STATEMENTS ......................................... 39- TABLE 14: BANK RESOURCES: STAFF INPUTS .............................................................. 39 TABLE 15: BANK RESOURCES: MISSIONS .............................................................. 40 Annex A: Aide-memoire de la mission SECALIE de la Banque mondiale Annex B: Borrower assessment of Project Implementation Annex C: Map No IBRD 20035R 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 MADAGASCAR FOOD SECURITY AND NUTRITION PROJECT CREDIT 2474-MAG PREFACE This is the Implementation Completion Report OCR) for the Food Security and Nutrition Project in Madagascar, for which a Credit (2474-MAG) in the amount of SDR15.5 million(US$21.3 million equivalent) was approved on March 18, 1993, signed on April 9, 1993, and made effective on July 29, 1993. The Credit aimed at assisting the Government to reduce food insecurity and malnutrition in the provinces of Antananarivo and Toliary. The Credit was closed on December 31, 1998, or five months behind schedule. An amount of SDR 3,673,673 (US$ 4,981,684 equivalent) was canceled on May 14, 1999. The last disbursement took place on November 13, 1999. In addition to the government counterpart funding and to the beneficiary contribution (about five and four percent; respectively, of total project costs excluding taxes and duties), the project was to be cofmanced by the World Food Program (WFP), UNICEF and Japan. The outcome of the project is satisfactory overall. The success of the project is due in large part to its flexibility and adaptability, but the real people behind the success are the Malagasy who worked to make it go and the poor for whom it was designed. The ICR was prepared by Mr. Paul Geli (Consultant) and Ms. Nathalie Lopez-Diouf (Team Assistant). It was reviewed by Ms. Eileen Murray (Task Manager for the project - AFTH4) and Mr. Arvil Van Adams (Sector Manager, AFTH4). Preparation of this ICR was started during the Bank's final supervision mission in August 1998. It is based on materials in the project file, and on the interviews of people who have been associated with the project during implementation. The Borrower contributed to the preparation of the ICR by providing views reflected in the mission's aide-memoire (Annex A), by preparing its own evaluation of the project's execution (Annex B) and by commenting on the draft ICR.  IMPLEMENTATION COMPLETION REPORT REPUBLIC OF MADAGASCAR FOOD SECURI1TY AND NUTRITION PROJECT (CREDIT 2474-MAG) EVALUATION SUMMARY Introduction. 1. At the time the project was processed and the credit made, Madagascar was among the least developed countries in the world. Despite Madagascar's significant development potential, its social conditions were, and continue to be below sub-Saharan African standards. To remedy that situation and to help the poorer segments of the population during the period of adjustment which started in 1985, the Bank financed sectoral operations in education and health, as well as an Economic Management and Social Action Project (EMSAP/PASAGE) which included pilot targeted programs to reduce food insecurity among the poor. The experience of those pilot programs was taken into account in the design of the project. Project Objectives. 2. The project's objective was to reduce food insecurity and malnutrition in Madagascar's two most food-insecure provinces (which are Antananarivo and Toliary) through income generating projects and targeted nutrition programs. The project objectives were not modified during project implementation. 3. To help achieve the above objectives, the project consisted of three components: (a) Income Generating Activities to be carried out through (i) the Fonds d'Intervention pour le Developpement (FID), a social fund financing labor intensive works and other income generation activities and (ii) a Food for Work Program targeted to the urban poor in Greater Antananarivo; (b) Nutrition Interventions including (i) a Community nutrition Program in the provinces of Antananarivo and Toliary working through mother groups organized by a community nutrition agent supported by NGOs to provide nutrition education, arrange supplemental feeding and refer severe cases of malnutrition to nutrition rehabilitation centers operating under medical supervision and (ii) a national Iodine Deficiency Disorders (IDD) control program; and (c) Institutional Strengthening to support the development and execution of an Information, Education and  Evaluation Summary Page ii Communication (IEC) program and support the development of a National Food Security Strategy for the long term. 4. The Food Security and Nutrition Project was to be implemented under the overall guidance of a National Coordinator assisted by the SECALINE Project Office (Bureau d'Execution du Projet SECALINE - BPS) with specific arrangements depending on the component and sub-component. The BPS' role was to coordinate, support and monitor implementation, including project financial management, accounting and auditing, but with the exception of FID which had been set up as a non-profit association operating independently. The total project cost estimate was US$32.4 million equivalent, and the project was expected to be completed by January 31, 1998 and the credit closed on July 31, 1998. 5. In addition to the standard clauses for counterpart funds, procurement and audit, covenants in the Development Credit Agreement (DCA) and the Project Agreement and a supplemental letter to the DCA were expected to promote the achievement of project objectives. Those covenants and letter dealt with project management and execution, and performance and monitoring indicators. 6. The formulation of the project's objective was both too broad and too narrow. The SAR ad the legal documents should have specified what was clearly intended, namely that the project's main objectives was to reduce food insecurity and malnutritionfor the target groups in the targeted areas, but that on the other hand there were other objectives, such as to reduce the goiter prevalence among pregnant women and school children and to prepare a National Food Security Strategy, and, through FID, to improve access of rural poor to social and economic infrastructure and to promote the development of local small contractors and consultants. Given Madagascar's very low level of development, alleviating poverty was a priority of the Bank's assistance program. The SAR recognized that, although necessary, sustained growth would not in itself be sufficient to alleviate poverty, and that the poorest households needed to receive targeted protection. The Bank strategy was to rely increasingly on NGOs and private organizations with a proven track record in the field for efficient delivery of programs reaching the most vulnerable groups. The project was complex, with many sub- components; however, it was not too demanding for Government since adequate arrangements had been made for the execution of those sub-components by other organizations. Implementation Experience and Results. 7. Achievements can be assessed as "substantial" for physical objectives (compared to the targets included in the SAR), gender issues and private sector development, "partial" for institutional development and poverty reduction, and "negligible" for macro policies and sector policies; other objectives listed in Table 1 do not apply. 8. The achievements generated in relation to the project's major objectives are likely to be maintained in the future. Both SECALINE and FID have become household words  Evaluation Summary Page iii in Madagascar; in rural areas, families are even naming their newly born "SECALINE". Generally, behavioral changes which have been promoted through well designed and conducted IEC campaigns may be the main elements of sustainability of the project. NGOs have kept most of the 535 community nutrition centers or sites active; the Ministry of Health is following up on the Iodine Deficiency Disorders (IDD) control program; the same type of urban works as those undertaken under the food-for-work sub-component will be continued by the Municipality of Antananarivo; IEC activities are also being continued on a national scale; and the National Food Security Strategy has been adopted by Government and is the main reference for any activity or research regarding food security. The additional phases of FID requested by Government demonstrate that an autonomous institution such as the FID remains the best option to implement small-scale sub-projects at the community level. Regarding the sub-projects financed by FID, the important community involvement in their identification, preparation, appraisal, selection and implementation will contribute to their sustainability. Generally, the participatory approach at the grass-roots level which characterizes this project means that many stakeholders will want to make the achievements of the project last and to ensure that the newly created assets are properly maintained. The sustainability of the project will also be reinforced by the Second Social Fund Project or FID II (CR. 2778-MAG) approved in 1995, the Community Nutrition II Project (CR. 3060-MAG) or SEECALINE approved in 1998 and the Third Social Fund Project or FID Im approved in 1999, which continue and expand in the six provinces of Madagascar most of the activities undertaken under this project. 9. The project was basically implemented according to schedule. The slight delay of five months is attributable to the fact that the project was still needed to finance some necessary operating costs before SECALINE II became effective. In addition, it was envisaged at one point that the undisbursed balance of the credit would be used to finance emergency locust control activities. The latest estimate of the cost of the project is US $ 28.8 million, compared to the SAR estimate of US $ 32.4 million excluding taxes and duties, or an 11 percent decrease. IDA disbursements in dollars were less than originally forecast (minus 19 percent), but the World Food Program contributed more than the original estimate (plus 26 percent). The contribution from Japan and UNICEF were the same as forecast. Thirty-eight percent of the money was spent on FID sub-projects, 27 percent for the urban food-for-work sub-component, 21 percent for the community nutrition program and the balance of 14 percent for the other sub-components and project management. 10. A number of factors affected project implementation and the achievement of the project objectives. One factor which affected the project negatively in a major way was the inability of SECALINE and the Ministry of Health to make satisfactory arrangements for the treatment of severely malnourished children in nutrition rehabilitation centers run by the Ministry of Health. Another problem of great significance at the time was the dismissal of the General Manager of FID at the end of 1995. This was the only occurrence of political interference in the project. The other factors that affected project implementation negatively were a shortage of food for the food-for-work sub-component,  Evaluation Summary Page iv delays in procurement, problems with the installation of computerized accounting systems for both the BPS and FID, and too low a ceiling for the FID special account. 11. On the positive side, the project benefited greatly from the fact that it was outside the traditional government entities, worked closely with communities and relied extensively on NGOs. This was one of the first IDA-financed projects with this type of design. It also benefited from the availability of a reasonably well prepared implementation plan. Under the successful SECALINE strategy, village communities have been placed at the center of all project activities, as primary actors responsible for their execution and as direct beneficiaries. Also, the IEC strategy and program designed and implemented by nationals who had an intimate knowledge and understanding of local behavior and customs had a high impact at a low cost. Finally, the project had considerable backing from the country's political leadership who publicly speak of the project as a Malagasy effort and not as a World Bank-financed project; generally Government, and particularly the Prime Minister, have been very supportive of SECALINE and FID and have not interfered with their day-to-day management. Close collaboration with other donors also contributed to the project's success. 12. The Bank performance on this project has been satisfactory at the identification stage and for preparation assistance, appraisal and supervision. The Borrower performance can also be rated as satisfactory for preparation, and highly satisfactory for implementation and covenant compliance. 13. The outcome of the project is satisfactory overall. The close monitoring done by project management shows that, between the beginning of activities on the sites and March 1998, the rate of malnutrition in the target community nutrition centers or sites has decreased on average by 58 percent in the Province of Antananarivo and 48 percent in the Province of Toliary. The Food-for-Work sub-component provided food rations to the poorest segments of the population of Greater Antananarivo, and the FID operations injected significant amounts of money in the rural areas of Madagascar, part of which must have been used by the population to purchase food. Nationwide, the impact of the project has been limited, since it seems that for the whole population of Madagascar access to food has not increased but rather decreased and that overall the malnutrition rate for Malagasy children has remained about the same, or is even slightly worse. In the absence of sustained economic growth, the project contributed to attenuate the deterioration in the conditions of Malagasy households, but the activities undertaken under the project were not a scope sufficient to have a real impact on food insecurity and malnutrition overall. Nevertheless, the successful implementation of the Community Nutrition Program in the target sites paved the way for the launching of a more ambitious program in the six provinces. One of the most interesting aspects of this component has been the close link between IEC, nutrition and community development. As a result of the Iodine Deficiency Disorders (IDD) control program, the goiter prevalence in pregnant women and school children dramatically decreased from 45 percent in 1992 to 15 percent in 1998. FID has had a very positive impact in poor rural areas; over the years it has become the instrument of choice of Government to implement its rural development  Evaluahon Summary Page v strategy. The Food-for Work sub-component provided support to the poorest in urban areas (the majority are women heads of households) by giving them food rations in return for work performed in cleaning their neighborhoods. The National Food Security Strategy was adopted by Government in December 1997 and is supposed to be used as a reference for all actions and research on food security. Summary of Findings, Future Operations, and Key Lessons Learned. 14. The success of the project is due in large part to its flexibility and adaptability, but the real people behind the success are the Malagasy who worked to make it go and the poor for whom it was designed. This project is essentially a Government and Malagasy project, which has been successfully implemented by Malagasy without any external long term technical assistance. In Madagascar, it was the first project of this scope and size working with communities and NGOs. One important finding is that it has clearly demonstrated the benefits of such an approach on a scale which goes well beyond previous attempts by pilot type operations. Achievements include: (i) the financing and execution by FID of 348 infrastructure sub-projects, 36 income generating activities and 10 training sub-projects, which generated almost 2 million persons/days of temporary employment and contributed to private sector development; (ii) the execution by BPS of drainage and other urban works in Antananarivo (with co-financing by the WFP), which generated almost 1.3 millions persons/days of temporary employment, of which over 70 percent benefited very poor women; (iii) the implementation by the Regional Coordinations of SECAL1NE and NGOs, with co-financing by the WFP, of the community nutrition program, which covered 535 community nutrition centers or sites and provided growth monitoring for almost half a million children in the two provinces of Antananarivo and Toliary; (iv) the very successful implementation by the BPS, the Ministry of Health and UNICEF of the Iodine Deficiency Disorder (IDD) control program; (v) the design and implementation by the BPS and the Regional Coordinations of SECALINE of an effective IEC strategy; and (vi) the preparation by BPS with the assistance of Malagasy experts of a national food security strategy which was adopted by Government in December 1997. 15. Out of the six sub-components included in the project, three will be continued and expanded with IDA financing: FID, the community nutrition program and the lEC. The Community Nutrition II Project (CR. 3060-MAG) aims to improve the nutritional status of children under three, primary school children and pregnant and lactating women in the project target areas. The second Social Fund Project (FID II) and the Third Social Fund Project (FID HI) were approved in 1995 and 1999, respectively. The objectives of FID II are to alleviate poverty and support community development through partnership with NGOs and beneficiary communities. The objectives of FPD HI are: (i) improved access of poor rural population to social and economic infrastructure; (ii) on a pilot basis, empowerment of poor rural communities and/or communes to identify, organize, manage funds, and implement sub-projects responsive to community needs in order to achieve decentralized social and economic development; (iii) employment creation; and (iv) improved capacity of private sector: local small contractors and consultants, artisans,  Evaluation Summary Page vi skilled labor and NGOs. Also, the scope of FID activities has been expanded considerably. 16. A number of lessons can be learned from the implementation of this Food Security and Nutrition Project. They have been taken into account in the design of the Social Fund II and III and the Community Nutrition II Projects. The SECALINE approach also inspired the design of Senegal's Community Nutrition Project as well as Benin's Food Security and Nutrition Project. The main lessons are the following: * Projects that are managed outside the traditional government entities tend to be more efficient and flexible in getting quick results in the field and in serving the communities. Both the BPS and FID were able to recruit on a contractual basis and motivate competent and dedicated staff. Also, the fact that the project relied extensively on NGOs and other decentralized community structures contributed to its success. The effectiveness of the project was reinforced by the "contracting approach" that was adopted, which lead to formal contracts (such as those with NGOs) and more informal agreements (such as those with community nutrition workers).