Niger - Population Project

Dnumat of The World Bank FOR OFFICIAL USE ONLY Report No. P-5669-NTR ,hspW ri. N. 1- ~>ti69L . l! j4 A'M- MEMORANDUM AND RECOMMENDATION OF THE PRESIDENT OF THE INTERNATIONAL DEVELOPMENT ASSOCIATION TO THF EXECUTIVE DIRECTORS ON A PROP 'T CREDIT OF SDR 12.9 MILLION l'O THE RFPLUBIIC OF NTGER FOR A POPULATION PROJECT APRIL 3, 1992 This document has a restricted distribution and may be used by recipients oniv in the performance of their official duties. Its contents ma; not otherwise be disclosed without World Bank authorization.  CLJ.RRENCY EOUIVALENTS Curren.y Unit = CFA Franc (CFAF)/US5I = CFAF 272 (February 1992) i'EASURES Metric system ABBREVIATIONS AND ACRONYNIS CONAPO Commission Nationale de la Population (National Commission on Population Activities) CPR Contraceptive Prevalence Rate P1 Family Planning IEC Information, Education and Communication MCH Maternal and Child Health iC' t Project Coordinating Ulnit SOE Statement ot Expenditure \WID Women in Developnment FISCAL YEAR January I - December 31  FOR OFFICIAL USE ONLY REPlBLIC OF NIGER POPULATION. PROJECT CREDIT AND PROJECT StJMMARY Iorrower: Republic of Niger Beneficiaries: Ministries of Public Health; Social Development, Population and Women's Promotion; Economy and Finance; and Communication, Culture, Youth and Sports Credit Amount: SDR 12.9 million (US$17.6 million) Terms: Standard, with 40 years maturity Onlending Terms: Not applicable Financilng Plan: IDA 17.6 Government 2.7 NGOs/Private sector 0. I Communities 0.1 Belgium 2.5 UNICEF 1 0 TOTAL a/ 24.1 Economic Rate otf Return: Not applicable Stat'f Appraisal Report: Report No. '0047-NIR Map: IBRD 23562 a/ Total inay not add up due to roundinyg This document has a restricted distribution and may be used by re. 'y in the performance of their official duties. Its contents may not otherwise be disclosed .wt or!d Bank authorization.  MEMORANDUM AND RECOMMENDATION OF THE PRESIDENT OF THE IDA TO THE EXECUTIVE DIRECTORS ON A PROPOSED CREDIT TO THE REPUBLIC OF NIGER FOR A POPULATION PROJECT 1. I submit for your apn;roval the following report and recommendation on a proposed development credit to the Republic of Niger for SDR 12.9 million, the equivalei t of US$17.6 million, on standard IDA terms with a maturity of 40 years to help finance a population project. The Governmvnt, nongovernmental organizations, the private sector and local communities would contributc US$3.0 million. Cofinancing is expected from the Government of Belgium (US$2.5 million), and UNICEF (US$1.0 million). 2. Sector Background. Niger's high and accelerating rate of population giowth imposes severe constraints on this resource-poor country's long-term development prospects. "he Government's commitment to addressinig this problem has evolved rapialy over the last several years. Its Five-Year Developmen. Plaii 1987-91) identified rapid populatior growth, currently estimated at 3.4% per annurn, as a major constraint to the medium- and long-term economic and social development of the country. Subsequently, the national family planning strategy (1988-93) and the demographic plan of action (1991-95) spelled out the Government's priorities and strategies in population and family planning, which aim to: (a) provide broader access to family planning services through an integrated maternal and child health care and t'amily planning (MCH!FP) program; (b) reduce maternal and child mortality; (c) support programs to improve the status of women; and (d) improve demographic data collection and research, and strengthen the national capacity for population policy analysis, program planning, management and coordination. 3. To provide policy guidance and institutional focus tor these objectives, the Government enacted in )88 an ordinance on contrace,)tive practice, established a Department for Family Planning and. in 1989, established a Ministry for Social Affairs and Women's Promotion (recently renamed the Ministry tor Social Development, Population and Women's Promotion). These policy and institutional changes are reflected in the steady progress that has been achieved over the last three years in the expansion of family planning services to almost all urban areas of the country. Although the contraceptive prevalence rate is still very low for the country as a whole -- about 2-3% -- it has risen rapidly in the major urban areas to about 18%. All of these efforts, however, are constrained by strong pro-natalist traditions, the low level ot' female literacy, high maternal and child mortality and poor nutrition, a limited capacity for demographic planning and program development, and an inadequate health service delivery system. Thus, while the Governmient's objective of achieving a contraceptive prevalence rate of between 25% and 30% in urban areas and between 5% and 10% in rural areas by the end of the project is feasible, it may be difficult to achieve given the above-mentioned constraiPts, without the adoption of a more effective service exransion strategy and further et'forts to generate effective demand for services. These two objectives, i.e., service expansion and creating et't'ective demand, constitute the major thrust of the proposed project. 4. Proiect Objectives. The project would 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 si7e norms, and enhancing the capacity of women to effectively participate in socioeconomic development. 5. Project Description. The project comprises the following components: (a) Strengthening the delivery of maternal and child health and family planning (MCH/FP) services (52% of total base costs) by: (i) supporting policy reform in the areas of essential drugs and cost recovery, and strengthening departmental and district capacities in sector management, planning, monitoring and evaluation; and (ii) increasing access to and improving the quality of MCH/FP services at all levels of service delivery (village, canton, district, and department), and providing support for the participation of NGOs. including  - 2 - community groups and other private sector agencies, in MCH/FP service delivery and information, education, and communication (IEC) activities; (b) Promrioting family welfare and women's status (34% of total base costs) by encouraging behavior f;voring a reduction in family size norms and by eihancing the capacity of womeni to effectively particir,ate in socioeconomic development, through suppolt for: (i) a nationwide IEC program; (ii) promoting tlhe status of women; and (iii) nutrition interventions; and (c) Reinforcii.g the Government's capacity for population poliky analysis, research. monitoring and coordination G( % of total base costs) by: (i) improving the capacity for sociodemographic data col'ection, analysis, research and evaluation; (ii) strengthening the institutional capacity for the promotion ard coordination of the national population program; and (iii) establishing a Population Fund tu encourage active private sector and NGO involvement in the population program. The project will also finance project coordination and management, as well as refinancing of the PPF (7% of total base costs). Schedt'es A to D annexed to this memorandum provide summaries of project costs and financing plans, procurement methods and disbursements, key project processing events, and status of Bank Group operations. 6. Project Implementation. Each of the three project components will be implemented by the relevant units in the responsible ministries, namely the Ministry of Public Health; Social Development, Population and Womern's Promotion; and Economy and Finance. The project reinforces the planning, management and technical capacities of the key implementiiig agencies. A Pro ject Coordinating Unit (PCU) located in the Ministry of Social Development, Population and Women's Promotion will be responsible for administrative and financial matters, as well as monitoring and evaluation. In addition, the PCU wi!l administer the Population Fund. The project is expected to be completed over a four- year period, and the IDA credit would be disbursed over a six-year period, compared to Niger's standard disbursement profile of ueven ye'ars. 7. Project Sustainability. Three aspects of project design will help promote the sustainability of Nige.'s population prog.arn beyond project completion. First, the strengthening of program planning and management at the departmental and district levels, and the redeployment of health personnel from urban to rural areas will ensure more cost-effective use of available resources. Second, these reforms, together with project support to enhance the quality of service delivery and to promote family welfare and women's status will stimulate effective demand for FP services. Third, increased cost recovery and support under the Population Fund for private sector and NGO involvement in MCH/FP service delivery, and for community initiatives in WID and nutrition activities would help expand internal resource mobilization for the population program outside of the public sector. 8. Lessons Learned. The project benefits from the experienc>e gained under the ongoing IDA- funded Health Project (Cr.1668-NIR), the results of the recent OED evaluation of eight case studies (including one Sahelian country) on the impact of Bank assistance on fertility reduction, as well as from project experiences in other African countries, such as Zimbabwe and Kenya. These experiences have demonstrated the importance -- under a nascent population and family planning program such as that in Niger -- of: (a) an effective integration of FP services irnto ongoing MCH programs; (b) a multi-channel approach to MCHIFP service delivery and communication; and (c) a broad-based demand creation strategy, including an expanded IEC program with support for programs aimed at improving women's status and social welfare. The lessons learned also relate to the need to improve efficiency of service delivery through well-designed training programs, effective decentralization, ariU efficient allocation of personnel. Finally, in order to ensure effective implementation of project activities, there is a need for substantial improvemr.ent in project management, particularly in the areas of financial management and procurement. 9. Rationale for IIDA Involvement. There is consensus between the Government and IDA on the importance of the "population factor" in the country's long-term development goals and strategies, and  on the need to act now. This consensus has been achieved through a continuing dialogue with the Government over the past few vears, and has contributed to the recent development of a naticnal policy on population. IDA's strong position in influencing the Government's plans and strategies in the population sector a& well as its ability to help mobilize financial support for the sector, is recognized by both the donor community and the concerned government agencies. This places IDA in a position to continue playing a catalytic role in assisting the Government in its efforts to further this prccess, and to help build on the current momentum for increased population and FP activities. The proposed project is consistent with iDA's human resource development objectives in the Sahelian countries and with the Bank-wide policy objective of poverty alleviation in Sub-Saharan Africa. 10. Agreed Actions. The following are conditions of credit effectiveness: (a) Publication of an Arrete defining the structure of the 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 pol;:y document defining the persorael recruiiment and redeployment plan for 1993-95; (b) Adoption of an action plan establishing guidelines for the extension of the drug distribution network, as well as procedures for the intioduction of the national essential drug! list; (c) Adoption of the revised departmental in-service tr..ining modules for MCH/. P and nutrition, including a detailed in-service training plan for the first two years of project implernentation (1993-94); (d) Adoption of the st: ite 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 Arret1 defining the norms and standards for the prcvision of MCH/FP at each service delivery ievel; (t) Publication of an Arrat (i) authorizing newly-recruited village health workers to provide refills for hormonal coiatraceptives, as well as supplies of barrier methods, and (ii) defining the revised chiecklist to be used to screen new FP acceptors and other modalities for its utilization; (g) Adoption of thle by-lavs 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 berneficiaries of the Fund; and es:ablishment cf the committee for the selection of sub-projects to be financed under the Fund; (h) Publication of the Arrete establishing the Interministerial TEC Technical Committee; (i) Submission to IDA, for review and comment, of draft bidding documents for all bid packages in the first year of the project; and (j) Finalization and signature of the contract with the selected auditor. Also, as a condition of credit effectiveness, the Government will have satisfied IDA that it has concluded appropriate agreements with other cofinanciers in view of securing all complementary financing required for the execution of the projcct, ind has satisfied all the conditions precedent therec - other than any such conditions related to the effectiveness of the IDA credit. It should be noted that the draft versions of the policy documents listed in conditions (a) - (ji above were discussed and agreed upon at negotiations. For that reason, timely fulfillment of these effectiveness conditions is expected. 11. Environmental Aspects. The project is rated C. Actions to reduce population growth will have direct long-term positive effects on the environment. 12. Project Objective Categories. The project responds directly to the human resource development and antipoverty objectives of the Government. Extending FP services, strengthening MCH services, promoting women's interests and improving populaticn policy analysis, planning and management will contribute significantly to the achievement of the long-terrm development objectives of the country. 13. Project Benefits. Project benefits would be widespread, especially in five areas. Eirst, between 0.8 to 1.0 million women of reproductive age would gain direct access to MCH/FP services. Pre- and post-natal consultations wouLld be significantly increased, thus directly affecting maternal and infant mortality rates. FP service consultations, the number of new acceptors, and continuity of contraceptives use wouid rise significantly, resulting in a estimated contraceptive prevalence rate of between 25%o and 30% in  - 4 - urban areas, and between 5% and 10% in rural areas by the end of the project period. In addition, ther efficiency and qualitv Lf service delivery of the health care system at the regional, d'strict and village levels would be greatly improved. Scnd, the JEC sub-component is expected to have far-reaching qualitative impact on tne social and economic well-being of the Nigerien population. The lEC activities would cover the whole country through mass media (about 95% of the population have access to radio and 125% tc television), and would enhance people awareness of population, environmental, health and FP issues, thus facilitating the Government's efforts to implement more aggressive and effective policy reforms. Thid, the WID sub-component, through its support for energy- and time-saving technologies, expansion of microenterprises, functional literacy programs ind nutrition surveillance, would have a far-reaching impact on women's health ani nutrition, as we!' -- on faniily welfare, and would help reinforce the FP objectives of the project. Fourth, the population policy analysis. research and coordination component would signitwiantly enhance the Government's ability to promote and coordinate broad-based program implemen- tation. The establishment of a permanent secretariat for the National Commission on Population Activities (CONAPO) will provide ilh needed institutional leadership, and help strengthen the political cormnitment essential for establishing a stable, susta' iable, and legitimate national population program. By the end of the project period, the quality of overall development and sectoral planning would have significantly improved, as a result of improved analytical work, the availability of a more reliable and comprehensive data base, and a body of technical expertise in relevant ministries able to integrate demographic factors into development planning. Fifth, the Population Fund would help expand the capacity to deal with social sector issues by encouraging increased participation of the private sector and NGO involvement in the population program. 14. Proiect Ris!s. There are three main risks. First, it the current unstable political situation were to persist, the population and family planning program may not continue to receive the same attention and visibility that it currently enjoys. However, the open attitude that has come to prevail in the discussions of these issues, as well as the track record of strong and broad-based suppor. for FP throughout the country, are reasons to believe this is now a well-accepted item on the national agenda. Furthermore, the support provided by this project for the establishment of a nationwide IEC program should help maintain population issues as a high priority national concern. Second, the implementation of the decentralization strategy at the departmental and district levels may be slow to materialize. It is expected that project interventions aimed at improving the management, administrative and technical capacities of health personnel at the provincial levels will mitigate this risk. Third, the redeployment of health personnel from the central to the regional and district levels may not be achieved effectively. To minimize this risk, a personnel recruitment and redeployment plan was discussed and agreed at negotiations; Government's adoption of the agreed plan is a condition of effectiveness. 15. Recommendation. I am satisfied that the proposed credit would comply with the Articles of Agreement of the Association and recommend that the Executive Directors approve it. Lewis T. Preston President Washington, D.C. April 3, 1992 Attachments  -5- Schedule A Page I of I REPUBLIC OF NIGER POPULATIQN PROJECT SUMMARY AND PROJECT COST ESTIMATES (USS million) A/ ESTIMATED PROJECT COSTS b/ LOCAL FOREIGN TOTAL 1. Strengtheoing the Aelivery of Maternal Health and FP Services 4.5 6.5 11.0 2. Promoting Family Welfare and the Status of Women 4.4 2.6 7.0 3. Reinforcing Population Policy Analysis, Research and Coordination 0.6 0.7 1.4 4. Project Coordination and Management 0.5 0.6 1.1 5. Refinanning of PPF 0.1 0.3 0.4 Total Base Costs 10.2 10.7 21.0 Physical Contingencies 0.6 0.8 1.4 Price Contingencies 0.9 0.7 1.7 TOTAL PROJECT COSTS 11.8 12.3 24.1 Financing Plan (US$ mnillion) IDA 8.0 9.6 17.6 Government 2.7 0.0 2.7 NGO/Private Sector 0.1 .1I 0 1 Communities 0.1 0.0 0.1 Belgi"'m 0.5 2.0 2.5 UNICEF 0.5 0.5 1.0 TOTAL 11.8 12.3 24.1 a/ Totals may not add up due to rounding. b/ Net of taxes and duties.  -6- ScheGuIe B Page I of 2 REPUBLIC OF NIGER POPULA .'ION PRO:ECT Procurement Method and Disbursements umnary of, Proposed Procurement Armngements (USS miliion equivalent, including contingencies) Category of Exoenditures ICE1 OTHgR NBF TOTAL COST 1. Works 1.1 New Construction -.9 - - 2.9 - (2.9) - (9) 1.2 Rehabilitation - 1.0 1.0 - (1.0) - (1.0) 2. Goods 2.1 Vehicles 0.9 0.9 (0.9) - - - (0.9) 2.2 Equipmvnt 2.0 - 0.' 0.1 _/ 2.3 (2.0) - (0.2) - (2.2) 2.3 Furniture 0.3 0.5 - 0.8 (0.3) (0.5) - - (0.8) 2.4 Contraceptives 0.6 - - 0.6 (0.6) - - - (0.6) 2 5 Materials & Supplies 0.1 0.2 0.1 0.1 _ 0.5 (0.1) (0.2) (.li) - (0.4) 3. Service Contracts 0.6 - 0.4 *1 - 1.0 ((0.6) - (0.4) - (1.0) 4. Consultancies 4 1 Studies, Evaluation - - 0.6 0.6 & Supervision - - (0.6) - (0.6) 4 2 Technical Assistance - 0.7 2.5 cl 3.2 (0.7) (0.7) 4.3 Training - - 0.3 - 0.3 - - (0.3) - (0.3) 5. Other 5 1 Refinancing of PPF - - 0.4 - 0.4 - - (0.4) - (0.4) 5.2 Training Costs - - 3.2 0.2 d/ 3.4 - - (3.2) - (3.2) 5.3 Popuilation Fund - - 0.5 0.1 e/ 0.7 - - (0.5) (0.5) 5 4 Micro-projects - - 0.5 0.5 f/ 1.0 - - (0.5) - (0.5) 5.5 Operating Expenses - 1.5 2.9 g/ 4.4 : : (1-5) (i.5) l'otal Costs 4.5 4,6 8.5 6.5 24.1 l'otal Financed by IDA (4.5) (4.6) (8. Note. Totals may not add up due to rounding. Figures in parentheses represent amounts financed under the IDA credit. NBF - Not Bank Financed. */ Service contracts for ORTN production costs US$0.4 million, Footnotes indicate amounts financed by other donors and procured under their procedures. a/ UNICEF USS0.1 million. _/ NGOs/Private Agencies USSO.1 million. bl UNICEF USS0.1 million. fl UNICEF USS0.4 million; Communities US$O.I million. c/ AGCD US$2.5 million. g/ Government U3$2.7 million, UNICEF USS0.2 million. d/ UN BEF USSO.2 million.  -7- Schedulg B Page 2 of 2 REPUBLIC OF NIGER POPULATION PROJEC1 Allocation and Disbursement of the IDA Credit Category of Expenditure Proposed IDA Allocations % of Expenditures (UJSS Million) Financed by IDA 1. Civil Works 3.5 100% ' Vehicles, equipment, furniture, materials & supplies, contraceptives 4.4 100% 3 Service Contracts 0.8 100% 4 Consultancies 1.5 100% 5. Training costs 2.9 100% 6. PopLiation Fund 0.5 80% 7. Micro-Projects 0.5 80% S. Operating Costs (a) PCU 0.5 100% (b) Other 1.0 7C% 9. ppF 0.4 10. Unallocated 6 Total 7.6 Estimated IDA Disbursements: --------------------USS million---------------------- IDA FY 93 94 95 96 97 98 Annual 0.8 2.0 5.5 5.0 3.0 1.3 Cumulative 0.8 2.8 8.3 13.3 16.3 17.6  -8- Schedule C Page 1 of I REPUBLIC OF NIGER POPULATION PROJET Timetable of Key Project Processing Events (a) Time taken to prepare 15 months (b) Prepared by Goveniment with IDA assistance * (c) First IDA mission June 1990 (d) Appraisal mission departure June 1991 (e) Negotiations March 1992 (f) Planned date of effectiveness July 1992 (g) List of relevant PCRs and PPARs n.a. * This report is based on the finr'.ngs of an appraisal mission that visited Niger in June/July 1991 and a post- appraisal rnission (November 1991) led by Mr. Edward Brown (Demographer). The report was prepared by Mr. Brown, with the assistance of Ms. Sabrina Huffman. Ms. Katherine Marshall and Mr. Birger Fredriksen are the Department Director and the managliLg Division Chief, respectively, for the operation.  9 - Schedule D Page I of 2 ,2RPUBLIC O2f LA POPULATION PRQJECT Status of Bank Grou, Operations (as of March 28, 1992) Amounts in USS million (tcus canccllations) Loin or Undis- C.,)3 ,hg Credit No. Year PUrDo Bank IDA %rl&cd Date Credits 27 Credits closed. 273.37 1511-NIG 1985 Power Enginecring 7.50 0.29 12/31/91 (R) 16'1-NIG 1985 Irrigation Rchabilitation 9.30 0.49 1 ./31/91 (R) 1668-NIG 1986 Health 27.80 15.62 6/30/93 1706-NIC 1986 Transport ScUtor 15.00 0.73 6/30/93 A0310-NIG 1987 Public Enterprise Sector Adjustment 20.00 1.e32 9!30/90 (R, 1740-NIG 1987 Primary Education Development 18.40 9.03 6/30194 1830-NIG 1987 Public Enterprise Sector Adjustment 60.00 7.01 9/30/90 (R) 1838-NIG 1988 Public Enterprisc Institutional Developmcnt 5.50 1 46 6/30/92 1880-NIG 1988 Energy 31.50 25.-: i,'31/94 1890-N1tr 1988 Small Rural Operations 9.30 4.34 6/30/96 -12'-NIG 1990 Agncultural Research 19.90 19.6! 12/31/95 2209-NIG 1991 Pjblic Works and Employment 20.00 16.71 12/31/94 TOTAL number credits = 12 244.20 101.66 TOTAL $** 517.57 of which repaid 10.32 TOTAL held by Bank & IDA 507.25 Amount so.d of which repaid TOTAL undisbursed 101.66 LLst ot,closed SALs/SECALs Loan or Undis- Closing Credit No. Year Pumosc Bank IDA bursed Date A012-NIG 1986 SAL 40.00 00.00 12/31/87 1660-NIG 1986 SAL 20 00 00.00 12/31/87 TOTAL 60-00 00.00 NOTES: Total approved, repaymiets. and outistanding balancc represetit hoth act.v. and inactivc lu(ans ati(i crcdits (R) indicatcs formally revised closing date  - 10 - Schedule 1) Page 2 ot 2 REPUBLIC OF NIGER POPULATION PROJECT Summary ot' IFC Investments (as of Fehruarv 29, 1992) Fiscal Type of Original Gross Commitments Year Company business Loan Equilv Total (USS million) 1982 Les Moulins du Sahel Food Processing 2 1 0 2 2.3 Less Repayments, write-offs, cancellations and exchange adjustments (0.5) 0.2 103) Net Conitimiefncnt held bv IFC 2.6 2.6 IFC Africa I March 1992 b.nop rin (nigcr niop)  \ ALGFRP , \LIBYA NIGER~~~~~~~~~~~~~~~~IY 4 / ) ~~~~~~~~~~~N I G E R L1Y POPULATION PROJECT ( tCh1AD PROJET POPULATION < ~~~~~FOEI DEWv .Fr. 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