Madagascar - Multi-Sectoral STI/HIV/AIDS Prevention Project

Report No. 23215 Report No: p072987 <--Please check for duplicates! Integrated Safeguards Data Sheet (Initial) Date ISDS Prepared/Updated: 11/09/2001 Section I - Basic Information A. Basic Project Data Country: MADAGASCAR Project ID: P072987 Project: Multisectoral STI/HIV/AIDS Prevention Project Task Team Leader: Claudia Rokx Appraisal Date: November 15, 2001 IBRD Amount ($m): Board Date: December 20, 2001 IDA Amount ($m): 13.37 Managing Unit: HDNHE Sector: HA - HIV/AIDS Lending Instrument: Specific Investment Loan (SIL) Status: Lending I.A.2. Project Objectives: The development objective of the Multisectoral STI/HIV/AIDS Prevention Project (MSPP) is to support the Government of Madagascar in maintaining the prevalence rate of HIV/AIDS at less than 1%. To do so, the project will scale up the response to HIV/AIDS and sexually transmitted infections (STIs), a key risk factor and contributor to the spread of HIV/AIDS. I.A.3. Project Description: This project, under the regional MAP, will finance a share of the NSP to curtail the spread of STI/HIV/AIDS. The project will build on activities already underway and create synergies with ongoing interventions and projects as well as identify opportunities to utilize existing structures. This credit will be one of many sources of technical and financial assistance. Several other donors (see for details section D.2.) are contributing to the fight against HIV/AIDS with both new and on-going projects and all donors collaboratively support the NSP. The details of the project components are described in Annex 2 of the project document. A PPF was requested to immediately scale up existing activities in the 'hotspot' areas. It became effective in May 2001. A PHRD grant has been obtained to finance baseline epidemiological and behavior studies and the development of the financial and operational manuals. Early results of these studies have been used as information sources in this document. All study-reports are available from the project files. In addition, an edited version consolidating all reports will be published shortly after finalizing all studies. Project Component 1: STI/HIV/AIDS Prevention Activities The project will create a mechanism to provide financial incentives to correct market inefficiencies in the demand for, and provision, of prevention activities. On the demand side, there is a general lack of knowledge about the virus, protection methods, and risks. On the other hand, there is a lack of human and financial capacity to provide adequate services. The fund is expected to encourage greater private and NGO sector participation in HIV/AIDS prevention activities, resulting in an increase  in prevention at all levels (national, regional and local) and across all high risk groups. In addition, capacity will be built and strengthened in these institutions to ensure sustainability. The Fund will finance demand-driven sub-projects in the following domains: a) IEC to create awareness and social marketing of condoms and STI kits; b) Establishment and strengthening of institutions, such as NGOs, CBOs, local associations, youth clubs, etc; c) Training and support to develop and strengthen the capacity of such institutions; and d) Testing and counseling. There are two key groups of eligible beneficiaries: i) NGOs, CBOs and associations that already are implementing activities in one or more of the above categories, but need support to scale up qualitatively and quantitatively; and ii) existing entities that do not yet have the capacity to plan and implement HIV/AIDS prevention activities. Project Component 2: Development of Sector Strategies, Sector Action Plans and Financing of Pilot Sub-Projects The development of sector plans for the prevention of HIV/AIDS is critical to the multisectoral approach as highlighted by the MAP. The objective of this component is to develop sector strategies and operational plans for eight sectors (as seen in the table below) using a clear methodology developed under the PPF and subsequently, refine them based on the experiences and results of the pilot sub-projects. The goal of these strategies is to ensure: (a) the preparation of action plans that are feasible and sustainable, at the regional and national levels; (b) the creation of a synergy and complementarity of activities of each sector and within the framework of a multisectoral approach; and (c) the involvement of all key sectoral partners in the development process. In the first year of the project, tripartite Comites Sectoriels (CS) will be formed on a permanent basis to develop the strategies and action plans and will be made up equally of public, private and civil society representatives. Members are selected by their peers. These CS are responsible for: (i) the facilitation and drafting of the sector strategies and related action plans; (ii) monitoring and evaluating the pilot sub-projects for each sector; and (iii) coordination of interventions undertaken in each sector. In addition, one or more representatives of each CS will sit on the national Comite Intersectoriel (CIS), also on a permanent basis. The CIS will coordinate the development of sectoral policy, ensure coherence between sectors, prevent duplication of efforts, and lead the development of national sectoral operational activities. Once the action plans have been developed, activities be identified as candidates for financing as pilots, with at least one sub-project having been launched by the end of the second year. These sub-projects should function as the cornerstone of the sector strategy and guide development of sectoral best practices. Experiences, information and data collected during and following the implementation of the pilot sub-projects will be fed back into the strategy to strengthen it. - 2 -  Project Component 3: Monitoring and Evaluation (M&E) The focus of this component is threefold: fn Monitor project activities; n Evaluate the impact of project activities; and n Provide support for the studies to be conducted under Component 2. M&E activities will address three areas: 1) inputs and effects of sub-project activities on beneficiaries (high risk groups and the general population); 2) inputs and effects of capacity building on service providers (fund recipients); and 3) the effectiveness and efficiency of the operation of the Fund and the project as a whole. Component 4: Program Management and Strengthening of Institutional and Organizational Capacity The UGP is responsible for the day-to-day management of the project and reports directly to the Office of the Prime Minister. It will share key data and analysis with the Cellule through the BCN. The UGP's responsibilities include: (i) development of the annual work program and budget; (ii) financial management oversight of project components and the FMA; (iii) procurement and disbursement activities; and (iv) oversight of the monitoring and evaluation (contracted out locally) of the project. The capacity building part of this component will target the Cellule and its executive office, the BCN, and the UGP. First, the Cellule's institutional capacity will be strengthened by: (i) reinforcing and clearly defining its modus operandi (decision making processes, moderation skills, and consensus seeking); (ii) establishment of a core group and permanence of delegates, including NGOs and civil society, in order to create ownership, responsibility and decisive participation in the Cellule's decision-making process. Second, the areas of capacity strengthening of the UGP include: (i) program management, coordination and administrative tasks; (ii) advocacy and awareness creation; (iii) training of trainers and technical support; and (iv) situation assessment, monitoring and evaluation. I.A.4. Project Location: (Geographic location, information about the key environmental and social characteristics of the area and population likely to be affected, and proximity to any protected areas, or sites or critical natural habitats, or any other culturally or socially sensitive areas.) Overall responsibility for the implementation of the multisectoral STI/HIV/AIDS prevention project will be undertaken by the Project Unit (UGP). It will be responsible for the day-to-day management of the project and reports directly to the Office of the Prime Minister. The Office is located in the capital city, Antananarivo. B. Check Environmental Classification: B (Partial Assessment) Comments: This project is being processed without a separate Environmental Assessment because the project has been retroactively categorized as B and as such will conduct an environmental assessment during appraisal and -3 -  prepare a Medical Waste Management Plan as a condition of effectiveness. C. Safeguard Policies Triggered Policy Applicability Environmental Assessment (OP/BP/GP 4.01) Yes Forestry (OP/GP 4.36) No Natural Habitats (OP/BP 4.04) No Safety of Dams (OP/BP 4.37) No Pest Management (OP 4.09) No Involuntary Resettlement (OD 4.30) No Indigenous Peoples (OD 4.20) No Cultural Property (OP 4.11) No Projects in Disputed Territories (OP/BP/GP 7.60)* No Projects in International Waterways (OP/BP/GP 7.50) No *By supporting the proposed project, the Bank does not intend to prejudice the final determination of the parties' claims on the disputed areas Section II - Key Safeguard Issues and Their Management D. Summary of Key Safeguard Issues. Please fill in all relevant questions. If information is not available, describe steps to be taken to obtain necessary data. II.D.la. Describe any safeguard issues and impacts associated with the proposed project. Identify and describe any potential large scale, significant and/or irreversible impacts. The project is not expected to raise any major adverse environmental issues. However, there are risks attached to the handling and disposal of HIV/AIDS infected materials. These risks potentially affect personnel in hospitals, health centers and municipalities who handle waste, families whose income derives from the triage of waste and also the general public to the extent that waste is not disposed of on site or safely contained in protected areas. A Medical Waste Management Plan to include proper disposal of hazardous bio-medical waste, a bio-safety training program for the staff of all hospital, health centers and community-based programs, including traditional midwifes and practitioners, who may be involved in HIV/AIDS testing and treatment, will be undertaken by a Consultant identified by ASPEN and will be financed under the PHRD grant. The institutional arrangement with appropriate costing for the execution of the plan is a necessary step which we will discuss with the Government. A draft TOR will be sent by the ASPEN team to carry out the study prior to project effectiveness. II.D.lb. Describe any potential cumulative impacts due to application of more than one safeguard policy or due to multiple project component. II.D.lc Describe any potential long term impacts due to anticipated future activities in the project area. II.D.2. In light of 1, describe the proposed treatment of alternatives (if required) II.D.3. Describe arrangement for the borrower to address safeguard issues - 4 -  II.D.4. Identify the key stakeholders and describe the mechanisms for consultation and disclosure on safeguard policies, with an emphasis on potentially affected people. E. Safeguards Classification. Category is determined by the highest impact in any policy. Or on basis of cumulative impacts from multiple safeguards. Whenever an individual safeguard policy is triggered the provisions of that policy apply. I S1. - Significant, cumulative and/or irreversible impacts; or significant technical and institutional risks in management of one or more safeguard areas [XI S2. - One or more safeguard policies are triggered, but effects are limited in their impact and are technically and institutionally manageable 1 S3. - No safeguard issues I SF. - Financial intermediary projects, social development funds, community driven development or similar projects which require a safeguard framework or programmatic approach to address safeguard issues. F. Disclosure Requirements Environmental Assessment/Analysis/Management Plan: Expected Actual Date of receipt by the Bank Not Applicable Not Applicable Date of "in-country" disclosure Date of submission to InfoShop Date of distributing the Exec. Summary of the EA to the ED (For category A projects) Resettlement Action Plan/Framework: Expected Actual Date of receipt by the Bank Not Applicable Not Applicable Date of "in-country" disclosure Date of submission to InfoShop Indigenous Peoples Development Plan/Framework: Expected Actual Date of receipt by the Bank Not Applicable Not Applicable Date of "in-country" disclosure Date of submission to InfoShop Pest Management Plan: Expected Actual Date of receipt by the Bank Not Applicable Not Applicable Date of "in-country" disclosure Date of submission to InfoShop Dam Safety Management Plan: Expected Actual Date of receipt by the Bank Not Applicable Not Applicable Date of "in-country" disclosure Date of submission to InfoShop If in-country disclosure of any of the above documents is not expected, please explain why. Signed and submitted by Name Date Task Team Leader: Claudia Rokx 11/02/01 Project Safeguards Specialists 1: Serigne Omar Fye/Person/World Bank 11/05/01 Project Safeguards Specialists 2: Kristine M. Ivarsdotter/Person/World Bank 11/06/01 Project Safeguards Specialists 3: Approved by: Name Date Regional Safeguards Coordinator: Serigne Omar Fye 11/05/01 Sector Manager/Director: Arvil Van Adams 11/02/01 - 5-  For a list of World Bank news releases on projects and reports, click here - 6 -