Senegal - Community Nutrition Project

Document of The World Bank FOR OMCIAL USE ONLY Ctf - i2 72 3 -Se Report No. P-6553-SE MEMORANDUM AND RECOMMENDATION OF THE PRESIDENT OF THE INTERNATIONAL DEVELOPMENT ASSOCIATION TO THE EXECUTIVE DIRECTORS ON A PROPOSED CREDIT IN THE AMOUNT EQuIVALENT TO SDR 11.7 MILLION TO THE REPUBLIC OF SENEGAL FOR A COMMUNITY NUTRITION PROJECT APRIL 26, 1995 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 EOUIVALENTS Currcncy Unit: CFA Franc (CFAF) US$1 = CFAF 580 (Junc 1994) ABBREVIATIONS AND ACRONYMS AGETIP Public works Executing Agency (Agence d'Execulion des Travaux d'lnteret Public contre le Sous-l mploi) CNC Conmnunity Nutrition Center GIE Small Economic Interest Groups (Groupemen, d'interrt economique) IEC Information, Education and Communication KfW Krcditanstalt fur Wiederaufbau MIC Micro-entrepreneur MOC Local NGO supervisor (Maitre d'oeuvre communaulaire) NGO Non-Governmental Organization NMD Nutrition Management Division SONES National Water Company of Senegal (Soci&6 Nationale des Eaux du Sdnegal) UNICEF United Nations Children Fund USAID United States Agency for International Devclopment WFP World Food Program WHO World Health Organization ZOPP Objectives-oriented project planning (Zielorientierte Projekt-Planung) FISCAL YEAR January I - December 31  FOR OFFICIAL USE ONLY REPUBLIC OF SENEGAL COMMUNITY NUTRITION PROJECT CREDIT AND PROJECT SUMMARY Borrower: Republic of Senegal Beneficiaries: 1.2 million persons for the nutrition and water programs Staff of MOHK SONES, AGETIP, and municipalities Credit Amount: SDR 11.7 million (US$18.2 million equivalent) Terms: Standard, with 40 years maturity Finaucinq Plan: IDA 18.2 (in US$ Million) WFP j.2 KfW 3.0 Govermnent 1.6 TOTAL 28.0 Poverty Category: Program of targeted interventions to halt a deterioration in the nutritional status of the most vulnerable groups in specific poor neighborhoods selected on the basis of a poverty assessment, to reduce fteir food insecurity, and to generate employment and income for community groups through small-scale activities Econoniic Rate of Return: Not applicable. Staff Appraisal Report: Report No. 14004-SE Map: IBRD 26962  MEMORANDUM AND RECOMMENDATION OF THE PRESIDENT OF THE IDA TO THE EXECUTIVE DIRECTORS ON A PROPOSED CREDIT TO THE REPUBLIC OF SENEGAL FOR A COMMUNITY NUTRITION PROJECT 1. I submit for your approval the following memorandum and recommendation on a proposed development credit to the Pepublic of Senegal for SDR 11.7 million, the equivalent of US$18.2 million, on standard IDA terms with a maturity of 40 years, to help finance a project for cormmunity nutrition. WFP through parallel cofinancing will contribute the equivalent of US$5.2 million. Germany (KfW) will finance an equivalent of US$3.0 million through parallel financing. Thc Govemment will contribute the equivalent of US$ 1.6 million. PART I. COUNTRY POLICIES AND IDA ASSISTANCE STRATEGY A. Background 2. Senegal is a lower-middle income country with a population of 7.8 million, growing at 2.7% per year, and an average per capita income of US$470, unequaLly distributed. It is better off th some of its Sahelian neighbors, but more urbanized (40% of the population). It faces many of their constraints, including rapid population growth, economic stagnation and high unemployment, dependence on a single agricultural commodity (groundnuts), arid land and declining rainfall. Health and education have generally improved over the past decade. However, life expectancy is only'49 years of age, there is chronic malnutrition of children under five years old, a growing incidence of onchocerciasis in rural areas, widescale malaria, diarrhea, and respiratory disease. 3. Over the past decade, dramatic declines in formal sector activity have, combined with longer-term trends, plunged the country into a severe and prolonged economic recession. The Governmne launched adjustment and stabilization programs in the early 1980s, resulting in partial liberalization of agriculture, fiscal stabilization through austere expenditure contaction, and financial reform. But this imternal adjustment was insufficient to improve the competitiveness of the economy and achieve the type of economic growth that would have a strong impact on poverty. The Januaiy 1994 devaluation of the CFA franc offers an opportunity to regain competitiveness and to reverse economic performance by improving rural incomes through higher prices for the most important revenue source of the poor (groundnuts) and by encouraging other export-oriented industries, sach as fishing, tourism, agro-processing, and small manurn. 4. The economic crisis has particularly affected vulnerable groups in Senegal. While the devaluation is expected to promote long-term economic growth in Senegal, it has led to a deterioration of incomes and food access for vulnerable groups in the short term. For example, food expendites, which represent 70% of the household budget of the poor increased nearly 40 percent during 1994. The urban poor are particularly afficted by increases in the prices of imported food. In early 1994, the Govemnment of Senegal introduced accompanying measures aimed at passing the benefits of the parity change on to rural producers; limiting the wage bill; reducing regressive levels of taxation, while balancing fiscal and credit measures to control inflation; and improving the availability of social services in health and education by increasing budgetary appropriations to these sectors. In the short tern, temporarY measures to miiize increases in the prices of certain basic food and non-food goods (bread, rice, edible oils, kerosene, medicines, and basic health care) were adopted.  -2- B. Human Resource Development and Poverty Alleviation 5. Altlhough significant improvements have been recorded sintcC independence, the overall health, nutrition, and education status is still vcry poor. The under 5 mortality rate is over 100 per 1,000 live births, and less than one infant in two has been vaccinated. Maternal mortaity is over 500 per 100,000 live births. The population is characterized by a high fertility rate (5.9%/a) associated with a low contraceptive prevalence ratc (less than 10%). Recent household survey data (1992) indicate that one-third of the Senegalese population did not have the necessary minimum daily caloric intake. The poor spend a higher percentage of their income on rice than on any other food item and, on average, receive more income from groundnuts than from any other source. For women, the sources of income (e.g., cultivating their own plots, petty trading) are very limited. There are significant gaps in providing access to primary health care for both urban and rural dwellers, expanding preventive medicine, and improving the availability of affordable essential and generic drugs. Despite efforts made to improve primary health care, including family planning services, and to decentralize health management, the health sector continues to be characterized by financial and staff management constaint which prevent the establishmnent of a sustainable and efficidnt national health care delivery system. Illiteracy rates are among the highest in the world, particularly among rural women. In 1990, an estimated 86% of women aged 15 and over were illiterate compared with 60% of men. In rural areas, over 90% of women were illiterate. Even among women aged 15-35, years of peak fertility, and motherhood, illiteracy rates average about 90% in rural areas and 55% in urban areas. 6. Senegal also faces environmental difficulties, such as soil degradation, the salinization of agricultural land in low-lying coastal areas, and loss of forest cover. It is estimated that in some areas, soil fertility is declining by 3-5% a year while forestry resources are decreasing by 1.2% a year. This land degradation has been exacerbated by the decline in rainfall over the last 25 years and the lack of investment and natural resources management. The high rate of urban population growth which reflects land shortage and very poor income opportunities and amenities in rural areas, is taking its toll on the capacity of the urban environment to meet food and wood fuel needs. 7. To compensate for the hardships of the poorest population groups, particularly in urban areas, resulting from declining income, the Govemment plans to provide direct assistance to certain vulnerable groups by facilitating the establishment of fmily- or commnity-oriented projects aimed at halting a further deterioration of already high malnmition rates. It is in this vein that the Presidency created a National Commission for the Fight Against Malnutrition and requested IDA's support. The proposed project, which will complement other ongoing employmmt/fod security efforts of the Public Works Executing Agency (AGETIP), a privately operated agency, supported by IDA, the World Food Program (WFP), and Gennany (KfW), is a response to this request It also presents a challenge and an opportuity to lay the basis for a long- term program to address the country's entrenched nutrition problems, an objective towards which the proposed project hopes to contribute. C. Nutrition and Food Security Situation 8. The main nutrition problem - and the effect of food insecurity in Senegal - is chronic protein-calorie malntrition. Average levels of caloric intake have been barely adequate in both rural and urban areas for many years. All uwban zones in Senegal show caloric inadequacy, estimted to be 80% of normal consumption below which households are considered in a state of  -3 - nutritional risk. Throughout Senegal, but particularly in the urban areas, rice consumption has become an important part of the cereal diet. In urban areas, morc than 98% of noon meals, 50% of evening meals, and 20-50% of momitig meals use rice as thc staple. Thc phasing out of subsidies for rice is likely to cause hardship for low income people, particularly because in the short-run the supply response is not cxpectcd to provide adequate stocks of low-cost coarse grains to substitute for the morc expensive ricc. Unless the urban-poor households are ablc to reduce their non-food expcnditures by the amount of real income loss, and transfer these amounts to food expenditures, the result will be further nutritional deterioration. 9. The 1992 Priority Survey found that 29% of children under five ycars of age were chronically malnourished. Yet, a baseline survey conducted after devaluation in 1994 during the pilot phase of this project indicated that roughly 30% of childrcn under three years of age suffered from moderate to severe malnutrition. Malnutrition begins before birth, and in Senegal about 10% of children are low birthweight babies (less than 2.5 kg). Iron deficiency anemia is a severe public health problem with 63% of children estimated to be anemic. Significant regional and seasonal vitamin A deficiency was found, while iodine deficiency is also considered a problem. Fifteen percent of women of reproductive age have a low Body Mass Index, indicating chronic energy deficiency in this cohort, which is usually a good marker of the nutritional status in infnts. 10. Large differences in malnutrition rates have been found dependig on the socio- economic profile of the community; for instance in one poor area (Guediawaye), the proportion of children with chronic malnutrition is 1.6 times higher than in another (Medina). Even in the same suburb of Dakar, there are great disparities, dependug mainly on whether the area is a squatter or a planned area. In the Pikine area, chronic malnutrition rates were higher in the squatter areas of Yeumbel and Medira Gounass than tW were in the planned neighborhoods of Pikine Extension and Pikine Ancien. The principal causes for this malnutrition situation in Senegal are poverty, lack of good feeding practices, food insecurity (especially during critical periods for the household), endemic diseases, ivadequacy of potable water and poor sanitation. PART II. THE COMMUNITY NUTRITION PROJECT A. Project Objectives 11. The project's development objectives are to: (i) halt a deterioration in the nutritional status of vulnerable groups (malnourished children under three years of age, and pregnant and nursing women) in targeted poor urban neighborhoods; (ii) provide potable water to unserviced neighborhoods targeted under the nutrition program; and (iii) enhance household food security among poor urban populations and households "at risk" in targeted rural areas during critical periods of vulnerability. Specific implementation objectives are to: (i) demonstrate the foasibility of targeted, efficient and cost-effective delivery of community nutrition interventions; and (ii) execute a poverty-oriented program through AGETIP, rather han a mnistry, applying delegated contract management to local entrepreneurs, such as women and youth groups, community associations, and local Non-Governmental Organizations (NGOs). B. Project Description 12. This project starts with the premise that it is possible to build on the institutional capacity of a non-govemmental institution such as AGETIP to achieve social sector goals in poverty stricken areas, often difficult to penetrate by traditional public sector institutions. It  -4- combines AGETIP's practical experience in manAgcment and contracting oversight, and its know- how in social mobilization, with a package of targetd nutrition and food security interventions that arc, in the main, community-driven, and community-owned. It brings together multiplc complemcntary objectives with multiple interventions, ranging from food supplernntation, to income transfer, to improving beneficiary knowledgc and self-capacity. Most of the rcsource flows are to-and remain within-te community, whether i food supplemcnts or the staff costs of the implementing entities, such as the micro-entrepreneur. ?MICs) or their supervisors (the NGOs also called Maitre d'oeuvre conmmunautaires, MOCs). 13. The project components are: (i) a nutrition program and a rclated small fund for research and development; (ii) a potable water program; and (iii) a pilot rural household food security program. An integral part of these three components will be (iv) social mobilization and informationteducation/communication (IEC) campaigns; (v) training, to build local capacity for nutrition/health service delivery; and (vi) a management information system for monitoring and evaluation. 14. The proposed project will be IDA's first free-standing nutrition project in Senegal and one of the first projects of this kdnd in Africa. It is not an emergen,y intervention, but an experimental one that attempts to test an innovative approach, i.e. a private delivey mechanism to assist targeted vulnerable groups in ihe area of nutrition. Iimportant lessons provided by IDA's experience in the nutrition sector in other regions of the world and with health projects in Africa are that strong political commitnent by government, community ownership and involvement of all stakeholders in the decision-making process are crucial for successfil implementation. The creation of the National Commission for the Fight Against Malnutrition, with the strong support from the President of Senegal, is an encouraging example of Govenwent commitment to address the problem of malnutrition among its most vulnerable population groups. The preparation of the proposed project has addressed broad ownership aspects. A rapid beneficiary assessment and a Planning by Objectives workshop or ZOPP (Ziel-Orientierte Projelt Planung) was carried out to identify project objectives and target groups, to understand where coping strategies are inadequate to ensure household food security and good nutritional status of segments of the target population, to define jointly with the targeted population appropriate nutrition inteventions, and detennine the willingess and mechanisms by which the target group would participate in the implementation of the nutntion component. This project, which has been developed by a six-month pilot testing, will cornplement ongoing donor-assisted nutrition projects which provide EEC on nutrition rehabilitation of malnourished children through the health system. 15. The nutrition program will involve EEC interventions aimed at changing nutrition behavioral patterns, supported by supplementary feeding, and child growth monitoring, some basic prevaeive health care through a refeal service of severely malnourished children to nutriton or health facilities; and a fund for research and development. Micro-entrepreneurs, such as women's groups, community associations and youth groups, will operate the community nutrition centers (CNC). A weekdy take-home supplement will be provided to pregnant and nursing women and to malnourished children aged 6 to 36 months (including siblings of malnourished children below three years) in selected poor urban areas of 10 cities. One hundred grams of the dry supplement will provide 370-400 kcal and around 15 grams of protein in keeping with WHO-UNICEF standards. The supplement would be provided only a&icr group IEC or individual counseling. A monthly growth monitoring session will be held by specially trained CNC staff. Beneficianes who receive full service (i.e., food supplement, growth monitoring, and IEC) will be charged a fee of CFAF 50/week for their participation, in keeping with the Ministry of Health's current practice of  - - partial cost rccovery. This fec will bc revicwed annually iir light of project objectives. The fees collected will bc managed b) the Local Stcering Committees in collaboration witd the MICs, and will be used exclusively for the CNC's upkeep and for emergency situations. Basic preventive health will bc supportod through refrrals of chronically malnourished children to nutrition rchabilitation centers, and gencrally, by referral to health posts and centers for basic health care. The provision of basic health care by the CNCs will be supported through the ongoing IDA- assistod Health Project (Cr. 2255-SE). To fonnalize relationships between the Ministry of Health (MOE) and AGETIP, a Convention has been signed between these two entities, which spells out the mechanisrn by which the Community Health Committecs of the MOH will ensure iat essential drugs (vitamin A, oral rehydration salt, iron and folic acid, deworning and malaria tablets) will be made available to CNCs's beneficiaries. WFP will finance the local production of the food supplement through monetization of imported food aid and will coordinate the activities of the entire food chain from local procurement to processing, packaging, storage, distribution to the and quality control at all levels. The experience of the pilot phase has demoted the need to provide AGETIP some flexibility over the delivery mechanism but also over the composition of the food supplement and packaging, over a future diversification of supply sources, and ways of addressing technical issues as they arise. Therefore, a Special Fund will be created and managed by AGETIP. The Fund is principally designed to encourage development of small entrepreneurs in the food supply and processing business in selected peri-urban and rural areas in the vicinity of CNCs; and to bring about needed program improvements identified during project implementation. 16. The water program will supply potable drinking water and improve the general health conditions of the population concemed in t targeted communities that do not have vster connections. During the first year, the program nwill cover 12 poor neighborhoods that have poor water services, of which five are in Dakar and seven in the provincial towns (Diourbel one, Kaolack three, Ziguinchor three). In these areas, standpipes are to be insalled and managed by private entrepreneurs. The rural household food security program will formulate and test targeted approaches to assist chronically food insecure and malnourshed women and children living below the poverty line in rural areas, by providing available information and advice, food supplements, food or cash equivalents for work, principally through labor-intensive infrastructure and income-generating activities. A measured approach to implementation beyond peri-urban areas is planned. For the mrual program to benefit firom what is learned during the first phase of project operations in the ten priority urban ceers, it will only becomc operational during the third year of implementation. 17. The social mobilization and EEC programs will encourage participation and behavioral change among the target populations. The social mobilization program will: (i) mobilize political support and collaboration at the national, regional and conmmunity level, including local leaders; (ii) ensure that the community has a sense of ownership and participates in project planning and execution; and (iii) imnprove the capacity of communities to provide, and broaden access to, nutrition and related health services. The training component will include (i) on-the-job training services related to work orgamzation, management, and technical and nutitional training to contacted small and micro.entrepreneurs; (ii) a traing program for supervisory services, contracted through NGOs; and (iii) training in planning and conducting IEC activities, including strategy preparation, materials development, use of materials, and inter- personal commumications techniques, provided to local consultants who will train small and nucro- entrepreneurs and local NGOs, and participants.  -6 - 1a. A monitoring and evaluation system will: (i) support the establishment of a povcrty task force at the Ministry of Economy, Finance and Plan to monitor and strengthcn the Govcrnmcnt's monitoring and evaluation capacity in nutrition, and to analyze thc cost-effectiveness and appropriateness of various intervention strategics; (ii) determine the progress of project activities according to plamned targcts and schedule, and to propose appropriatc corrective actions; (iii) verify and update existing information on the extent, severity and location of various forms of malnutridion; (iv) establish the impact of the project activities on nutritional status and to relate these changes to other socio-cconomic and behavioral variables; (v) provide a basis for ongoing evaluation of the project effectiveness by local, district and national level govemmcnt; and (vi) permit the continuous review and calibration of the program design. These mutually supportive efforts offer the potential of laying the basis for a longer term strategy to deal with nutrition and household food security problems. C. Project Implementation 19. This project is seen as a key vantage point from whicl to consider widcr policy issues related to hunger and malnutrition. Activity oversight is in the hands of the National Commission for the Fight Agairst Malnutrition, recently created by the Presidency for the purpose of ensuring that a social safity net exists for poverty households. It will be the guiding force for this project. It is composed of representatives of the Presidency, the Prime Minister's Office, the Ministries of Economy, Finance and Plan, Health and Social Action, and Women, Children and Family Affairs, AGETIP, and the NGOs. The National Commission places special cnphasis on this project which represents an important testing ground for indigenous Senegalese social sector approaches, and for fiuture national nutrition policy and programs. AGETIP's involvement in the preparation of this operation wa, supported not only by the Govermnent of Senegal, but also by other local stkeholders that have collaborated with AGETIP in the past (small entrepreneurs, eonsulting firns, NGOs) and foreign donors that have entrusted AGETIP with implementation of some of their ongoing operations (WFP, Genrany). 20. The President of Senegal designated AGETIP as the executing agency because AGETIP has dernonstrated its ability to execute a broad range of public works projects successfully and expeditiously, based on its strong managerial and operational capacities. To bring these skills to bear in executing community-based nutrition prograns, a new Nutrition Management Division (NMD) has been created and will include a small technical staff specialized in the areas of nutrition and health, water, IEC and social mobilization, traing, monitoring and evaluation. AGETIP will execute the project under the established procedures of "delegated contract management", with extensive use of short-term consultants. At the mid-term review an assessment will be carried out to determine the feasibility of separating the NMD from AGETIP to make it a stand-alone agency. There will also be a review as to wheher other entities could execute delegated contract management responsibilities similar to those performed by AGETIP. In light of the growing role of AGETP in delegated project contracting, this action aims at lessening the monopoly risk that may otherwise be created. 21. To ensure local ownership of th project, District Steeing Committees playing an advisory role, will be given official status by decree of the Governor of the region. The committees will be composed of representatives of the Governor, "Priet" or "Sous-Pr6ft", the District medical officer, the mayor, neighborhood leaders, as well as agents from technical services imvolved in the project. Local comnittees will be organized in each target neighborhood, in order  -7 - to participate in the elaboration of the social mobilization strategy pertinent to the neighborhood and to provide periodic feedback to AGETIP on the ovcrall projcct impact and performance. 22. The nutrition program will be implemented by -icro-cnt=rcneursincluding economic interest groups, women groups, community associations, and youth groups. They will be responsiblc for identifying and motivating beneficiaries, for ensuring greater community participation, and for delivering nutrition services. Nutrition center supervisors will train and supervise the small and micro-entrepreneurs responsible for managing the supplementary fecdirg program at thc community level. A roster of pre-qualified small and micro-entrepreneurs and supervisors will be submitted for IDA approval no later than July 1, 1995. Selection of entrepreneurs and supervisors will be based on competitive bidding, as spelled out in a Manual of Procedures. Local health structures, supported through the ongoing IDA-assisted Health Project, will participate in the project and provide primary care for pregnant and nursing women and children referred by the nutrition centers for periodic clinical exams and other hcalth services. 23. The water program will be implemtented under the supervision of AGETIP, which will sub-contract the technical execution to local enterprises according to a schedule of charges established by the National Water Company (SONES). For the purpose of greater involvement of the beneficiary population, the contracted enterprises will recruit workers and unskilled laborers from the targeted neighborhoods. AGETP will enter into an agreement with SONES to ensure technical standards are net by the local contractors. 24. The rural household food security program will be implemented and supervised by conununity based organzations and volunteers, as done, for instance, under the peri-urban component. More detailed preparation of this component will be undertaken during the first two years of project imnplementation. This time period will be used to determine the type of works and to specify the most appropriate time for this intervention. It is envisaged that this component will become filly operational in the third year of project implementation. 25. Project implementation will be guided by a detailed Manual of Procedures whic', anong others things, will stipulate enty and exit criteria for program participation to avoid food dependency, and establish linkages with the health system to ensure referral health services. The Manual will spell out objective targeting criteria for cost-effective targefing and specific indicators to monitor project implementation. To improve coordination with the health system, contractual arrangements between AGETIP and the MO will be defined in the Manual of Procedures. The accounting system of AGETIP will be modified to incorporate this diversification of its operations. D. Project Sustainability 26. The project's sustainability has been enhanced through important design features. First, AGETIP, as the executing agency, has demonstrated efficient and cost-effective management of community programs. Second, gmssroots contating will guarantee not only ownership and participation by the communities, but also low administrativ unit costs. Third, broader and longer term policies affecting the nutritional status of vulnerable groups wnll be considered during project execution. Sustamnability is closely linked to macroeconomic performance, namely ta only through economic growth and cost-effective public expenditures will the Govenmment be able to take over the nutrition activities started under the project.  Z. Les.m from Past Nutrition Project. 27. Best practics fiom ohr Dank and donor finded supplemy ioding project, in pariar from dho IDA-finded Tamil Nadu Nutrition Poject, and the 15-yar nutrition projct implemented by USAI/Calholic Rolief Seoces in Segal, have boen integated in te project design so a to cmure proect wutsnabty, namely ho use of elftarpted food to avoid re-sale, lare cmmunity volvant, t ing of poor housebolds and well defined eony and eit cntnria for food suppenmm in order to avoid food deedeny. Ihu bls also include tho importance of cmmication Nd omm ty nmbiion m ugeted inrventis; and the need for regular on-tebjob training and supportive supervision system with clearly defind accountabilities. F. Rationle for IDA Iuvolveanmt 28. The CAS sttemt wa revewed by the Board - February 16, 199. It contains a full discussion of recent econoic developments, and IDMs assisbnce program. This project is filly cosit wih IDA strategy, which is to assist Senegal to achieve susainable economic growth with equity and targeed poverty reduction. Its focus is: (a) to promote iveness in order to make the econmy more rponsve and to creae more oportunties for the private seetr; (b) to comlete stuctural refrs in agricuture; and (c) to deliver essential services efficiently and ifecvely. Moreover, a central aspect of the Banks partship with Senegal is the str i of the quality of the disaogue between Govermnent and civil society to enhace participation and ownershp. The 1990 World Development Report provides the basis for IDA's two-pronged approach. (a) inceasing economic growth and incomes, maly throigh labor-itensive methods; and (b) inproving access to basic social services. A complement to this approach is assuring dequa socal safety nets for the truly vulnerable. IMA's main nutrition objective is to assist the Govrmn in adoptng staties and cost-effective prognrms to deal wihi the hunger problems of the most vulnable groups. IDA is well equipped to play the importa catytic role required on te managemet side of the proam. It has played a critical role in a number of important policy refoms in the human resources sector in Senga and is best positioned to mobilize needed aismce firm the donor's commuity and to influence govements stratey. G. Agreed Actions 29. The Government has agreed on the following actons: a. As conditions of effectiveness: (i) WFP's cwfinnation in terms and conditions satisfactory to IDA and reflected in WFP's Grat Agrement of he availabiliLy of fiuds to purchase the local ingredients for the purposes of the supplemey feeding pmgam; (ii) deposit by te Goverment of the equivalen in CFA francs of an agggate amount of not less than US$0.4 million in AGETIP's account as its countpat contrbution for the first year of project iplementation; (iii) the appoitment of the key staff of the Nutition Mnagment Division by AGETIP; (iv) the signng of an agreeent betwee AGETIP and SONES for the purpose of implet he water program under Ums and conditions acceptable to IMA; (v) the adaption and impl ion by AGETIP of an acmcui and financid managent system acceptable to IDA; and (vi) the employment of i dt audXitors acceptble to IDA for the audit of project records, accounts, and finaial s_men.  .9- b. As condition of disbursement for the rural household food security program: tho approval by IDA during the mid-tamin roview ofl a plan of action and an investment program to be presented by AGETIP. H. Poverty Category 30. Thc proposcd project is a povwrty-targetcd intervention, geared to halting a fuzrthor doterioration in the nutritional status of the most vulnerable groups in tagetd poor neighborhoods of Sencgal, roducing food insecurity in tlhese areas, and generating employment and incomc for community groups through the promotion of small-scale activities. 1. Environmental Aspects 31. The overall environmental impact of the project is expected to bc neutral to positive, Thc cnvironmental category is C. Thc impact of the small public works to be fimmeed under the project, such as th rehabilitation of community infrastructure, will be neutrl on the environment. Componant, such as the water program, will have a positive impact on the environment, by providing potable water to the beneficiaries of the targeted neighborhoods. J. Program Objective Categories 32. In addition to the poverty alleviation measures discussed in pam. 30 above, the project promotes the development of small and micro-entrepreneurs, comnunity participation, and the involvement of NGOs and local consultants in implementation into the hands of the target group populations and thereby cnsuring long-term sustinability. The project responds to the Governmentes objectives of human resource development and peverty alleviation. K. Participatory Approach 33. Project design benefited from te collaboration of a vaziety of institutions, stakholders, and beneficiaries. The National Commission played a strong role in supporting AGETIP's commnunity mobilization efforts and in ensuring coordination among ministries involved in project implementation. A Planning by Objectives Workshop or ZOPP was held during project preparation for key stakeholders involved in the planning of the project. A beneficiary assessment of poor urban households to examine changes in household food consumption behavior following the devaluation and to solicit these households' views on a supplemental feeding program was carried out during project preparation. 34. The ZOPP approach will continue thmughout project execution to assure systmatic client consultation. Adjustments will be made to reflect participant views. Furthermore, the project will provide virtually continuous feedback to all conced stalcholders, includig donors, on project performance. In sunm, the project will encourage communities to contribute to the project's success, and in so doing develop NGO and private sector capacity to deliver social services and snhen institutional capacity of local comnwmities and grassroots groups to execute development projects.  - 10- J. Project Benefits 35. The project will have two main benefits. First, the immediate impact is intended to halt a deterioration in the nutritional status of the most vulnerable groups in the poorest urban areas, estimated at a total target population of 469,000 (about 230,000 malnourished children under three years of age and 120,000 nursing and pregnant women receiving food, growth monitoring and IEC services; and 119,000 mothers and children receiving only growth monitoring and IEC serviocs). Based on preliniinary estimates the project is expected to reach about 30% of urban malnourished children in targeted areas. Nutrition education activities should set in motion behavioral changes and adoption of better child-feeding practices, leading subsequently to nutritional improvement of children under 3 years. Increased access to safe drinking water through the water program should reduce the incidence of diarrhea and water-bome diseases aflfcting the nutritional status of 174,000 residents in the targeted neighborhoods for the first year of operation. Total beneficiaries for the subsequent years are estimated at 522,000, totaling 696,000 over the life of the project for the water program. The total number of beneficiaries for the nutrition and water prograns is thus estimated at nearly 1.2 million persons. The proposed project will also lead to an increased dmand and use of health services. An additional benefit of the rual household food security and water programs will be the provision of development-oriented infastructure in treted rural and urban areas. 36. Second, the project will establish local capacity to deliver community-managed nutrition services with private sector efficiency, both in terms of mangement and administraive cost contaimnent. It will also contribute to capacity building of NGOs by providing training in the supenrision of community nutrition centers and IEC methods. Furthermore, closer collaboration between NGOs and public health services will improve the delivery of social programs geared to the most vulnerable households. K. Risks 37. One risk relates to the production of the local food supplement, which currndy is in the hands of a single producer/supplier. However, altemative production sources for the food supplement will be identified during the first year of operation, through competitiv bidding. This broadening of supplier sources should address risks inherent in the existing virtal monopoly situation. Another risk is the need for close coordination among the many stakeholders which could pose a logistical problem, and, that implementation might be delayed by shortfalls in community mobilization, organization, and tmining. However, the detailed Manual of Pmcedures, firm supervision procedures, extensiv testing of program opeations, active invohemnt of the National Commission in social mobilization efforts, and a rigorous training program, should respond adequately to these potential problems. There is also the risk that nutrition-health coordination arrangements between AGETIP and the Ministry of Health do not meet expectations. A clearly defined contracual arrangement between AGETIP and the Ministy of Health, as weU as linkages with the ongoing IDA healtih project, should assure the necessary coordination. Finally, there is the risk that the project's administrative costs are higher than estimated. In the past, AGETIP's contractual management slklls, supported by its strong management information system, have proven highly effective in terms of cost containment and administrative performance.  L. Recomendation 38. I am satisfied that the proposed credit would comply with the Articles of Agreement of the Association and recommend tatthe cecuxive Directors approve it. Lewis T. Preston President by Gautam S. Kaji Washington, D.C. April 25, 1995  -12- SCHEDULE A Page I of I REPUBLIC OF SENEGAL COMMUNITY NUTRITION PROJECT ESTIMATED COSTS* AND FIN4ANCING PLAN (US$ million) COMPONENT| LOCAL FOREIGN TOTAL Nutrition Program 14.6 0.7 15.3 Rural Household Food Secrity Program 1.1 0.1 1.2 Water Program 0.6 2.2 2.8 Training 1.1 .OA 1.5 Monitoring and Evaluation 0.8 0.7 1.5 IEC and Social Mobilization Profgrm 1.3 0.3 1.6 AGETIP'sManagemcntFee 0.7 0.3 1.0 Pilot Operations and Project Preparation 0.4 0.1 0.5 Total BASELINE COSTS 20.6 4.8 25.4 Physica and price contingencies 2.3 0.3 2.6 Total PROJECT COSTS 22.9 5.1 2ao C Costs are net of duties and taxes. Totals may not add up due to rounding. Finandng Plan by Disburnment Category" (USS million) IDA WFP Germany Govt Total Amt % Amt % Amt % Amt % Amt % Water Program 2.8 10.0 2.2 10.0 Nutrition services 9.2 32.8 5.2 18.6 1.6 5.7 16.0 57.1 Training 1.5 5.4 1.5 5.4 AGETIP Management 0.8 2.9 0.2 0.7 1.0 3.6 Fee Consultant Services 3.6 12.9 3.6 12.9 PPFA.dvance 0.5 1.8 0.5 1.8 Unallocated 2.6 9.2 2.6 9.2 Total Disbursements 18.2 65.0 5.2 18.6 3.0 10.7 L6 5.7 29.0 100.0 * Costs are net of duties and taxes. Totals may not add up due to rounding.  - 13 - SCHEDULE B Page 1 of 1 REPUBLIC OF SENEGAL COMMUNITY NUTRITION AND WATER PROJECT Summary of Proposed ProWrement Arrangements (USS mllion) PROCUREMENT METHOD PROJECT ELENT ICR LCB Other N.B.F. TOTAL WaterPrgrm . 2.8 2.8 Equipmcnt 12 0.4 0.1 1.7 (1.2) (0.4) (0.1) (1.7) Service Contacts aI 7.8 1.8 9.6 _____________________ _________ ~~~(7.8) _ _ _ _ _ (7.8) Consultant Seavices b/ 6.1 6.1 (6.1) (6.1) Mliscellaneous Opeating Costs 2.1 21 (2.1) (2.1) Food 5.2 5.2 PPF Advance 0.5 0.5 ______________________ ~~~~(0.5) __ _ _ _ _ _ _ _ _ _ _(0.5) TOTAL 1.2 0.9 16.1 9.8 28.0 IDA financed (1.2) (0.9) (16.1) (18.2) *Costs are net of duties and taxes. Totals may not add up due to rounding. Note: Figues in paentheses show IDA amnoumt N3.F. = Not Bank-Financed. Nutrition activities will be prcured m accordanmc with the AGEllPs PRocedures Manual (acceptable to IDA) Consulting smrvices will be procued according to IDA guidelines. at For services provided by micro-mtreprneurs. br For supermv serces provided by NGOs and for studies and tecbnical assistance by private finns or individual Dhbsoimm ProUmIPvoU do Deb .n_ ta bsdwtnOlU ftte IDA Isci Yom J Kgigal cd buafW Cumulaw Cmiit SaCtff Anama S.w.w pfgok JOA Ctf1 uamet,a ~- tg_Delw Cum*IICuif .ue 1911 1 0.! Qf 5* 2 0.9 16 a 1% 2% 3 0.9 27 16% 3% 36 *4 a.9 20% S% 1997 1 1.4 5.0 27% 6% 2 1.4 6.4 35% 6% 3 .4 7 6 43% 10% se A 1.4 9.1 51% 12% 1998 1 1.4 10-S 5U% 14% 2 1.9 120 66% 16% 3 1.3 133 73% 11% 5 4 4 1.3 14.6 10% 20% 1999 1 0.9 1 ! % 22% 2 0.9 164 90% 26% 3 0.9 17 3 9S% 30% 3.6 4 - 0.9 191 100% 34%  -14- SCHEDULE C Page I of 1 REPUBLIC OF SENEGAL COMMUNITY NUTRITION PROJECT Timetable of Key Project Processing Events 1. Time taken to prepare project 11 months 2. Prepared by : Govemment vith IDA assistance l/ 3. First IDA Mission : March 1994 4. Appraisal Mission Departure January 26, 1995 5. Negotiations : April 6-7, 1995 6. Planned Date of Effectiveness July 1995 7. Relevant PCRs : Eleven Centers Water Supply Project (ReportNo. 13833) Dakar Container Port Project (Report No. 12327) Human Resources Development Project (Report No. 12319) 1/ M. Leslie PNan (Sr. Project OMficcr, mission leader), Mr. Emmerich Schebeck (Departmental Project Advisor), Ms. Tonia Marek (Nutritioniist), Ms. Adriana De Lava (Economist), Mr. Ricbard Seifnan (Nutritionist), Mr. Uwe Krach (Consultant, United Nations), Mr. Goazalo Ribo-Dieguez (Chief Desk Officer, WFP/Romel Mr. Ibrahim Shari& Director WFPJSenegal), Mr. Paul CrovAey (Consultant, Food Tedmologist/Consultant WFP), Mr. Mafired Dittmar (Diretor, Africa, KfW), Mr. Christophe Twerenbold (Economist, KfW), Ms. Liaba We iner (NutritionistConsultant, KfW), Mr. Magatte Wade (Director General, AGETIP), Mr. Ibnou Gaye (Director of Development, AGEllP). Ms. Judith McGuire (PHN) is the Lead Advisor. Ms. Maryse Piere-Louis (Sr. PHN Specialist) and Mr. Bemard Abeille (Sr. Procurement Specialist) are the peer reviewers. Mr. Jean-Louis Sarbib is the Department Director. Mr. Ok Pannenborg (Chief, Population and Human Resources Division) and Mr. Alberto Harth (Chie