Malawi - Population/Family Planning Project

Report No. PIC843 Project Malawi-Population/Family Planning Project (@ Region Africa Sector Population Health & Nutrition Project ID MWPE36038 Borrower Government of Malawi Implementing Agency Ministry of Health and Population Attention Dr. Mukiwa, Permanent Secretary P. 0. Box 30377, Capital City Lilongwe 3, Malawi Phone (265) 783-044 Fax (265) 783-109 Date this PID Prepared March 20, 1997 Date this PID Revised March 24, 1997 Projected Appraisal Date March 6, 1998 Projected Board Date August 19, 1998 1. Country and Sector Background. The population growth rate of Malawi stands at around 3.0 percent (excluding migration and refugees), which is about 10 percent higher than the average growth rate for Sub-Saharan Africa. Malawi's growth rate implies that its population of 11 million will double within 20 years. Poverty is widespread and concentrated in rural areas. Government is committed to making poverty alleviation the major emphasis of its policy, and rapid population growth has a negative impact on this policy. Rapid population growth places pressures on natural resources, social services and labor markets. In addition, the combination of lower quality of land currently not under cultivation and present land holdings in many areas that is insufficient for subsistence production, the threat of malnutrition is ever present. With a youthful population (over 45 percent of the population is under 15 years), the demand for health and education will increase and the ability of the system to maintain quality will be an issue. According to the 1992 Population Sector Study (8513-MAI), an annual savings of US$2 million could be realized in maternal and child health care and primary education by the year 2005 under a moderate fertility decline scenario. This amount would increase to US$7-9 million if the decline were rapid. Prior to the introduction of the multi-party system in Malawi, one could not speak of family planning, and the phrase child spacing was used instead. Since 1994, however, Government has adopted a National Population Policy whose main objective is to improve the standard of living and quality of life in Malawi through reduction of fertility, infant, child and maternal mortality rates. The Policy's strategies are making family planning services available to all men and women in reproductive ages, increasing the number of service delivery points and launching an extensive nation-wide IEC campaign on the advantages of a small family size. A Population/Family Planning  Sector Study (June 1995) was carried out in collaboration with a Population Task Force convened by the Government of Malawi to advise on issues relating to population. 2. Project Objectives. In order to assist Government in its poverty alleviation goals in the medium- and long-term, and in line with the National Population Policy objectives, the Project objectives would be to: (a) improve reproductive health services and increase the contraceptive prevalence rate using modern methods from 7% to 28% and thereby reduce the high total fertility rate of 6.7 and the large family size; (b) reduce high maternal, infant and child mortality rates; and (c) ultimately, reduce the population growth rate of around 3 percent per annum. To achieve these objectives, the project plans to increase access to, availability and quality of family planning services, and improve the method mix; and increase the demand for family planning through targeted population/family planning IEC. The proposed project would also address problems facing youth. 3. Project Description. The Project will provide support for reproductive health services and for carrying out the Population Policy through (a) rehabilitation and expansion of static facilities; (b) expansion of community-based distribution; and (c) strengthening information, education and communication (IEC) activities. This support will be in the form of capacity building through the training of service providers, and the restructuring and development of alternative delivery systems. Since current activities are at their nascence, it is envisaged that support will need to be provided on the policy front. Activities with the highest value-added, in terms of their potential contribution to filling gaps in Government and donor funded programs, will be given higher priority for funding purposes. 4. Project Financing. Total project costs are estimated to be US$30 million over a five year period. Interest in co-financing has been expressed but no firm commitments have been made. Major donors such as UNFPA, USAID, and ODA have on-going activities in the sector. Every effort will be made to ensure that duplication is avoided and complementarity sought where appropriate. Government's contribution to the Project is expected to be a minimum of 10 percent, and the remainder of the funding will be provided by IDA. 5. Project Implementation. It is anticipated that the Ministry of Health and Population, Ministry of Economic, Planning and Development and the National Family Welfare Council, a parastatal under the Ministry of Women's and Children's Affairs will each have a role to play in the Project. The modalities for implementing the Project will have to be discussed within Government and a decision taken as to who should take the lead. 6. Environmental Aspects. As the project mainly focuses on strengthening reproductive health and expanding population/family planning interventions, which would involve some infrastructure, capacity building, and IEC activities, it would have limited impact on the environment and therefore an environment category of C is -2 -  proposed. Furthermore, the reduced population growth deriving from the Project should have a positive impact on the environment. 7. Program Objective Categories. The Project is part of the core poverty program for Malawi and is proposed and included in the program of targeted interventions. Contact Point Public Information Center The World Bank 1818 H Street N.W. Washington, D.C. 20433 Telephone No. (202) 458-5454 Fax No. (202) 522-1500 Note: This is information on an evolving project. Certain components may not necessarily be included in the final project. Processed by the Public Information Center week ending April 4, 1997 - 3 -