Malawi - Health And Nutrition Project

Report No. PIC844 Project Name Malawi-Health and Nutrition Project Region Africa Sector Health and Nutrition Project ID MWPA36039 Borrower Government of Malawi Implementing Agency Ministry of Health & Population Secretary for Health P.O. Box 30377 Capital City, Lilongwe 3 Malawi Tel: (265)730-099 Fax: (265)783-109 Date PID Prepared November 16, 1995 Projected Board Date July 1998 1. Background Although some improvement in health status from the mid 1980s has been shown with respect to life expectancy, infant and child morbidity and mortality, maternal mortality, these social indicators are still among the worst in Sub-Saharan Africa. This is a follow-on project to the ongoing PHN Sector Credit due to end December 31, 1996. IDA is supporting the Government led discussions to finalize the Health Policy Framework Paper which sets out the Government+s health agenda into the twenty first century. The focus is on efforts to reduce morbidity and mortality through sustained and stronger, primary health care programs. These programs would be supported by mechanisms for managing and monitoring the pace of implementation. These activities will be targeted at the predominantly rural population of Malawi. 2. Objectives The ultimate objective of the Health Policy Framework paper developed by GOM in close consultation with all major donors is the improvement of the health status of the population by the turn of the century through an increase in health coverage with a better quality of services provided. Through a consortium of all major donors and the Government, the project will cover the whole program of the Ministry of Health and Population and will finance a five-year time slice of the Health Policy Framework. In accordance with the sector+s strategy, the project which encompasses all sector program activities, will address the following areas: (a) strengthening preventive and promotive health programs including maternal and child health, STD/AIDS, nutrition interventions, and control programs (malaria, diarrhea and cholera); (b) strengthening management through support to services and financial decentralization as well as staffing; and (c) strengthening of support services through improved logistics and pharmaceuticals, and IEC. 3. Description. The IDA credit will concentrate on providing ongoing support to efforts begun under the PHN Sector Credit (FY91-FY96) which include: continuing support to the ongoing preventive and promotive health programs such as diarrhea and malaria diseases control, and  nutrition and reproductive health interventions. The emphasis would be on rural populations. It is envisioned that support will also be provided to activities aimed at: training the professional as well as community based manpower; enhancing MIS capacity; expanding the IEC programs; strengthening the cost sharing and decentralization efforts; logistics management; and improving the supply of drugs, which are priorities for quality health services. 4. Financing. The project is designed to finance the overall five- year Integrated Health Sector Program. The Government will contribute largely to cover recurrent costs and counterpart expenditures, co- financing will be sought and IDA will financing gaps. 5. Implementation. It is expected that the Ministry of Health would be the executing agency for the Project. The Project would be implemented in a four year period (FY99-FY02). 6. Environmental Aspects. The Project is not expected to have any negative impacts on the environment and a rating of Category C will be sought. 7. Poverty Category: Program of Targeted Interventions Assistance to the sector will focus on continuing support for the provision of services to people in under-served areas, in this case the rural communities, where the majority of the poor reside. 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. - 2 -