India - Integrated Child Development Services

 ICRR 10101 Report Number : ICRR10101 ICR Review Operations Evaluation Department 1. Project Data : OEDID: OEDID : C2173 Project ID : P010361 Project Name : Integrated Child Development Services Country : India Sector : Targeted Health L/C Number : C2173 Partners involved : Prepared by : Ronald G. Ridker, OEDST Reviewed by : Susan Stout (Robert van der Lugt) Group Manager : Roger Slade Date Posted : 06/25/1998 2. Project Objectives, Financing, Costs and Components : The project's overall objective was to improve nutrition and health status of children under six, with special emphasis on ages 0-3, and pregnant and lactating women, in Andhra Pradesh and Orissa. Specific targets include reducing severe malnutrition by 50% of children 6-36 months old, and increasing the proportion of normal and mildly malnourished by 25%, and reducing the incidence of low birth weight births and the infant mortality rate by amounts specific to each states. The project covered 301 rural, predominantly tribal, blocks in both states and included four components: service delivery, communications (IEC), community mobilization, and project management and evaluation. Total project cost at appraisal was estimated to be US$ 157.5 million of which the IBRD and IDA were to provide US$ 106.0 million.The Bank’s contribution was subsequently revised to include only an IDA credit for US$74.35 million. The credit was fully disbursed and closed as planned on December 31, 1997. 3. Achievement of Relevant Objectives : Progress was made toward the nutrition targets in Andhra but not in Orissa where malnutrition may have actually worsened. On the other hand the infant mortality reduction in Orissa appears to have surpassed the target while there was hardly any change in Andhra . There are inadequate data to evaluate birth weight incidence . However, service delivery and process indicators suggest that the project did not contribute to any of these changes . 4. Significant Achievements : The most disadvantaged population groups in the two states were successfully targeted. Most physical targets (e.g., civil works, equipment) were achieved. A useful MIS was developed in Andhra Pradesh which has served as a model for other states. 5. Significant Shortcomings : Service delivery (especially child weighing and supplementary feeding) was poor, in part because training was inadequate, and communications and community mobilization efforts were weak. Operational research studies were completed too late to be of use during the life of the project 6. Ratings : ICR OED Review Reason for Disagreement /Comments Outcome : Unsatisfactory Unsatisfactory Institutional Dev .: Partial Modest Sustainability : Likely Likely Bank Performance : Deficient Unsatisfactory Borrower Perf .: Deficient Unsatisfactory Quality of ICR : Satisfactory 7. Lessons of Broad Applicability : Implementation was focused on achieving certain numbers of children being fed and enrolled in the pre-school education program, but not on preventing malnutrition through behavior change among mothers. High quality, properly oriented and timely training is a sine qua non for high quality service delivery. The ICDS (Integrated Child Development Services) program supported by the project contained too many components and insufficient resources and manpower to undertake them all well. 8. Audit Recommended? Yes No 9. Comments on Quality of ICR : Competent, high quality. The ICR does not have an overall rating for Bank performance. Two of the components are listed as satisfactory and two as deficient. My judgement is that the two deficient components (appraisal and supervision) are the most important. The same point applies to Borrower performance where 2 components are rates as satisfactory and 2 as deficient (implementation and covenant compliance).