China - Iodine Deficiency Disorders Control Project

Document of The World Bank FOR OFFICIAL USE ONLY Report No: 22277 IMPLEMENTATION COMPLETION REPORT (39140; 3914A; 27560) ON A CREDIT IN THE AMOUNT OF SDR 12.7 MILLION TO THE PEOPLE'S REPUBLIC OF CHNA FOR THE IODINE DEFICIENCY DISORDERS CONTROL PROJECT June 27, 2001 Human Development Sector Unit East Asia & Pacific Region 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 EQUIVALENTS (Exchange Rate Effective May, 2001) Currency Unit = Renminbi (RMB) RMB 1.00 = US$ 0.12 US$ I = Y8.3 FISCAL YEAR January 1 December 31 ABBREVIATIONS AND ACRONYMS AusAID - Austalian Agency for International Development CAS - Country Assistance Strategy CNCLI - China National Council of Light Industry CNSIC - China National Salt Industry Corporation GOC - Government of China IBRD - International Bank for Reconstruction and Development ICCIDD - International Council for the Control of IDD IDA - International Development Association IDD - Iodine Deficiency Disorders IDDC - Iodine Deficiency Disorders Control ISIDF - Iodized Salt Industry Development Fund mtpy - Million tons per year MCH - Maternal and Child Health MI - Micronutrient Initiative MOF - Ministry of Finance MOH - Ministry of Health NGO - Non-governmental Organization NIDDEP - National IDD Elimination Program PIU - Project Implementation Unit SAR - Staff Appraisal Report SDBC - State Development Bank of China SDR - Special Drawing Rights SDPC - State Development and Planning Commission SIL - Sector Investment Loan SOE - Statement of Expenditure TT - Technology Transfer UNDP - United Nations Development Progmme UNICEF - United Nations Children's Fund UNIDO- United Nations Industrial Development Organization USI - Universal Salt Iodization WBOB - World Bank Office, Beijing WHO - World Health Organization Vice President: . Jemal-ud-din Kassum Country Manager/Director: Yukon Huang Sector Manager/Director: Maureen Law Task Team Leader/Task Manager: Janet I.Hohnen  FOR OFFICIAL USE ONLY CHINA IODINE DEFICIENCY DISORDERS CONTROL PROJECT CONTENTS Page No. 1. Project Data I 2. Principal Performance Ratings 1 3. Assessment of Development Objective and Design, and of Quality at Entry 2 4. Achievement of Objective and Outputs 7 5. Major Factors Affecting Implementation and Outcome 10 6. Sustainability 16 7. Bank and Borrower Performance 22 8. Lessons Learned 31 9. Partner Comments 34 10. Additional Information 38 Annex 1. Key Performance Indicators/Log Frame Matrix 43 Annex 2. Project Costs and Financing 44 Annex 3. Economic Costs and Benefits 47 Annex 4. Bank Inputs 48 Annex 5. Ratings for Achievement of Objectives/Outputs of Components 50 Annex 6. Ratings of Bank and Borrower Performance 51 Annex 7. List of Supporting Documents 52 Annex 8. Beneficiary Survey Results 54 Annex 9. Stakeholder Workshop Results 55 Annex 10. Borrower's Report 62 Annex 11. Summary of UN Agency Programs 77 Annex 12. Executive Summary 83 Annex 13. Government Letters 88 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.   Acknowledgements Background. Pioneering studies of iodine deficiency disorders (IDD) began in China in the 1960s under the leadership of Professor Ju Chen Yi and Professor Ma Tai, assisted later by Professor Chen Zu Pei and the collaboration of Australian scholars including Professors Basil Hetzel, Cres Eastman and Glen Maberley. This work provided the scientific basis for advocacy to the Ministry of Health for early control of IDD and the start of salt iodization in the 1980s. IDD control in China was encouraged by Dr. James Grant of UNICEF and followed up by representatives and technical staff of UNDP, UNICEF, WHO and UJNIDO in Beijing, led by Mr. Arthur Holcombe, Representative of UNDP. Following the World Summit for Children in 1990, Premier Li Peng committed China to the global goals of Universal Salt lodization and Elimination of IDD. China then embarked on a new IDD control project with UN support, which sponsored the National Advocacy Meeting in September 1993, to launch the National IDD Elimination Program. On this occasion State Councillor Madam Peng Peiyun requested World Bank support, which was agreed by Vice President Javed Burki. Proiect Preparation and Supervision. The China IDD Control Project was identified by Jagadish Upadhyay (Senior Project Officer) as a component of the Comprehensive Maternal and Child Health Project, but was then prepared as a stand-alone project by a team consisting of N. C. Krishnamurthy (Industry Specialist, team leader), Lalit Raina (Finance Specialist), Janet Hohnen (Public Health Specialist) Dingyong Hou and Darren Dorkin (Social Sector Operations Analysts) and Yingwei Wu (Procurement Officer), with assistance of Judith McGuire (Nutrition Adviser), under the guidance of Division Chief Vinay Bhargava, Country Director Nicholas Hope and Resident Mission Chief Pieter Bottelier. The Bank task team, supported by Sector Managers Joseph Goldberg, Alan Ruby and Maureen Law, retained N. C. Krishnamurthy, J. Hohnen and D. Dorkin throughout project implementation and over time included Beijing based staff Naiqin Lu (Industry Sector); Hongwen Zhao and Shiyong Wang (Health), Jinan Shi (Procurement), Junxue Chu (Financial Management and Disbursement) and Lansong Zhang (Administrative Support), and Leon Chen (Project Operations Consultant). Consultants Cres Eastman and William Watkins participated in the Mid Term Review. Implementation Completion Report. This Intensive Learning ICR was prepared by the task team of J. Hohnen, N. C. Krishnamurthy, D. Dorkin with administrative support of Juliana Williams, as well as assistance from Shiyong Wang, Lansong Zhang and Leon Chen in Beijing. It was translated by Mr. Chen. The ICR was based on: a field visit and report by Chorching Goh (OED); an independent review of the project conducted in October 2000 by Mr. Venkatesh Mannar, Executive Director of Micronutrient Initiative; the completion mission of the project in November/December 2000, which included a stakeholders' workshop and a meeting with UN agencies; and materials in the project files. The draft was finalized after discussion with the Government in April 2001, and two seminars in World Bank Headquarters in June 2001. The ICR was reviewed by EASHD Sector Director Maureen Law and cleared by China Country Director Yukon Huang. The Borrower's contribution is in Annex 10 and the UJN agencies' contribution is in Annex 11.   Project ID: P037156 Project Name: IODINE DEFICIENCY DISORDERS CONTROL Team Leader: Janet I. Hohnen TL Unit: EASHD ICR Type: Intensive Learning Model (ILM) of ICR Report Date: June 2 7, 2001 1. Project Data Name: IODINE DEFICIENCY DISORDERS CONTROL L/C/TFNumber: 39140; 3914A; 27560 Country/Department: CHINA Region: East Asia and Pacific Region Sector/subsector: HT - Targeted Health KEY DATES Original Revised/Actual PCD: 12/02/92 Effective: 09/01/95 04/16/96 Appraisal: 01/31/95 MTR: 10/30/96 05/04/98 Approval: 06/28/95 Closing: 12/31/98 12/31/2000 Borrower/Implementing Agency: PRC/CHINA NATIONAL SALT INDUSTRY CORPORATION (CNSIC). Other Partners: STAFF Current At Appraisal Vice President: Jemal-ud-din Kassum Russell Cheetham Country Manager: Yukon Huang Nicholas Hope Sector Manager: Maureen Law Vinay K. Bhargava Team Leader at ICR: Janet 1. Hohnen N.C. Krishnamurthy ICR Primary Author: Janet I. Hohnen; N. C. Krishnamurthy 2. Principal Performance Ratings (HS=Highly Satisfactory, S=Satisfactory, U=Unsatisfactory, HL=Highly Likely, L=Likely, UN=Unlikely, HUN=Highly Unlikely, HU=Highly Unsatisfactory, H=High, SU=Substantial, M=Modest, N=Negligible) Outcome: HS Sustainability: HL Institutional Development Impact: SU Bank Performance: S Borrower Performance: S QAG (if available) ICR Quality at Entry: S S Project at Risk at Any Time: No  3. Assessment of Development Objective and Design, and of Quality at Entry 3.1 Original Objective: Assessment of the objective and design of the project is made in the context of the National Iodine Deficiency Disorders Elimination Program (NIDDEP), referred to in Chinese as NIDDEP 2000, which began in 1993 to meet China's commitment to the global goals of universal salt iodization (USI) by 1996 and virtual elimination of IDD by 2000. The efficacy and cost effectiveness of targeted interventions to reduce micronutrient malnutrition, including the iodization of salt to prevent IDD, had been demonstrated in many countries. The World Bank group was supporting micronutrient initiatives in several countries when this project was being prepared, including four projects or components of other projects incorporating salt iodization, iodine supplementation by other means, or programs to eliminate IDD (A summary of the project background and context is in ref. 16, Mannar, V. Section 1). The NIDDEP is a comprehensive multi-sectoral nationwide effort to eliminate IDD, a major preventable cause of impaired mental development and physical deformity, through making available edible salt fortified with iodine to all households in China, in line with the goal of Universal Salt Iodization (USI). It comprises several components including: organization and advocacy; health education; legislation; program planning and review; monitoring and surveillance; technical support and international cooperation; scientific research; and ensuring an adequate supply of iodized salt. The NIDDEP has been supported by many national and international partners under the leadership of the State Council. Within this broad program, the specific role of the Iodine Deficiency Disorders Control (IDDC) Project has been to assist China to develop the capacity to produce and deliver the required amount of adequately iodized salt. A major factor in the outstanding success of the NIDDEP was Government's recognition of the central role of the salt industry, and the making of a set of legal, administrative and financial decisions to support this central role. The project's overall development objective was to help reduce the incidence of IDD in China by supporting the NIDDEP through financing investments in production, iodization, packaging and distribution of iodized salt. The project scope and outputs were clearly defined, with specific targets for physical infrastructure which formed the essential deliverables of the project. There was no revision of the development objective during the project, although the support provided to some participating salt enterprises was adjusted during implementation in line with ongoing industry rationalization. The project objective supported one of the Borrower's disease prevention priorities and its international conrmitment to IDD elimination. The project was included in the lending pipeline at short notice on request of the State Council to the Bank's Country Director for China. The project's scope resulted from the decision of the Government of China (GOC) to use Bank assistance solely in the salt sector, for the physical underpinning of the key NIDDEP strategy of improved supply of iodized salt. The project objective was also consistent with the aim of the Bank's 1995 China country assistance strategy (CAS) to help alleviate poverty through social sector support, in this case through control of a high priority health problem which disproportionately afflicts the poor. At the time of project identification it was estimated that 400 million people in China were at risk of IDD, constituting 40% of the global total. In rural China -2 -  whole communities were intellectually impoverished and unable to contribute fully to their own development, due to IDD. The project strategy of industry upgrading was also consistent with the Government's ongoing drive for economic development through enterprise reform, also supported in the 1995 China CAS. The project's facilitation of reform and rationalization of the salt industry resulted in a strong alignment of the interests of the industry and social sectors. In addition, the project's support of technology transfer in the manufacture of packaging machines matched the Government's aspirations for industrial development and import substitution. The project objective itself was found to be achievable, although project implementation period estimated at appraisal proved unrealistic, due to the complexity and vast geographic distribution of the participating enterprises. The Bank team became aware of these complexities during preparation, but was faced with the optimistic assurances of the implementing agency and some pressure on GOC to achieve the international goal of USI by 1996. The time required to complete the technology transfer was also underestimated. In the event, as discussed below, the project was extended by two years. 3.2 Revised Objective: The project objective was not revised 3.3 Original Components: As described in the Development Credit Agreement (DCA), the project consisted of two parts: Part A, comprising physical projects at enterprise level, including civil works, equipment, installation, training and management support for the upgrading of existing facilities and creation of additional new capacity for raw salt upgrading, iodizing, packaging and distribution of edible salt; and Part B, a limited program of technical assistance in information systems and project management. The basic elements of the project design were straightforward, involving construction of simple buildings and the procurement, manufacture, installation and operation of equipment which was not technologically complex. However, the project overall was ambitious, complex and demanding due to the following factors: (a) the size and geographic scope, covering over 200 enterprises in 31 province-level jurisdictions; (b) the technology transfer element, involving many factors which were difficult to control during implementation; (c) the environment of enterprise reform and rationalization, then just gaining momentum in China, and in the salt industry given an added incentive by the project; (d) the in-country financial mobilization required; the Bank's initial funding amounted to less than 20% of the estimated project cost. (e) the lack of previous experience of the implementing agency with Bank practices; (f) the coordination required with other UN and bilateral partners for supply of technical assistance and machine prototypes; and (g) the coordination required to ensure participation of the enterprises and other stakeholders in project definition, implementation arrangements and selection of equipment. -3 -  The design included specific targets for capacity rationalization and upgrading in each province. The targets were modified during project implementation as a result of ongoing industry rationalization and re-estimation of total capacity needed and capacity switching amongst units; however the overall physical targets remained valid. At appraisal, the major risk identified was continued consumption of non-iodized salt, which would detract from full utilization of project capacities and delay IDD elimination. Lower risks related to timely delivery of equipment, and project management capacity in relation to the scale of the project. These risks were addressed through the following elements of design and the implementation environment, which were either place or were committed before project implementation began: (a) strong government commitment, with policy guidance and oversight from the highest level of the Government (the State Council) and a framework for supervision, coordination and monitoring of progress in NIDDEP at each level down to the enterprise itself, (b) a law prohibiting production or sale of edible salt unless iodized to the required standard; (c) regulations for licensing of enterprises involved in production, distribution, transport and sale of iodized salt, and for the labeling of iodized salt packages; (d) financing mechanisms, including a new price for standard iodized salt, with a small portion of the price channeled into the national Iodized Salt Industry Development Fund (ISIDF); (e) strong, coordinated support among UN agencies and other donors under the NIDDEP; and (f) a Government letter assuring the Bank that it would implement all the NIDDEP interventions required to ensure the project's impact; (g) provision for technical assistance on project management to the implementing agency. The main limitations of the design which might have been anticipated, but might not have been avoided, were: (a) the short implementation period (noted above), which underestimated time needed for the technology transfer process, for mobilizing provincial authorities and enterprises to participate in the project, and for internal review and approval procedures; (b) the Bank's requirement for all provincial and enterprise agreements to be in place before effectiveness, resulting in an interval of 10 months rather than the estimated three months from Board approval to effectiveness. However, the delay was not material since there was provision for retroactive financing of activities started before effectiveness; (c) the lack of Bank funding for any NIDDEP activities outside the salt sector. This decision was made by GOC, with support of the Minister of Health, in keeping with its policy on onlending and repayment of World Bank funds, also taking into account the expected support of other agencies for health sector activities of NIDDEP. The decision disappointed Ministry of Health (MOH) staff, especially as US$10 million of the project credit had been deducted from another health project, and MOH had expected some World Bank funds would be used for activities such as public - 4 -  education, standard setting, surveillance and health worker training. This situation made it difficult in the early stages of the project, for the Bank team to maintain dialogue on plans and progress in the full range of NIDDEP activities, as mandated in the project's legal agreement. However, this early difficulty in MOH-Bank relations did not significantly affect project implementation, and the situation improved as the project and the NIDDEP progressed. 3.4 Revised Components: The project components were not revised. 3.5 Quality at Entry: The project's quality at entry is rated as Satisfactory based on the following features of project design and readiness and the policy and regulatory environment: (a) the responsiveness of the objectives and design to the priorities and strategies of the borrower (described above); (b) the strong organizational, regulatory and financial framework in place (described in 3.1 above); (c) both the project implementation unit (PIU) and the implementation plan for the first year were in place; (d) some procurement actions were underway, with completion before effectiveness of the evaluation of international and domestic packaging machine manufacturers, preparation of technical specifications, preliminary quotations and a procurement plan; (e) there was strong support for initial project activities from the UN agencies; a coordination mechanism among UN agencies was operating and was later formalized through signing of a Memorandum of Understanding (MOU) on September 14, 1995; (f) the monitoring indicators for the project had been agreed during negotiation and arrangements were in place for their collection; (g) a master plan was prepared specifying the physical facilities to be created, as well as the roles and responsibilities of concerned agencies for implementation; and (h) a clear financing plan was in place, with commitments to provide agreed shares from identified counterpart financing agencies. Overall, great effort was made to ensure the readiness of the project, in the face of: (a) pressure to start implementation quickly to meet China's commitment to USI; and (b) some differences of Bank and GOC views on what constituted readiness for implementation in terms of detailed planning, establishment of the PIU, implementation arrangements, counterpart financing, etc. Appraisal was in fact postponed twice by the Bank team to allow more time to complete those actions considered essential to improve readiness. The Government also postponed approval until its own project feasibility report was revised to meet its requirements. This approval was given in February 1995. Financial readiness: The financial readiness of the project was evident from the following: (a) agreements were reached with MOF, the two main counterpart financiers, ISIDF and the State Development Bank of China (SDBC), the provinces and enterprises on the - s -  size and conditions for their contributions to the project, including funding of any cost overruns. Signed agreements with the provinces and enterprises were a condition of effectiveness; (b) onlending, disbursement and repayment arrangements for the Credit/Loan were agreed involving MOF, the China National Salt Industry Corporation (CNSIC), a financial intermediary and the provinces; and (c) a new price for iodized salt was set by GOC (and formalized in January 1996). The resulting increased income to the ISIDF helped ensure the project's counterpart funding, as well as additional resources for industry upgrading and related activities outside the project. Technical readiness: The technology for upgrading the physical facilities was not sophisticated or expensive, comprising iodizing, mixing and packaging machines; basic laboratory testing methods and simple warehouse buildings with features for reducing dust and salt in the air. Assessment and selection of models of equipment to be funded had begun earlier with support of UNICEF and UNIDO. Upgrading of domestic manufacturing capability for retail packaging machines through technology transfer was an objective of the project. Standard plant designs were developed by a local engineering company (completed in July 1995) and used in the provincial feasibility studies. A program of research and development was also defined before project effectiveness, giving priority to reducing iodine losses through: (i) improving iodizing machines; (ii) increasing the stability of iodine in salt; and (iii) irriroved packaging machinery. Bank safegyards: None of the specified monitorable Bank safeguard policies was applicable to this project. There were no issues of negative environmental impact, resettlement or threat to minority communities. External factors: The project was designed under two main assumptions about external factors: (a) the major assumption was that complementary activities of the NIDDEP would be carried out, thus ensuring that the project's support for the edible salt industry would in fact lead to realization of its development objective of improved use of iodized salt at household level and reduction of IDD. This assumption was considered reasonable due to top level political commitment, a good strategy and strong institutional arrangements for the NIDDEP, technical support and finance from other international agencies, and the commitment on this matter given by MOH to the World Bank during appraisal and negotiations (see ref. 1, Staff Appraisal Report, Annex 2). (b) the second important assumption was that the new price of iodized salt, which underpinned the financing of the upgraded capacity and distribution of iodized salt across China, would not significantly affect affordability or demand for iodized salt at household level. This assumption was based on the estimation that the price increase for quality iodized salt represented less than one percent of the household budget, in both rural and urban areas, and would therefore not be a concern for the vast majority of families. The assessment at project completion is that on balance the Government's decision to set a new higher price for quality iodized salt was the right decision, and helped to finance the needed great expansion in supply of iodized salt. However, for some - 6 -  disadvantaged communities, where price may still be one of the factors affecting use, advocacy and marketing as well as compensation, price subsidy or other alternative strategies might be needed to ensure household uptake. 4. Achievement of Objective and Outputs 4.1 Outcome/achievement of objective. The project outcome is rated as Highly Satisfactory, based on the contribution of the project to the achievement of the goals of the NIDDEP, within the relatively short period of about six years. The standard for assessing achievement of the project development objective did not change over the implementation period. NIDDEP progress was monitored through three national surveys, conducted in 1995, 1997 and 1999 by MOH and Provincial Bureaus of Health, with national and international assistance. The surveys assessed three program indicators: the availability of adequately iodized salt at household level, and the prevalence of two biological markers for iodine deficiency, enlargement of the thyroid (goiter) and low urinary iodine excretion. The results showed that, for the country as a whole, coverage of quality iodized salt at household level increased from 39.9% in 1995 to 88.9% in 1999; while measures of goitre and low urinary iodine in school children decl'ned dramatically in the same period. Table 4a. Outcome/Impact Indicators Indicaw.-r 1995 1997 999 1. % households consuming quality iodized salt 39.9 81.1 88.9 (20 ppm or over in tested sarl samples) 2a. % school children 8-10 years with enlarged n. a. 9.9 8.0 thy-roid (measured by ultrasound) 2b. % school children 8-10 years with enlarged 20.4 10.9 8.8 thyroid (measured by palpation). 3. % school children 8-10 yrs with low urinary 13.3 3.5 3.3 iodine (50 ug/L or less) T Source: Three national surveys conducted by GOC with intenational support (Annex 7, ref. 24) ug/L = micrograms per liter ppm = parts per million [Note: The international criteria for IDD elimination are: (a) 90% of households consuming salt with 20 ppm iodine or above; (b) no more than 20% of school children with urinary iodine below 50 ug/L; and (c) no more than 5% schoolchildren with thyroid enlargement, by palpation or ultrasound.] The project's health impact, through its contribution to the NIDDEP, is rated as High. The increase in household coverage of adequately iodized salt implies that an additional 50% of families in China will now benefit from greatly reduced incidence of miscarriage and stillbirth, physical deformity and mental retardation caused by iodine deficiency, bearing in mind that IDD is the commonest cause of preventable mental retardation in the world and that at the beginning of the 1990s, China was estimated to have 40% of the world population at risk of IDD. In addition, studies in China and other countries, as reported by Micronutrient Initiative, have concluded that -7-  all children born in previously iodine deficient communities and now protected from IDD will have on average intelligence 13-5 IQ points greater than if not protected. Out of an estimated 18.2 million births per year in China, 17.2 million newborns are now protected from IDD, including about 9 million with protection provided through the increased coverage of iodized salt resulting from this project. Apart from improved reproductive health, the enhancement of learning ability and productivity, and reduction of dependency and medical costs due to disability, will make an important contribution to social and economic development. The impact on povertv reduction is rated as Modest. The additional 50% of China's families now using iodized salt, with the benefits described above, include a large number of the poor and very poor, and to the extent that poor families and communities are more burdened by the effects of ill-health and disability than non-poor, they will particularly be advantaged by the success of the Program. Economists consider that the marginal productivity increase of improved health is likely to be higher for poorer than for richer families, which would further underline pro-poor benefits of project. On the other hand, it is known that the estimated 10% of households not yet consuming iodized salt are predominantly located in the poorer provinces and counties. These were not reached directly by the project. However, the Government has made new plans to address these areas, and as discussed below, one important resources available to assist is the ISIDF which was greatly strengthened as a result of the project. In June 2000, an evaluation group representing six government agencies made a further comprehensi'e assessment of each province and concluded that China had satisfied the criteria for virtual elimination of IDD at the country level and in 24 provinces. The review identified remaining problems in the other seven provinces, especially in remote inland areas and in some coastal areas where salt is produced by small enterprises. These problem areas contain 14% of China's population. While these gaps could not have been addressed within the scope of the project as designed, in October 2000, GOC and the provinces made detailed plans to address this challenge in the next five years, through such activies as: (a) establishing small salt iodizing and packaging plants some local population centers; (b) social marketing; (c) targetted subsidies of the salt price or transport cost, and (d) incentives to reduce excess production capacity, especially among small producers. Until such strategies are well established, alternative iodine supplementaton for vulnerable groups, especially women and young children, should remain in place. The ISIDF, which has grown strong as a result of the project, is available for use in these remaining problem areas. For example, a small iodization plant has been built in Tibet and two more are planned there, using the ISIDF along with funds from WHO and the Australian Agency for International Development (AusAID). 4.2 Outputs by components: Part A. Physical Capacity Building (Credit US$17.29 million!. The achievement of outputs in this component is rated Highly Satisfactory, based on the completion of all physical targets of the project, including installed capacities for salt production, iodization and packaging as well as successful technology transfer for production of retail packaging machines in China (see Annex 1, Table I b). In summary the project outputs were as follows: - 8 -  (a) upgrading of 1.54 mtpy low quality raw salt production in 55 enterprises, with concurrent expansion of capacity to 2.45 mtpy (compared with SAR target of 2.2 mtpy in 57 enterprises) (b) installation of iodization capacity at 112 locations, with increase of total iodization capacity from 3.5 to 8.1 mtpy (target adjusted down from SAR target of 8.16mtpy) (c) installation of new bulk packaging capacity at 29 locations to 3.76 mtpy (compared with the appraisal target of 2.93 mtpy) (d) installation of new retail packaging capacity at 147 locations up to 3.45 mtpy (compared with the appraisal target of 3.16 mtpy) (e) installation of new carton packaging capacity at 2 locations, each of 0.05 mtpy (same as the appraisal target). Part B. Technical Assistance (Credit US$0.14 million). The output of this small component (0.6