Madagascar - Second Nutrition Project - Supplemental Credit

Initial Project Information Document (PID) Report No: AB316 Project Name MADAGASCAR - Madagascar: Nutrition II - Supplemental Credit Region Africa Regional Office Sector Health (70%); Primary education (19%); Central government administration (10%); Agricultural extension and research (1%) Theme Nutrition and food security (P); Civic engagement, participation and community driven development (P); Child health (S) Project P084601 Borrower(s) GOVERNMENT OF MADAGASCAR Implementing Agency(ies) PRIME MINISTER'S OFFICE Address: Lot 1BG 21 Ter, Place d'Antsahavola, Antananarivo, 101, Madagascar Contact Person: Georges RANDRIAMAMONJISOA/Blanchard ANDRIAMPARANY Tel: 261 20 22 241 09 Fax: 261 20 22 241 12 Email: nutricom@dts.mg Environment Category C (Not Required) Date PID Prepared September 9, 2003 Auth Appr/Negs Date August 14, 2003 Bank Approval Date October 16, 2003 1. Country and Sector Background Country context. After having been one of the most rapidly growing African economies in recent years, Madagascar plunged into deep political crisis at the beginning of 2002. The crisis ended 6 months later, but social and economic impact is extremely pronounced, with poverty levels rising to where they were a decade ago. The new Government presented a recovery program to the donor community in July 2002 and IDA supported this through a US$50 million emergency credit and a substantial portfolio restructuring. After emerging from this deep political and economic crisis the new Government is embarking on an ambitious reform program, as described in the new CAS that is currently under preparation. Sectoral background. Malnutrition was already a serious development problem in Madagascar before the crises. Almost 50 percent of children under five years of age were chronically malnourished or stunted. Analysis of malnutrition data among the different income groups confirms that malnutrition is largely a poor peoples problem. Poverty, as well as lack of knowledge, poor feeding, health and caring practices, inadequate food production and consumption, are the main determinants of chronic malnutrition. Recurrent infectious diseases, especially diarrhea, measles, malaria, and helminth infections cause bouts of acute malnutrition and contribute to chronic growth retardation. Malnutrition prevalence trends in Madagascar are decreasing, but very slowly. It is likely that after the crises, gains achieved have been lost, due to the deterioration in the causes of malnutrition as explained above. Continued and more intensive efforts are needed to achieve the project development objective, which contributes to the achievement of the Millennium Development Goal for nutrition