Public Disclosure Copy The World Bank Implementation Status & Results Report Maternal and Child Nutrition and Health Results Project (P143650) Maternal and Child Nutrition and Health Results Project (P143650) AFRICA | Gambia, The | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2014 | Seq No: 7 | ARCHIVED on 01-Feb-2017 | ISR26884 | Implementing Agencies: Key Dates Key Project Dates Bank Approval Date:21-Mar-2014 Effectiveness Date:20-May-2014 Planned Mid Term Review Date:31-Mar-2017 Actual Mid-Term Review Date:-- Original Closing Date:31-Jul-2019 Revised Closing Date:31-Jul-2021 Project Development Objectives Project Development Objective (from Project Appraisal Document) A. Proposed Development Objective The development objective of the project is to increase the utilization of communitynutritionand primary maternal and child health services in selected regions in the Recipient’s territory. Has the Project Development Objective been changed since Board Approval of the Project Objective? No PHRPDODEL Components Name Community mobilization for social and behavior change:(Cost $5.15 M) Delivery of community nutrition and primary health care services:(Cost $11.53 M) Capacity building for service delivery, results-based financing, food and nutrition security and cash transfers:(Cost $4.00 M) Ebola preparedness and control:(Cost $0.50 M) Contingent Emergency Response Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO  Satisfactory  Satisfactory 2/1/2017 Page 1 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Maternal and Child Nutrition and Health Results Project (P143650) Overall Implementation Progress (IP)  Satisfactory  Satisfactory Overall Risk Rating  Substantial  Substantial Implementation Status and Key Decisions The Project was approved on March 21 and became effective on May 20, 2014. The project was restructured on December 1, 2014 to support the government's Ebola preparedness and control response (US$0.50 reallocation). Additional Financing (AF) in the amount of US$5.0 million (US$2.525 million IDA grant and US$2.475 million credit) was approved on April 24, 2015 and became effective on November 30, 2015. A Second Additional Financing (AF2) was approved on January 9, 2017 in the amount of US$7.5 million (US$4.3 million IDA grant and US$3.2 million IDA credit). The project is multisectoral and addresses health, nutrition, population and food security challenges through five components: (i) Community mobilization for social and behavior change; (ii) Delivery of community nutrition and primary health care services; (iii) Capacity building for service delivery and Results- Based Financing; (iv) Ebola preparedness and control; and (v) Contingent Emergency Response. The project builds on a pilot learning experience implemented in the North Bank West Region and has scaled up original activities to Central River and Upper River Regions. Implementation is going well and meets expectations. The project has scaled up to all five regions, covering all health centers and hospitals in these regions, an increase in the number of communities being directly contracted through the community RBF scheme, and social and behavior change communication tools having been finalized and training conducted on them. A community mobilization strategy has also been finalized with tools undergoing development. While there has been substantial progress and improved capacity for the original project components, the focus now is on roll-out of new food and nutrition security activities – as part of the AF of 2015 – which has been lagging behind. Special emphasis will be needed on food and nutrition security, M&E capacity, quality of care and overall project management in this next phase of implementation. In recognition of macroeconomic challenges facing the country, the AF2 will help address short-term economic effects on achieving the overall objectives of the project. The AF2 supports: (i) the introduction of UCTs to vulnerable households to help them weather the anticipated external financial shocks; (ii) interventions to address specific bottlenecks in project performance; (iii) the scaling up of food and nutrition security activities in the existing five project regions; and (iv) expansion and intensification of social and behavior change communication interventions. Rapid signing and effectiveness of the AF2 will be critical in moving forward these new activities. 2/1/2017 Page 2 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Maternal and Child Nutrition and Health Results Project (P143650) 2/1/2017 Page 3 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Maternal and Child Nutrition and Health Results Project (P143650) 2/1/2017 Page 4 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Maternal and Child Nutrition and Health Results Project (P143650) Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance  --  High  High Macroeconomic  --  High  High Sector Strategies and Policies  --  Moderate  Moderate Technical Design of Project or Program  --  Substantial  Substantial Institutional Capacity for Implementation and Sustainability  --  Moderate  Moderate Fiduciary  --  Substantial  Substantial Environment and Social  --  Low  Low Stakeholders  --  Moderate  Moderate Other  --  --  -- Overall  --  Substantial  Substantial Results Project Development Objective Indicators PHINDPDOTBL  Children 0-6 months exclusively breastfed (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 47.00 49.00 49.00 60.00 Date 31-Dec-2013 31-Dec-2015 31-Dec-2015 31-Jul-2021 2/1/2017 Page 5 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Maternal and Child Nutrition and Health Results Project (P143650) PHINDPDOTBL  Births (deliveries) attended by skilled health personnel (number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 8,885.00 15,315.00 15,315.00 23,000.00 Date 31-Dec-2013 30-Sep-2016 30-Sep-2016 31-Jul-2021 PHINDPDOTBL  Children 6-23 months consuming at least four out of six food groups (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 19.00 -- -- 35.00 Date 31-Dec-2013 -- -- 31-Jul-2021 PHINDPDOTBL  Women using modern methods of family planning (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 12,925.00 14,963.00 14,963.00 20,000.00 Date 31-Dec-2013 30-Sep-2016 30-Sep-2016 31-Jul-2021 PHINDPDOTBL  Direct project beneficiaries (Number, Core) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 201,622.00 201,622.00 1,400,000.00 Date 28-Feb-2014 31-Dec-2015 31-Dec-2015 31-Jul-2021 PHINDPDOTBL  Female beneficiaries (Percentage, Core Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 70.00 83.00 83.00 70.00 2/1/2017 Page 6 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Maternal and Child Nutrition and Health Results Project (P143650) Overall Comments Intermediate Results Indicators PHINDIRITBL  Pregnant women referred by VSG members for delivery and complication management (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 3,165.00 3,165.00 12,000.00 Date 28-Feb-2014 29-Apr-2016 29-Apr-2016 31-Jul-2021 PHINDIRITBL  Hand washing stations/points established (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 2,049.00 2,049.00 6,000.00 Date 28-Feb-2014 29-Apr-2016 29-Apr-2016 31-Jul-2021 PHINDIRITBL  Community registers updated quarterly (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 341.00 634.00 634.00 560.00 Date 31-Jan-2014 30-Sep-2016 30-Sep-2016 31-Jul-2021 2/1/2017 Page 7 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Maternal and Child Nutrition and Health Results Project (P143650) PHINDIRITBL  Pregnant/lactating women, adolescent girls and/or children under age five-reached by basic nutrition services (number) (Number, Core) Baseline Actual (Previous) Actual (Current) End Target Value 90,000.00 186,380.00 186,380.00 593,000.00 Date 31-Jan-2014 29-Apr-2016 29-Apr-2016 31-Jul-2021 PHINDIRITBL  Children between the age of 6 and 59 months receiving Vitamin A supplementation (number) (Number, Core Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 70,000.00 83,806.00 83,806.00 475,000.00 Date 31-Jan-2014 30-Sep-2016 30-Sep-2016 31-Jul-2021 PHINDIRITBL  Pregnant women receiving iron and folic acid (IFA) supplements (number) (Number, Core Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 9,000.00 59,929.00 59,929.00 18,000.00 Date 31-Jan-2014 30-Sep-2016 30-Sep-2016 31-Jul-2021 PHINDIRITBL  Children under the age of 24 months benefiting from improved infant and young child feeding (IYCF) practices (number) (Number, Core Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 10,000.00 39,252.00 39,252.00 95,000.00 Date 31-Jan-2014 30-Sep-2016 30-Sep-2016 31-Jul-2021 2/1/2017 Page 8 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Maternal and Child Nutrition and Health Results Project (P143650) PHINDIRITBL  Children under age five treated for moderate or severe acute malnutrition (number) (Number, Core Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 200.00 2,060.00 2,060.00 5,000.00 Date 31-Jan-2014 30-Sep-2016 30-Sep-2016 31-Jul-2021 PHINDIRITBL  Communities implementing BFCI activities (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 633.00 633.00 633.00 1,100.00 Date 11-Mar-2015 30-Sep-2016 30-Sep-2016 31-Jul-2021 PHINDIRITBL  Children 12-59 dewormed in the preceding year (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 6,461.00 53,067.00 53,067.00 46,000.00 Date 31-Dec-2013 30-Sep-2016 30-Sep-2016 31-Jul-2021 PHINDIRITBL  Pregnant women coming for ANC in the first trimester in the preceding year (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 2,342.00 9,277.00 9,277.00 12,000.00 Date 31-Dec-2013 30-Sep-2016 30-Sep-2016 31-Jul-2021 2/1/2017 Page 9 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Maternal and Child Nutrition and Health Results Project (P143650) PHINDIRITBL  Post-partum mothers supplemented with VAS in the preceding year (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 22,200.00 21,130.00 21,130.00 26,000.00 Date 31-Dec-2013 29-Apr-2016 29-Apr-2016 31-Jul-2021 PHINDIRITBL  Vulnerable households supported in participating in gardening, keeping ruminants, or keeping poultry (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 5,000.00 Date 26-Feb-2015 31-Dec-2015 31-Dec-2016 31-Jul-2021 PHINDIRITBL  Communities supported in establishing child food banks (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 250.00 Date 09-Feb-2015 31-Dec-2015 31-Dec-2016 31-Jul-2021 PHINDIRITBL  Health workers (including central and regional level managers) trained on RBF management (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 38.00 332.00 332.00 200.00 Date 31-Jan-2014 29-Apr-2016 29-Apr-2016 31-Jul-2021 2/1/2017 Page 10 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Maternal and Child Nutrition and Health Results Project (P143650) PHINDIRITBL  RBF adopted in the revised health financing policy (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value N N N Y Date 31-Dec-2013 29-Apr-2016 29-Apr-2016 31-Jul-2019 PHINDIRITBL  Health personnel receiving training (number) (Number, Core) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 810.00 810.00 1,200.00 Date 28-Feb-2014 29-Apr-2016 29-Apr-2016 31-Jul-2021 PHINDIRITBL  Health personnel trained on Ebola prevention and management (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 305.00 305.00 100.00 Date 11-Nov-2014 30-Jun-2016 30-Jun-2016 31-Jul-2019 PHINDIRITBL  Health facilities receiving Client Tracer and Satisfaction Survey feedback at least 3 times during the calendar year (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- -- 70.00 Date 15-Nov-2016 -- -- 31-Jul-2021 2/1/2017 Page 11 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Maternal and Child Nutrition and Health Results Project (P143650) PHINDIRITBL  Health facilities scoring at least 75% on the Quality Checklist (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- -- 100.00 Date 15-Nov-2016 -- -- 31-Jul-2021 PHINDIRITBL  Selected recipients who meet the targeting criteria (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- -- 80.00 Date 15-Nov-2016 -- -- 31-Jul-2021 PHINDIRITBL  Selected recipients who receive all cash transfers according to the payment plan (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- -- 80.00 Date 15-Nov-2016 -- -- 31-Jul-2021 PHINDIRITBL  Recipients of UCT (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- -- 5,000.00 Date 15-Nov-2016 -- -- 31-Jul-2021 Overall Comments There are more recent data available for some of the indicators above but due to the political situation, we were not able to get it over the last couple of months. These will be updated in the next ISR. 2/1/2017 Page 12 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Maternal and Child Nutrition and Health Results Project (P143650) Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed Disbursed P143650 IDA-56230 Effective USD 2.48 2.48 0.00 0.00 2.52 0% Not P143650 IDA-59420 USD 3.20 3.20 0.00 0.00 3.25 0% Effective P143650 IDA-D0500 Effective USD 2.53 2.53 0.00 0.77 1.68 31% Not P143650 IDA-D1600 USD 4.30 4.30 0.00 0.00 4.34 0% Effective P143650 IDA-H9230 Effective USD 3.68 3.68 0.00 2.55 0.77 69% P143650 TF-16640 Effective USD 5.00 5.00 0.00 2.60 2.40 52% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P143650 IDA-56230 Effective 24-Apr-2015 04-Jun-2015 30-Nov-2015 31-Jul-2019 31-Jul-2019 Not P143650 IDA-59420 09-Jan-2017 -- -- 31-Jul-2021 31-Jul-2021 Effective P143650 IDA-D0500 Effective 24-Apr-2015 04-Jun-2015 30-Nov-2015 31-Jul-2019 31-Jul-2019 Not P143650 IDA-D1600 09-Jan-2017 -- -- 31-Jul-2021 31-Jul-2021 Effective P143650 IDA-H9230 Effective 21-Mar-2014 09-Apr-2014 20-May-2014 31-Jul-2019 31-Jul-2019 P143650 TF-16640 Effective 09-Apr-2014 09-Apr-2014 20-May-2014 31-Jul-2019 31-Jul-2019 Cumulative Disbursements 2/1/2017 Page 13 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Maternal and Child Nutrition and Health Results Project (P143650) Restructuring History Level 2 Approved on 18-Dec-2014 Related Project(s) P154007-GM Maternal and Child Nutrition and Health Results Project ,P159693-AF Maternal and Child Nutrition and Health Results Project 2/1/2017 Page 14 of 14 Public Disclosure Copy