Document of The World Bank Report No: ICR2896 IMPLEMENTATION COMPLETION AND RESULTS REPORT (IDA-40970 and IDA-49640) ON A CREDIT IN THE AMOUNT OF SDR13.3 MILLION (US$20.0 MILLION EQUIVALENT) AND ITS ADDITIONAL FINANCING IN THE AMOUNT OF SDR 2.3 MILLION (US$3.6 MILLION EQUIVALENT) TO THE REPUBLIC OF HONDURAS FOR A NUTRITION AND SOCIAL PROTECTION PROJECT December 19, 2013 Human Development Sector Management Unit Central America Country Management Unit Latin American and the Caribbean Region CURRENCY EQUIVALENTS (Exchange Rate Effective August 16, 2013) Currency Unit = Lempiras 1.00 = US$ 0.05 US$ 1.00 = 17.58 lempiras FISCAL YEAR January 1 – December 31 ABBREVIATIONS AND ACRONYMS AF Additional Financing AIN-C Community-based Nutrition Program (Atención Integral a la Niñez en la Comunidad) CADERH Advisory Services to Human Resource Development CCT Conditional Cash Transfer Program Bono 10.000 CECAPs Training Centers for the FEP CTEP Technical Committee for Evaluation of Proposals DSIF Department of Integrated Family Health (Departamento de Salud Integral a la Familia) FEP First Employment Program GOH Government of Honduras IDA International Development Association INE National Institute for Statistics INFOP National Institute for Professional Training IPDP Indigenous Plan M&E Monitoring and Evaluation PAD Project Appraisal Document PAIN Integrated Attention for Children Program (Programa de Atención Integral a la Niñez) PCU Project Coordination Unit PDO Project Development Objective PRSP Poverty Reduction Strategy Paper SDR Special Drawing Rights SENAEH National Employment Service SEPA Procurement Plan Management System (Sistema de Ejecucion de Planes de Adquisiciones) SLSS Secretariat of Labor and Social Security SOE Employment Orientation Service (Servicio de Orientación de Empleo) SOH Secretariat of Health SOP Secretariat of Presidency SSD Secretariat of Social Development PCU Project Coordination Unit UAT Administrative Unit for Projects with the Secretariat of the Presidency UATP Technical Support Unit within the Secretariat of the Presidency UECF Unit of Extension of Coverage and Financing (Unidad de Extensión de Cobertura y Financiamiento) UNAT Technical Unit within the Secretariat of Presidency (Replaced by UATP) Vice President: Hasan A. Tuluy Country Director: Felipe Jaramillo Sector Manager: Mansoora Rashid Project Team Leader: Lucy Bassett ICR Team Leader: Lucy Bassett ICR Author: M. Rosa Puech   HONDURAS Nutrition and Social Protection Project CONTENTS Data Sheet A. Basic Information B. Key Dates C. Ratings Summary D. Sector and Theme Codes E. Bank Staff F. Results Framework Analysis G. Ratings of Project Performance in ISRs H. Restructuring I. Disbursement Graph 1. Project Context, Development Objectives and Design ............................................... 1 2. Key Factors Affecting Implementation and Outcomes .............................................. 5 3. Assessment of Outcomes .......................................................................................... 11 4. Assessment of Risk to Development Outcome......................................................... 17 5. Assessment of Bank and Borrower Performance ..................................................... 18 6. Lessons Learned ....................................................................................................... 21 7. Comments on Issues Raised by Borrower/Implementing Agencies/Partners .......... 23 Annex 1. Project Costs and Financing .......................................................................... 24 Annex 2. Outputs by Component ................................................................................. 25 Annex 3. Economic and Financial Analysis ................................................................. 34 Annex 4. Bank Lending and Implementation Support/Supervision Processes ............ 38 Annex 5. Beneficiary Survey Results ........................................................................... 40 Annex 6. Stakeholder Workshop Report and Results................................................... 41 Annex 7. Summary of Borrower's ICR and/or Comments on Draft ICR ..................... 42 Annex 8. Comments of Cofinanciers and Other Partners/Stakeholders ....................... 55 Annex 9. List of Supporting Documents ...................................................................... 56 Annex 10. Comparative Results Framework……………………………………….....58 Annex 11. Methodology of FEP and AIN-C evaluations……………………………..60 Annex 12. Institutional Change/Strengthening Outcomes…………………………….61 MAP…………………………………………………………………………………...63   A. Basic Information Nutrition and Social Country: Honduras Project Name: Protection project IDA-40970,IDA- Project ID: P082242 L/C/TF Number(s): 49640,TF-11667 ICR Date: 12/20/2013 ICR Type: Core ICR REPUBLIC OF Lending Instrument: SIL Borrower: HONDURAS Original Total USD 20.00M Disbursed Amount: USD 20.85M Commitment: Revised Amount: USD 20.49M Environmental Category: C Implementing Agencies: Secretary of Social Development Secretary of Labor Secretary of Health Secretary of the Presidency Cofinanciers and Other External Partners: B. Key Dates Revised / Actual Process Date Process Original Date Date(s) Concept Review: 06/14/2004 Effectiveness: 02/28/2006 02/28/2006 12/11/2007 06/11/2010 06/16/2011 Appraisal: 04/11/2005 Restructuring(s): 04/12/2013 06/19/2013 06/28/2013 Approval: 07/07/2005 Mid-term Review: 04/11/2012 04/20/2012 Closing: 06/30/2010 06/30/2013 C. Ratings Summary C.1 Performance Rating by ICR Outcomes: Moderately Satisfactory Risk to Development Outcome: Moderate Bank Performance: Moderately Satisfactory Borrower Performance: Moderately Satisfactory i C.2 Detailed Ratings of Bank and Borrower Performance (by ICR) Bank Ratings Borrower Ratings Quality at Entry: Moderately Satisfactory Government: Moderately Satisfactory Implementing Quality of Supervision: Moderately Satisfactory Moderately Satisfactory Agency/Agencies: Overall Bank Overall Borrower Moderately Satisfactory Moderately Satisfactory Performance: Performance: C.3 Quality at Entry and Implementation Performance Indicators Implementation QAG Assessments Indicators Rating Performance (if any) Potential Problem Project Quality at Entry Yes None at any time (Yes/No): (QEA): Problem Project at any Quality of Yes None time (Yes/No): Supervision (QSA): DO rating before Moderately Closing/Inactive status: Satisfactory D. Sector and Theme Codes Original Actual Sector Code (as % of total Bank financing) Central government administration 20 20 Other social services 45 45 Sub-national government administration 5 5 Vocational training 30 30 Theme Code (as % of total Bank financing) Child health 33 33 Other human development 17 17 Participation and civic engagement 17 17 Social safety nets 33 33 E. Bank Staff Positions At ICR At Approval Vice President: Hasan A. Tuluy Pamela Cox Country Director: Carlos Felipe Jaramillo Jane Armitage Sector Manager: Mansoora Rashid Helena G. Ribe Project Team Leader: Lucy Katherine Bassett Manuel Salazar ICR Team Leader: Lucy Katherine Bassett ICR Primary Author: Maria R. Puech Fernandez ii F. Results Framework Analysis Project Development Objectives (from Project Appraisal Document) The project development objective is to improve Honduras social safety net for children and youth. This would be achieved by (i) improving nutritional and basic health status of young children through and expanding the successful AIN-C program, and (ii) increasing employability of disadvantaged youth through piloting a First Employment program. The coordinated implementation of these interventions constitutes the first step towards consolidating the government’s institutional and technical capacity to formulate, coordinate, and monitor a comprehensive social safety net. This objective supports government’s strategy of fostering human capital investment among poor families in the poorest municipalities of the country to reduce poverty. The project represents the initial phase of a concerted effort to improve Honduras social safety net. With its emphasis on improving the institutional framework for the two program interventions, the project will help to: (i) create conditions to further expand such programs based on sound policies and strategies and accurate information from monitoring and evaluation mechanisms; (ii)enhance the GOH’s capacity to include additional vulnerable groups and interventions gradually as part of the process to consolidate a national social protection structure, and (iii) improve and consolidate a monitoring and evaluation system for social protection programs. Revised Project Development Objectives (as approved by original approving authority) The PDO did not change in substance but it was re-worded to improve its clarity as follows: to improve the social safety net for children and youth by: (i) strengthening the Borrower's capacity to administer social assistance programs; (ii) improving nutritional and health status of young children by expanding the AIN-C program; and (iii) increasing employability of at-risk youth by piloting a First Employment program. (a) PDO Indicator(s) Original Target Formally Actual Value Values (from Revised Achieved at Indicator Baseline Value approval Target Completion or documents) Values Target Years Institutional structure for social protection policy formulation, planning, Indicator 1 : implementation and evaluation is created by Governmental decree SSD created with a SSD created with a Institutional and legal mandate to mandate to Value framework for PRSP Institutional coordinate, coordinate, design, quantitative or implementation structure created design, implement and Qualitative) (Social Cabinet, UNAT by decree implement and evaluate social and Consultative Council) evaluate social policy policy Date achieved 06/30/2005 06/30/2009 06/30/2013 06/30/2013 iii Comments Achieved. This indicator was revised during the 2011 restructuring since the (incl. % word “coherent” was not defined and the social protection institutional structure achievement) goes beyond children and youth, so it needed to be set up accordingly. Reduction in chronic malnutrition for children under 2 years of age participating Indicator 2 : in AIN-C Reduction of 6 Reduction of 4.7 Value percentage percentage points 8% reduction from quantitative or 32% points from (children exposed the baseline value Qualitative) baseline (over for an average of 1 2 years) year) Date achieved 06/30/2005 06/30/2009 06/30/2013 06/30/2013 Largely achieved. Indicator modified in 2011 to focus on beneficiary Comments communities. 4.7pp reduction for children exposed for average of 1 year (incl. % represents 78% attainment of 2-year target of 6pp; out-performed annualized achievement) target of 3pp for 1 year of treatment. Percentage of program graduates in paid employment or self-employment 6 Indicator 3 : months after program graduation Value quantitative or 0 40% 40% 30% Qualitative) Date achieved 06/30/2005 06/30/2009 06/30/2013 06/30/2013 Partially achieved. Results due to 2009 political crisis, which affected Comments implementation of the 3rd round (drop outs, quality of the training and likelihood (incl. % of obtaining employment after training) and the cancellation of the 4th round of achievement) the FEP. (b) Intermediate Outcome Indicator(s) Original Target Actual Value Formally Values (from Achieved at Indicator Baseline Value Revised approval Completion or Target Values documents) Target Years Information system for monitoring and evaluation of social protection programs Indicator 1 : is designed and operational Monitoring reports produced for some social protection programs; beneficiary registry Monitoring and program Poverty Reduction reports on key registry designed Value Strategy information and social and functioning; (quantitative N/A monitoring system protection monitoring module or Qualitative) established programs are of the System for produced Evaluating social programs (SUEPPS) completed; evaluation module under design. iv Date achieved 06/30/2005 06/30/2009 06/30/2013 06/30/2013 Comments Surpassed. This indicator was revised in the 2011 restructuring since the (incl. % Government did not have a M&E system in place to be strengthened. achievement) Indicator 2 : Coordination mechanisms defined and in use Value Coordination mechanisms Progress reports (quantitative for the 5th pillar of the for Plan N/A N/A or Qualitative) PRSP defined Implementation Date achieved 06/30/2005 06/30/2009 06/30/2013 06/30/2013 Comments Dropped at restructuring. It was vague and coordination mechanisms were (incl. % included in the PDO indicator to measure the institutional strengthening achievement) outcome. Indicator 3 : Household data collection to identify beneficiaries for Bono 10,000 Value 100,000 101,019 socio- (quantitative N/A N/A surveys economic surveys or Qualitative) completed completed Date achieved 06/30/2005 06/30/2009 06/30/2013 06/30/2013 Comments Surpassed. This indicator was added in 2011 to reflect an additional activity (incl. % included and funded under the AF. The baseline value was 0 in 2011. achievement) Indicator 4 : Targeting mechanism for urban area validated Targeting Targeting methodology and Value methodology manual completed. (quantitative N/A N/A and manual Targeting algorithm or Qualitative) completed designed and piloted Date achieved 06/30/2005 06/30/2009 06/30/2013 06/30/2013 Comments Achieved. Indicator added in 2011 to reflect an additional activity included under (incl. % the AF. Activity was financed by the Government with national resources and achievement) discussed and approved by the Social Cabinet and validated through a pilot test. Indicator 5 : Social Protection Policy finalized and approved by the Social Protection Cabinet Social Protection policy approved by Executive Decree Social PCM008-2012 and Protection published on March Policy 2012. On June 5, finalized and Draft SP policy with its 2013 the Social Value approved by conceptual bases and Protection Policy (quantitative N/A the Social implementation was signed into or Qualitative) Cabinet and instruments law. Strategic Implementatio Implement Plan n of the Social prepared and policy approved by the completed. Social Protection Technical Committee Date achieved 06/30/2005 06/30/2009 06/30/2013 06/30/2013 v Surpassed. Indicator revised in 2011 restructuring (original called for a draft, Comments revised calls for finalization). Not only was the implementation plan prepared, (incl. % but the Social Protection Policy was signed into law, so indicator is considered achievement) surpassed. Indicator 6 : Number of new communities covered by AIN-C program Value (quantitative 0 1,000 1,036 1,038 or Qualitative) Date achieved 06/30/2005 06/30/2009 06/30/2013 06/30/2013 Comments (incl. % Surpassed. achievement) Indicator 7 : Percentage of children under 2 years old who participate in the weighing sessions Value (quantitative 0 90% 94% 97% or Qualitative) Date achieved 06/30/2005 06/30/2009 06/30/2013 06/30/2013 Comments (incl. % Surpassed. achievement) Percentage of children under 2 years old with inadequate growth in two Indicator 8 : successive checkups Value (quantitative 0 30 N/A 21 or Qualitative) Date achieved 06/30/2005 06/30/2009 06/30/2013 06/30/2013 Surpassed. Impact evaluation indicated that some reasons for this were the Comments reduction in the consumption of liquids other than breast milk before 6 months (incl. % and an increase in the consumption of thick soups (with greater nutritional value) achievement) after 6 months. Percentage of children under 2 years old who began to participate in the program Indicator 9 : before 3 months of age Value (quantitative 0 80% N/A 65.40% or Qualitative) Date achieved 06/30/2005 06/30/2009 06/30/2013 06/30/2013 Comments Partially achieved. Achievements were affected by: (i) the interruption of the (incl. % provision of services during the political crisis (June 2009-June 2010); and (ii) achievement) problems with NGOs contracts (December 2011-February 2012). Indicator 10 : Percentage of children exclusively breastfed for 6 months Value Target not (quantitative 83% Target not defined 82.5% defined or Qualitative) Date achieved 06/30/2005 06/30/2009 06/30/2013 06/30/2013 Achieved. The original and AF PADs did not define a target. The baseline was Comments obtained through the first measurement of the impact evaluation. The IE found (incl. % an impact of 4.2 percentage points. achievement) vi Percent reduction in the number of children with reported cases of diarrhea in the Indicator 11 : last two weeks, in beneficiary communities Value 13.64% (quantitative N/A 10.5% 16.80% (Nov. 2010) or Qualitative) Date achieved 06/30/2005 06/30/2009 06/30/2013 06/30/2013 Not achieved. Indicator added in 2011 to measure improvements in health status. Comments Results may be due to increased reporting of diarrhea (better awareness of (incl. % symptoms). Factors leading to increased diarrhea could be out of the Project’s achievement) control (water). Percentage of providers who meet at least 80% of the quality standards for Indicator 12 : service delivery Value (quantitative 0 80% N/A 97% or Qualitative) Date achieved 06/30/2005 06/30/2009 06/30/2013 06/30/2013 Comments Surpassed. There was improvement in the providers’ technical capacity and in (incl. % the central and regional SOH teams as a result of the training provided during the achievement) implementation of the AIN-C program. Indicator 13 : Number of youths who use the SLSS information Service in project areas Value (quantitative 0 800 5,000 9,705 or Qualitative) Date achieved 06/30/2005 06/30/2009 06/30/2013 06/30/2013 Comments (incl. % Surpassed. achievement) Indicator 14 : Number of businesses that offer internships Value (quantitative 0 400 615 689 or Qualitative) Date achieved 06/30/2005 06/30/2009 06/30/2013 06/30/2013 Comments (incl. % Surpassed. achievement) Indicator 15 : Number of youths participating in the First Employment Program (FEP) Value (quantitative 0 6,000 7,100 4,883 or Qualitative) Date achieved 06/30/2005 06/30/2009 06/30/2013 06/30/2013 Comments Partially achieved. Achievement affected by: the higher than estimated cost of (incl. % training; the pace of implementation of pilot; the effects of the 2009 political achievement) crisis and the impossibility to implement the 4th round of training. Indicator 16 : Percentage of youths successfully completing all phases of the FEP Value (quantitative 0 80% 80% 86% or Qualitative) Date achieved 06/30/2005 06/30/2009 06/30/2013 06/30/2013 vii Comments (incl. % Achieved and surpassed. achievement) Indicator 17 : Direct Project Beneficiaries (number) of which female (percentage) Value (quantitative N/A N/A 47% 50% or Qualitative) Date achieved 06/30/2005 06/30/2009 06/30/2013 06/30/2013 Comments (incl. % Partially achieved. This indicator was added during the 2011 AF restructuring. achievement) Percentage of indigenous and Afro-Honduran youths finishing the program, from Indicator 18 : the total registered Value (quantitative 0 N/A 85% 51% or Qualitative) Date achieved 06/30/2005 06/30/2009 06/30/2013 06/30/2013 Partially achieved. Indicator introduced in 2011 to gather evidence on Comments effectiveness of active outreach for Indigenous and Afro-Honduran beneficiaries. (incl. % Information for this indicator was only collected for 3rd round of FEP, (4th achievement) round not completed). Percentage of indigenous and Afro-Honduran beneficiaries, from the total of Indicator 19 : beneficiaries Value (quantitative N/A N/A 15% 9% or Qualitative) Date achieved 06/30/2005 06/30/2009 06/30/2013 06/30/2013 Comments Partially achieved. Indicator introduced in 2011 to gather evidence on (incl. % effectiveness of active outreach for Indigenous and Afro-Honduran beneficiaries. achievement) Information for this indicator was only collected for the 3rd round of FEP. G. Ratings of Project Performance in ISRs Actual Date ISR No. DO IP Disbursements Archived (USD millions) 1 12/02/2005 Satisfactory 0.00 2 03/09/2006 Satisfactory Satisfactory 0.20 3 11/10/2006 Satisfactory Satisfactory 1.29 4 05/10/2007 Satisfactory Satisfactory 2.24 5 12/26/2007 Moderately Satisfactory Moderately Satisfactory 3.35 Moderately Moderately 6 06/26/2008 4.89 Unsatisfactory Unsatisfactory Moderately Moderately 7 11/30/2008 6.21 Unsatisfactory Unsatisfactory 8 06/04/2009 Moderately Satisfactory Moderately Satisfactory 7.62 9 12/13/2009 Moderately Satisfactory Moderately Satisfactory 8.55 viii 10 01/26/2010 Moderately Satisfactory Moderately Satisfactory 9.76 11 06/15/2010 Moderately Satisfactory Moderately Satisfactory 10.50 12 02/26/2011 Moderately Satisfactory Moderately Satisfactory 14.38 13 07/31/2011 Moderately Satisfactory Moderately Satisfactory 16.04 14 02/12/2012 Satisfactory Moderately Satisfactory 17.69 15 09/21/2012 Satisfactory Moderately Satisfactory 19.47 16 04/13/2013 Moderately Satisfactory Moderately Satisfactory 20.44 17 06/25/2013 Moderately Satisfactory Moderately Satisfactory 20.92 H. Restructuring (if any) ISR Ratings at Amount Board Restructuring Disbursed at Restructuring Reason for Restructuring & Approved Restructuring Date(s) Key Changes Made PDO Change DO IP in USD millions Increase the authorized allocation of the SLSS Special 12/11/2007 S S 3.14 Account from US$550,000 to US$900,000 Extension of the closing date to 06/11/2010 MS MS 10.50 May 31 2012. Additional financing (AF)of US$ 3.6 million to support new activities (the development of a targeting instrument for urban areas and implementation of a household survey) in Component 1 and a cost overrun and scaling up of training activities related to the First Employment program in Component 3. The PDO was re- 06/16/2011 Y MS MS 16.00 worded to improve clarity. Project indicators were revised to reflect these changes. Implementation arrangements were changed to make the SSD responsible for the implementation of Project activities and Project oversight for Component 1. The SOP remained responsible for oversight and coordination of the entire Project. Modify the training scheme of 04/12/2013 S MS 20.44 the First Employment program under Component 3 and its ix ISR Ratings at Amount Board Restructuring Disbursed at Restructuring Reason for Restructuring & Approved Restructuring Date(s) Key Changes Made PDO Change DO IP in USD millions implementation arrangements; revise one intermediate indicator target to reflect those changes and change one disbursement category in the Financing Agreement to facilitate disbursement under Component I. In the original Credit: reallocation across disbursement categories. In the 06/19/2013 MS MS 20.91 Financing agreement: Change in one disbursement category to allow financing of activities under Component 1. Cancellation of US$0.51 million from the original credit 06/28/2013 MS MS 20.92 and US$2.66 million from the AF. If PDO and/or Key Outcome Targets were formally revised (approved by the original approving body) enter ratings below: Outcome Ratings Against Original PDO/Targets Moderately Satisfactory Against Formally Revised PDO/Targets Moderately Satisfactory Overall (weighted) rating Moderately Satisfactory x I. Disbursement Profile xi   1. Project Context, Development Objectives and Design 1.1 Context at Appraisal 1. At the time of appraisal in 2005, Honduras was one of the poorest countries in Latin America. Despite modest gains in poverty reduction in the 1990s, the prevalence of vulnerability remained high. For many Hondurans, economic and human development was beyond their reach and the most vulnerable were young children and youth. These groups were exposed to additional risks that increased their probability of being poor. For young children, the critical risk was chronic malnutrition; for youth 15-19 years of age, the risk was the inadequate level of skills due to incomplete and low quality education. The Government of Honduras (GOH) was focused on addressing the challenge of breaking the intergenerational transmission of poverty in the context of the Honduras Poverty Reduction Strategy (PRS), which proposed to accelerate human capital accumulation through integrated social policies targeted to the most vulnerable groups, with complementary social protection interventions. Table 1 below shows the evolution of some key development indicators from Project appraisal to closing. Table 1: Honduras Development Indicators Indicators 2005 2012 Poverty (national) 48% 46% Chronic malnutrition (children 0-5) 30% 23% Anemia (children 0-5 years) 36% 29% Youth unemployment 7% 6.9% For sources and definitions, see Annex 9. 2. The World Bank had been financing IDA operations to support the PRS, and had been working with the Government to develop the analytical and operational building blocks to support public efforts to reduce poverty sustainably. The World Bank’s focus was largely on including young children and adolescents in a social protection policy. The Project built on these previous efforts. 1.2 Original Project Development Objectives (PDO) and Key Indicators 3. The PDO, as stated in the original PAD, was to improve Honduras’ social safety net for children and youth. This would be achieved by: (i) improving nutritional and basic health status of young children by expanding the successful community-based nutrition program (Atención Integral a la Niñez en la Comunidad, AIN-C); and (ii) increasing employability of disadvantaged youth by piloting a First Employment program. The key PDO indicators were:  Coherent institutional structure for policy formulation, planning, budgeting, coordination, implementation and M&E of social protection actions for children and youth in place;  Reduction in the rate of chronic malnutrition of children under 2 years old, by 8 percentage points from the baseline data; and 1  40 percent of program graduates in paid employment or self-employment six months after program graduation. 1.3 Revised PDO and Key Indicators, and reasons/justification 4. In June 2011 additional financing (AF) for SDR 2.3 million (US$3.6 million equivalent) was approved for the Project. The PDO did not change in substance, but it was re-worded to improve its clarity1 and to include the strengthening of the Government institutional and technical capacity in social protection as a component, as follows: to improve the social safety net for children and youth by: (i) strengthening the Borrower’s capacity to administer social assistance programs; (ii) improving nutritional and health status of young children by expanding the AIN-C program; and (iii) increasing employability of at-risk youth by piloting a First Employment program. 5. The key PDO performance indicators2 were revised to read as follows:  Institutional structure for social protection policy formulation, planning, implementation and evaluation is created by Governmental decree;  Reduction in chronic malnutrition for children under 2 years of age participating in AIN-C by 8 percentage points; and  40 percent of program graduates in paid employment or self-employment six months after program graduation. 1.4 Main Beneficiaries 6. The original Project expected to benefit: (i) under Component 1: children and youth as a whole through the strengthening of social safety net interventions; (ii) under Component 2: 35,000 children under two years of age in 1,000 communities who would benefit from the AIN-C nutrition program; and (iii) under Component 3: around 6,000 15-19 year old in urban areas who would benefit from the FEP. With the approval of the AF, additional beneficiaries included: under Component 1: 75,000 families who would be eligible to participate in the CCT program Bono 10,000; and (ii) under Component 3: 2,300 youth to reach a total of 7,100.3 1.5 Original Components The Project consisted of three components: 7. Component 1: Institutional strengthening of the social protection framework for children and youth (US$1.00 million). This component sought to support long-term efforts to create a coherent institutional structure to make policy decisions, coordinate 1 The PDO in the legal agreement was vague: To assist the Borrower in: (i) improving the nutritional condition of children inside its territory (as opposed to those who are poor and vulnerable), and (ii) increasing the job marketability of its disadvantaged youth (marketability is not a term used in social protection, and disadvantaged was not defined). 2 Annex 10 includes a comparison of the original PAD and AF PAD indicators. 3 The actual number of youth participating in the FEP had reached 4,883 due to higher training costs than estimated in the original PAD. 2 implementation and monitor social protection interventions. It had four subcomponents: (i) Social protection policy formulation and coordination; (ii) Instruments to improve the effectiveness of social protection expenditures; (iii) Support to the Secretariat of the Presidency as coordinator of Social Protection Policy and coordinator of the Project; and (iv) Social Audit of Social Protection Programs. 8. Component 2: Consolidation and expansion of the AIN-C program (US$15.0 million of total Project cost). This component aimed to prevent early childhood chronic malnutrition by strengthening the institutional base and expanding coverage of a community-based program of growth promotion and basic health services (AIN-C). It had two subcomponents: (i) Coverage expansion of the AIN-C model; and (ii) Institutional strengthening of the Secretariat of Health (SOH) at the central and local levels. 9. Component 3: First Employment Pilot Program (FEP) for Youth at Risk (US$7.3 million of total Project cost). This component aimed to promote labor market insertion of poor urban youth aged 15-19 who were not enrolled in formal education or enrolled in an alternative education program with a minimum of three years of formal education, or who were unemployed or visibly underemployed through the development and implementation of a pilot employment project. It had four subcomponents: (i) targeting and selection of beneficiaries; (ii) training services and preparation for the labor market; (iii) promotion, dissemination and support for labor market insertion; and (iv) program management and evaluation (see Annex 2 for a description of the subcomponents). 1.6 Revised Components 10. While the Project’s general components were not changed with the AF some new activities were introduced. Under Component 1: (i) household data collection to identify eligible beneficiaries for the Bono 10,000 program4 financed under the Social Protection Project (P115592); and (ii) the provision of technical assistance for development of the targeting methodology for urban areas to receive the CCT. In Component 3: drawing lessons from the first three rounds of the FEP, the age limit to select beneficiaries was increased to 21 years old and the requirement to be enrolled in a program of alternative education was dropped (to include as participants in FEP youth who were not enrolled due to lack of access, while still encouraging enrollment in formal education). The 2013 restructuring (see paragraph 13) also added new activities to Component 1, namely consultancies to consolidate the social agenda for the transition to the new Government in 2014. 1.7 Other significant changes 11. Original credit (P082242; Cr. No. 4097-HN). The original Credit (SDR13.3 million or US$20 million equivalent) was approved in July 2005 and became effective in February 2006. The credit was amended in December 2007 to increase the allocation of 4 See footnote 5. 3 the Special Account of the Secretariat of Labor and Social Security (SLSS) and in June 2010 to extend the closing date to May 31 2012. 12. Additional financing (P126158; Cr. 4964-HN). The AF appointed the Secretariat for Social Development (SSD) as the implementation agency for Component 1; revised Project indicators; adjusted targets, and added indicators to measure new activities in Component 1 and improvements in health status of beneficiary children; and extended the closing date to June 30, 2013. 13. The AF was restructured in April 2013. Changes to Component 3 included: switching the implementation agency for the training scheme of the FEP from the Advisory Center for Human Resource Development (CADERH) to the National Institute for Professional Training (Instituto Nacional de Formación Profesional, INFOP); condensing the length of the technical and life skill training for the fourth round and making the internship optional,5 and revising the target in the indicator for number of business offering internships. Regarding Component 1, the restructuring changed a disbursement category to allow financing of new activities6 to strengthen the social protection framework: key studies on social protection topics (citizen participation, services for indigenous populations, efficiency of public expenditures in social protection), a National Forum on Social Protection, and a strategy for the sustainability of social protection. 14. Restructuring in June 2013. The Project was restructured again on June 19, 2013. This restructuring included the key elements of the April 2013 restructuring for Component 1 as well as cancelations of funds in light of the impossibility to implement the training under the fourth round of the FEP because the condition of effectiveness of signing the subsidiary agreement with INFOP was not fulfilled. It involved: (i) a reallocation of expenditures among disbursement categories under the original Credit; (ii) a change in a category to allow disbursements under Component 1 of the AF, explained in paragraph 13, and (iii) a cancellation of funds under both Credits. AF funds for US$2.6 million under Component 3 were cancelled and an additional US$50,000 was cancelled from Component 1, since the SDS found alternative resources to fund the Social Protection Forum.7 A total US$105,000 from the original Credit was cancelled as well. 5 Though not best practice, given the short time left to implement the fourth round of the FEP, it was not possible to maintain the mandatory internship. Instead of eliminating it altogether, the internship was made optional and allowed to continue beyond the end of the fourth round of training. Participating youth would still receive support and advice about job search and job placement through the SLSS during training. 6 The Government financed the development of an urban targeting methodology with national resources, leaving resources available under Component 1 for other activities. 7 A Social Protection Forum took place in Tegucigalpa in June 2013 with participation of other countries in the LAC region and national stakeholders. 4 2. Key Factors Affecting Implementation and Outcomes 2.1 Project Preparation, Design and Quality at Entry 15. Solid background analysis and preparation. Project preparation was based on thorough analysis and knowledge of the country’s context.8 Government commitment9 was adequate, led by the Secretariat of the Presidency (SOP), which was coordinating the social protection agenda at the time. Stakeholders were involved in Project preparation through the social assessment carried out as part of preparation. The preparation took into account that elections were due in 2005 and a new government was going to implement the Project. The PAD included many effectiveness conditions that could have substantially delayed Project implementation. Some of them were key, such as the definition of detailed implementation plans for each component, the operational manual as well as the strengthening of the project execution units in each secretariat. Despite this shortcoming at design, effectiveness was not substantially delayed thanks to the Government’s commitment and the World Bank’s support. 16. Sound though complex Project design. The PDO was well chosen, aligned with the Government and country’s priorities and in line with the Poverty Reduction Strategy. The Project’s components were adequate, as well as the activities to achieve the PDO. However, Component 1 lacked definition of specific activities, which would result in slow implementation later. In addition, the Project design was complex; institutional arrangements were challenging and complicated, given the number of institutions involved in implementation and their weak capacity. 17. Lessons learned were incorporated into the Project’s design. Lessons from youth programs in the region (Chile, Peru, Colombia) were taken into account when designing the pilot for the FEP. These included the incorporation of life and vocational skills, effective targeting and internship as a sign of training pertinence. Lessons from the pilot experience regarding the AIN-C program were taken into account as well. These included the importance of: (i) adequate targeting to improve the program’s impact; (ii) developing an institutional structure to supervise the program; (iii) training and refresher training; and (iv) periodic evaluations to better understand the programs implementation, its outcomes and impacts. 18. Risks were adequately assessed during preparation. The World Bank identified overall weak implementation capacity of the Honduran Government and identified mitigation activities. It foresaw the need to support intensely all of the administrative units responsible for Project implementation throughout the life of the Project. It also acknowledged the need for the use of third parties to implement the Project, easing the burden of the implementing agencies. In the case of Component 2, it opted for working with NGOs to implement the AIN-C package; in the case of Component 3, it opted for working with an institution to provide the training courses and the administration of the training contracts. The World Bank and the Borrower started with pilots for the AIN-C 89 , See Annex 9 for a list of background documents used during Project preparation. 5 and the FEP to consolidate the institutional arrangements, before scaling up these interventions. 2.2 Implementation 19. Strong government commitment to the social protection agenda. Throughout the life of the Project, the various Government administrations showed commitment to consolidating and advancing the country’s social protection agenda, in particular for children and youth, by overcoming the difficulties faced during implementation after elections in 2005 and 2009, the suspension of implementation during the 2009 crisis, and the 2010 change of Government. 20. Piloting activities allowed for feedback loops and improvements during implementation. In the case of Component 3, each round of the FEP introduced changes and innovations, incorporating lessons learned during implementation. During the first round, the training centers (Centros de Entrenamiento y Capacitación, CECAPS) showed low capacity to offer a diversity of courses to meet the expected quota and labor market needs. This was overcome in the next round through closer work with each participating CECAP before they would prepare their offers of courses and a more aggressive information campaign. The SSLS developed a system to assess the performance of the CECAPs and to control payment to beneficiaries, improving the FEP effectiveness. Other changes included closer coaching of participants, introduction of psychological counseling, life skills training and greater involvement of the CECAPs. In the 3rd round of the FEP, the CECAPs led the beneficiary selection process and promotion activities to capture beneficiaries. Promotion activities became more local and alliances were developed with institutions working with youth and indigenous organizations. In the case of the AIN-C, a systematization of experiences of implementing the program with NGOs was carried out after the first year of implementation of the program, capturing the main factors that had helped and hindered the achievement of the programs goals and contributing to introduce mitigating measures in the subsequent rounds. 21. The political crisis stalled implementation. In June 2009 a political crisis began when the President was removed from office, and an interim administration held office until elections five months later. The World Bank suspended disbursements to the country during that period. Though the political crisis lasted six months, it affected the Project’s activities for a longer period of time, given that AIN-C and FEP were exclusively financed by the Project. In the case of Component 3, it disrupted the third round of the FEP. The first phase of the FEP started in June 2009 and could not conclude until April 2010. This delay increased dropouts, which reached 30 percent of the initial enrollments. In the case of Component 2, it interrupted the provision of services to communities. Contracts with NGOs were put on hold after having been signed in May 2009, restarting in January 2010. One of the NGOs opted not to continue implementation as a result of this pause, due to the cost for the NGO to start anew the work in the communities. 6 22. Weak institutional capacity, combined with complex implementation arrangements and budget management, delayed implementation. The SOP, SOH and SLSS were weak at preparation, though they were strengthened as a main focus of the Project. They were the agencies with the mandate to carry out activities in their areas and thus with all of the institutional and political support to carry out the Project. The SOP, through the UNAT (changed to UAP) was responsible for overall Project coordination. It collaborated with the Consultative Council (Consejo Consultivo) which included civil society and other secretariats. The SOP led the Social policy and the Social Protection Strategy, a pillar of the PSRP. Once the SSD was established, responsibility for part of Component 1 was moved to that secretariat, although the SOP remained as overall Project coordinator. Because of weak capacity, implementation was slow at the beginning. In the case of SOH, there were internal bottlenecks due to the slow operation of the UECF, the uncertainty regarding the contracts of the program team that were month to month and complex coordination within the SOH for procurement processes. Moreover, Credit resources had to be incorporated into the national budget’s quotas of the implementing agencies before they could access them. This delayed implementation by up to four months, since the executing agencies delayed some Project activities until they were certain that the resources would be made available. 23. Initial lack of defined priorities regarding Component1. During the first years of implementation (2006-2008) the SOP had difficulties in identifying concrete activities which could contribute to strengthen its capacity to administer social protection programs, the main objective of Component 1. There were constant changes of priorities and activities. This was due in part to the steep learning curve the Government experienced to develop an integrated social protection strategy and to establish the Secretariat for Social Development in 2009. Performance of this component improved after the mid-term review in October 2008, when the Government and the World Bank agreed to define concrete products for this component. After surpassing its goals (see section 3.2), the AF expanded the scope of this component’s activities to support the implementation of the Bono 10,000. 24. Change in the implementation arrangements under the FEP derailed implementation of the fourth round of training. As a result of an increase in CADERH’s costs, the SLSS requested the World Bank’s approval for the SLSS PCU to carry out the training activities. After having approved this option in early 2012 and modifying the Operational Manual, the World Bank and the Government deemed bidding processes to hire the CECAPs to be too complex and therefore not feasible. In June 2012, the SLSS requested that INFOP provide the training, aiming to reach the target for trained youth set in the AF. The World Bank and the SLSS worked together from June 2012 to March 2013 to assess alternatives and address the challenges associated with this choice of implementation partner. The main obstacles revolved around the contract for INFOP, which were amply discussed between May and September 2012. In September 2012, the World Bank indicated that INFOP, being a public institution, was not eligible to be hired as a consultant to execute the Project and instead, a subsidiary agreement needed to be signed, the Project restructured, and INFOP’s fiduciary capacity assessed by the World Bank. The World Bank conducted the fiduciary assessment in October 2012 and its 7 findings were discussed with the Government over the subsequent months. The full restructuring process took a long time and was finally completed in March 2013. In the end, this proved too late to implement the fourth round of FEP before the Credit closing. 2.3 Monitoring and Evaluation (M&E) Design, Implementation and Utilization 25. Monitoring and Evaluation was considered moderately satisfactory in the design phase and improved during implementation. The design of the results framework began during project preparation, with some weaknesses. During implementation, monitoring systems were established or strengthened and baseline studies and evaluations were conducted, providing important information on Project results. Design. 26. Overall, the results framework was moderately satisfactory, though the PDO was too broad and the outcome indicators presented some weaknesses in terms of measuring outcomes that could be attributable to Project interventions. Monitoring and evaluation systems were under preparation in each of the three implementing agencies at the time of approval and they were to be supported by the Project, as all components included activities to build up and strengthen the information systems. The PAD indicated that an M&E system would generate reports on the physical and financial progress of each component prepared by the SOH and SLSS, they would be consolidated and would collect data and allow analysis of outcomes. The SOP would coordinate with line ministries as the ultimate responsible agency for the social protection strategy and the Project’s implementation. The PAD also indicated that the Project was to finance baselines studies and impact evaluations for Components 2 and 3. Implementation. 27. Monitoring systems were established or strengthened in the implementing agencies. The Project supported the creation of a Project monitoring system in the SLSS that was later used by the management evaluation and planning unit (UPEG) in the SLSS to monitor other projects at institutional level. An information system (SIME) was established to monitor and evaluate the implementation and outcomes of the AIN-C. Providers and SOH staff at decentralized levels were trained on its use. The Project supported the SSD in the development of a monitoring and evaluation system for the social protection policies and programs. 28. Baseline studies and evaluations were carried out for the AIN-C and the FEP programs. The SOH and the SLSS monitored the activities of the components they were implementing, and presented regular progress reports. The SLSS gathered information on the youth participating in 1rst and 2nd rounds of the FEP and monitored the labor market insertion of FEP participants. A more complete baseline was prepared to carry out an evaluation of the 3rd round of FEP (a longitudinal study10) based on information of 1,270 10 Descriptions of the methodology of the FEP longitudinal study and of the AIN-C impact evaluation are included in Annex 11. 8 FEP participants and 880 young people as the control group. Personal, socio-economic, and labor data; job insertion; quality of employment; and life skills behavior of participants were captured. The evaluation’s findings served to design the fourth round of FEP and its main findings are included in sections 3.2, 3.3 and Annex 2. An impact evaluation (IE) of the AIN-C program was carried out between 2010 and 2012 to measure the program’s outcomes. Using a quasi-experimental model, it was based on a sample of 9,000 children under two years old who participated in the program. Four measurements were done to gather data, using well-structured questionnaires. Information was gathered on height, weight, hemoglobin, household characteristics, infrastructure, wealth, mothers’ education, and knowledge of nutrition and healthcare. Its main findings are included in section 3.2 and Annex 2. 29. Systematization of experiences were prepared as well for the AIN-C and the FEP programs to capture know-how on the implementation, challenges and lessons on the programs. Key findings are included throughout this ICR, in particular in section 6. Utilization. 30. The SLSS used the key findings from the evaluation and systematization of experiences of the three rounds to introduce changes to the fourth round of the FEP, as mentioned in paragraph 26. Changes were related to the type of courses, monitoring, and administrative aspects to improve the FEP as a training program. Changes to the enrollment, administration and monitoring system for the fourth round. These improvements to the program could not be tested, as the fourth round of training was not implemented. The SOH used the information captured through the SIME and through the monitoring of the providers’ contract to better implement the AIN-C program. 2.4 Safeguard and Fiduciary Compliance 31. Indigenous Peoples. An IPDP was prepared and agreed upon with the SOH and the SLSS. In the 3rd round of the FEP,11 in order to fulfill the safeguard commitment, changes were introduced to the enrollment documents to capture information and monitor participation of ethnic youth. Promotion activities were locally focused and the SLSS and the CECAPs worked with local indigenous and afro-descendant organizations to identify and reach indigenous youth in La Ceiba, Tela, San Pedro Sula and La Esperanza, resulting in enrollment of Lenca, Chorti, Garifunas and Misquitos beneficiaries. In the 3rd round, 206 ethnic youth enrolled in the FEP, 189 took the training, 96 completed the training and 39 were employed six months after training completion. For the 4th round, two intermediate indicators were specifically introduced to monitor participation and retention of indigenous and afro-Hondurans youth. The SLSS collaborated with the Secretariat for Indigenous and Afro-Honduran People (SEDINAFROH), the National Education Program for Indigenous and Afro-Honduran People (PROHEEAHH), the Organization for Ethnic Community Development (ODECO) and the Program for the 11 For the 1rst and 2nd FEP rounds, which were small pilot rounds, participation of indigenous and afro-Hondurans was not monitored. The 1rst round took place in San Pedro Sula and Tegucigalpa with participation of 320 youth. The 2nd round took place in five urban areas. 9 Integral Development of Autochthonous People (DIPA) to coordinate and tailor the program (enrollment, promotion, etc.) to better target these youth groups. 32. In the case of the AIN-C program, the Program was implemented in multi-cultural geographical areas, where 30 percent of the population was Lenca and Chorti and 50 percent from Lenca tradition. The SOH carried out a study to prepare a module to train providers and SOH staff. The study included the traditional feeding and medical practices in caring for pregnant women, newborn and young children among the Maya Chorti and Lenca. The program took this into account in its design to reach all of the population in a culturally adequate strategy. 33. Procurement. Procurement was slow throughout the Project in particular during the first two years of implementation, suffering from slow bidding and contracting processes. Procurement delays affected the Project’s implementation, especially in the early years in Component 2 and were a major cause for extending the closing date of the Project in 2010. The fact that there were three procurement teams in three PCUs in three different implementing institutions in a country with weak institutional capacity was challenging. Internal bureaucracy, political interference and lack of previous experience in working with the World Bank or other international agencies contributed to slow and bumpy procurement that affected implementation. Thanks to continuous training and emphasis on using the Annual Action Plans to guide the procurement activities contributed to improvements in performance and to the successful use of most of the credit’s resources and to the establishment of well trained and capable procurement teams in each of the implementing agencies by Project completion. Unfortunately there was a cancellation of funds before closing (see paragraph 1.7). 34. Financial Management. There were weaknesses in financial management in the first two years of implementation during which performance was considered moderately satisfactory. Performance improved through Bank’s technical assistance and action on the part of the implementation agencies to improve their internal controls. 2.5 Post-completion Operation/Next Phase 35. The SOP led the preparation of studies, financed by the Project and completed in June 2013, to prepare a transition agenda to the Government, which will take office in January 2014. The studies summarize the achievements in social protection to ensure continuity of human development policies in Honduras. A Social Protection (SP) Project (Credit No. IDA 5294-HN; P115592) is being implemented which includes strengthening national capacity to administer social protection programs focusing on the management of the CCT program Bono 10.000. Additional financing for the SP project was approved in July 2013, to scale-up the CCT program by targeting rural areas and strengthened management in rural areas. A Rapid Social Response (RSR) grant is under implementation until December 2013 in support of the AIN-C Program. It finances a pilot of early childhood stimulation, the provision of powdered micronutrient supplements, training, mobile technology for data collection, and dissemination activities. The FEP is not being continued by the SLSS due in part to a change of priorities of the new Minister, 10 who took office in 2013. Nevertheless a 40 million-Euro program inspired by the FEP will be implemented by SEPLAN, INFOP and the German Cooperation to provide job training to 2,500 youth at-risk and 100 professionals, in cooperation with key Honduran public and private institutions. This indicates that the FEP pilot has had a powerful impact despite not being continued by the SLSS. 3. Assessment of Outcomes 3.1 Relevance of Objectives, Design and Implementation Rating: Substantial 36. The relevance of the PDOs is considered high. As illustrated by table 1 (section 1.1.), the PDO remains in line with the country’s sector priorities as stated in the Visión de País 2010-2038, the Plan de Nación 2010-2022, the Plan de Gobierno 2010-2014 and the PRSP. The PDO is in line with the Plan de Nación 2010-2022 social goals to eradicate extreme poverty, to improve social protection system, to reduce vulnerability among its population and to develop opportunities of quality employment. The PDO is in line with the strategic and specific objectives of the Social Protection Policy, approved by the Government in 2012. They are in line with the Country Partnership Strategy 2010- 2015 (Report 63370-HN) which has as one of its strategic objectives the expansion of opportunities through the reduction of vulnerabilities and as one of the key results the consolidation and strengthening of the social protection system. 37. The relevance of design is considered substantial. The components were well chosen to achieve the PDOs, despite not having defined all activities designed upfront for Component 1. The relevance of implementation is considered substantial with shortcomings. The World Bank worked with the Borrower to adapt to the institutional changes in the country with the creation of the SSD which became the implementing agency for Component 1, the introduction of new activities related to the CCT program supported by another Bank Project, and the support for the preparation of the strategic transition agenda. The World Bank and the Borrower built on the implementation of activities on the FEP to expand the program and incorporate lessons learned in the previous rounds of training. Despite the positive implementation performance for a substantial part of the life of the Project, the World Bank and the Borrower did not succeed in overcoming the difficulties arisen by the change in the implementation arrangements under the FEP, which resulted in the fourth round of training not taking place and a lost opportunity to contribute to the institutionalization of the Program. 3.2 Achievement of Project Development Objectives Rating: Moderately satisfactory 38. Out of the three PDO indicators, one was fully achieved and even surpassed, and two were largely achieved (reaching more than 75 percent achievement). Out of 18 11 results indicators,12 12 were fully achieved or surpassed, five were partially achieved, and one was not met. Table 2 shows the Project’s achievements for each PDO indicator, measured by the key performance indicators. Table 2: Honduras Nutrition and Social Project - Outcome Indicators Outcome/Indicator Target Achievement (i) Strengthening the Borrower’s capacity to administer social protection programs Institutional structure for social SSD created with a mandate to Achieved and surpassed. SSD protection policy formulation, coordinate, design, implement with a mandate to coordinate, planning, implementation and and evaluate social policy design, implement and evaluate evaluation is created by social policy created and fully Government decree operational. (ii) Improving the nutritional and health status of young children by expanding the AIN-C program Reduction of chronic malnutrition Reduction of 6 percentage points Largely achieved. Reduction of for children under 2 years of age from baseline (over two years) 4.7 percentage points for children participating in AIN-C exposed for average of 1 year. Achieved 78% of two-year target of 6pp and out-performed annualized target of 3pp for one year of treatment. (iii) Increasing employability of at-risk youth by piloting a First Employment Program (FEP) Percentage of program graduates 40% Largely achieved. Graduation in paid employment or self- increased from 0 to 30%, which employment 6 months after is 75% achievement overall. Program graduation Strengthening the Borrower’s capacity to administer social assistance programs 39. By Project completion the institutional capacity in Honduras to administer social assistance programs had significantly improved. An adequate institutional structure for social protection policy formulation, planning, implementation and evaluation was in place, including the Secretariat of Social Development (SSD), created by Decree 193- 2009, which is responsible for coordinating, designing, implementing and evaluating social policy. The SSD led the formulation of the Social Protection Policy, approved by decree (PCM 008-2012) on March 8, 2012 and signed into law in June 2013. Before Project completion, the content of the policy was disseminated to government and civil society organizations, and at the central and regional level. Furthermore, an action plan to operationalize the social protection policy was developed and is under implementation. The SOP also was strengthened through the creation of the Presidential Technical Support Unit (Unidad de Apoyo Técnico Presidencial, UATP) by Decree in 2010. This unit provides support to the President within the SOP in public policy, governance, and policy implementation cycles. 40. Within this institutional framework, the National Information Center for the Social Sector (Centro Nacional de Información del Sector Social, CENISS) has been established 12 Note that one intermediate results indicator, “Coordination mechanisms defined and in use,” was dropped, leaving a total of 18. 12 and strengthened. The CENISS includes a Single Registry for Beneficiaries (RUB) and the Registry for Institutions (ROI). An information system for social policies, the Social Public Policy Single Evaluation System (Sistema Único de Evaluación de Políticas Públicas Sociales, SUEPPS), has been developed and is being implemented. The Project contributed to strengthen the management of social protection programs by providing support and technical assistance to the SOP and the SSD, including: (i) defining SSD’s functioning and structure; (ii) consultations to prepare the Social Protection Strategy and its Implementation Plan; (iii) revising the competencies of existing public institutions with responsibility in social policies design; and (iv) design of the SUEPPS and CENISS. Improving nutritional and health status of young children by expanding the AIN-C program 41. The health and nutritional status of young children in 1,038 communities in six departments (Copán, Intibucá, La Paz, Lempira, Ocotepeque and El Paraíso) where the AIN-C Program was implemented, improved by Project completion. The program’s Impact Evaluation (IE) shows the AIN-C strategy had considerable impact in educating mothers, improving their behavior towards their young children regarding feeding, micronutrients, and exclusive breastfeeding. These changes resulted in significant improvement in the growth of children two years of age and younger, measured by chronic and acute malnutrition indicators. The AIN-C strategy also increased the knowledge of caretakers in prevention and treatment of diarrhea and acute respiratory illnesses (ERA).13 42. The AIN-C Program resulted in a reduction in chronic malnutrition, or stunting. The impact evaluation found a 4.7 percentage point reduction in chronic malnutrition among children under-two who benefited from the program for an average of one year.14 The target was established for a two-year period, with 6 percentage-point reduction for two years of treatment. Adjusting this target for a one year reference period, the adjusted annualized target would be a reduction of 3 percentage points for one year of treatment. Therefore, the impact of 4.7 percentage points achieved 78 percent of the two-year target of 6 percentage points and out-performed the annualized target of 3 percentage points for one year of treatment.15 Underweight in Honduras was reduced by 3.1 percentage points and risk of acute malnutrition was reduced by 4.6 percentage points for children under two with an average of one year exposure. 43. The Project contributed to these outcomes through the financing of the consolidation and expansion of the AIN-C Program in 1,038 communities, surpassing the target of 1,000 communities. NGOs were hired to provide the AIN-C services in six 13 The IE indicated, however, that this knowledge did not translate into lower prevalence rate for these diseases. Some reasons for this could be the higher reporting of diarrhea cases by mothers and increase in diarrhea due to factors out of the Project’s control such as contaminated water. 14 Reasons for this are: (i) the impact evaluation was delayed by the political crisis, so its duration was shortened, and (ii) the evaluation captured children from the age group 0-2 years who were entering and exiting the program based on their age – overall the average participation of these children was one year., 15 Note all measurements cited here use the National Center for Health Statistics (NCHS) growth reference, The IE used both the NCHS reference and WHO standard. Using the WHO standard, the reduction in chronic malnutrition was 6.7 percentage points, but this result is not statistically significant. 13 departments with high poverty levels. A total of 3,530 monitoras were trained and 36,766 children under 2 years of age participated. The Project also strengthened the institutional capacity of the different levels of the SOH and of the health institutions providing the prevention services and the consolidation and expansion of the community based program, as described in section 3.5. Increasing employability of at-risk youth by piloting a First Employment program 44. The FEP contributed to improve employability and social inclusion of the youth at risk who participated in the program. The FEP provided training courses and internships to youth at risk 15-19 years old in three rounds of training; however, the fourth round of training was cancelled. Participants built technical and life skills, enhancing their opportunities to access the labor market as they completed the program better prepared to meet labor market demand and more knowledgeable of employment opportunities. Table 3 summarizes the key achievements of the program: Table 3: FEP achievements by round 1st round 2nd round 3rd round 4th round Indicator Sept 2006- (June 2007- (Sept 2008 - (cancelled Total* Oct 2007) Aug 2008) Mar 2011) 2013) Percentage of participants employed 8% 49% 32% 0 30% 6 months after the program (average) Number of participants (selected and 321 1,514 3,048 2,300 4,883 enrolled) Number of participants who 286 1,321 2,602 0 4,209 completed the training and internship (89%) (87%) (85.3%) (87%) improving their knowledge of labor demand and labor market Number of youth who participated 254 1,153 1,535 0 2,942 FEP, did not get a job and benefited from intermediation services from the SLSS through the Servicio de Orientación de Empleo Firms providing internships 47 211 215 142 473 Average number of hours per youth 260 280 330 0 worked during the 2-month internship Number of participants certified (% 122 548 1,646 0 2,316 of those who completed the training) (43%) (42%) (63%) Number of courses 22 174 493 0 689 -offered by the 65 CECAPs - 18 90 139 247 taught at the 65 CECAPS *Total excludes fourth round since this was cancelled. 45. The Project contributed to this outcome by financing the implementation of the FEP program in three rounds. It provided support to the SLSS to carry out the activities to target, select and enroll the beneficiaries and supported the changes and improvements in each round to better target and enroll the beneficiaries. It provided resources to contract CADERH to manage the youth training process. It also financed a stipend which was paid to the beneficiaries upon enrolling in the training. The Project contributed to 14 institutional strengthening, supporting the construction of the monitoring and evaluation system to follow up beneficiaries and strengthening the SLSS as explained in section 3.5. 3.3 Efficiency Rating: Modest 46. Actual Project costs, based on data from the SLSS, were in line with the PAD estimates for Components 1 and 2 (see Annex 1). However, the cost of training was underestimated for Component 3, in part due to the higher number of hours of training received by the participants (see table 2, Annex 3) and to the extension of the third round due to the political crisis.16 The higher cost resulted in a lower than expected number of adolescents trained, though the cost of training was gradually lowered from approximately $1,404 in the first round to $1,048 in the third round, or by 25 percent (see Annex 3). 47. Overall, however, the Project achieved its outcomes and targets, surpassing many of them, within the credit resources approved. Efficiency was limited by a longer than planned implementation period, in part due to factors out of the Government’s control (e.g. the 2009 political crisis) and in part due to factors related to weak institutional capacity and lack of experience of working with the World Bank. 48. The ICR team reviewed the economic analysis both at preparation and at the time of AF to assess the economic rationale of the Project at the time of completion. In the case of the FEP, the economic rationale for investing in youth at risk in Honduras remains valid based on two considerations: (i) participants improved their employability through the training received; and (ii) the labor market insertion of youth who neither work nor study would diminish the probability of them engaging in risky behavior. The evaluation of the 3rd round of the FEP provided some findings relevant to the economic analysis related to the direct and indirect benefits of the Program: (i) while direct benefits were realized by those participants employed six months after the program, the beneficiaries’ ability to find a job was affected by the political crisis and marked by national legislation limiting employment opportunities for people in their age group; (ii) the average salary for beneficiaries was higher than the national average for that age group (15-19 years old); (iii) the Program had positively impacted their personal, family and professional lives, as they perceived it; and (iv) only 20 percent of the participants in the study had found work in the area they were trained on. Annex 3 includes comparative information on salaries and cost with the control group and by training provider. 49. The IE of the AIN-C Program highlights some of the impacts of program implementation in participating communities (included in Annex 3), as well as the cost of the program by areas of intervention. The results suggest that the community-based approach has been effective in changing feeding and caring practices, resulting in improved nutritional outcomes. According to an analysis by the World Bank on the costs and benefits of community-based nutrition programs, changes in behavior in mothers and 16 Informe Final de Cierre del Programa FEP. June 2013. SLSS. The actual hours of training were determined by the courses offered by the training institutions in each of the rounds, as indicated by the SLSS. 15 caretakers are estimated to bring benefits of US$53-153 per disability-adjusted life-year (DALY) saved.17 This suggests that the impacts of AIN-C carry important positive consequences. 3.4 Justification of Overall Outcome Rating Rating: Moderately Satisfactory. 50. The overall outcome rating is considered moderately satisfactory. While the relevance of objectives remains high and relevance of design is substantial, there were shortcomings in implementation. On the positive side, the outcome was deemed to be in the range of "satisfactory" because (a) the relevance of objectives remains high; (b) the relevance of project design is substantial; and (c) the goal for strengthening the capacity of the Government to manage social protection programs was surpassed. The overall outcome rating is "moderately satisfactory" because implementation was more complex than envisaged. Also, the achievements regarding the reduction in chronic malnutrition and increase in employability of youth at-risk targeted by FEP fell somewhat short of the goals set, due in part to disruption of the 2009 political crisis, and, for the employability target, in part due to the cancellation of the fourth round of training, leaving 2,300 beneficiaries untrained and missing the chance to better streamline the achievements of FEP within the SLSS. Other shortcomings justifying the moderately satisfactory rating are: (i) the longer than planned implementation time; and (ii) the significantly higher than foreseen budget costs to the World Bank. 3.5 Overarching Themes, Other Outcomes and Impacts (a) Poverty Impacts, Gender Aspects, and Social Development 51. The AIN-C Program was implemented in six of the poorest departments of Honduras. It focused on vulnerable populations in remote rural areas. It contributed to improve knowledge and behavior of women through monthly growth monitoring and with the support provided through the monitoras and the health staff with whom they worked. Social capital was built through the training of the monitoras, who accompany women in their communities in the prevention of malnutrition and illnesses in young children. The AIN-C Program contributed to improve the eating habits in these communities and fostered the use of local products in their diets. 52. The FEP has contributed to improve the human capital in a group of youth at risk. The program focused of adolescents who had low levels of skills to enter the job market or who were out of school. The FEP benefited in similar scale male and female students. (b) Institutional Change/Strengthening 53. The Project contributed to strengthen the three implementing agencies (SOH, SLSS, SSD) and the SOP through technical assistance and training. Significant institutional strengthening took place though the preparation of the four rounds for the 17 World Bank, 2010. Scaling Up Nutrition: What Will it Cost? 16 FEP and with the implementation of three of these rounds. Also, the Project provided support to define core competencies and functioning of the SSD and support for AIN-C contributed to significant institutional building at the central, regional and local level in the SOH. (See Annex 12 for more details.) 3.6 Summary of Findings of Beneficiary Survey and/or Stakeholder Workshops 54. The qualitative aspect of the Impact Evaluation for the AIN-C captured feedback from the mothers participating in the program on the access, transmission and application of the knowledge and training provided by the monitoras and health promoters. It captured the views of the monitoras, SOH personnel, and health promoters on the implementation of the strategy (see Annex 5 for more details). Components 2 and 3 carried out focus groups to gather feedback from beneficiaries and to systematize the Project’s experiences. The main findings are in Annex 5. 4. Assessment of Risk to Development Outcome Rating: Moderate 55. The risk to the development outcomes is considered moderate. There are clear solid factors contributing to sustaining the Project’s achievements. The Social Protection Policy was passed into Law, strengthening it as a national policy, beyond a single administration’s mandate, and its implementation plan is underway. The Government prepared strategic papers on relevant topics of the social protection agenda, as part of the transition preparation for the next administration. The SSD is well established within the Honduran institutional landscape to manage social protection programs. The SUEPPS continues to be developed to provide Honduras with a functioning monitoring and evaluation system for social protection policies. 56. AIN-C is streamlined into the national program for integrated childhood assistance. Standards for this program were established and implemented and they are being implemented by other organizations supporting AIN-C. Since Project completion, the program has continued working through the cooperation between the SOH at central and decentralized level and the municipalities, though without resources for the monitoras or health workers (promotores). AIN-C has been consolidated as a model to provide preventive support for mothers and children in rural areas, education and results-based health service provision agreements.18 57. The SENAEH has been strengthened through the establishment of the Employment Orientation Service (Servicio de Orientación de Empleo) and the Citizen Assistance Service (Servicio de Atención al Ciudadano, SAC) within it premises. 18 Under the RSR grant, the Secretaries of Health and Education signed a collaboration agreement through the program EDUCATODOS to increase the level of education of mothers, monitoras and parents of the beneficiary children. The aim is to increase the level of education among these to facilitate learning and acquisition and application of the content of the training provided under the AIN-C. 17 58. There are, however, some risks to the sustainability of the outcomes achieved. In the case of the AIN-C Program, the cost of the initial training provided to the monitoras and the materials produced make the first year of the program expensive. The AIN-C Program as supported by the Project included goods for which financing would be needed. The Program can work without these as well. After the Project’s completion, the program will not be implemented through NGOs, but instead through the SOH department and local levels. 59. Failing to implement the fourth round of the FEP prevented the SLSS from piloting the work with INFOP and has tested the functioning of the employment support program through a public institution which could have contributed to its sustainability. There are risks to the institutional strengthening achievements within the SLSS as the know-how and the monitoring systems developed for the FEP were not properly handed over within the SLSS before Project completion. 5. Assessment of Bank and Borrower Performance 5.1 Bank Performance (a) Bank Performance in Ensuring Quality at Entry Rating: Moderately satisfactory 60. The World Bank’s performance in ensuring quality at entry was moderately satisfactory. The Project was in line with the country’s development priorities and the World Bank’s CAS at the time. A sound and thorough analysis of the country and sector context was carried out at preparation. Assessment of risk was adequate, identifying weak institutional capacity at the SOH and SLSS as factors of high risks. The World Bank worked with the Borrower during preparation to propose arrangements to overcome the risks identified during preparation. The World Bank aimed to strengthen those institutions which had the mandates to carry out the Project activities. 61. The main shortcomings were: (i) the complexity of the implementation arrangements, despite knowing the agencies’ weaknesses; and (ii) the number of effectiveness conditions, most of them important for the readiness for implementation. This reflected a lack of readiness to execute, with substantial information gaps (there were no baselines for Components 2 and 4 or detailed information for the implementation plans for each component). Despite this, effectiveness was not substantially delayed. (b) Quality of Supervision Rating: Moderately satisfactory 62. The World Bank carried out regular supervision missions, well-staffed during which it provided quality technical assistance to the Borrower. The Bank used the supervision missions to adjust the Project’s activities to better achieve the PDO. The mid- term review was used to propose adjustments to Project activities to achieve targets and outcomes. The World Bank provided substantial technical assistance and training to the 18 implementing units within each of the Secretariats to become acquainted and proficient on World Bank fiduciary procedures. The World Bank supported the country’s efforts by supporting the preparation and approval of additional financing for the Project, in the context of satisfactory implementation. The Project was led by four task managers and transitions were overall smooth. However, changes in the procurement team affected implementation as they brought changes of interpretation to the procurement practices the Project had been applying. 63. The main shortcoming during supervision was the lack of effective coordination within the Bank team to provide a timely and clear response to the Borrower’s request to change the implementation arrangements for the FEP. The World Bank and Government explored several alternatives to implementation (for example, moving FEP to another Project with a longer implementation period); however, these were not deemed feasible. The World Bank took longer than desirable to provide guidance to the Borrower on changing the implementation arrangements of the FEP, and to carry out the necessary capacity assessment of INFOP, which had not previously worked with the Bank, missing the opportunity to implement the last round of the FEP. (c) Justification of Rating for Overall Bank Performance Rating: Moderately satisfactory 64. Overall Bank performance is rated as moderately satisfactory given that quality at entry was moderately satisfactory, quality of supervision was moderately satisfactory and the overall outcome is rated moderately satisfactory. 5.2 Borrower Performance (a) Government Performance Rating: Moderately satisfactory 65. The Government worked closely with the Bank during preparation and showed strong commitment to the PDO during preparation and supervision. Despite the political crisis the country experienced in mid-2009, the Governments sustained their commitment to the PDO, the sector objectives and national social protection policy. The Government provided the committed budget resources and additional national resources to carry out some key activities under the Project, such as the development of a methodology to target rural areas for the Bono 10,000. There were some shortcomings in the Government’s performance: (i) the budget practices were quite bureaucratic and required a few months for the Project’s activities to receive the Project’s funds; (ii) there was political interference at some points of implementation which delayed implementation as it affected the technical aspects of the components’ implementation; and (iii) the budget ceilings created by the need to incorporate the credit resources to the national budget adversely influenced implementation. 19 (b) Implementing Agency or Agencies Performance Rating: Moderately satisfactory 66. Secretariat of the Presidency: The SOP carried out the coordination of the Project as a whole and the implementation of Component 1. During early implementation, the SOP took time to focus the activities to be financed under Component 1 to effectively prepare the social protection strategy and not follow procurement guidelines by virtue of hiring consultants without the no-objection of the World Bank. Closely working with the World Bank, the SOP adapted the implementation arrangements to the new institutional framework for social protection with the establishment of the SSD to achieve the PDO. 67. Secretariat of Social Development: The SSD adequately implemented the Project activities under Component 1, overcoming the difficulties in procurement with World Bank support and succeeding in establishing a structure to implement the Project activities in support of the development and implementation of the social protection strategy. 68. Secretariat of Labor and Social Security: The SLSS worked with the World Bank, the SOP and CADERH to successfully implement the FEP. It succeeded in establishing a PCU that effectively implemented the Project activities, organized carrying out the evaluations of the rounds of training and extracted lessons from each round to improve the next one. It worked to fulfill the commitment towards indigenous populations participating in the program. 69. Secretariat of Health: Overall the SOH carried out an adequate implementation of the component. The implementation team was well staffed with capable professionals that remained as part of the team for most of the life of the Project, providing continuity to the program’s implementation and contributing to a timely achievement of outputs and outcomes of the AIN-C. The initial weaknesses of the procurement team were overcome with World Bank’s support. Despite the high rotation of ministers (four in five years) and the difficulties faced during the 2009 political crisis, the team maintained a good dialogue with the NGOs, the decentralized SOH levels to keep the implementation of the program going in a difficult context. There was at time a difficult coordination with the SOP, which was resolved through dialogue. There were internal tensions between the Unidad de Extension de Cobertura y Financiamiento (UECF before UDECOFIS) and the PCU for the AIN-C Program with the Project’s support, which caused delays and confusion. The World Bank provided technical support through the local office to the technical team with the Minister, for signatures, approvals, to improve implementation. (c) Justification of Rating for Overall Borrower Performance Rating: Moderately satisfactory 70. The overall Borrower performance is considered moderately satisfactory given that the Government and the implementing agencies’ performances are considered moderately satisfactory. 20 6. Lessons Learned 71. Implementing projects with more than one executing agency is complex. In a country with limited institutional capacity, to have more than one executing agency makes implementation difficult. In the case of the Project, there were three and later on four implementing agencies with a clear role and responsibility for implementing the Project’s activities. Giving that the implementation role to each of these secretariats had a rationale, and contributed to build their institutional capacity, it required significant coordinating efforts on the part of the SOP, the overall Project coordinator. For example, the SOP integrated all Project activities in a single procurement plan, requiring great coordination efforts on the part of SOP, and creating bottlenecks. 72. Monitoring and evaluation of project activities is critical to identify the Project’s achievements and demonstrate a country’s commitment. The Project benefited from the preparation of baseline studies, systematization of experiences, and impact evaluations that help understand implementation problems, draw lessons, and introduce changes along the way. This contributed to solidly documenting the Project’s outcome achievements and provided a deeper understanding of its impacts. In Honduras, these accomplishments are remarkable given the implementation agencies’ institutional weaknesses, and therefore signal strong country commitment to learning and improving to achieve the agreed targets and outcomes. 73. Consistency in procurement guidance is key to avoid bottlenecks in implementation. Changes in World Bank procurement staff brought changes in points of view on how to procure the Project’s activities. This was particularly the case in Component 2 and Component 3. If changes break with the way activities were procured previously in the life of the Project, great efforts should be made not to delay implementation. Clear guidelines on how proceed when hiring a public institution should be provided in a timely manner to the country in order to enable the implementation of activities within the Project’s life and achieve the PDOs. Time to answer and provide guidelines on next steps often took a long time and when decisions are not taken in a timely manner, it undermines confidence in public programs. 74. Importance of sharing best practices designed and piloted with World Bank support to promote sustainability. The World Bank should take the chance to communicate to other stakeholder who can provide financial resources to replicate successful programs. This is the case of the FEP, which will continue but not with World Bank financing. The FEP’s experience, training model, and lessons learned have been taken into account to formulate similar projects with an improved model for vocational training, for example the recently launched training program implemented by INFOP, SEPLAN and the German Cooperation. For Component 2, the SOH reached out to the Salud Mesoamericana initiative to ensure continuation of some activities. 21 Lessons on the FEP 75. Involvement of local organizations contributes to reach indigenous populations. It is important to monitor from the beginning of the program indigenous groups to be sure to achieve the goals set. Activities to reach out to these groups must be different from the general outreach activities. Local elements must be included form promotion and enrollment of students. In general, promotion of the program through local media and local institutions proved to be more effective in reaching out to the targeted population. 76. Youth employment programs are more effective if three elements are combined: private sector participation, combination of classroom work and internships and some form of counseling. The FEP had a combination of the three of them, with the involvement of the private sector through the internships. The evaluation study after the 3rd round of training pointed that in the case of Honduras, the youth who was working after the training did it on jobs not related to the training received, suggesting a mismatch between the skills provided and the demands of the labor market. The counseling provided in the framework of the FEP was found helpful as life-skills building for participants. 77. Follow up of participants for a longer period of time could provide more information on the effectiveness of the program. The Project focused on the ability to find work six months after internship completion while some participants were unemployed up to nine months after training and found work afterwards. Monitoring participants throughout a longer period of time would be beneficial to better understand the implications, achievements and shortcomings of the FEP. Given that longitudinal studies were carried out after the rounds of FEP, it would be worthwhile to have a follow- up of participants to gather further information on earnings and of the sustainability of the FEP’s benefits. Lessons on the AIN-C program 78. Emphasis on elaborating clear procedures for the program contributed to achieve its objectives: Implementation of this component focused initially in organizing and developing the AIN-C, which had been piloted before the Project. The focus on organizing and strengthening the counseling (consejeria) and monitoring took a long time, but it allowed the program to achieve positive results. 79. Choosing professional NGOs contributed to continuity. Some of the NGOs hired had higher costs, but there was less staff turnover, which is critical for a program such as AIN-C. CARE or CRS were more expensive but consistent. 80. Continuous support through training of field personnel and critical actors is the key to the adequate implementation and sustainability of the AIN-C program. The systematization of experiences has shown that continuous training beyond the initial one provided to the monitoras is needed for them to acquire and maintain the skills and 22 abilities to carry out their tasks. Continuous training of field personnel (promotores and decentralized SOH staff) is also critical for the monitoring and support of the program. 81. A good communication strategy contributes to the achievement of a program’s objectives. In the case of AIN-C, emphasis was placed on socialization activities with communities and municipal leaders, which contributed to greater involvement and ownership by the beneficiaries. 7. Comments on Issues Raised by Borrower/Implementing Agencies/Partners (a) Borrower/implementing agencies 82. The Borrower’s contribution includes contributions from the SOP, SDS, SOH and SLSS (See Annex 7). One key point raised by the SLSS is that changes in the procurement team and respective procurement practices affected the preparation and design of the fourth round of the FEP. (b) Cofinanciers n/a (c) Other partners and stakeholders n/a 23 Annex 1. Project Costs and Financing (a) Project Cost by Component (in USD Million equivalent) financed by IDA Appraisal Restruct. Actual/Latest Estimate CA+AF Percentage Components Estimate (USD (USD (USD of Appraisal millions) millions) millions) Component 1 Institutional strengthening of the 1.00 2.00 1.92 186 social protection framework for children and youth Component 2 Consolidation and expansion of the 12.00 12.00 12.00 100 AIN-C Program Component 3 First Employment Program (FEP) 100 7.00 9.60 7.00 for youth at risk Total Project Costs 20.00 23.60 20.92 In June 2013 a total of US$105,000 from the original credit (Cr.4097-HN) and US$2,650,000 million from the additional financing (Cr.4964-HN) were cancelled. (b) Financing Actual/ Appraisal Percent. Type of Restructuring Latest Estimate of Source of Funds Cofinan AF Estimate (USD Appraisa Cing (USD millions) (USD millions) l millions) Borrower 3.30 0 2.33 70 International Development 20.00 23.60 20.92 105 Association (IDA) Total 23.30 23.60 23.25 100 The Project performed along the lines set for the overall Honduran World Bank portfolio. The quality of Project management improved markedly after 2011 thanks to extensive training and support on fiduciary matters. Disbursement improved for activities within the Project not linked to the fourth round of FEP, which could not be implemented. 24 Annex 2. Outputs by Component Honduras Nutrition and Social Project - Outcome Indicators Baseline Original Revised Outcome/Indicator Actual Value 2005 End-target End-target i Strengthening the Borrower’s capacity to administer social protection programs Institutional structure for Institutional and Institutional SSD created with a SSD created with a social protection policy legal framework structure mandate to mandate to coordinate, formulation, planning, for PRSP created by coordinate, design, design, implement and implementation and implementation decree implement and evaluate social policy and evaluation is created by evaluate social fully functional. Government decree policy Social Protection Policy Draft SP policy N/A SP policy finalized SP policy approved by finalized and approved by with conceptual and approved and Decree and signed into the Social Protection bases and implementation Law on June 2013; Cabinet implementation completed Strategic implementation instruments plan approved by the Social Protection Technical Committee. Information system for PRS information Monitoring reports Monitoring reports for monitoring and evaluation and monitoring on key social some social protection of social protection system in place protection program programs produced programs designed and produced RUB and ROI designed operational to support and functioning. administration of social SUEPPS completed and in protection programs use. Household data collection N/A N/A 100,000 surveys 101,019 socio-economic to identify beneficiaries for completed surveys completed and Bono 10,000 used to select beneficiaries for this program. ii Improving the nutritional and health status of young children by expanding the AIN-C program Reduction of chronic 32 % 8% reduction Reduction of 6 Reduction of 4.7 malnutrition for children from baseline percentage points percentage points for under 2 years of age from baseline children exposed for participating in AIN-C average of 12 months (78% achievement). If the children had been exposed for the full two years (age 0-2), the reduction would have been 11.5 percentage points (double the target). Percentage of children 0 90% 94% 97% under 2 years old who participate in the weighing sessions Percentage of children 0 30% N/A 21% under 2 years old with inadequate growth in two successive checkups Improvement in the 0 Significant increase (11.3 treatment of children under N/A percentage points) in the two years of age with number of sick children diarrhea visited by health workers; Increase of 6.5 percentage 25 Baseline Original Revised Outcome/Indicator Actual Value 2005 End-target End-target points in the number of sick children referred to a health center. iii Increasing employability of at-risk youth by piloting a First Employment Program (FEP) Percentage of program 0 40% 40% 30% graduates in paid employment or self- employment 6 months after Program graduation Improved skills relevant to N/A N/A N/A Technical and life skills the labor market of youth acquired by 4,883 youth participating in the FEP participating in the FEP. Psychological and social counseling provided by the SLSS. Component 1: Institutional Strengthening of the social protection framework for children and youth. This component contributed to improve the government capacity to administer social programs by creating a coherent institutional structure to make policy decisions, coordinate implementation and budget allocations and monitor social protection interventions. This component provided support initially to the SOP who was responsible for the coordination of social policy formulation and monitoring, including social protection. Later on, it provided support to both the SOP and the SSD, once this one was created by Decree 193-2009. The SSD coordinates the Social Protection Technical Committee (CTPS) comprised of government institutions (which ones) and civil society organizations. It is supported by the Executive decree PCM008-2012. The Project through Component 1 supported the strengthening of the SDS. 1. The following was achieved under the four subcomponents: 1.1 Social protection policy formulation: it supported the definition, formulation, implementation evaluation and monitoring of children and youth social protection policies, strategies and programs. The main outputs were:  The elaboration of the Social Protection Policy and its implementation plan: The IP was elaboration in a participatory manner, with full involvement of civil society. The IP is being implemented.  Preparation of a strategic agenda 2014-2018: to prepare the transition for the new Government, identifying the main implementation lines in the IP for each social protection area. Studies/consultancies were financed on five pillars: (i) macroeconomic; (ii) management of public finances; (iii) competitiveness; (iv) human development and social protection; and (v) governance and security.  Social Protection Forum: to position the Honduran Social Protection System nationally and internationally. The Project financed the majority of the event 26 1.2 Instruments to improve effectiveness of social protection expenditures; development of instruments, systems and mechanisms designed to ensure the efficiency of public expenditures in the area of social protection. The outputs were the following:  Development and implementation of information systems: development of the Centro Nacional de Información del Sector Social (CENISS) and its components: the Single Beneficiary Registry (Registro Unico de Beneficiarios, RUB); Registro de Oferta Institucional, ROI and Centro Nacional de Documentación (CENAD).  Sistema Unico de Evaluación de Políticas Públicas Sociales (SUEPPS): workshops to design the system (with UPEGs and key sector actors), development of social development indicators to be monitored; technical assistance to explain the relationship among the different monitoring systems of social indicators (SOP, SEPLAN and SSD) and technical assistance and IT equipment for the development of the system.  The collection of household data to identify eligible beneficiaries for Bono 10,000. The INE carried out this exercise, since it had already carried the first surveys for Bono 10,000 and it had experience in household surveys.  Technical assistance for development of a targeting methodology for urban areas. A targeting scoring formula was defined and a data collection instrument was designed and piloted. 1.3 Support to the Secretariat of the Presidency as coordinator of Social Protection Policy and coordinator of the Project: During the first years of implementation, the Project financed staff for financial management and procurement to strengthen the UNAT within the SOP to implement the Project activities. The Project financed staff in the Technical Office in charge of Red Solidaria, a program which coordinated social protection interventions for people in extreme poverty. The Project financed consultancies seeking to improve the effectiveness in public expenditure in social protection. After the approval of the AF, the Project supported activities to build capacity in the SOP and SSD to undertake policy development and Project coordination activities. The SSD became responsible for the implementation of project activities and technical oversight of Component 1. It prepared progress reports for this component, updated the implementation plan. The SOP (through the UAP) remained responsible for the procurement and FM for Component 1 and it remained responsible for coordinating the entire Project. 1.4 Social Audit of Social Protection Programs: This subcomponent was implemented until the AF. After the AF, this subcomponent was dropped since the Government’s Social Protection Strategy included participatory social monitoring of social program mechanisms and these were financed by the national budget. 27 Component 2: Consolidation and Expansion of the AIN-C program. 2. This component had two subcomponents: expansion of coverage and institutional strengthening of the SOH at all levels. The AIN-C Program was implemented in 1,038 communities in six of the poorest departments in Honduras through contracting NGOs to deliver the AIN-C services. The expansion was carried out gradually, in three phases of service provision. The program sought to provide services to: (i) parents or people caring for children under two years of age; (ii) mothers of children under five years of age with diarrhea and respiratory diseases in their communities; (iii) children under 2 years of age to monitor their growth and treatment of disease; (iv) pregnant women or those who recently had a child; and (v) children under 5 years old who are experiencing diarrhea and respiratory diseases. 3. The following tables include information on each of the phases: First Phase of Service Provision Provider Department Number of Numbers of Number of Municipalities communities Children Beneficiaries ANED Lempira 3 79 1,169 *ESA/ASP/ANED Copán 4 68 993 ANED Intibucá 2 51 975 ANED La Paz 1 28 480 CRS La Paz 1 22 392 CHILDFUND La Paz 1 17 311 TOTAL 4 12 265 4,320 Second phase Provider Department Number of Number of Number of Municipaliti Communities children es beneficiaries Intibucá 5 107 2,622 ANED Lempira 9 135 3,215 Consultores La Paz 9 80 2,111 TOTAL 23 322 7,948 Third Phase Provider Department Number of Number of Number of Municipaliti Communities children es beneficiaries CRS/CARITAS Copán 14 137 3,556 CRS/CARITAS Ocotepeque 15 130 2,060 CRS/CARITAS El Paraíso 9 184 3,849 TOTAL 39 451 9,465 4. The selection of the NGOs to provide the services was carried out through International Competitive Bidding. The Project financed the following activities: 28  Planning: These activities were carried out by the Project, the PAIN, NGOs and the SOH regional departments. The main outputs were: (i) the selection of the communities to benefit from AIN-C; (ii) hiring the firm to prepare the baseline for the impact evaluation and carrying out the baseline, (iii) updating the key AIN-C documents and manuals; (iv) hiring the NGOs to provide the services; (v) approval of the operational plans prepared by the service providers; (vi) selection of 3,530 monitoras in the 1,038 communities; and (vii) authorization to operate by the regional regulation department of the NGOs.  Training: Monitoras, NGOs’ field personnel and regional SOH staff were trained on the key components of AIN-C: growth monitoring, caring of sick children in their communities, caring of pregnant women and newborns and early stimulation. Manuals and guides were used to carry out the appropriate training for each group.  Implementation: The main results were the implementation of the program in 1,038 communities; monthly meetings in each of the communities carried out by the monitoras with participation of 94 percent of children under two; the establishment of support groups and groups of nutrition practices in each of the beneficiary communities; use of an instrument to follow up the activities of the monitoras in their communities.  Monitoring: These activities strengthened the intuitional capacity of all participants in the program and all levels of the SOH. The main outputs under this activity were: (i) the development of the Monitoring and Evaluation System (SIME) to capture information on the program implementation from the monitoras and the NGOs in the communities and send it to the central level of the SOH, to monitor the program; (ii) training of NGOs’ technical staff and SOH regional staff in the use of SIME; (iii) design and use of a monitoring of a monitoring instrument to assess the performance of the service providers and training of the SOH staff on how to use to evaluate the performance of the NGOs; and provision of technical assistance to the SOH regional offices to develop and implement the AIN-C activities in their departments. A list of the main outputs financed by the Project19 are below: 1. AIN-C Monitoring and Evaluation Document 2. Conceptual Basis for Early Stimulation 3. Early Stimulation Manual for Monitoras 4. Manual for Early Stimulation Facilitator (Institutional and Community) 5. Impact Evaluation 6. AIN-C Institutionalization Document 7. Document on the Interculturality in Health in Indigenous Populations 8. Manual on Intercultural Training 9. Video: My Future in my First Centimeters. 10. Executive Summaries of: AIN-C, EDUCATODOS, Early Stimulation, Impact Evaluation, Innovations, Institutionalization, Inter-cultural health, SIME. 19 http://www.uecfhn.org/productospnps/ 29 11. Document on the Systematization of the AIN-C Experiences. 12. Software installer of SIME. 13. SIME User Manual. 14. 4 Videos of AIN-C TV SPOTS. 15. Manual for the TIC Monitora. 16. Document on the Methodology of the Sub-Pilot TIC. 17. Video: Early stimulation in Honduras: https://www.youtube.com/watch?v=zntRn4yt7HI 5. The IE found that the strategy had more impact on the reduction of chronic malnutrition when the mothers had completed primary school, were between the ages of 19-25, the family had a vegetable garden, the population was not indigenous, when the family lives farther away from a health post, and the head of the family was a single woman. Component 3: First Employment Pilot Program for Youth-at-Risk 6. This component succeeded in promoting the labor market insertion of 4,883 poor urban youth ages 15-19 (versus a target of 7,100) who had abandoned the education system and who did not work or worked in very low return informal activities. The component financed the development and implementation of a pilot program known as Mi Primer Empleo which was part of a larger effort by the Government for to construct a system for training and professional development for youth to improve their possibilities for labor market insertion. The FEP was implemented in 2006-2011 in three rounds (Convocatorias) of training in 33 cities providing training courses and internships to at risk youth. The program was evaluated after the implementation of the 3rs round in 2011 to draw lessons that were incorporated into the design of the 4th round of training to make sustainable, reduce the cost per trainee and to institutionalize it. 1. Subcomponent 3.1 – Targeting and selection of beneficiaries 7. This component financed the targeting, enrollment and selection of youth who participated in the program. Its implementation was led by the SLSS. A total of 5,000 youth ages 15-19 were selected to participate in the program in three rounds of training between 2006 and 2011. Of these, 4,883 culminated the training, including those selected initially to participate and those waitlisted as substitutes in case the selected students would drop out. 8. The SLSS gathered information on youth seeking to participate in the program. The SLSS developed a form (“ficha de inscripción”) to capture socio-economic information of youth to determine their eligibility for the program. Young people were selected randomly (through an automated process based on the information they provided). The selection process of each round had its own characteristics, and it gradually improved. The third round included a more direct participation of the training centers (Centros de Capacitación, CECAP), and enrollment took place directly in their premises. An information system was developed during the third round to identify in real time the 30 availability of courses in the training centers. The MIS served to better control the selection and participation process, providing information on the youth enrolled by city, by course, etc. For the fourth round, the selection process was designed in coordination with the SSD through the single registry of beneficiaries (Registro Unico de Beneficiarios, RUB) and selected a total of 2,300 additional youth eligible to participate in the program. Subcomponent 3.2 – Training services and preparation for the world of work 9. This subcomponent financed the costs of providing the courses and paying the youth participants a stipend to cover transportation costs. The Advisory Center for the Development of Human Resources (CADERH) was hired to manage the provision of training for the three rounds of the FEP. A total of 4,209 participants completed the technical training and the internship. 2,316 of the beneficiaries received certifications provided by CADERH after passing the tests required. A total of 1,261 youth were employed or self-employed six months after the completion of the program. Other beneficiaries found employment after the six-month period or decided to go back to school. The cost of training under the FEP was higher than anticipated as well as number of training hours needed. Therefore the target to train 6,000 youth was not achieved before the AF. 10. The courses evolved during the three rounds to become more relevant, including topics such as environment and entrepreneurship. Around 65 CECAPs enrolled in an enrollment registry (Registro de Oferentes de Capacitación, ROC) and provided the courses. The number and variety of courses offered through the FEP increased in each round, from 22 courses in the 1rst round, 174 in the 2nd round to 493 in the 3rd round (a total of 689 by Project completion). A total of 247 courses were selected to be taught. The quality of the courses offered improved, as well as the CECAPs capacity to reach out, enroll youth and connect with private companies as a result of the FEP. CADERH assessed their performance in the different phases of the program from enrollment of youth to the provision of courses and provision of stipends. 11. First Round: this pilot round took place between July 2006 and October 2007. CADERH selected and invited the training centers to participate. A total of 12 CECAPs registered with the Registry of Training Institutions (Registro de Oferentes de Entrenamiento, ROFE) and 7 of those offered 22 courses. The Technical Committee to evaluate the courses offered (CTEP) selected 18 of the 22 courses to train 321 students in 5 CECAPs in urban area in the northern part of the country. The selection of youth was carried out by the PCU in the SLSS, who worked in coordination with the CECAP. 12. Second Round: it took place from March 2007 to November 2008. A total of 76 CECAP registered in the ROFE, a substantial increase in the number of centers in response to more promotion and carrying it out as a public open competition. The CECAPs offered a total of 176 courses, which were evaluated by the CTEP with support from technical experts on the topic of the courses. A total of 89 of the courses were selected and 1,512 beneficiaries took them. A system to monitor the implementation of the courses and assess the performance of the CECAPs was established and they were 31 classified accordingly to their performance. An automated system to monitor the payment of student compensation was developed improving the control over payments and the performance of the CECAPs on this task. 13. The main shortcoming of this round was the high cost of the courses per students as the bidding documents did not indicate a cost ceiling and the excessive number of certain courses such as computers and hairdressers, revealing low capacity of some of the CECAPs to offer a more diverse and relevant set of training courses. 14. Third Round: This round lasted from October 2008-February 2011 training 3,031 youth beneficiaries. It was implemented in three phases in an open competition among CECAPs. Coverage of the program expanded to areas in the south, east and west in the country not previously considered in the program. The main reasons were: (i) low participation of CECAPs in the high urban areas targeted by the Project; and (ii) low relevance of the courses offered by CECAPs in previous rounds, already saturated which were not in line with the labor market demands of skills. This was the first rounds in which 100 percent of youth graduated received their certifications. 15. First Phase of the 3rd round: Training of 1,933 youth started in June 2009 and finished in April 2010. Training had to be interrupted due to the political crisis in June 2009 which delayed the implementation of the training and caused drop out to soar to 30 percent of the original enrollment. A total of 1,035 youth finished the training and only 785 of them got certificated. 16. Second Phase of the 3rd round: A total of 37 courses were selected and 688 beneficiaries received the training between April and May 2010. All youth who participated in the program as a replacement for a participant who dropped out was given the change to opt to get their certification. 17. Third Phase of the 3rd round: This phase had not been originally planned but it was carried out given there were funds remnants from the previous ones due to drop out from students, given the political crisis in 2009-2010. The CTEP added 26 courses for 400 students between July 2010 and January and February 2011. 18. Fourth Round: A 4th round was designed to be financed with AF approved to the original Credit. The new round included lessons learned from the evaluation of the 3rd round. During the preparation of training delivery, CADERH announced an increase in their costs which caused the SLSS to opt for requesting a change in the implementation arrangements to work with INFOP to provide the training. This change required an amendment of the AF agreement and an assessment of the fiduciary capacity of INFOP. This process took longer than expected and given the time left until the Credit’s closing, the Bank and the Borrower revised the length of the technical and life skill training to two and a half months (from four months in the first three rounds). With this change, there was not enough time for a mandatory internship before the Credit’s closing, so the internship was made internship optional and, thereby, could continue beyond the Credit closing. To compensate for the reduction of the time of training, the life skills module 32 was expanded by fifty per cent, entrepreneurship training was added, technical courses were to be offered in a more intense fashion and the youth who would complete the full training package would be accredited by the INFOP. In place of the mandatory internship, participating youth will receive support and advice about job search and job placement through the STSS during and after the training; Subcomponent 3.3 – Promotion, dissemination and support for labor market insertion. 19. The Project supported the dissemination of the program and the creation of an intermediation service (Servicio Orientación de Empleo, SOE) within the National Employment Center (SENAEH). By Project completion the SENAEH was providing support to youth seeking employment, working as an intermediary between job seekers and job providers. An electronic job market platform within SENAEH, called “Empleate”, was functioning, led by the SLSS accessible to firms and individuals. SENAEH remains involved in enrollment and monitoring of the implementation of employment programs such as FEP. Around 2,942 beneficiaries who did not get employment received support from the SOE. 20. The Project strengthened the Department of Employment (DGE) by: (i) supporting the definition a new organizational structure for the DGE, (ii) the provision of furniture, equipment and upgraded infrastructure for the SLSS, provision of information systems; (iii) the establishment of “Empleate” as the first electronic job market accessible to individuals and companies as part of the SENAEH; (iv) financing of DGE staff; (v) the design and implementation of the psychometric tests system to support the performance of the DGE; (vi) the establishment of an orientation service to citizens (Servicio de Atención al Ciudadano) within the SLSS to direct people within the SLSS; and (vii) the provision of IT support (internet access and webpage for FPE) for the SLSS regional offices in San Pedro Sula, Choluteca, Danli, El Progreso, Comayagua, La Ceiba y Tegucigalpa. Subcomponent 3.4 – Program Management and Evaluation. 21. The Project financed the development of a monitoring and evaluation system in the SLSS to inform and support the development of a youth training and labor market insertion system, following up participants after they completed the program. .It financed part of the staff of the PCU in the SLSS. 33 Annex 3. Economic and Financial Analysis 1. The ICR team reviewed the economic analysis both at preparation and at the time of AF to assess the economic rationale of the Project. The Project costs were in line with the original PAD estimates for Components 1 and 2 while the costs of training was underestimated for Component 3. Part of the increase in cost was due to the higher number of hours of training received by the participants. The higher cost resulted in a lower than expected number of adolescents trained. Overall, the Project achieved its targets within the credit resources approved. Implementation took longer than planned in part due to factors out of the Government’s control e.g. the 2009 political crisis and in part due to factors related to weak institutional capacity and lack of experience of work with the Bank and Bank procedures. The cost of supervision was much higher than budgeted in the PAD. 2. In the case of the FEP, the economic rationale for investing in youth at risk in Honduras remains valid based on two considerations confirmed in the longitudinal study: (i) participants improved their employability through the training received, improving their knowledge of labor demand and of the labor market; and (ii) the labor market insertion of youth who neither work nor study diminished the probability of them engaging in risky behavior. The Project achieved direct benefits in terms of labor insertion for participants and higher salaries. Labor insertion was lower than envisaged in the PAD (30 percent versus a target of 40 percent), reducing the direct benefits from the Project. The evaluation of the 3rd round of the FEP, carried out in 2011 after its completion, provided some findings relevant to the economic analysis. Namely: (i) the beneficiaries’ ability to find a job was adversely affected by the national political crisis, the global economic crisis and marked by the labor legislation that imposed restrictions to hire people in their age group; (ii) the average salary for beneficiaries was higher than the national average for that age group (15-19 years old); (iii) the program had positively impacted their personal, family and professional lives, as they perceived it. Though not quantified, the indirect benefits from this behavior are expected to impact the society as a whole. Youth criminality and violence continue to be one of the most serious problems the country is facing today; and (iv) only 20 percent of the participants in the study had found work in the area they were trained on. 3. In terms of earnings, the study found that participant saw their earning increased, compared to the control group and that male earnings were higher than female earnings. The study found a trend of decrease in salary for this age group. Earnings (in lempiras) per workday for participants in the Third Round Phase I Phase II Participants 4,774 3,826 Male 5,507 4,151 Female 3,746 3,358 Control Group 3.494 3,543 Male 3,844 3,991 Female 2,930 2,707 34 4. The cost per participant was calculated for each of the FEP rounds, as shown below: FEP Costs per participant – US$ Costs of FEP First Round Second Round Third Round Management cost per participant $287.95 $76.17 $94.56* Cost of technical assistance per participant $143.98 $38.09 $47.28 Cost of certification per participant** $18 $24.68 $31.49 Cost of the courses per participant $953.72 $945.30 874.85 Cost per participant $1,404.26 $1,084.24 $1,048.18 Average hours of training and internship per 706 653 658 participant*** *The cost of the third round increased due to the political crisis. The first phase of the third round had to be extended increasing the costs. **The average cost of certification was with the range expected at the time of appraisal. *** The actual number of hours of training and internship was higher than the 600 planned at the time of appraisal. 5. The cost of FEP training is presented below, comparing the costs for CADERH and INFOP: Direct Cost of Training (in Lempiras): CADERH (Average costs of each in previous rounds) vs. INFOP (Fourth round) Category CADERH INFOP Technical training courses 28,117,000 16,084,000 Certification 1,080,000 0.00 Technical Assistance 1,925,020 0.00 Transport and per diem 527,000 1,003,100 Total 31,650,000 17,086,810 Stipends 15,800,400 18,216,000 Total direct costs 47,450,400 35,302,810 Total cost of training without stipend 31,650,400 17,086,810 Number of beneficiaries 1,800 2,300 Average cost per student 17,583 7,429 6. The average cost of the training per students was approximately 15,000 Lempiras during the three FEP rounds. Each participant received US$2.50 per day attended to cover transportation, insurance and the cost of the evaluation of their labor competencies for the certification. 7. In the case of the AIN-C Program, the SOH document on systematization of the program’s implementation included a summary of the program’s cost by region and of the cost per child in each region. 35 COSTOS POR NIÑOS POR DEPARTAMENTOS Paraiso 2,111 Ocotepeque 2,837 Intibuca 2,143 COSTOS POR NIÑOS POR La Paz 2,249 DEPARTAMENTOS Lempira 1,806 Copan 2,630 0 500 1,000 1,500 2,000 2,500 3,000 8. The cost of the first year of implementation of the AIN-C Program was the highest in all departments since it required resources for equipment, medications and training of all staff at all levels. The average cost per child in the six departments was 2,295 Lempiras ($120.66). The cost depended upon the number of children serviced by community: Lempira had the lowest cost (1,806 Lempiras with 25 children per community) versus Ocotepeque (2,837 Lempiras with 18 children per community). A cost-benefit study was under revision at the time of the ICR, though the updated conclusions were not yet finalized. 9. The Impact Evaluation of the AIN-C Program evidenced the positive outcomes achieved in the intervened communities in terms of reduction of chronic and acute malnutrition, as well as the improvements in caretakers’ behaviors regarding nutrition, breastfeeding and immunizations of young children, among other aspects of their care. Given the evidenced impacts, it is feasible to affirm that the AIN-C program was an effective intervention to reduce chronic malnutrition in the benefited communities. 10. The original PAD identified direct and indirect benefits derived from the implementation of the AIN-C Program; among the direct benefits were the savings in health care costs resulting from the reduction in the number of SOH outpatient consultations. The indirect benefits resulted from the children’s lives saved as well as the positive physical and cognitive impact. Given the outcomes achieved through the implementation of the AIN-C Program, evidenced in the impact evaluation, it is safe to affirm that these benefits have been realized as a result of the implementation of the Project. 11. The ICR team used evidence from several studies20 as a proxy of the savings in costs and monetized benefits of similar nutrition interventions. A regional study 20 Sources: “The Cost of Hunger: Social and economic impact of child under nutrition in Central America and the Dominican Republic”. ECLAC. February 2008. “Longitudinal Study in Guatemala” (Hoddinott et al. 2008). “Scaling up Nutrition: What would it cost?”. The World Bank. 2010. 36 estimated the cost of malnutrition (measured as underweight) in Honduras at 10.6 percent of GDP in 2004.21 Regarding benefits, a longitudinal study in Guatemala demonstrated that children who received fortified complementary food before they were three years of age grew up to have wages that were 46 percent higher than the control group (for males). Finally, community-based nutrition programs show that changes in behavior in mothers and caretakers are estimated to bring benefits of US$53-153 per disability- adjusted life-year (DALY) saved.22 21 Martinez, R. and A. Fernandez.2008. The cost of hunger Social and economic impact of child undernutrition in Central America and the Dominican Republic. 22 World Bank, 2010. Scaling Up Nutrition: What Will it Cost? 37 Annex 4. Bank Lending and Implementation Support/Supervision Processes (a) Task Team members Responsibility/ Names Title Unit Specialty Lending Task Manager – Social Protection Manuel Salazar AFTSE Specialist LCSHS- Patricia O. Orna Language Program Assistant DPT John L. Fiedler Senior Health Economist LCSHH LCSHS- Rebeca P. Santos Operations Officer DPT Andrea Vermehren Lead Social Protection Special AFTSE Svetlana Klimenko Financial Management Specialist LCOAA Aracelly Woodall Costing Specialist Luis Tineo Procurement Specialist LCOPR Morag Van Praag Senior Finance Officer LOAG1 Ximena Traa-Valero Social Evaluation Specialist LCSHD Pilar Gonzalez Legal Counsel LEGLA Solange Alliali Senior Counsel LEGLA Jaime Ramirez Consultant LCSHD Nancy Gillespie Consultant LCSHD Supervision/ICR Task Manager - Social Protection Manuel Salazar AFTSE Specialist Cornelia Tesliuc Task Manager AFTSE Karla McEvoy Task Manager LCSHS Lucy Bassett Task Manager LCSHS Angela Demas Senior Education Specialist HDNED Danilo Fernandez Consultant LCSHS Lidia Fromm Consultant LCSHS Anna Fruttero Economist LCSHS Tomoko Kato Consultant IEGPS Rebeca P. Santos Operations Officer LCSHS Miriam Montenegro Operations Officer LCSHS Luc Razafimandimby Senior Economist LCSPE Jose Simon Rezk Financial Management Specialist LCSFM Andres Mac Gaul Senior Procurement Specialist LCSPT Annemarie Guth Proite Procurement Specialist LCSPT Pablo Ariel Acosta Senior Economist LCSHS Ximena B. Traa-Valarezo Consultant LCSSO Maria Concepcion Steta Senior Social Protection Specialist LCSHS Nancy Benegas Consultant LCSHS Maria Fernanda Rodriguez Program Assistant LCSHS Mary Lou M. Veizaga Consultant LCSPT Christel M. J. Vermeersch Senior Health Specialist LCSHH Andrea Vermehren Lead Social Protection Special AFTSE 38 (b) Staff Time and Cost Staff Time and Cost (Bank Budget Only) Stage of Project Cycle USD Thousands (including No. of staff weeks travel and consultant costs) Lending FY04 10.18 36.68 FY05 57.68 290.00 FY06 0.2 3.95 Total: 68.06 330.63 Supervision/ICR FY05 0 2.14 FY06 35.97 146.16 FY07 75.25 265.64 FY08 55.47 194.33 FY09 50.27 195.00 FY10 31.03 110.33 FY11 16.63 91.71 FY12 38.62 185.87 FY13 55.89 205.57 FY14 36 4.82 7.67 Total: 363.95 1,404.42 39 Annex 5. Beneficiary Survey Results Study of the 3rd round of the FEP 1. The study focused on the analysis of five aspects for the beneficiaries and a control group: (i) Life conditions; (ii) Training; (iii) Employability; (iv) values and life skills; and (v) gender equity in FEP. 2. The study included a total of 1,211 beneficiaries, 478 youth as control group from phase I, 1,344 beneficiaries and 297 youth as control group from phase II. The total number of participants in the FEP was 4,883 in all three rounds of the program. Thus the study included around 50 percent of participants. 3. Labor situation and conditions: the participants were minors and they were socially vulnerable socio-economic status. Access and conditions of access to the labor market by the participants was framed by the laws and regulations on minimum wage, permission to participate in the labor market, social security, etc. The study found that around 25 percent of the participants were working six months after the completion of training. The main reason for this was that the participants had not found a job or they were studying. The large majority (around 60 percent) was working as an employee or worker for a private company. Regarding the conditions of labor, 80 percent of the study’s participants expressed the view that their jobs entailed occupational risks and 12 percent said their jobs meant risks as they work on the streets and they can be victims of aggressions. Around 65 percent is employed in temporary jobs. The participants received higher salaries than the control group though in a context of decreasing salaries overtime (salaries were lower between the first and second phase of the 3rd round of FEP). In general, male participants reported longer hours of work than females and over the 40-44 rage of hours per week (45 hours). 4. Participants reported low reception of social benefits. 65 percent of participants reported not receiving any social benefits; 9 percent reported having received holidays; 2 percent paid vacations; 2 percent considered a benefit receiving the minimum wage and 5 percent had received a Christmas bonus. 5. Participants received placement assistance directly through the firms where they carried out their internships. Otherwise, newspapers, radio ads or no placement services were used to find a job. The study showed that a low number of female participants were register in the SENAEH, while a larger number of women in the control group were enrolled in that service. 6. The beneficiaries expressed that their participation in the FEP program contributed to diminish their participation in risky behaviors. 40 Annex 6. Stakeholder Workshop Report and Results N/A 41 Annex 7. Summary of Borrower's ICR and/or Comments on Draft ICR Contribution from the Secretariat of the Presidency Component I – Information on the Implementation Completion and Results Report (ICR). An evaluation of the objective, design, operational experience, and execution of the operation. The “Law for the Establishment of a Country Vision and the Adoption of a National Plan for Honduras” defines the guiding principles for development, strategic lines of action, and national objectives and goals for 2010-2038. The Country Vision refers to a panorama of social, political, and economic targets that the country should achieve for each cycle of 28 years, through the execution of successive national plans and government plans that are consistent with each other. The National Plan sets out the strategic pillars around which public and private action should be executed to achieve the midterm objectives of the Country Vision, in successive 12-year periods, and it defines the indicators for each national target, with 2009 as the baseline. The Government Plan is the set of policies, programs, and projects that each government administration establishes in order to contribute to the achievement of the goals and indicators of the National Plan. In addition, this Law defines the entities responsible for its execution, with the Secretariat of the Presidency (SDP) responsible for executing and supervising fulfillment of the National Plan by: (i) ensuring that the National Plan is successfully executed and that its national targets and indicators are achieved; (ii) coordinating the government’s sector cabinets for execution of the National Plan; and (iii) ensuring compliance with the agreements of the government’s sector cabinets, among other activities. In line with the above and emphasizing and affirming the authority of the SDP as the policy arm of the Presidency, through Executive Decree PCM-008-2010, published on 7 April 2010, the Technical Support Unit of the Presidency (UATP) was created as a technical agency that would enable the SDP to support the President of the Republic, sector cabinets, regional planning commissions, and other presidential commissions in the areas of public policy, policy cycles, transparency, governance, and others. In this regard, the Honduran government and the G-16 signed a joint declaration in August 2012 that established a critical path to be supported through cooperation and implemented by the Honduran government in the following priority areas: political process for the 2012-2013 elections, citizen security, human rights, socially inclusive growth, and fiscal governance and transparency in public administration. For the purpose of strengthening the transition agenda, efforts were made to coordinate and harmonize public policies around critical paths and plans, in order to lock in sustained growth with social equity and strengthen democratic governance. 42 The design and execution of a strategy were needed to guarantee the smooth transition of government, including disseminating and providing training on priority issues during the transition. It was decided at the highest level that the SDP would lead the transition process, and in this framework, a strategy has been developed to guarantee the provision of technical and operational assistance for a transition process that involves activities to document and disclose information to interested parties and to build skills among staff in the incoming administration at the central level as well as at the regional and municipal levels. In the framework of this strategy, the government has decided to focus its efforts on readying the processes and documents that will be transferred, which are grouped into four levels: 1.) Transition documented with reporting by the entire public sector, consisting of the preparation by each secretariat of a document with the main issues and public policies affected by the transition, and documentation by the National Office for Integrated Internal Control (ONADICI) of the operational files; 2.) Positioning of strategic issues in the context of the transition, grouped around five thematic pillars (macroeconomics and public debt sustainability, management of public finances, competitiveness and business development, human development and social protection, and governance and security). This level includes technical studies and documents; 3.) Transition paths prepared with the participation of civil society; and 4.) Institutional reforms. The World Bank, through the Additional Financing for the Nutrition and Social Protection Project, Credit IDA 4694-HO, provided strong support for this strategy under its thematic pillar Human Development and Social Protection, after a restructuring to include activities related to strengthening Honduras’s Social Agenda. I. An evaluation of the outcome of the operation in relation to the agreed upon objectives. The project objective to improve Honduras’s social safety net for children and youth by: (i) strengthening the recipient’s capacity to administer social assistance programs has been fulfilled. This has been accomplished by strengthening the institutional capacity of the SDP to improve investment in the human capital of poor families through: a.) Support for the definition, formulation, execution, evaluation, and monitoring of social protection policies, the strategy, and programs for children and youth; b.) Development of instruments, systems, and mechanisms to guarantee the efficiency of public spending on social protection; c.) Support for building capacity at the SOP and SSD to carry out policy formulation activities and project coordination activities; and d.) (a) collection of household data to identify eligible beneficiaries for the Bono 10,000 program; and (b) provision of technical assistance for the development of a 43 targeting methodology for urban areas by, inter alia: (i) defining a targeting scoring formula; (ii) designing a data collection instrument; and (iii) piloting the data collection instrument. II. An evaluation of the borrower’s own performance during preparation and execution of the operation, with special emphasis on lessons learned that could be useful in the future. In relation to the evaluation of performance in executing Component I, the SDP and its partner institutions have reflected on the lessons learned throughout the design, preparation, and implementation of the different actions contained in the annual work plan for the component. In this framework of lessons learned, performance was good in terms of gathering socioeconomic information on eligible households for the Bono 10,000 program, which culminated in the development of a database of beneficiaries with descriptive information on the target population. The learning that stands out in this area is the ongoing improvement made in interagency coordination processes, with respect to the timely and precise joint definition of technical specifications for procurement processes. In addition, the operational mechanism for the Bono 10,000 program entails strong institutional coordination, so this exercise has contributed to better communication among the partner entities and by extension has enhanced all program processes. As mentioned previously, the Honduran government has proposed a Government Transition Strategy 2013-2014, the basic objective of which is to ensure an orderly and smooth transition to prevent the planning gaps and delays that have traditionally occurred during changes in administration. With this in mind, through the UATP/SDP, a series of prospective studies were conducted on the efficiency and inclusion of social programs and the outcomes achieved in the area of social protection and were strategically disseminated to position the Social Agenda on all levels and ensure the sustainability of the core social policies that have been approved and are in execution. Regarding the prospective studies and the studies on the efficiency and inclusion of social programs, relevant and timely diagnostic information was obtained, which will serve as an input for the formulation of public social policies and the strengthening of programs and projects, in the framework of execution of the Social Protection Policy and the Consolidated Social Protection System. It should be noted that the UATP/SDP implemented the strategy to promote collaboration among the different consultants who were in charge of carrying out the studies, which yielded a relevant lesson, by virtue of the level of performance achieved in preparing and executing these activities, about the effectiveness of teamwork, especially with respect to the collection and analysis of information that is not always available for doing research. Moreover, while diagnostics were being conducted, action proposals were prepared for the government transition process and the new authorities, which were also analyzed jointly. A lesson learned from this process is that by analyzing a country’s social problems from various viewpoints, more comprehensive solutions can be identified. 44 Monitoring of the four subagendas of the Social Strategic Agenda, in the framework of the National Accord, yielded as a lesson learned that these monitoring mechanisms provide the inputs needed to make informed decisions at the highest level, provided that priority is given to the most strategic goals, oriented towards solving the country’s problems and aligned with national planning instruments. Moreover, it is important to develop indicators that are timely and feasible in terms of quality, quantity, and measurement times. Also noteworthy is the work done to position the Social Agenda to ensure the sustainability of the core social policies that are approved. A main lesson from these activities is the importance of results-based planning and monitoring. Lastly, in terms of the overall performance of this component, the technical support provided for planning and monitoring procurements and financial management was timely in terms of ensuring that the required administrative, contracting, and procurements processes were conducted in due time and form. Accordingly, this strategy constitutes an important lesson learned. III. An evaluation of the Bank’s performance, including the effectiveness of its relationships, with a special emphasis on lessons learned. The World Bank team provided support to the UATP at all times, which made for a streamlined implementation process. There was ongoing communication with the Bank’s team, which meant that response times to requests for no objection were quite short. In addition, the team authorized the restructuring of the project when a proposal was made for a series of studies and technical assistance operations that would provide inputs for monitoring the targets and indicators of the Social Agenda (in its four subagendas: social protection, education, health, and food security), for monitoring the National Accord, as well as elements for decision-making on the public social policies that would be given priority in the framework of the 2014-2018 government transition. These activities fall under five categories: prospective studies, studies on efficiency and inclusion of social programs, strategic communication of the results achieved in the area of social protection, and technical-fiduciary support for project implementation. All this made it possible to position the Social Agenda at all levels and prepare transition agendas for the social sector. These activities were implemented by the SDP in close coordination with the SDS. In addition, the Bank provided valuable support that contributed to the success of the Latin American Forum on Social Protection: Challenges for the Consolidation of Social Policy. IV. A description of the provisions that are proposed for the future operation of the project. With Bank financing and in light of the results obtained from each one of the consulting assignments contracted that are directly related to the government transition strategy and in relation to the objectives, it can be concluded that the SDP has sufficient documentation to strengthen the government transition process, on core issues and public policies in its thematic pillar Human Development and Social Protection, all in coordination with the Secretariat of Social Development and civil society. 45 Contribution from the Secretariat of Social Development 1. Evaluation of the objectives, design, and implementation of the project. The Government of Honduras and the World Bank (WB), in November 2010, agreed to strengthen the Secretariat of Social Development (SDS) with resources from Component 1 of the Nutrition and Social Protection Project (Credit IDA-4097) and from Component 1.3 of the Social Protection Project in support of the Bono 10,000 (Credit IDA-4774), for the purpose of establishing a Comprehensive Social Protection Strategy for Honduras. The actions contained in this project have enabled the SDS to lay the groundwork for effective implementation of social assistance and protection measures in the country, through a strategy that promotes broad participation by public and private actors not only at the central level but also at the level of the confederations of municipalities selected for validation. The strategy used for project implementation has five components, which are the vehicle for achieving the project objectives: (1) Definition, Enactment, and Approval of the Social Protection Policy; (2) Strategic Plan for Implementation of the Social Protection Policy; (3) National Information Center for the Social Sector (CENISS) and the Consolidated Public Social Policy Evaluation System (SUEPPS); (4) Capacity-building of the UAP/SDP and SDS; (5) Operational Expenses of the SDS. Part (1), Definition, Enactment, and Approval of the Social Protection Policy, was based on a broad consultation and consensus-building process among the government institutions in the social sector, civil society organizations mostly representing the most vulnerable sectors in the country, and private business, in order to have a national policy in place whose sustainability would be assured. Plans called for a consulting assignment for the design of the Social Protection Public Policy and three workshops for a review of background, new competencies of institutions involved in social development and poverty, creation of the Social Protection Technical Committee, analysis and discussion of progress towards developing the Policy, as well as dissemination of the final document. The Social Protection Policy was unanimously approved by the Council of Ministers through Executive Decree PCM 008-2012, published in the official gazette “La Gaceta” on Wednesday, 28 March 2012. Part (2), Strategic Plan for Implementation of the Social Protection Policy, was also based on a broad consultation process between the public sector and the civil society organizations representing the vulnerable sectors targeted by the agreed upon Social Protection Policy. Plans called for a consulting assignment for the design of the Strategic Plan for Implementation of the Social Protection Policy 2011-2015 and three workshops to 46 establish the strategic guidelines, identify co-responsibilities, and review and adjust the strategic plan. Institutional, public, and audible versions of the approved Social Protection Policy were circulated. The latter was arranged in collaboration with civil society organizations representing the disability sector in the framework of the Social Protection Technical Committee. At project completion, the SDS has an implementation plan for the Social Protection Policy, which it is executing as planned. In preparation for the transition, the SDS is positioning the Social Protection Policy in coordination with the SDP, and the activities to define the strategic transition agendas for social protection incorporate the guiding principles of the implementation plan for the Social Protection Policy. Part (3), National Information Center for the Social Sector (CENISS) and the Consolidated Public Social Policy Evaluation Center (SUEPPS), is based on the conceptual design and development of the tools needed for timely decision-making using quality social data, based on the experience and expectations of the various actors involved in the implementation of social policies and programs. A consulting assignment was arranged for the conceptual design of the Consolidated Public Social Policy Evaluation System (SUEPPS), including the organization of two workshops with technical representatives to design the components and publicize the conceptual design, a consulting assignment to analyze and design the following submodules: (1) program and project monitoring; (2) consultations, reports, and executive panels on social program and project monitoring processes; (3) administration of users for the previous subsystems, as well as consulting assignments to analyze and design the following submodules: (1) registry of indicators for monitoring public policies; (2) systematization, searches, and consultations on the systematization of social program and project monitoring processes; and (3) administration of users for the previous subsystems. Both consulting assignments are part of the SUEPPS Monitoring Module. In the framework of implementation of the SUEPPS, the following actions should be noted: (i) monitoring exercise following the methodology proposed in the conceptual design of the program Vaso de Leche [Cup of Milk]; and (ii) analysis of the evolution of the Basic Social Development Indicators in the confederations participating in the Social Protection Roundtables (COLOSUCA, MANCOURISJ, MAMUNCRAC, GUISAYOTE, Gulf of Fonseca Region). At present, the process is being organized to establish the baseline for evaluating the nutritional status of children in preschool and first grade who receive a school snack in coordination with the SEDUC, SESAL, and the PMA. There are plans in 2013 to conduct monitoring of the basic social development indicators in the social protection roundtables. At project completion, the SDS has the SUEPPS information platform developed and implementation is under way for the Monitoring Module, and the platform for the system evaluation module is in development. 47 As for the National Information Center for the Social Sector (CENISS), under the project, hardware for use of the SUEPPS was procured, technical assistance was contracted for the design, layout, and production of information and training materials on the CENISS and the SUEPPS, an event was held to launch the CENISS, and specialized trainings were organized to build the skills of the CENISS team. At present, the CENISS is helping to equip the Honduran government with tools to make social sector interventions in the country more efficient and effective. The SDS, with national funds and financial support under the project and from other partners (UNDP), has been developing the infrastructure of the National Information Center for the Social Sector (CENISS) and its components Unique Registry of Beneficiaries (RUB, for its acronym in Spanish), the Institutional Provider Registry (ROI), and the National Documentation Center (CENAD). Development of the conceptual design and the software application for the CENISS and the Institutional Provider Registry (ROI) component was completed in the first half of 2012 with national funds. To date, both are in operation and functional. Part (4), Capacity-building of the UAP/SDP and SDS, has consisted in contracting consulting services for administrative and procurement support for the project, which is executed and supervised by the SDP, and a consulting assignment to coordinate, liaise, and monitor SDS institutional strengthening activities for the implementation of projects with the World Bank and the UNDP, whose results and lessons learned have been systematized, the procurement of portable audiovisual equipment for workshops, meetings, and coordination events, an exchange mission for the Honduran and Mexican governments to share their experiences with evaluation and monitoring and the registration of beneficiaries of social programs, as well as a mission for Honduras and the Dominican Republic to share experiences for the implementation of the targeting system for social compensation mechanisms. Lastly, Part (5), Operational Expenses of the SDS, consisted in the procurement of some materials for workshops. 2. Evaluation of the project impacts against the project objectives In light of the results obtained in relation to the objectives, it can be concluded that the SDS has a comprehensive framework of policies, strategies, and tools in place to promote inclusive social development. Following its approval, the Social Protection Policy has been integrated into the Institutional Plans in the framework of the strategic plan for implementation of the Policy, and specific measures are already being taken in the relation to the pillars of coordination between and within institutions as well as among policies, inclusion of the population in conditions of poverty, extreme poverty, vulnerability, and social exclusion, establish permanent monitoring and evaluation systems for the Social Protection Policy, in the framework of the components of the Social Protection Policy. 48 Likewise, in coordination with the SDP and the civil society organizations that make up the Social Protection Technical Committee, a transition agenda is being developed that will enable the progress made thus far to be integrated into the new government’s action plans so that financing is available for the implementation of specific priority actions for the sectors targeted by the policy. The CENISS has already proven to be an effective decision-making tool for important programs and projects such as the Bono de Solidaridad Productiva [Productive Solidarity Supplement Program], Mi Primer Empleo [My First Job], Vivienda de Interés Social [Low-cost Housing], and the Bono 10,000 program. 3. Evaluation of the government’s performance during project preparation and implementation. Since the start of his administration, President Lobo has worked hard to lay the groundwork in the social sector for the nation’s sustainable development. Based on this commitment, he created the Secretariat of Social Development, which has made it feasible to set the framework conditions for social policy. In the context of the project, the SDS fully assumed its role in the design, execution, monitoring, and evaluation of the planned activities, bringing them successfully and sustainably to fruition. The SDS has fulfilled its role in guiding the formulation of the Social Protection Policy and its Implementation Plan, coordinating institutional services for vulnerable sectors, improving the targeting criteria and mechanisms of the principal social programs and projects, and laying the foundation for monitoring and evaluation. 4. Evaluation of the World Bank’s performance during project preparation and implementation. The team designated by the World Bank provided support to the SDS throughout the project implementation process, demonstrating an attitude of openness to the specific needs identified by the institution and a constant willingness to help us technically with the different components of the project. Despite the problems that arose with procurements, contracts, and infrastructure, the Bank team helped the SDS follow through with these processes, which were completed satisfactorily, along with systematic and timely supervision of the project. 5. Discussion of project sustainability and the government’s plans for the future of the program and the different incentives under the project. Based on the results obtained with the project and with the approval of the Framework Law on Public Social Policies, the legal foundation is established, as well as the institutional competencies for regulating, steering, and coordinating the actions for transforming the human, sociocultural, and material conditions with an emphasis on the vulnerable population, the creation of the National Council on Coordination of Social Policies, which strengthens the Social Protection Technical Committee, consolidates the competencies of the Secretariat of Social Development, defines the mechanisms for allocating resources for financing, and lastly, instructs the public institutions that execute social programs to adjust their work plans and budgets for coordinated implementation, it 49 can be concluded that the project results are completely aligned and consistent with the stated objectives, and their sustainability is assured. Contribution from the Secretariat of Health a. Implementation of the AIN-C Services began to be provided as part of implementation of the AIN-C strategy in May 2008 with the first 265 communities and an average registration of: (i) 3,749 children; (ii) 951 pregnant women in 13 municipalities in 4 departments: Copán, Lempira, Intibucá, and La Paz. With the inclusion of the departments of El Paraíso and Ocotepeque, coverage was expanded and the second and third stages were formalized with 773 communities, with an initial average registration of (i) 11,006 children under the age of two; (ii) 4,522 pregnant women in 63 municipalities in 6 departments. With the process of selection, the physical target of 1,000 communities was met at the start of the intervention, and 1,038 communities were ultimately covered. In the third stage of communities selected for intervention with the AIN-C strategy, coverage was expanded to the departments of Copán, Lempira, Intibucá, and La Paz, reaching 452 communities and 5,824 children under the age of two. The delivery of AIN- C services was facilitated by external health providers who were contracted in a competitive bidding process. By department, the main findings on global malnutrition were as follows: Department of Copán: In May 2008, the organization ESA/ASP was contracted to provide the AIN services in Copán, for 68 communities and 698 children, with a global malnutrition rate of 21%. Department of Lempira: The second stage involving 135 communities was contracted to the provider ANED for a period of two years, with a global malnutrition rate of 16.4% at completion. Department of Intibucá: The second stage involving 107 communities was contracted to the provider ANED for a period of two years, with services provided to an average of 1,556 children under the age of two, and a global malnutrition rate of 16.4% at completion. Department of La Paz: The provider CRS provides AIN-C services in 22 communities serving on average 349 children, and with 22% of children below the third percentile, coverage was expanded to 1,471 children. Department of Ocotepeque: This department was selected due to its high rates of poverty and malnutrition; the ELB identified 1,086 children in 130 communities in 14 municipios in the department of Ocotepeque. A service contract was signed with Christian Relief Services, and 1,390 children were receiving services at completion, with a global malnutrition rate of 14%. Department of El Paraíso: The purpose was to improve the nutritional status of 2,295 children registered with the ELB, in 184 communities in 9 municipios in the department of El Paraíso, with 2,365 children ultimately registered, and a global malnutrition rate of 11.3% at completion. 50 b. Summary of indicators by health region The percentage of children remaining in the program has averaged 96%, an indicator that suggests that the strategy has been embraced by parents and the children who are the primary beneficiaries. The percentage of children below the third percentile for weight is the global malnutrition seen in the targeted communities through the AIN-C strategy, with Intibucá having the highest malnutrition rate, at 25%, among the departments, followed by Lempira at 21% and La Paz at 19%. The average rate for this indicator is 19%. The strategy promotes and monitors exclusive breastfeeding in a child’s first six months of life, a practice that has been shown to support the health and good growth and development of the baby. Table 1. Indicators by Health Region % of children Persistent Exclusive % below the third Health region inadequate breastfeedin retention percentile of growth g weight for age Copán 96% 18% 26% 82% El Paraíso 97% 15% 23% 83% Intibucá 95% 25% 36% 86% La Paz 95% 19% 30% 86% Lempira 96% 21% 26% 87% Ocotepeque 95% 17% 28% 87% Averages 96% 19% 28% 85% c. External impact evaluation of the AIN-C strategy. The results of the impact evaluation of the most important nutritional indicators point to declines of 4.7 percentage points in chronic malnutrition, 3.1 percentage points in global malnutrition, and 4.6 percentage points in the risk of acute malnutrition. These results are statistically significant with 95% confidence. The AIN-C strategy also resulted in expanded delivery of micronutrient supplements to children under two years of age. Zinc supplementation increased by 21.9 percentage points and iron supplementation by 20.4 percentage points. Nevertheless, no significant impacts have been observed on anemia levels, which suggests that the strategy should be strengthened by counseling mothers to refrain from giving their children supplements with other types of food, such milk and eggs, which inhibit absorption. The AIN-C strategy has also had a positive impact on breastfeeding and child nutrition indicators: the percentage of children being breastfed exclusively to six months has increased by 4.2 percentage points, and the consumption of liquids other than water and milk prior to six months has fallen by 3.5 percentage points. There has also been an increase in the consumption of cereals, eggs, and thick soups after six months of age. The positive 51 impact on the percentage of children consuming thick soups is very important because it is specific recommendation made by the AIN-C strategy to mothers through health workers. Although the evaluation did not find significant impacts on child morbidity, it does show that mothers have acquired more knowledge about health, on acute diarrheal disease, acute respiratory infection, and health care during pregnancy and breastfeeding. Checkups have increased by 13.1 percentage points for pregnant women, by 11.3 percentage points for children with acute diarrheal disease, and by 13.5 percentage points for children with acute respiratory illness. Referrals to health clinics for cases of acute diarrheal diseases increased by 6.5 percentage points, and the percentage of women receiving prenatal care rose by 3.2 percentage points. Based on these findings, continuing with the AIN-C strategy and strengthening it with food security strategies is recommended. It is also important to look further into the reasons why the strategy has not had an impact on the prevalence of childhood anemia and identify possible solutions. d. Implementation of the AIN-C with the early stimulation component AIN-C services under the early stimulation module are being provided by the Christian Children’s Fund (CCF) in 17 communities in the municipio of Chinacla, department of La Paz, with coverage for 297 children under the age of two and the participation of 52 health workers; the services will be continued by the Red Cross. e. Main lessons learned - The decentralized provider implementing the strategy should have experience with the health component, inasmuch as it will be facilitating the fieldwork. It should also have a solid financial base. - The provider’s technical team should include an information technology specialist, with training in the electronic SIME and the AIN-C, since during the first year, management of the information system was problematic, with responsibility falling to the technical personnel. - The health workers are key for the development of the process considering that each worker should not be responsible for more than eight communities, or seven communities in the case of the early stimulation component, in order to ensure the quality of monitoring. In addition, these workers should receive appropriate pay so they do not resign. - The technical personnel in the departmental health control regions and the Coverage and Financing Extension Unit (UECF) who conduct performance monitoring and evaluations should be trained in all components of the strategy as well as in the methodology and instruments that are applied for contract monitoring. f. Financing Component 2 has two subcomponents: (i) coverage expansion of the AIN-C model with a budgetary allocation of US$11.5 million; and (ii) institutional strengthening of the Secretariat of Health with a budgetary allocation of US$3.0 million. 52 In summary, there was a total investment of credit funds of US$11,363,524 as of June. However, during this grace period, the execution of the remainder of the credit and counterpart funds is pending, due to the fact that payment of income tax of GESAWORLD is being incorporated, so to date the financial execution rate is 99% and will be 100% of the total once the incorporation has been approved and that tax is paid (the total approved credit was US$11,500,000). As for counterpart funds, US$2,326,884 of US$3,000,000 had been executed as of June, for an execution rate of 78%, with the expenses from the grace period still pending. The total investment of external and national funds was US$13,690,408, for an overall financial execution rate of 98% as of June 2013. Contribution from the Secretariat of Labor and Social Security Impacts of the Mi Primer Empleo [My First Job] Program The program generated a number of impacts at the institutional level, on the young beneficiaries, on the training centers (CECAP) that participated, and on the firms that hired these young people for internships or employment. The SLSS partnered with other institutions such as the Secretariat for Indigenous and Afro-Honduran People (SEDINAFROH),, the Secretariat of Education through PRONEEAH, chambers of commerce, the Honduran Institute for the Prevention of Alcoholism and Drug addiction (IHADFA), and the Secretariat of Health, with a shared objective and created job training opportunities for young people, with a comprehensive system of services, strengthening the Department of Employment through orientation services, which also provided psychological counseling services for the young people participating in the program. The Secretariat of Social Development joined forces with the SLSS, becoming the first project in which a partnership was created to select young people eligible for Mi Primer Empleo, through the Unique Registry of Beneficiaries (RUB). The young people who graduated from the program received training in technical skills, giving them a tool for social inclusion and employment. Of them, 975 had jobs six months after completing the program, enabling them to provide their households with new aspirations and income, and a large number of them returned to school. Of the young people from indigenous groups, 39 of them, mostly from the Lenca community, found employment. Based on the lessons learned from the first three rounds, the fourth one was designed to better coordinate the involvement of the different institutions that could refer at-risk youth, with the result that 1,900 young people were enrolled, 105 from indigenous groups. Cancelling the fourth round has a negative impact on young people, especially those who were already enrolled, and on the associations and institutions with which the program was promoted. Aspects to note As part of the program execution process, there are aspects that as the executing agency, the SLSS, through the project coordination unit (PCU), recognizes and recommends to 53 financial institutions, for the purpose of improving program results and execution. The following as some aspects that the PCU considers to be important:  Operations carried out with more than one executing agency are complex, and execution can be challenging, with communications compromised by staff turnover in positions at the executing units.  The World Bank’s Procurement Plan Management System (SEPA for its acronym in Spanish) is not designed to provide independence to each executing unit of the participating institutions, so a great deal of coordination must occur in order to upload a single procurement plan to the system, making the SEPA a bottleneck in project execution.  The Bank’s procurement specialist is willing and able, but due to the volume of work generated by the country portfolio, we understand that it is hard to provide quick service, so it would be a good idea to have technical assistance to provide support in this area.  A culture of communication should be promoted within the Bank, so that decisions on actions related to the execution of projects are made by consensus among all the areas involved, thus preventing burnout within the institution and additional work for the executing units.  The absence of clear guidelines for contracting the co-executing agency for Mi Primer Empleo was one of the biggest obstacles, and as a result the program was not executed.  Greater commitment by the government is needed to execute this type of project, in pursuit of national development.  Bureaucratic processes at the level of the World Bank and the government draw out response times and delay decisions that are essential to the program. On the quality of the World Bank’s contribution: We would like to acknowledge the technical assistance that we received from the World Bank’s fiduciary, procurement, and technical teams, as well as the support of the country office team. We value the contributions and confidence of the World Bank teams to overcome the various obstacles that arose over the course of the project, especially in terms of the internal processes to comply with the stipulations of the Agreements and Operating Manual for the Program. 54 Annex 8. Comments of Cofinanciers and Other Partners/Stakeholders N/A 55 Annex 9. List of Supporting Documents Documents used for ICR preparation  Project Appraisal Document. May 2005.  Project Paper on a Proposed Additional Credit (AF). May 2011.  Credit Agreement September 2005  Financial Agreement March 2011  Amendments and restructuring papers 2007-2013.  Aide Memoires 2004-2013  “Informe Final de la Consultoría de Evaluación Externa de Impacto de la Estrategia de Atención Integral a la Niñez en la Comunidad (AIN-C)”. Enero 2013. GESAWORLD.  “Informe de Resultados del Componente 2. Proyecto de Nutrición y Protección Social No 4097-HO.” Secretaria de Salud.  “Sistema de Monitoreo Proyecto de Nutrición y Protección Social. Unidad de Extensión de Cobertura y Financiamiento (UECF).” Mayo 2013. “Programa Mi Primer Empleo/ Informe de Cierre del Programa.” June 2013. SLSS  “Informe de Implementación, Cumplimiento y Resultados del Proyecto de Nutrición y Protección Social. Crédito IDA-4097-HN.” SDS.  “Informe de Resultados Final”. Septiembre 2013.Unidad Administradora de Proyectos. Secretaria de Estado del Despacho Presidencial (UAP-SDP).  La política de Protección Social en Honduras: Hacia un sistema integrado para la gerencia social efectiva”. Lidia Fromm. Revista de Cooperación y Desarrollo de Honduras.  Documento de Sistematización de Experiencias del MPE. Secretaria de Trabajo y Seguridad Social. “Programa Mi Primer Empleo. Informe de Cierre del Programa.” Junio 2013. STSS.  “Programa Mi Primer Empleo. Informe Final de Ejecución del Componente SECAPREML”. Marzo 2011. CADERH – SLSS.  Manual de Usuario del Sistema de Control de Pago de Estipendios. CADERH.  Informe Final de Evaluación de la III Convocatoria. Mayo 2009. SLSS.  Política de Protección Social. SDS. 2012 List of Background Documents used at Project Preparation  Honduras - Country Assistance Strategy, May 29, 2003.  Honduras – Interim Poverty Reduction Strategy Paper (PRSP) – Volume 1, April 18, 2000.  Honduras – Poverty Reduction Strategy Paper (PRSC), May 26, 2004.  Honduras – Development Policy Review (DPR), August 11, 2004.  Elaboración del documento de Proyecto de Nutrición: Consolidación y Expansión del Programa AIN-C, March 6 2005, Matilde Neret (unpublished).  Youth at Risk Component, March 6, 2005, Jaime Ramirez (unpublished).  The Joint Staff Assessment of progress in PRSP implementation, February 2, 2002. 56  Central America SSNA Cross Country Review of Findings, August 6, 2003, Jose. C. Marquez. Country Documents produced by the Government for preparation  Focalización de la Política Social, Secretariat of Presidency, 2003.  Bases Conceptuales y Operativas de la Atención Integral a la Niñez en la Comunidad (AIN-C ), Secretariat of Health, 2004.  Propuesta Metodológica: Operacionalización de la Estrategia de Atención Integral a la Niñez en el Ámbito Comunitario (AIN-C), Tegucigalpa, November 2004, Glenda Hernandez.  Política de la Salud Integral de la Niñez de Honduras (AIN-C), draft, October- November 2004, Lic. Gertalina Cerrato Gattorno.  Alcanzando las Metas de la Estrategia para la Reducción de la Pobreza, Plan de Implementación 2004-2006.  Revisión y Readecuación del Modelo de Operación Metodología de la Estrategia de Atención Integral a la Niñez (AIN-C), October 2004, Secretariat of Health.  Revisión de las Bases Conceptuales y Elaboración de Políticas, Secretariat of Health and Secretariat of the Presidency, 2005.  Identificación de Programas Complementarios Potenciales a la Implementación de la Estrategia de Atención Integral a la Niñez (AIN-C), first draft, November 2004, Victoria Vivas de Alvarado.  Resultado de la Consultoría Nacional para Asistencia en Sistematización de Focalización del Proceso de Implementación de la Atención Integral a la Niñez en la Comunidad (AIN-C), en 10s Departamentos de Santa Barbara, Copán, Ocotepeque, Lempira, Intibucá y la Paz, January 2005, Irene Orellana.  Esquema del Documento: Consultoría Nacional para la Revisión y Readecuación del Modelo de Operación y Metodología de la Estrategia de Atención Integral a la Niñez (AIN-C), October 2004, Judith Galindo and Glenda Hernandez.  Sistematización de logros y obstáculos con vistas a mejorar el impacto social del bono juvenil del PRAF para jóvenes en riesgo social de San Pedro Sula. II Informe (Preliminar), April 2004 Sources for Table 1- Honduras Development Indicators  Honduras Sector/Project Brief: Social Policy Challenges in Honduras: Poverty, Malnutrition and Youth Employment. September 2013.  Strengthening the Social Protection and Labor System in Honduras. Pablo Acosta, October 2013.Annex 10. Comparative Results Framework Original and AF PAD Revisions to the Results Framework Comments PDO Original PAD Additional Financing The objectives of the Project are Revised. The project development The original PDO articulated in the to assist the Borrower in: (i) objective is to improve Recipient’ legal agreement was broad 57 improving the nutritional social safety net for children and (improving nutritional condition of condition and basic health status youth by: (i) strengthening the children inside its territory as of infants and young children Government’s capacity to administer opposed to those who are poor and inside its territory; and (ii) social assistance programs; (ii) vulnerable), and vague increasing the job marketability of improving nutritional and health (“marketability” is not a term used in its disadvantaged youth status of young children by social protection parlance, and expanding the AIN-C program, and “disadvantaged was not defined. (iii) increasing employability of at- risk youth by piloting a First Employment program PDO indicators PDO Indicators for Component 1: Institutional strengthening of the Recipient’s social protection framework for children and youth Original PAD Additional Financing Coherent institutional structure for Revised. Institutional structure for “Coherent” was not defined, and the policy formulation, planning social protection policy formulation, institutional structure for social budgeting, coordination, planning, implementation, and protection goes beyond children and implementation and M&E of evaluation is created by youth, and should be set up social protection actions for C&Y in Governmental decree accordingly. place Intermediate Results Indicators M&E system strengthened and in Revised: Information System for The new articulation reflected that use with results feedback to policy Monitoring and Evaluation of Social the Government did not have a M&E and program design as well as Protection Programs is designed and system in place (so it could not have budget allocations operational been strengthened as noted in the original indicator) Coordination mechanisms defined Dropped. It is not clear to which It was not clear to which coordination and in use coordination mechanisms the indicators was referring and in any case, coordination was covered under the PDO Indicator for this component (e.g., institutional structure in place) New: Household data collection to This was a new indicator that identify beneficiaries for Bono reflected an additional activity that 10,000 would be funded under the Additional Financing, not foreseen in the original project’s design New: Targeting mechanism for urban This was a new indicator that area validated reflected an additional activity that would be funded under the Additional Financing, not foreseen in the original project’s design Draft social protection policy for Revised: Social Protection Policy Since Honduras did not have a social C&Y with its 3 year finalized and approved by the Social protection policy, the one produced implementation plan which Cabinet under this project should cover the defines roles, responsibilities and entire lifecycle, including children products of each participating and youth. Also, the original institution indicator called for a draft, but given the importance of a SP policy to organizing the sector, the new indicator called for its finalization PDO Indicators for Component 2: Support for the implementation of the Recipient’s AIN-C Program Original PAD AF PAD Percentage of reduction in the Revised: Reduction in chronic The original indicator was slightly rate of chronic malnutrition of malnutrition for children under 2 more complex and did not articulate children under 2 years old years of age participating in AIN-C that the reduction would be measured in beneficiary communities 58 Intermediate Results Indicators Number of new communities Continued covered by program Percentage of children under 2 Continued years old who participate in the weighing sessions Percentage of children under 2 Continued years old with inadequate growth in two successive checkups Percentage of children under 2 Continued years old who began to participate in the program before 3 months of age Percentage of children exclusively Continued breastfed for 6 months This was a new indicator. The PDO New: Percent reduction in number of children with reported cases of articulated that children’s nutritional diarrhea in the last two weeks, inand health status would be improved beneficiary communities under the project; there was no indicator to measure health status under the original Project. The new indicator filled this gap. PDO Indicators for Component 3: Implementation of Recipient’s FE Program for Disadvantaged Youth Original PAD AF PAD Percentage of program graduates Continued in paid employment or self employment 6 months after program graduation Intermediate Results Indicators Original PAD AF PAD Number of youths who use the Continued SLSS Information Service in project areas Number of businesses that offer Continued internships Number of youths participating in Change in target value. First Employment program Original target: 6,000 New Target: 7,100 Percentage of youths successfully Continued completing all phases of the FEP New: percentage of Indigenous and Need to have evidence on Afro-Honduran beneficiaries, from effectiveness of active outreach for the total of beneficiaries; Indigenous and Afro-Honduran beneficiaries New: percentage of Indigenous and Need to have evidence on Afro-Honduran youths finishing the effectiveness of active outreach for program, from the total registered Indigenous and Afro- Honduran beneficiaries 59 Annex 11: Methodology of the FEP and AIN-C evaluations First Employment Program 1. A longitudinal study of phases I and II of the third round on training of the FEP program was carried out in 2011. The study analyzed four aspects:  The participation in the training program improved the beneficiaries’ results in the labor market in terms of salaries, benefits and quality of employment;  The participation in the program reduces risk behavior in beneficiaries;  Effectiveness of the training provided;  Comparison among evaluated groups of their live standards. 2. The study followed youth who participated in the training and those who enrolled but did not take the training. The study was designed to capture information nine months and 12 months after completing the training. The study covers a sample of 1,641 young 15-19 year-olds of a universe of 2,150 (or 76 percent). A total of 1,491 are the beneficiaries and 290 are the control group. Questionnaires were designed and applied to the participants. The consulting firm that carried out the study used as the baseline the database provided by the SLSS. AIN-C Program 3. The impact evaluation of AIN-C used a quasi-experimental evaluation that applied an intensity model with and without effects in the communities. The results obtained through this methodology were further explored through workshops in beneficiary communities to undertake a deeper qualitative analysis of AIN-C. 4. Quantitative methodology: the primary data were collected in four moments in time with a first measurement and three follow up measurements: six, 12 and 22 months, after the first data collection. The sample was divided in two groups: beneficiary and non- beneficiary communities. The units of observation were: children under two years of age, pregnant women, monitoras in the communities under evaluation and community leaders in the non-intervention communities. The departments were Copan, El Paraiso, Intibuca, La Paz, Lempira and Ocotepeque. 5. The IE document includes details on the preparation of the sample, the preparation and validation of the questionnaires applied and the quality control of the information collected. This document is part of the ICR electronic files. 60 Annex 12: Institutional Change/Strengthening Outcomes 1. The Project contributed to strengthen the three implementing agencies (SOH, SLSS, SSD) and the SOP through technical assistance and training. Significant institutional strengthening took place though the preparation of the four rounds for the FEP and with the implementation of three of these rounds. The SLSS was strengthened through the establishment of the PCU staffed with personnel trained to manage projects. It’s financial and procurement capacity was significantly improved with Bank support and the implementation of internal controls, succeeding in using all available resources for the FEP and contributing to increase transparency in their working processes, all available in the SLSS’s web. Provision of furniture, equipment for information systems and upgraded infrastructure for the SLSS contributed to institutional strengthening as well. The Directorate for Employment (Dirección General de Empleo, DGE) was strengthened through the definition of a new organizational structure and staff. The CECAPs were strengthened as well, empowered to lead the beneficiaries’ selection process and the promotion activities, tailored to be local and close to the potential beneficiaries. They led a process of interaction with grassroots local organizations in particular to reach afro-Hondurans and indigenous youth. The SENAEH was also strengthened. An orientation service to citizens (Servicio de Atención al Ciudadano) within the SLSS was established to direct people within the SLSS and IT support (internet access and webpage for FPE) was provided for the SLSS regional offices in San Pedro Sula, Choluteca, Danli, El Progreso, Comayagua, La Ceiba y Tegucigalpa. 2. The Project contributed to design a comprehensive support system for youth at risk who were targeted by FEP. The DGE was strengthened through the establishment of the Employment Orientation Service (Servicio de Orientación, SOE) where young people could receive psychological guidance and support as they prepared to look for a job. Psychometric tests were applied to young people as part of the support provided to find a job. The SLSS established alliances with key institutions such as the Secretariat of Education (through the Program for Education of Indigenous People, PRONEEAH), Secretariat for Indigenous People (SEDINAFROH), chambers of commerce, SOH, Honduran Institute for the Prevention of Alcoholism and Drug addiction (IHADFA). In the context of the fourth FEP round, the SLSS and SSD agreed to collaborate using the Single Beneficiary Registry (RUB) to select the young people to participate in the FEP, based on the requirements of the Program. 3. The support for AIN-C contributed to significant institutional building at the central, regional and local level in the SOH. The SOH played a leading role in developing a basic package of services for centralized and decentralized providers, to be followed by other donors who implement the AIN-C Program. The Project supported the development and implementation of an information, monitoring, and evaluation system (Sistema de Información, Monitoreo y Evaluación, SIME) to capture the program’s information and generate indicators to assess progress. SOH staff at municipal and regional levels was trained in the content and use of the SIME, which contributed to better quality of information provided from these levels and the use of the indicators generated by the SIME to adjust the program when needed. Furthermore, the AIN-C program has been 61 incorporated to the university level studies of nursing. Teachers were trained in Tegucigalpa, San Pedro Sula, and La Ceiba in the modules of monitoring and growth, assistance to sick children in their communities and assistance to pregnant women in their communities in 2011 and 2012. 4. The AIN-C Program worked with results-based contracts with the NGOs, building a culture of performance and results. The management and supervision of these contracts contributed to building capacity in the regional and municipal levels of the SOH. 5. The Project provided support to define core competencies and functioning of the SSD. Technical assistance was provided to strengthen the SSD administrative and procurement capacity, and project management capacity building activities. Study trips to understand how other social programs work and other countries experiences were carried out with Mexico and the Dominican Republic. 62 89°W 88°W 87°W 86°W 85°W 17°N 17°N B ELI Z E Caribbean Sea HONDURAS Roatán A BAHI LA DE Gulf of S Honduras LA 16°N IS 16°N Trujillo Iriona Puerto Cortés za Barra Patuca Tela La Ceiba Balfate Corocito r an Brus C O L Ó N Es pe G U AT E M ALA A T L Á N T I D A bre de Dios La Laguna ya CORTES Tocoa La ula Nom Sonaguera a M Pa Lago de San Pedro ll e r a u an Ag rr o s Ahuas Izabal Sula Cordi Olanchito e q El Progreso Si GRACIAS u i t Quimistan Las Vegas El Carbón Puerto Sico Morazán YORO ia Lempira Higuerito A DIOS Ulú San Esteban a Nuevo Arcadia S A N TA Embalse General Francisco Morazán Dulce Nombre Sirsirtara Yoro BÁRBARA de Culmí Su 15°N 15°N lac n COPÁN Santa OLANCHO ló o a Co uc Bárbara Lago de Catacamas Salamá de at CO Copán Ruinas Santa Rosa Yojoa P Hu San Luis Guaya l s ca pe tu Awasbila m de Copán de Pa ña uya Jaitique M To a To Mon as nt Puerto AY Chiquimula Juticalpa de C taña añ Gracias o Cabezas o m a y Cedros t M on AG O C O T E - Cerro Comayagua agua Guaimaca M re Las Minas mb Nueva P E Q U E (2,870 m) La CÁ UA aa AZ SCO Ocotepeque Esperanza y La Paz Gu LEMPIRA n BU AN á Valle de Jal To o San Salvador Angeles TI oc OR CI Marcala EL PARAÍSO C IN Mapulaca L A PA Z M AN 14°N Camasca TEGUCIGALPA Danlí 14°N Yuscarán H ONDURAS FR To Sabana Las Manos E L S ALVAD OR San Miguel Grande SELECTED CITIES AND TOWNS VALLE To NICA RAGUA Estelí DEPARTMENT CAPITALS To Nacaome San Marcos San Salvador de Colón NATIONAL CAPITAL San Lorenzo Choluteca ECA RIVERS LUT 0 20 40 60 80 100 Kilometers O onse ca CH PAN AMERICAN HIGHWAY l fo de F Triunf El Triunfo 0 20 40 60 Miles MAIN ROADS 13°N o 13°N IBRD 33418R1 G This map was produced by the Map Design Unit of The World Bank. FEBRUARY 2008 To RAILROADS PAC IF IC OC EAN Managua The boundaries, colors, denominations and any other information shown on this map do not imply, on the part of The World Bank Group, any judgment on the legal status of any territory, or any DEPARTMENT BOUNDARIES endorsement or acceptance of such boundaries. 89°W 88°W 87°W 86°W 85°W INTERNATIONAL BOUNDARIES