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Document of The World Bank FOR OFFICIAL USE ONLY Public Disclosure Authorized Report No: 34315-GT PROJECT APPRAISAL DOCUMENT ON A Public Disclosure Authorized PROPOSED LOAN IN THE AMOUNT OF US$49.0 MILLION TO THE REPUBLIC OF GUATEMALA FOR A MATERNAL-INFANT HEALTH AND NUTRITION PROJECT Public Disclosure Authorized December 15,2005 Human Development Sector Management Unit Central America Country Management Unit Latin America and the Caribbean Region This document has a restricted distribution and may be used by recipients only in the Public Disclosure Authorized performance of their official duties. Its contents may not otherwise be disclosed without World Bank authorization. CURRENCY EQUIVALENTS (Exchange Rate Effective 11/28/05) Currency Unit = Guatemalan Quetzales (GTQ) US$l.OO = 7.63 GTQ FISCAL YEAR January 1 - December 31 ABBREVIATIONS AND ACRONYMS AINM-C Community Integrated Care for Children and Women (Atencio'n Integral a la Nifiez y Mujer - Comunitario) ARI Acute Respiratory Infection CAIMIs Maternal and Infant Integral Health Care Centers (Centros de Atencidn Integral Materno Znfan ti 1) CAS Country Assistance Strategy CETC Communication, Education and Training at Community level Strategy DHS Demographic Health Surveys DPL Development Policy Loan FG Focus Groups GDP Gross Domestic Product GNI Gross Net Income GNP Gross National Product GOG Government of Guatemala GSR Government Social Policy (Guate Solidaria Rural) HCW Health Care Waste HIV/AIDS Human Immune-Deficiency Virus/AIDS IBRD International Bank for Reconstruction and Development IDA International DeveloDment Association IDB Inter-American Development Bank INE National Institute of Statistics (Znstituto Nacional de Estadisticas) LAC Latin American and the Caribbean Region M&E Monitoring and Evaluation MAGA Ministry of Agriculture (Ministerio de Agricultura, Ganaderia y Alimentacidn) MDGs MillenniumDevelopment Goals MSPAS Ministry of Public Health and Social Welfare (Ministerio de Salud Phblica y Asistencia Social) NGOs Non-Governmental Organizations PCU Proiect Coordination Unit PEC Program for the Extension of Coverage PHRD Japan Policy and Human Resources Development Fund POAs Annual Operational Plan (Plan Operativo Anual) SEGEPLAN Secretariat of Programming and Planning (Secretaria de Planijicacidn y Programacidn de la Presidencia) SESAN Secretariat of Food and Nutritional Security (Secretaria de Seguridad Alimentaria y Nutricional i 1 STAS I Directorate of Internal Health Svstem fDireccidn Sistema Integral de Atencidn en Salud) I -sIL Specific Investment Loan SOE Statement of Expenditures SOSEP Social Work Secretariat of the President’s Wife (Secretaria Obra Social Esposa del Presidente) STIs Sexually Transmitted Infections TBAs Traditional Birth Attendants UCPYP Project and Program Coordination Unit (Unidad Coordinadora de Programas y Proyectos) UPS1 Primary Level Service Provision Unit (Unidad de Provisidn de Sewicio de Primer Nivel) UPS2 Secondary Level Service Provision Unit (Unidad de Provisidn de Sewicio de Segundo Nivel) Vice President: Pamela Cox Country Director: Jane Armitage Sector Director: Evangeline Javier Sector Manager: Keith Hansen Sector Leader: Laura Rawlings rTask Team Leaders: Marcelo Bortman FOR OFFICIAL USE ONLY This document has a restricted distribution and may be used by recipients only in the performance of their official duties. Its contents may not be otherwise disclosed without World Bank authorization. GUATEMALA MATERNAL-INFANT HEALTH AND NUTRITION PROJECT CONTENTS Page No. A . STRATEGIC CONTEXT AND RATIONALE .................................................................. 1 1. Country and sector issues .................................................................................................... 1 2 . Rationale for Bank involvement .......................................................................................... 3 3 . Higher level objectives to which the project contributes ..................................................... 4 B. PROJECT DESCRIPTION.................................................................................................. 5 1. Lending instrument .............................................................................................................. 5 2 . Project development objective and key indicators .............................................................. 6 3 . Project components .............................................................................................................. 6 4 . Lessons learned and reflected in the project design .......................................................... 10 5 . Project Alternatives considered and reasons for rejection................................................. 14 C. IMPLEMENTATION ......................................................................................................... 16 1. Partnership arrangements ................................................................................................... 16 2 . Institutional and implementation arrangements ................................................................. 16 3 . Monitoring and evaluation of outcomes/results ................................................................ 17 4 . Sustainability ..................................................................................................................... 19 5 . Critical risks and possible controversial aspects ............................................................... 19 .. 6 . Loan condltlons and covenants .......................................................................................... 20 D. APPRAISAL SUMMARY .................................................................................................. 21 1. Economic and financial analyses ....................................................................................... 21 2 . Technical ............................................................................................................................ 23 3 . Fiduciary ............................................................................................................................ 24 4 . Social ................................................................................................................................. 24 5 . Environment ...................................................................................................................... 24 6 . Safeguard policies .............................................................................................................. 25 7 . Policy Exceptions and Readiness ...................................................................................... 25 Annex 1: Country and Sector or Program Background .......................................................... 26 Annex 2: Major Related Projects Financed by the Bank and/or other Agencies ..................37 Annex 3: Results Framework and Monitoring ......................................................................... 40 Annex 4: Detailed Project Description ...................................................................................... 43 Annex 5: Project Costs ................................................................................................................ 58 Annex 6: Implementation Arrangements .................................................................................. 61 Annex 7: Financial Management and Disbursement Arrangements ...................................... 66 Annex 8: Procurement Arrangements ....................................................................................... 70 Annex 9: Economic and Financial Analysis .............................................................................. 75 Annex 10: Safeguard Policy Issues: Environmental and Social Assesments ......................... 82 Annex 11: Project Preparation and Supervision ...................................................................... 98 Annex 12: Documents in the Project File .................................................................................. 99 Annex 13: Statement of Loans and Credits ............................................................................. 101 Annex 14: Country at a Glance ................................................................................................ 102 Annex 15: Map IBRD 33413 ..................................................................................................... 104 GUATEMALA GUATEMALA MATERNAL- INFANT HEALTH AND NUTRITION PROJECT APPRAISAL DOCUMENT LATIN AMERICA AND CARIBBEAN LCSHH Date: December 14,2005 Team Leader: Carlos Marcel0 Bortman Country Director: Jane Armitage Sectors: Health (75%);0ther social services Sector ManagerDirector: Keith E. Hansen (25%) Themes: Child health (P);Nutrition and food security (P);Other human development (S) Project ID: PO77756 Environmental screening category: Partial Assessment For LoandCredits/O thers : Total Bank financing (US$m.): 49.00 DEVELOPMENT Total: 44.40 4.60 49.00 I Borrower: Republic of Guatemala Responsible Agency: Ministry of Public Health and Social Welfare - Guatemala Ing. Marco Tulio Sosa Ramirez Minister 6a. Ave. 3-45, Zona 11, Escuela de Enfermeria, 3er Nivel, Ciudad de Guatemala, Guatemala. Phone: 502-2440-0516 Fax: 502-2475-1 125 Email: despachoministerial @mspas.gob.gt innual 17.72 11.08 11.02 5.56 3.62 0.00 0.00 0.00 0.00 3umulative 17.72 28.80 39.82 45.38 49.00 0.00 0.00 0.00 0.00 Ref. PAD A.3 No Does the project require any exceptions from Bank policies? Ref.
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