Document of The World Bank FOR OFFICIAL USE ONLY AA. 3zS3 /4 Public Disclosure Authorized oo iZ / -73 -/ Report No.8568-IN STAFF APPRAISALREPORT Public Disclosure Authorized INDIA INTEGRATEDCHILD DEVELOPMENTSERVICES PROJECT JUNE 1, 1990 Public Disclosure Authorized Asia CountryDepartment IV (India) Public Disclosure Authorized Population,Human Resources,Urban and Water OperationsDivision Thisdocument has a restited distributionand may be usedby redieus ony In the pedormanc of their officiaduties. Its contents may not othenwie be dislosed without Wodd Bank authnoroion. CURRENCYEQUIVALENTS Currency Unit = Indian Rupee (Rs) US$ 1.00 = Rs 17 Rs 1.00 - USS 0.059 WEIGHTS AND MEASURES Metric System FISCAL YEAR April 1 - March 31 ABBREVIATIONS AND ACRONYMS AID - United States Agency for International Development AP Andhra Pradesh AR , Anganwadi (Village ICDS Center) AWW = Anganwadi Worker CARE = Cooperative for American Relief Everywhere CDPO = Child Development Project Officer GOI Government of India ICDS = Integrated Child Development Services IEC - Information, Education and Communication IMR - Infant Mortality Rate LBW - Low birth weight MDM = Mid-day Meals Program MM - Mahila Mandal (women's society) NFI = Nutrition Foundation of India NGO = Non-government Organization NORAD Norwegian Agency for International Development NIPCCD = National Institute of Public Cooperation and Child Development NMP Noon Meals Program PDS Public Distribution System PMO Project Management Office SIDA Swedish International Development Agency SNP - Special Nutrition Program TINP - Tamil Nadu Integrated Nutrition Project UNICEF = United Nations Children's Fund WCD - Department of Women and Child Development, GOI WILL 'Women's Integrated Learning for Life program FOR OFCIAL USE ONLY - i - INDIA INTEGRATEDCHILD DEVELOPMENT SERVICES PROJECT Table of Contents Page No. LOANICREDITAND PROJECT SUMMARY ... .. ii I. BACKGROUND A. Introduction . B. National Nutrition Programs . 3 C. Nutrition Programs in Andhra Pradesh . 7 D. Nutrition Programs in Orissa . 8 E. Learning from Other Experiences . 9 F. National Nutrition Policy and Strategy . 11 G. Other Donor Role . 12 H. Bank Role and Assistance Strategy . 12 II. THE PROJECT A. Goals and Objectives . 14 B. Scope .... 15 C. Strategy . 15 D. Project Description . 17 Service Delivery . 17 E. Communications . 23 F. Community Mobilization .... 24 G. Project Management,Monitoring and Evaluation. 25 III. PROJECT COSTS. FINANCING AND IMPLEMENTATION A. Cost Estimates .... 27 B. Financing Plan .... 29 C. Recurrent Cost Implications . 29 D. Project Implementation . 30 E. Disbursements .... 31 F. Procurement .... 32 G. Accounting and Auditing .... 34 This report is based on the findings of an appraisal mission to India from January 19-February 22, 1990 comprising of Mr. James Grecne (Principal Nutrition Specialist-MissionLeader), Mr. Richard Heaver (Senior Operations Officer), and the following consultants:Mr. Jay Satia (Management Specialist),Drs. J. Kevany and W. Cutting ( Public Health Specialists),Mr. S. Mehra (CommunicationSpecialist), Ms. H. Chatterjee (Women's Program Specialist),and Mr. M. N. Murthy (FinancialAnalyst). Mss. J. Bhasin (NDO), Vivian Mendoza and Paula Walden assisted in preparing the report. This document has a restricted distribution and may be used by recipients only in the performance of their official duties. Its contents may not otherwise be disclosed without World Bank authorization. - ii - Pane h'o. IV.BENEFITS AIDRISKS . 36 V. AGREEMENTSREACHED AND RECOMMENDATION. 38 TABLES 3.1 Estimated Project Costs by Component . 25 3.2 Estimated Project costs by Category of Expenditure . 26 3.3 Financing Plan . 28 ANNEXES 1. Integrated Child Development Services Scheme (ICDS) . 37 2. Impact and Process Objectives . .. 43 3. Details of Project Areas ... ....... 47 4. Training .... ...... 52 5. Communications Component .. 60 6. Community Mobilization through Women's Programs . 65 7. Detailed Project Cost Estimates ... ..... 69 8. Project Implementation Schedule . .. .. 78 9. Percentage of Incremental Operating Costs For Bank Group Financing .... ...... 82 10. Forecast of Annual Expenditures and Disbursements . 83 11. Selected Documents in the Project File . .. 84 - iii. - INDIA INTEGRATED CHILD DEVELOPMENTSERVICES PROJECT Loan/Credit and Project Summary Borrower: India, acting by its President Beneficiary: Governmentsof Andhra Pradesh and Orissa Amountt IBRDt US$10 million equivalent IDA: SDR 93.6 million (US$96 million equivalent) Terms: IBRD: 20 years, including5 years' grace, at standard variable interestrate IDA: Standard,with 35 years' maturity OnlendinigTerms: Governmentof Iadia to Andhra Pradesh and Orissa: In accordancewith standard arrangementsfor development assistancetc States for nutritionprojects on terms and conditionsapplicable at the time Description: The projectwould support the objectiveof the Central and Andhra Pradesh and Orissa state governmentsof improvingthe nutritionand health status of children under 6 years of age, with specialemphasis on those 0- 3 years old, and pregnant and nursingwomen. Its specificobjectives in project areas would be: (a) to reduce severe malnutritionin those children by 50o in both states; (b) in Andhra Pradesh to reduce moderate malnutritionand increase the proportionof those children in normal or only mild (Grade I) malnutrition status by 35? and help reduce the infant mortality rate (IMR) to 60 per 1,000 live births and the incidenceof low birth weight (LBW) by 302, and (c) in Orissa to reduce moderatemalnutrition and increase the proportion of those children in normal or Grade I status by 25Z and help reduce the IMR to 100 per 1,000 live births and LBW by 20Z. The projectwould comprise the following components: (a) servicedelivery, to increasethe range, coverageand qualityof nutritionand health servicesto target groups through improvementsin the design and implementationof software systems,training for health and nutritionworkers, provisionof nutrition and health educationand health referral services, increasingthe availabilityof drugs and equipmentfor maternal and child health and the supply of therapeutic supplementaryfood to malnourishedbeneficiaries, and constructionof villagenutrition centers, offices and - iv - residencesfor key field staff; (b) communicationsto stimulatedemand for project services and improvechild feedingpractices and care through productionand disseminationof media messages,provision of equipment and materialsand training;(c) communitymobilization to increaselocal participationin and support for project servicesand activitIesthrough testing of innovativewomen's developmentactivities including activationof villagewomen's groups, developmentof income-generatingactivities, non-formal study courses for women and developmentof training programs for adolescentgirls; and (d) projectmanagement and evaluationto manage, monitor and evaluate the project and conduct operationsresearch to analyzeand improve aspectsof project design. Benefits and Risks: The projectwould improvethe nutritionand health status of tribal,drought-prone and otherwise disadvantagedpopulation groups in Andhra Pradesh and Orissa. About five million pre-schoolchildren and around three million pregnant and lactatingwomen would directlybenefit from the project'snutrition and health services. Around 45,600 women would obtain trainingand part-timeemployment as workers, helpers or supervisors in project areas. Around 600,000women would be formed into women's groups and would receivetraining both in basic nutritionand health care and how to pass this knowledgealong to their communities. Around 5,600 women's groupswould take part in income-generating activitiesand over 150,000 adolescentgirls would receive apprenticeshiptraining in health and nutrition. An importantindirect project benefitwould be its overall impact on ICDS through testing of innovative software systemsfor broader replication. The main risks are that implementationcapability may be inadequate,which could adverselyaffect expected servicedelivery coverageand quality, and that authoritiesinvolved with nutritionmay not be willing to accept the merits of supplementarychild-feeding on the basis of verifiablenutrition and growth-faltering criteria rather than on worker-interpretedpoverty grounds. Actions to minimize the implementationrisk include strengtheningICDS organizationat block, district and state levels and training its managers; testingand refiningnew service deliverymodes and contentbefore full-scaleadoption, and a mid-term evaluation. The latter risk would be reducedby (a) assurancesthat modificationsto initially-agreed ICDS supplementaryfeeding criteriawould have to be satisfactoryto the Bank Group, (b) the carrying out of operationalresearch on alternativesupplementation procedures,and (c) the weight of accumulatingevidence that selectivesupplementation is effectiveand efficient. - v - Estimated Cost8: Local Foreign Total Percent __ _- USS millions ------------ A. Service Delivery 1. Nutrition 97.3 5.5 102.8 65 2. Health 10.1 2.1 12.2 8 3. Training 14.9 0.7 15.6 10 Subtotal 122.3 8.3 130.6 83 B. Communications 9.4 0.5 9.9 6 C. Community Mobilization 10.8 0.2 11.0 7 D. Project Management 1. Project Organization 4.6 0.2 4.8 3 2. Monitoring and Evaluation 1.2 0.0 1.2 1 Subtotal 5.8 0.2 6.0 4 Total Project Cost 148.3 9.2 157.5 100 *including taxes and duties of US$4.0 million. - vi - Project.Financing Plan: Costs including taxes and duties --------------S$ million---------- Local Foreign Total 2 IBRD/IDA