The World Bank Implementation Status & Results Report Investing in Early Years and Fertility in Burundi (NKURIZA) (P165253) Investing in Early Years and Fertility in Burundi (NKURIZA) (P165253) EASTERN AND SOUTHERN AFRICA | Burundi | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2020 | Seq No: 7 | ARCHIVED on 09-Jan-2023 | ISR54589 | Implementing Agencies: Ministry of Public Health and Fight against AIDS, Republic of Burundi Key Dates Key Project Dates Bank Approval Date: 05-Sep-2019 Effectiveness Date: 28-Feb-2020 Planned Mid Term Review Date: -- Actual Mid-Term Review Date: 28-Nov-2022 Original Closing Date: 30-Jun-2024 Revised Closing Date: 30-Jun-2024 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) Increase the coverage of community based nutrition interventions among women of reproductive age and children under two and to increase utilization of family planning services in targeted areas Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Community interventions to increase coverage of nutrition services and utilization of family planning services:(Cost $23.70 M) Strengthening institutions, leadership and monitoring:(Cost $6.30 M) Contingency Emergency Response Component (CERC) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Satisfactory Overall Risk Rating Substantial Substantial Implementation Status and Key Decisions The Investing in Early Years and Fertility in Burundi (NKURIZA) project aims to increase the coverage of community-based nutrition interventions among women of reproductive age and children under two and to increase utilization of family planning services in targeted areas. A Mid-Term Review for the project was held from November 28 – December 2, 2022. The mid-term review demonstrated that the MoH has made important progress, following implementation of the agreed actions from previous missions. Notable achievements include: (i) the project performance has improved substantially with an accelerated pace of activities implementation, which has been reflected in the substantive increase in disbursements: from 3% in June 2021 to 26% in December 2022; (ii) the project has initiated activities at community level, with support from MoH, through nutrition and reproductive health programs (while awaiting finalization of the recruitment of implementing agencies) and mass communication activities on nutrition and family planning; (iii) for the first time since the start of the project, the indicators for the results framework have been fully updated with two PDO indicators already surpassing their end-line target. 1/9/2023 Page 1 of 6 The World Bank Implementation Status & Results Report Investing in Early Years and Fertility in Burundi (NKURIZA) (P165253) The project, however, continues to face some challenges including delays in onboarding implementing agencies and implementing the Grievance Redress Mechanism (GRM). The Ministry of Health and the World Bank have discussed clear actions for improving the pace of implementation as well as ensuring activation of the GRM An extension of the closing date of the project is envisaged to allow more time to complete implementation of activities and fully realize the project’s objectives. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance High High High Macroeconomic High High High Sector Strategies and Policies Substantial Substantial Substantial Technical Design of Project or Program Substantial Substantial Substantial Institutional Capacity for Implementation and Substantial Substantial Substantial Sustainability Fiduciary Substantial Substantial Substantial Environment and Social Moderate Moderate Moderate Stakeholders Substantial Substantial Substantial Other High High High Overall Substantial Substantial Substantial Results PDO Indicators by Objectives / Outcomes Increase the coverage of community based nutrition interventions among women and children IN01236976 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 3,894,749.00 4,925,318.00 1,000,000.00 Date 27-Nov-2018 17-Jun-2022 30-Sep-2022 30-Jun-2023 This indicator has started being reported, but does not disentangle beneficiaries exclusively attributable to Comments: this project since community-based distribution started. IN01236979 Number of women and children who have received basic nutrition services (Number, Corporate Breakdown) 1/9/2023 Page 2 of 6 The World Bank Implementation Status & Results Report Investing in Early Years and Fertility in Burundi (NKURIZA) (P165253) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,888,906.00 2,694,255.00 1,000,000.00 Date 27-Nov-2018 17-Jun-2022 30-Sep-2022 30-Jun-2023 IN01236980 ►Children 0-23 months receiving essential community-based nutrition and early stimulation services in targeted areas (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 25.00 33.00 30.00 Date 16-Nov-2018 17-Jun-2022 30-Sep-2022 30-Jun-2023 Community distribution has started in December 2021. Comments: IN01236981 ►Children 0-23 months showing adequate weight gain in targeted areas (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 22.00 22.00 55.00 Date 16-Nov-2018 17-Jun-2022 30-Sep-2022 30-Jun-2023 This indicator will have to include community-based targeting, but is still not reported. Comments: Increase utilization of family planning services IN01236977 ►Women using modern contraceptive methods in targeted areas (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 19.90 40.00 40.00 29.90 Date 21-Aug-2018 17-Jun-2022 30-Sep-2022 30-Jun-2023 Comments: Women using modern contraceptive method/ 80% women of reproductive age in project areas * 100 IN01236978 ►Couple-Years Protection (CYP) in targeted areas (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 531,695.00 231,211.00 231,211.00 1,102,522.00 Date 31-Dec-2017 17-Jun-2022 30-Sep-2022 30-Jun-2023 Estimated protection provided by family planning services during a one year period, based upon the volume of all contraceptives sold or distributed free of charge to clients during that period. CYP is Comments: calculated by multiplying the quantity of each method distributed to clients by a conversion factor, which yields an estimate of the duration of contraceptive protection provided per unit of that method Overall Comments PDO 1/9/2023 Page 3 of 6 The World Bank Implementation Status & Results Report Investing in Early Years and Fertility in Burundi (NKURIZA) (P165253) There have been good progress in all PDO-level indicators, with some surpassing their targets. However, progress need to be accelerated for indicators directly linked to the project design, such as children with adequate weight gain, use of modern contraceptives, and couple-years protection. Intermediate Results Indicators by Components Community interventions to increase coverage of nutrition services and utilization of FP IN01236982 ►Community steering committees meeting quarterly and providing inputs into the project's quarterly reports, including on quality of and satisfaction with community nutrition interventions (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 36.00 36.00 133.00 Date 27-Sep-2018 17-Jun-2022 30-Sep-2022 30-Jun-2023 Steering committee meeting were hold at the targeted provincial level, and will start at the targeted Comments: collines' level in February 2022. IN01236984 ►Mothers participating in behavior change activities (cumulative) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 79,247.00 317,386.00 607,454.00 Date 21-Aug-2018 17-Jun-2022 30-Sep-2022 30-Jun-2023 Number of mothers benefiting from behavior change activities; cumulative Comments: IN01236986 ►Targeted households with targeted groups (children under two, pregnant and lactating women, adolescent girls) benefiting from nutrition sensitive community initiatives (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 35,886.00 Date 21-Aug-2018 17-Jun-2022 30-Sep-2022 30-Jun-2023 Comments: Cumulative number of Households/ targeted households in project areas IN01236987 ►Pregnant women benefiting from iron and folic acid supplementation (cumulative) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 549,277.00 581,393.00 1,738,047.00 Date 16-Nov-2018 17-Jun-2022 30-Sep-2022 30-Jun-2023 Comments: Number of Pregnant women receiving supplementation in project areas IN01236988 1/9/2023 Page 4 of 6 The World Bank Implementation Status & Results Report Investing in Early Years and Fertility in Burundi (NKURIZA) (P165253) ►Community Health workers trained to deliver Sayana Press (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 63.00 1,087.00 100.00 Date 16-Nov-2018 17-Jun-2022 30-Sep-2022 30-Jun-2023 This indicator is in good progress. It is aligned with the community-based distribution of contraceptives. Comments: Strengthening institutions, leadership and monitoring IN01236983 ►Faith-based health facilities staff trained on family planning methods and referrals in in targeted areas (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 63.00 63.00 80.00 Date 21-Aug-2018 17-Jun-2022 30-Sep-2022 30-Jun-2023 Comments: Staff trained (at least 1 per facility)/Targeted staff in project provinces*100 IN01236985 ►Number of people trained in Masters level training (1 year) (nutrition, reproductive health, and environmental public health) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 9.00 Date 16-Nov-2018 17-Jun-2022 30-Sep-2022 30-Jun-2023 Number of students registered to a masters level training in nutrition, reproductive health or environmental Comments: health Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P165253 IDA-D5140 Effective USD 30.00 30.00 0.00 7.52 21.53 26% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P165253 IDA-D5140 Effective 05-Sep-2019 19-Sep-2019 28-Feb-2020 30-Jun-2024 30-Jun-2024 1/9/2023 Page 5 of 6 The World Bank Implementation Status & Results Report Investing in Early Years and Fertility in Burundi (NKURIZA) (P165253) Cumulative Disbursements Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 1/9/2023 Page 6 of 6