The World Bank Implementation Status & Results Report Multisectoral Early Childhood Development Project (P166800) Multisectoral Early Childhood Development Project (P166800) EAST ASIA AND PACIFIC | Marshall Islands | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2019 | Seq No: 7 | ARCHIVED on 22-Dec-2022 | ISR54682 | Implementing Agencies: Ministry of Culture and Internal Affairs, Ministry of Education, Sports and Training, Ministry of Finance, Ministry of Health and Human Services, Office of Chief Secretary, The Republic of the Marshall Islands Key Dates Key Project Dates Bank Approval Date: 28-Feb-2019 Effectiveness Date: 30-May-2019 Planned Mid Term Review Date: 30-Dec-2022 Actual Mid-Term Review Date: Original Closing Date: 31-Dec-2024 Revised Closing Date: 31-Dec-2022 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) To improve coverage of multisectoral early childhood development services Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Component 1. Improve coverage of essential RMNCH-N services:(Cost $0.81 M) Component 2. Improve coverage of stimulation and early learning activities:(Cost $0.90 M) Component 3. Social assistance for early years families:(Cost $0.70 M) Component 4. Strengthening the multisectoral ECD system and Project management:(Cost $0.64 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Unsatisfactory Moderately Unsatisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Satisfactory Overall Risk Rating Moderate Moderate Implementation Status and Key Decisions This implementation status and results report covers the implementation period of the Multisectoral Early Childhood Development (ECD) Project from July to December 2022 and the hybrid implementation support mission held from November 29-December 6, 2022. Following the project restructuring in March 2022, grant proceeds equal to SDR 7,200,000 (around US$10 million equivalent) were cancelled and reallocated to the new Multisectoral Early Childhood Development Project – Phase II (ECD-II). In parallel, new Multisectoral Early Childhood Development Project – Phase II was approved on June 6, 2022 and became effective on October 14, 2022. Following the restructuring, the total remaining amount of the ECD Project grant is US$2.97 million, with current disbursement ratio of 100% just prior to project closure. 12/22/2022 Page 1 of 7 The World Bank Implementation Status & Results Report Multisectoral Early Childhood Development Project (P166800) As a result of the cancellation of the majority of project funds and the shortened implementation timeframe, progress towards achievement of project development objectives remains moderately unsatisfactory. However, overall implementation progress remains moderately satisfactory. Component 1 Activities have progressed though primarily at the input and intermediate outcome level and have not translated into increased utilization of essential ECD services. The project supported the Ministry of Health and Human Services to complete its first five-year strategic plan in over two decades, which was endorsed in October 2022. Operational strategies for re-introduction of the zone nursing system in Majuro, for Neighboring Island (NI) Enhanced Services, and for the development of the cadre of maternal health and child development aides were finalized in October 2022; training packages are currently under finalization; provider trainings and enhanced service deliver design will begin under ECD-II. Renovations in the Majuro labor and delivery ward were completed in September 2022. Component 2 Three public preschool classrooms have been in operation since November 2021; across the two school years, 126 four-year old students have been served. There are 47 additional children enrolled for preschool expansion in Ebeye, which will commence in January 2023 under the ECD-II project. The Parents as Teachers home visiting program delivered by Women United Together Marshall Islands (WUTMI) has employed 9 new parent educators and is serving 185 vulnerable families with pregnant women and/or children under age five. Component 3 The Ministry of Culture and Internal Affairs launched enrollment for its flagship maternal and child conditional cash transfer program in Majuro in July 2022, and as of December 2022, 1000 families were registered in the beneficiary registry system. The first social assistance payments were made to 162 vulnerable families residing on Majuro in October 2022. Component 4 The project team has contributed to the preparation of the Multisectoral ECD Policy, which is in final draft stage for endorsement of Cabinet in early 2023. S The Marshall Islands Epidemiological Projects Initiative has trained enumerators for the project’s baseline survey. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Moderate Low Low Macroeconomic Moderate Low Low Sector Strategies and Policies Substantial Moderate Moderate Technical Design of Project or Program Substantial Moderate Moderate Institutional Capacity for Implementation and Substantial Moderate Moderate Sustainability Fiduciary Substantial Substantial Substantial Environment and Social Moderate Moderate Moderate Stakeholders Moderate Low Low Other -- Substantial Substantial Overall Substantial Moderate Moderate Results 12/22/2022 Page 2 of 7 The World Bank Implementation Status & Results Report Multisectoral Early Childhood Development Project (P166800) PDO Indicators by Objectives / Outcomes To improve coverage of multisectoral ECD services IN01239790 ►Share of women who have had at least one ante-natal care visit by a skilled provider during the first trimester (%) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 34.00 34.00 34.00 65.00 Date 01-Nov-2018 01-Apr-2022 20-Dec-2022 31-Dec-2024 Share of women who have had at least one ante-natal care visit by a skilled provider during the first trimester (%). Comments: This indicator is updated by MOHHS on an annual basis in the KPI report; due to COVID-19, the latest value is that from the report was produced in 2021 for the 2020 year. IN01239841 ►Share of children aged 0-2 years who receive well-child visits as per established government guidelines* (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 50.00 Date 01-Nov-2018 01-Apr-2022 20-Dec-2022 31-Dec-2024 Share of children aged 0-2 years who receive well-child visits as per established government guidelines (%). *Well-child visits will be defined as part of the benefits package development. The service delivery Comments: guidelines have not been finalized and will be transferred to ECD-II. IN01239842 ►Number of families with children aged 0-4 years receiving home visits from parent educators (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 85.00 85.00 185.00 500.00 Date 01-Nov-2018 01-Apr-2022 20-Dec-2022 31-Dec-2024 Number of families with children aged 0-4 years receiving home visits from parent educators. Home visits Comments: by trained parent educators. IN01239843 ►Share of children aged 3 and 4 years attending pre-school (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 5.00 7.80 10.60 25.00 Date 01-Nov-2018 01-Apr-2022 20-Dec-2022 31-Dec-2024 Share of children aged 3 and 4 years attending pre-school. Pre-schools will be established and scaled up during the project. Comments: At baseline, 5% of children 3-4 years were reported as attending pre-school according to the ICHNS. The enrollment of 63 new preschool students accounts for an additional 2.8% of children age 3-4 enrolled. 12/22/2022 Page 3 of 7 The World Bank Implementation Status & Results Report Multisectoral Early Childhood Development Project (P166800) Intermediate Results Indicators by Components Component 1. Improve coverage of essential RMNCH-N services IN01239851 ►Number of health workers trained in maternal, infant, and young child nutrition promotion (or, trained to deliver a package of essential RMNCH-N services) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 60.00 Date 01-Nov-2018 01-Apr-2022 20-Dec-2022 15-Dec-2024 Number of health workers trained in maternal, infant, and young child nutrition promotion (or, trained to deliver a package of essential RMNCH-N services disaggregated by gender. Comments: As of December 2022, well baby clinical guidelines had not been finalized. IN01239852 ►Number of RMNCH-N providers undergoing regular performance monitoring (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 40.00 Date 01-Nov-2018 01-Apr-2022 20-Dec-2022 31-Dec-2024 Number of RMNCH-N providers undergoing regular performance monitoring (Number). Comments: Performance monitoring and quality improvement shifted to an ECD-II deliverable. IN01239853 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 19,850.00 Date 01-Nov-2018 01-Apr-2022 01-Apr-2022 31-Dec-2024 IN01239854 Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 4,600.00 Date 01-Nov-2018 01-Apr-2022 01-Apr-2022 31-Dec-2024 IN01239855 Number of women and children who have received basic nutrition services (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 9,750.00 Date 01-Nov-2018 01-Apr-2022 01-Apr-2022 31-Dec-2024 IN01239856 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) 12/22/2022 Page 4 of 7 The World Bank Implementation Status & Results Report Multisectoral Early Childhood Development Project (P166800) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 5,500.00 Date 01-Nov-2018 01-Apr-2022 01-Apr-2022 31-Dec-2024 Component 2. Improve coverage of stimulation and early learning activities IN01239844 ►Number of children aged 3-4 attending preschool (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 238.00 238.00 326.00 1,000.00 Date 01-Nov-2018 01-Apr-2022 20-Dec-2022 31-Dec-2024 Number of children ages 3-4 attending preschool. Comments: IN01239847 Number of girls aged 3-4 attending preschool (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 117.00 117.00 117.00 500.00 Date 01-Nov-2018 01-Apr-2022 01-Apr-2022 31-Dec-2024 IN01239849 ►Number of teaching aides, parent educators, coaches and MOEST/PSS staff receiving training under the project (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 218.00 231.00 70.00 Date 01-Nov-2018 01-Apr-2022 01-Apr-2022 31-Dec-2024 Number of teaching aides, parent educators, coaches and MOEST/PSS staff receiving training under the project (by gender) Comments: 129 ECE educators trained in SEL; 93 ECE educators certified in disability inclusive education; 9 parent educators trained; Component 3. Social assistance for early years' families IN01239845 ►Beneficiaries of social safety net programs (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 163.00 1,000.00 Date 01-Nov-2018 01-Apr-2022 01-Apr-2022 31-Dec-2024 IN01239848 Beneficiaries of social safety net programs - Female (Number, Corporate Supplement) 12/22/2022 Page 5 of 7 The World Bank Implementation Status & Results Report Multisectoral Early Childhood Development Project (P166800) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 800.00 IN01239850 ►Female beneficiaries complying with conditionalities (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 700.00 Date 01-Nov-2018 01-Apr-2022 20-Dec-2022 31-Dec-2024 Female beneficiaries complying with conditionalities. Comments: Conditionality compliance is not being monitored in year 1, as agreed. Component 4. Strengthening the multisectoral ECD system and Project management IN01239846 ►Implementation of the GRM and resolution of grievances within agreed timeframes (Percentage) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 100.00 80.00 Date 01-Nov-2018 01-Apr-2022 20-Dec-2022 31-Dec-2024 Three grievances were reported in the past six months and all resolved within agreed timelines. Comments: Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P166800 IDA-D4240 Effective USD 13.00 3.03 9.97 2.97 0.00 100% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P166800 IDA-D4240 Effective 28-Feb-2019 15-Mar-2019 30-May-2019 31-Dec-2024 31-Dec-2022 Cumulative Disbursements 12/22/2022 Page 6 of 7 The World Bank Implementation Status & Results Report Multisectoral Early Childhood Development Project (P166800) Restructuring History Level 2 Approved on 17-Mar-2022 Related Project(s) There are no related projects. 12/22/2022 Page 7 of 7