The World Bank Implementation Status & Results Report Rwanda Stunting Prevention and Reduction Project (P164845) Rwanda Stunting Prevention and Reduction Project (P164845) EASTERN AND SOUTHERN AFRICA | Rwanda | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2018 | Seq No: 9 | ARCHIVED on 20-Dec-2022 | ISR53754 | Implementing Agencies: MINISTRY OF FINANCE AND ECONOMIC PLANNING, Rwanda Biomedical Center Key Dates Key Project Dates Bank Approval Date: 28-Feb-2018 Effectiveness Date: 05-Jun-2018 Planned Mid Term Review Date: 19-Apr-2022 Actual Mid-Term Review Date: 19-Apr-2022 Original Closing Date: 30-Apr-2023 Revised Closing Date: 30-Apr-2023 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The proposed Project Development Objective (PDO) is to contribute to the reduction in the stunting rate among children under five years of age (with a focus on those under two) in the targeted districts. Has the Project Development Objective been changed since Board Approval of the Project Objective? Yes Board Approved Revised Project Development Objective (If project is formally restructured) The proposed Project Development Objectives (PDO) are to contribute to the reduction in the stunting rate among children under five years of age (with a focus on those under two) in the targeted districts and provide immediate and effective response in the case of an eligible crisis or emergency. Components Table Name Component 1: Prevention of Stunting at Community and Household Levels:(Cost $34800000.00 M) Component 2: High-impact Health and Nutrition Services:(Cost $12000000.00 M) Component 3: Monitoring and Evaluation, and Program Management:(Cost $5500000.00 M) CERC:(Cost $2700000.00 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating Substantial Substantial Implementation Status and Key Decisions The project was approved by the Board on February 28, 2018, and the legal agreements were signed between the Bank and the Government of Rwanda on March 7, 2018. Immediately following the launch of the Rwanda’s Multi-sectoral program to Combat Chronic Malnutrition and Invest in 12/20/2022 Page 1 of 8 The World Bank Implementation Status & Results Report Rwanda Stunting Prevention and Reduction Project (P164845) the early years in May 2018, the project became effective on June 5, 2018. The project is under implementation for almost 4 years and continues to enjoy high-level political commitment and attention, strong capacity to mobilize communities, and good collaboration on the ground with other development partners. Despite the impacts due to the global COVID-19 pandemic, the project implementation is steady with a disbursement rate of 89% as of mid December 2022. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Moderate Moderate Moderate Macroeconomic Moderate Moderate Moderate Sector Strategies and Policies Moderate Moderate Moderate Technical Design of Project or Program Substantial Substantial Substantial Institutional Capacity for Implementation and Substantial Substantial Substantial Sustainability Fiduciary Moderate Moderate Moderate Environment and Social Moderate Moderate Moderate Stakeholders Moderate Moderate Moderate Other -- Low Low Overall Substantial Substantial Substantial Results PDO Indicators by Objectives / Outcomes To contribute to reduction in the stunting rate among children under five in the target districts IN01212830 ►Indicator 1a: Percentage of children under 5 years with height-for-age z-score below -2 standard deviations (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 43.60 36.60 36.60 32.00 Date 28-Feb-2018 28-Apr-2022 30-Sep-2022 30-Apr-2023 IN01213086 ►Indicator 1b: Percentage of children under 2 years with height-for-age z-score below -2 standard deviations (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target 12/20/2022 Page 2 of 8 The World Bank Implementation Status & Results Report Rwanda Stunting Prevention and Reduction Project (P164845) Value 37.10 28.00 28.00 27.20 Date 28-Feb-2018 28-Apr-2022 30-Sep-2022 30-Apr-2023 IN01213087 ►Indicator 2: Percentage of children 6-23 months old who are fed a diverse diet (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 22.90 34.60 34.60 50.00 Date 28-Feb-2018 28-Apr-2022 30-Sep-2022 30-Apr-2023 IN01213088 ►Indicator 3: Percentage of women who attended 4 or more ANC visits during their most recent pregnancy (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 41.00 44.00 46.80 55.00 Date 28-Feb-2018 28-Apr-2022 30-Sep-2022 30-Apr-2023 IN01213089 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 9,747,647.00 12,135,856.00 1,660,000.00 Date 28-Feb-2018 28-Apr-2022 30-Sep-2022 30-Apr-2023 IN01213090 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 1,660,000.00 Date 28-Feb-2018 28-Apr-2022 30-Sep-2022 30-Apr-2023 IN01213091 Indicator 4a: Number of children under 5 were beneficiaries of project interventions (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 8,392,244.00 10,468,046.00 560,000.00 Date 28-Feb-2018 28-Apr-2022 30-Sep-2022 30-Apr-2023 IN01213092 Indicator 4b: Number of women of reproductive age (including pregnant and lactating women) who were beneficiaries of project interventions (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,355,403.00 1,667,810.00 1,100,000.00 Date 28-Feb-2018 28-Apr-2022 30-Sep-2022 30-Apr-2023 12/20/2022 Page 3 of 8 The World Bank Implementation Status & Results Report Rwanda Stunting Prevention and Reduction Project (P164845) Overall Comments PDO Results Framework will be updated as part of the proposed Additional Financing/Project Restructuring and will reflect revised end target values. Additionally, CRIs will be moved to Intermediate Results in line with GP and corporate guidance. Intermediate Results Indicators by Components Component 1: Prevention of Stunting at Community and Household Levels IN01213095 ►IRI 2: Percentage of home-based ECD centers with satisfactory scores on quality score card (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 80.00 Date 28-Feb-2018 28-Apr-2022 30-Sep-2022 30-Apr-2023 IN01213099 ►IRI 4: % of CHWs who received a quarterly supportive supervision visit from HC (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 40.00 96.00 96.00 80.00 Date 28-Feb-2018 28-Apr-2022 30-Sep-2022 30-Apr-2023 IN01213101 ►IRI 5: Percentage of pregnant women who attended the first ANC visit during the first trimester (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 40.00 50.00 49.00 70.00 Date 28-Feb-2018 28-Apr-2022 30-Sep-2022 30-Apr-2023 IN01213103 ►IRI 6: Percentage of pregnant women with anemia (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 2.00 1.00 0.90 1.00 Date 28-Feb-2018 28-Apr-2022 30-Sep-2022 30-Apr-2023 IN01213104 ►IRI 7: Percentage of participants at CHW education sessions surveyed who demonstrate knowledge of proper care, feeding, and WASH practices (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 50.00 12/20/2022 Page 4 of 8 The World Bank Implementation Status & Results Report Rwanda Stunting Prevention and Reduction Project (P164845) Date 28-Feb-2018 28-Apr-2022 30-Sep-2022 30-Apr-2023 IN01213106 ►IRI 8: Percentage of children 6-23 months old receiving micronutrient powders (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 38.40 30.00 90.00 Date 28-Feb-2018 28-Apr-2022 30-Sep-2022 30-Apr-2023 IN01213107 ►IRI 9: Percentage of children under two with diarrhea treated with ORS and zinc. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 83.00 82.00 50.00 Date 28-Feb-2018 28-Apr-2022 30-Sep-2022 30-Apr-2023 IN01213108 ►IRI 10: Number of Ubudehe 1 households with improved latrines (from project interventions) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 8,656.00 8,656.00 5,500.00 Date 28-Feb-2018 28-Apr-2022 30-Sep-2022 30-Apr-2023 IN01213109 ►IRI 11: Number of districts with satisfactory ratings on the DPEM activity scorecard (to be developed) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 13.00 Date 28-Feb-2018 28-Apr-2022 30-Sep-2022 30-Apr-2023 Component 2: High-impact Health and Nutrition Services IN01213093 ►IRI 12: Percentage of children under 5 with height measured and recorded at health facility (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 90.00 98.00 75.00 Date 28-Feb-2018 28-Apr-2022 30-Sep-2022 30-Apr-2023 IN01213096 ►IRI 13: Percentage of CHWs with no stock out of Zinc for diarrhea treatment. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 95.00 94.00 100.00 12/20/2022 Page 5 of 8 The World Bank Implementation Status & Results Report Rwanda Stunting Prevention and Reduction Project (P164845) Date 28-Feb-2018 28-Apr-2022 30-Sep-2022 30-Apr-2023 IN01213098 ►IRI 14: Percentage of women of reproductive age who are new acceptors of modern contraceptives (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 123,804.00 123,804.00 60.00 Date 28-Feb-2018 28-Apr-2022 30-Sep-2022 30-Apr-2023 IN01213100 ►IRI 15: Percentage of fortified blended food (FBF) distribution centers with no stock outs in the previous quarter. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 86.00 86.00 100.00 Date 20-Jun-2019 28-Apr-2022 30-Sep-2022 30-Apr-2023 IN01213102 ►IRI 16: Percent of eligible pregnant and lactating women from ubudehe 1 & 2 households who consumed FBF in the past 24 hours. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 41.00 41.00 80.00 Date 20-Jun-2019 28-Apr-2022 30-Sep-2022 30-Apr-2023 IN01213105 ►IRI 17: Percentage of children 6-23 months old who consumed FBF in the past 24 hours (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 65.00 65.00 75.00 Date 09-Aug-2019 28-Apr-2022 30-Sep-2022 30-Apr-2023 Component 3: Monitoring and Evaluation, and Program Management IN01213094 ►IRI 18: Percentage of participating health facilities that receive satisfactory rating from women and caregivers whose children received nutrition services (Citizen Engagement indicator) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 90.00 Date 28-Feb-2018 28-Apr-2022 30-Sep-2022 30-Apr-2023 IN01213097 ►IRI 19: Number of peer learning events conducted (within and between districts and sectors) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 10.00 10.00 25.00 12/20/2022 Page 6 of 8 The World Bank Implementation Status & Results Report Rwanda Stunting Prevention and Reduction Project (P164845) Date 28-Feb-2018 28-Apr-2022 30-Sep-2022 30-Apr-2023 Overall Comments IR Results Framework will be updated as part of the proposed Additional Financing/Project Among other things, update will include revision of end target values, formulation of the indicators and reflection of the CRIs, in line with GP and corporate guidance. Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P164845 IDA-61870 Effective USD 25.00 25.00 0.00 22.89 1.55 94% P164845 TF-A6567 Effective USD 20.00 20.00 0.00 15.50 4.50 78% P164845 TF-A6783 Effective USD 10.00 10.00 0.00 10.00 0.00 100% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P164845 IDA-61870 Effective 28-Feb-2018 07-Mar-2018 05-Jun-2018 30-Apr-2023 30-Apr-2023 P164845 TF-A6567 Effective 28-Feb-2018 07-Mar-2018 05-Jun-2018 30-Apr-2023 30-Apr-2023 P164845 TF-A6783 Effective 29-Jan-2018 07-Mar-2018 05-Jun-2018 31-Dec-2021 31-Dec-2022 Cumulative Disbursements 12/20/2022 Page 7 of 8 The World Bank Implementation Status & Results Report Rwanda Stunting Prevention and Reduction Project (P164845) Restructuring History Level 2 Approved on 20-Aug-2019 ,Level 2 Approved on 20-Feb-2022 Related Project(s) P179499-Additional Financing to Rwanda Stunting Prevention and Reduction Project 12/20/2022 Page 8 of 8