Public Disclosure Copy The World Bank Implementation Status & Results Report BZ JSDF Improving Children's Health (P120349) BZ JSDF Improving Children's Health (P120349) LATIN AMERICA AND CARIBBEAN | Belize | Health, Nutrition and Population Global Practice | Recipient Executed Activities | Technical Assistance Loan | FY 2011 | Seq No: 5 | ARCHIVED on 12-May-2015 | ISR19066 | Implementing Agencies: Key Dates Key Project Dates Board Approval date:01-Mar-2011 Effectiveness Date:26-Jul-2011 Planned Mid Term Review Date:10-Feb-2014 Actual Mid-Term Review Date:06-Oct-2014 Original Closing Date:15-Jul-2015 Revised Closing Date:15-Jul-2015 Project Development Objectives Project Development Objective (from Project Appraisal Document) To improve the health and nutrition of children in local Mayan communities in Toledo, Belize through an early childhood developmentapproach focusing on pre-natal care, nutrition monitoring in the critical window of opportunity, and school health interventions atthe primary school level. Has the Project Development Objective been changed since Board Approval of the Project Objective? No PHRPDODEL Components Name Prevent and address malnutrition in children under 5 years of age by empowering the local community:(Cost $169850.00 M) Develop Healthy Lifestyles Programs for Primary School Children in their eight years of primary education.:(Cost $1007650.00 M) Strengthen access and quality of community-based health services in support of maternal and child health.:(Cost $1053444.00 M) Promote behavior change in communities by increasing understanding of community's attitude and perception towards health.:(Cost $89150.00 M) Strengthen monitoring and evaluation, project management, and project administration.:(Cost $432800.00 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO  Moderately Satisfactory  Moderately Satisfactory Overall Implementation Progress (IP)  Moderately Satisfactory  Moderately Satisfactory 5/12/2015 Page 1 of 8 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report BZ JSDF Improving Children's Health (P120349) Implementation Status and Key Decisions The Government of Belize (GoB) continues to make good progress in improving the health and nutrition of children in local communities in the Toledo District and the achievement of the PDOs. Progress towards the PDOs has been made with anemia rates having decreased from 51.4 to 31 percent in the 0-5 age group and from 30.6 to 22.1 in the 5-12 age group. The Grant has also made progress in its intermediate indicators with the number of primary schools in the Toledo District with school feeding programs that include at least one portion of vegetables and one portion of fruits in their daily menu increasing from six to eight schools making progress towards the target of 12 schools. In addition, 44 Community Health Workers (CHWs) have been trained and certified on the implementation of a growth monitoring tool developed by WHO for the Belize community-level context. Following the mid-term review (MTR), a Level 2 Grant Restructuring was completed in March 2015. As a result, the Results Framework was updated to effectively measure the Grant’s progress with available data and to add indicators to measure progress on ongoing activities. In addition, Grant funds were reallocated to allow implementation of critical activities in line with the Grant objectives. 5/12/2015 Page 2 of 8 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report BZ JSDF Improving Children's Health (P120349) Results Project Development Objective Indicators PHINDPDOTBL  Percentage decrease in rate of worm infestation in primary school-aged children in Toledo’s rural communities. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 15.00 15.00 15.00 12.00 Date 31-Aug-2013 31-Aug-2013 28-Apr-2015 30-Jun-2015 Comments The final target and date for this indicator was updated during the Grant restructuring in order to align with the Grant end date. The measurement of this indicator will be based on an exit survey that will use the same methodology as that of the baseline survey, which was conducted in June 2013. No intermediate measurement is available for this indicator. The baseline and current values for this indicator are those reflected in ISRs 3 and 4 due to the data from the baseline survey which informed this indicator, only becoming available at the time ISR 3 was submitted. PHINDPDOTBL  Percentage decrease in rate of anemia in primary school-aged children in Toledo's rural communities. (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target 5/12/2015 Page 3 of 8 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report BZ JSDF Improving Children's Health (P120349) Value 14.40 14.40 14.40 12.20 Date 31-Aug-2013 31-Aug-2013 28-Apr-2015 30-Jun-2015 Overall Comments The final target and date for this indicator was updated during the Grant restructuring in order to align with the Grant end date. The measurement of this indicator will be based on an exit survey that will use the same methodology as that of the baseline survey, which was conducted in June 2013. No intermediate measurement is available for this indicator. The baseline and current values for this indicator are those reflected in ISRs 3 and 4 due to the data from the baseline survey which informed this indicator, only becoming available at the time ISR 3 was submitted. Intermediate Results Indicators PHINDIRITBL  Percentage increase in children between 0-11 months in Toledo whose weight and height are reported on growth chart at least once in the last quarter. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 25.00 -- 69.70 73.00 Date 01-Jun-2010 -- 28-Apr-2015 30-Jun-2015 Comments This new indicator was included during the Grant restructuring in order to have two separate population groups (0-11 months and 12-23 months) which follow the Ministry of Health vaccination calendar, when weight and height measurements are conducted in the health centers. Moreover, the indicator will use data from the last measurement available. Target values have been updated to reflect a realistic target based on data from the 2013 baseline survey. PHINDIRITBL  Percentage increase in children between 12-23 months in Toledo whose weight and height are reported on growth chart at least once in the last quarter. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 25.00 -- 62.50 83.00 Date 01-Jun-2010 -- 28-Apr-2015 30-Jun-2015 Comments This new indicator was included during the Grant restructuring in order to have two separate population groups (0-11 months and 12-23 months) which follow the Ministry of Health vaccination calendar, when weight and height measurements are conducted in the health centers. Target values have been updated to reflect a realistic target based on data from the 2013 baseline survey 5/12/2015 Page 4 of 8 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report BZ JSDF Improving Children's Health (P120349) PHINDIRITBL  Increase in the number of primary schools in the Toledo District with primary-school feeding programs that include at least one portion of vegetables and one portion of fruits in their daily menu. (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 5.00 21.00 8.00 12.00 Date 31-Aug-2013 31-Aug-2013 28-Apr-2015 30-Jun-2015 Comments This indicator is showing progress as the school feeding program is currently being implemented in theToledo District. Moreover, there have been discussions between the Ministry of Health and the Ministry of Agriculture regarding the future sustainability of this program. The target of this indicator was also updated during the Grant restructuring in order to reflect a realistic target of the Program. The "previous data" set at 21 schools contains a mistake but it cannot be changed in the system. PHINDIRITBL  Number of women in the Toledo District receiving at least 3 antenatal care consultations during pregnancy with at least once during every trimester of pregnancy (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 500.00 500.00 500.00 700.00 Date 31-Aug-2013 31-Aug-2013 28-Apr-2015 30-Jun-2015 Comments No data is available yet for this indicator to be able to gauge progress. However, the end target of this indicator has been updated to reflect a realistic target based on data from the 2013 baseline survey. An exit survey will be conducted at the end of the Grant to capture final data. PHINDIRITBL  Number of parents with children in the under-five age group, participating in community growth monitoring and improved nutrition practices (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value -- 14.00 14.00 51.00 Date 30-Jun-2010 31-Aug-2013 28-Apr-2015 30-Jun-2015 Comments At least one per Village. 5/12/2015 Page 5 of 8 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report BZ JSDF Improving Children's Health (P120349) PHINDIRITBL  Number of health facilities equipped according to MoH guidelines. (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 25.00 Date 31-Aug-2013 -- 28-Apr-2015 30-Jun-2015 Comments Although data is not yet available for this indicator as the works have not been completed, work has commenced and 25 facilities are expected to be refurbished. This indicator was added during the Grant restructuring to capture data on the investment related to the refurbishment and equipping of health facilities which contribute to strengthening the overall health system in the Toledo District. PHINDIRITBL  Number of satellite clinics in Toledo District properly equipped to access and input data into BHIS. (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 3.00 -- 3.00 6.00 Date 31-Aug-2013 -- 28-Apr-2015 30-Jun-2015 Comments There is no final data yet regarding this indicator as the satellite clinics are in the process of being upgraded. However, all necessary procurement processes have initiated and are on track for the e-health component (bids for satellite installations are being evaluated, bids for computer equipment are being evaluated, cellular phones and televisions for educational videos have already been purchased, the contract to provide solar photovoltaic systems for 2 satellite clinics has been awarded and installation is in process to be completed by late May). PHINDIRITBL  Number of Community Health Workers trained over the lifetime of the project in promotion of antenatal care, counseling, education, nutrition, infant and young child feeding practices, growth monitorin (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 44.00 50.00 Date 30-Jun-2013 -- 28-Apr-2015 30-Jun-2015 Comments This indicator is showing progress: CHWs and MOH officials have been trained to implement the growth monitoring tool at the community level. Additional training are scheduled to take place during April and May in other villages. Overall Comments 5/12/2015 Page 6 of 8 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report BZ JSDF Improving Children's Health (P120349) Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed Disbursed P120349 TF-99168 Effective USD 2.75 2.75 0.00 1.36 1.39 49% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P120349 TF-99168 Effective 22-Jun-2011 15-Jul-2011 26-Jul-2011 15-Jul-2015 15-Jul-2015 Cumulative Disbursements Restructuring History There has been no restructuring to date. Related Project(s) 5/12/2015 Page 7 of 8 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report BZ JSDF Improving Children's Health (P120349) There are no related projects. 5/12/2015 Page 8 of 8 Public Disclosure Copy