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 | IBRD/IDA | Investment Project Financing (IPF) | FY 2018 | Seq No: 13 | Archived on 21-Mar-2025 | ISR03122 Implementing Agencies: Rwanda Biomedical Center 1. OBJECTIVE 1.1 Development Objective Original Development Objective (Approved as part of Approval package on 11-Apr-2018) 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. Has the Development Objective been changed since Board Approval of the Project Objective? Yes Current Development Objective (Approved as part of Additional Financing package Seq. 2 on 30-Mar-2023) 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. 2. COMPONENTS Name Component 1: Prevention of Stunting at Community and Household Levels:(Cost 61,000,000,000,000.00) Component 2: High-impact Health and Nutrition Services:(Cost 15,100,000,000,000.00) Component 3: Monitoring and Evaluation, and Program Management:(Cost 2,900,000,000,000.00) CERC:(Cost 0.00) 3. OVERALL RATINGS Name Previous Current Progress towards achievement of PDO Satisfactory Satisfactory Mar 21, 2025 Page 1 of 10 The World Bank Implementation Status & Results Report Rwanda Stunting Prevention and Reduction Project (P164845) Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating Moderate Moderate 4. KEY ISSUES & STATUS 4.1 Implementation Status and Key Decisions The project was approved by the Board on February 28, 2018, and the legal agreements were signed between the World 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 the early years in May 2018, the project became effective on June 5, 2018. The project is under implementation for almost 5 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. The Additional Financing to the project was approved by the Board on March 30, 2023. Despite the impacts due to the global COVID-19 pandemic, the project implementation is steady with a disbursement rate of 76% as of January 2025. 5. SYSTEMATIC OPERATIONS RISK-RATING TOOL Rating at Approval Last Approved Rating Risk Category Approval Package - ISR Seq. 012 - 01 Oct Proposed Rating 11 Apr 2018 2024 Political and Governance Moderate Moderate Moderate Macroeconomic Moderate Moderate Moderate Sector Strategies and Policies Moderate Moderate Moderate Technical Design of Project or Program Substantial Moderate Moderate Institutional Capacity for Implementation and Substantial Substantial Substantial Sustainability Fiduciary Moderate Moderate Moderate Environment and Social Moderate Moderate Moderate Stakeholders Moderate Moderate Moderate Mar 21, 2025 Page 2 of 10 The World Bank Implementation Status & Results Report Rwanda Stunting Prevention and Reduction Project (P164845) Other  Low Low Overall Substantial Moderate Moderate Mar 21, 2025 Page 3 of 10 The World Bank Implementation Status & Results Report Rwanda Stunting Prevention and Reduction Project (P164845) 6. RESULTS 6.1 PDO Indicators by PDO Outcomes To contribute to reduction in the stunting rate among children under five in the target districts Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Percentage of children under 36.60 Dec/2022 36.60 15-Jun-2024 36.60 15-Dec-2024 32.00 Dec/2025 5 years with height-for-age z- score below -2 standard deviations (Percentage) Percentage of children under 28.40 Dec/2022 27.03 01-Aug-2024 27.03 01-Dec-2024 25.00 Dec/2025 2 years with height-for-age z- score below -2 standard deviations (Percentage) Percentage of children 6-23 34.60 Dec/2022 59.47 01-Aug-2024 59.50 01-Dec-2024 50.00 Dec/2025 months old who are fed a diverse diet (Percentage) Percentage of women who 45.00 Dec/2022 66.10 15-May-2024 47.10 15-Dec-2024 51.00 Dec/2025 attended 4 or more ANC Comments on In the previous round, the ANC4 rate was recorded from the midline survey instead of the visits during their most achieving targets defined HMIS source. This round reports the HMIS result. The stunting rate among children recent pregnancy under 2 years and the dietary diversity rate are preliminary midline survey findings, with (Percentage) further checks and analyses underway to confirm the results. 6.2 Intermediate Results Indicators by Components Component 1: Prevention of Stunting at Community and Household Levels Mar 21, 2025 Page 4 of 10 The World Bank Implementation Status & Results Report Rwanda Stunting Prevention and Reduction Project (P164845) Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year 0 Sep/2024 0 04-Sep-2024 0 04-Dec-2024 0 Dec/2025 New or better jobs (Number Comments on The indicator has been removed from the Results Framework of people) CRI achieving targets New or better jobs for 0 Sep/2024 0 04-Sep-2024 0 04-Dec-2024 0 Dec/2025 youth (Number of Comments on The indicator has been removed from the Results Framework people) CRI achieving targets New or better jobs for 0 Sep/2024 0 04-Sep-2024 0 04-Dec-2024 0 Dec/2025 women (Number of Comments on The indicator has been removed from the Results Framework people) CRI achieving targets Percentage of home-based 64.00 Dec/2022 78.60 15-May-2024 82.60 15-Dec-2024 80.00 Dec/2025 ECD centers with satisfactory scores on quality score card (Percentage) Percentage of CHWs who 96.00 Dec/2022 91 15-May-2024 91.80 15-Dec-2024 90.00 Dec/2025 received a quarterly supportive supervision visit from health center (Percentage) Percentage of pregnant 73.00 Dec/2022 52 15-May-2024 54.10 15-Dec-2024 85.00 Dec/2025 women who attended the Comments on Correct baseline value is 43% (as per information in "Key Issues & Status" section). The first ANC visit during the first achieving targets baseline percentage (73%) was wrongly recorded in the ISR as using the initial SPaR midline trimester (Percentage) survey, rather than the routine administrative data from HMIS as indicated in the AF. Percentage of children 6-23 38.40 Dec/2022 14.20 15-May-2024 42.00 15-Dec-2024 90.00 Dec/2025 months old receiving micronutrient powders (Percentage) Mar 21, 2025 Page 5 of 10 The World Bank Implementation Status & Results Report Rwanda Stunting Prevention and Reduction Project (P164845) Percentage of children under 0.00 Dec/2022 94 15-May-2024 92.90 15-Dec-2024 50.00 Dec/2025 five with diarrhea treated with ORS and zinc (Percentage) Number of eligible 8,656.00 Dec/2022 8,656.00 15-May-2024 8,656 15-Dec-2024 25,000.00 Dec/2025 households with improved latrines (from project interventions) (Number) Number of children enrolled 0.00 Dec/2022 0.00 15-May-2024 0.00 15-Dec-2024 2,600.00 Dec/2025 in ECD services that are designed to fulfill a childcare function (due to location, hours of operation or other design feature) (Number) Percentage of mothers / 0.00 Dec/2022 0.00 15-May-2024 0.00 15-Dec-2024 0.00 Dec/2025 caregivers with children enrolled in childcare/ECD who report increased hours spent in lucrative activities, including self-employment or paid work (Percentage) 215,460.00 Dec/2022 215,460.00 15-Dec-2023 681,698 15-Dec-2023 506,124.00 Dec/2025 Comments on In which: People who have received achieving targets Number of children participating in community height visualizations using length mats in the essential health, nutrition, 13 target districts (children aged 0-23 months): 193,493 and population (HNP) Number of children participating in ECDs in the 13 target districts (children aged 24-59 services (Number) months): 431,498 Number of pregnant and lactating women enrolled in FBF program: 56,707 Number of women and 215,460.00 Dec/2022 215,460.00 15-Dec-2023 681,698 15-Dec-2023 506,124.00 Dec/2025 children who have Mar 21, 2025 Page 6 of 10 The World Bank Implementation Status & Results Report Rwanda Stunting Prevention and Reduction Project (P164845) received basic nutrition services (Number) Component 2: High-impact Health and Nutrition Services Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Percentage of children under 90.00 Dec/2022 68 15-May-2024 73.70 15-Dec-2024 85.00 Dec/2025 5 with height measured and recorded at health facility (Percentage) Percentage of CHWs with no 95.00 Dec/2022 94 15-May-2024 94.00 15-Dec-2024 95.00 Dec/2025 stock out of Zinc for diarrhea treatment (Percentage) Percentage of fortified 86.00 Dec/2022 57 15-May-2024 70.70 15-Dec-2024 85.00 Dec/2025 blended food (FBF) distribution centers with no stock outs in the last quarter (Percentage) Percent of enrolled women 73.00 Dec/2022 54 15-May-2024 70.30 15-Dec-2024 85.00 Dec/2025 who received FBF in the last month (Percentage) Percentage of enrolled 73.00 Dec/2022 64 15-May-2024 85.60 15-Dec-2024 85.00 Dec/2025 children who received FBF last month (Percentage) Component 3: Monitoring and Evaluation, and Program Management Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Number of households 0.00 Dec/2022 6,564.00 15-May-2024 6,564.00 15-Dec-2024 138,362.00 Dec/2025 participating in ECD peer-to- peer model (Number) Mar 21, 2025 Page 7 of 10 The World Bank Implementation Status & Results Report Rwanda Stunting Prevention and Reduction Project (P164845) 7. DATA ON FINANCIAL PERFORMANCE 7.1 Cumulative Disbursements 7.2 Disbursements (by loan) Loan/Credit/TF Status Original Revised Cancelled Disbursed Undisbursed % Disbursed IDA-61870 Effective 25.00 23.26 0.00 24.40 0.00 99.98% TF-A6567 Effective 20.00 20.00 0.00 20.00 0.00 100.00 % TF-A6783 Closed 10.00 10.00 0.00 10.00 0.00 100.00 % TF-C0811 Effective 5.00 5.00 0.00 2.30 2.70 46.00% TF-C0802 Effective 4.00 4.00 0.00 1.15 2.85 28.74% Mar 21, 2025 Page 8 of 10 The World Bank Implementation Status & Results Report Rwanda Stunting Prevention and Reduction Project (P164845) IDA-72830 Effective 50.00 50.00 0.00 29.24 20.76 58.48% IDA-72820 Effective 20.00 16.96 0.00 11.45 5.60 67.15% 7.3 Key Dates (by loan) Loan/Credit/TF Status Approval Signing Effectiveness Orig. Closing Rev. Closing IDA-61870 Effective 28-Feb-2018 07-Mar-2018 05-Jun-2018 30-Apr-2023 31-Dec-2025 IDA-72820 Effective 30-Mar-2023 25-Apr-2023 18-Aug-2023 31-Dec-2025 31-Dec-2025 IDA-72830 Effective 30-Mar-2023 25-Apr-2023 18-Aug-2023 31-Dec-2025 31-Dec-2025 TF-A6567 Effective 28-Feb-2018 07-Mar-2018 05-Jun-2018 30-Apr-2023 31-Mar-2025 TF-A6783 Closed 29-Jan-2018 07-Mar-2018 05-Jun-2018 31-Dec-2021 31-Dec-2022 TF-C0802 Effective 30-Mar-2023 25-Apr-2023 18-Aug-2023 31-Dec-2025 31-Dec-2025 TF-C0811 Effective 30-Mar-2023 25-Apr-2023 18-Aug-2023 31-Mar-2025 31-Mar-2025 8. KEY DATES Key Events Planned Actual Approval 28-Feb-2018 28-Feb-2018 Effectiveness 05-Jun-2018 05-Jun-2018 Mid-Term Review No. 01 19-Apr-2022 19-Apr-2022 Operation Closing/Cancellation 31-Dec-2025 9. RESTRUCTURING HISTORY Restructuring Level 2 Approved on 09-Aug-2019 Restructuring Level 2 Approved on 16-Feb-2022 10. ASSOCIATED OPERATION(S) There are no associated operations Mar 21, 2025 Page 9 of 10 The World Bank Implementation Status & Results Report Rwanda Stunting Prevention and Reduction Project (P164845) Mar 21, 2025 Page 10 of 10