The World Bank Implementation Status & Results Report Niger, Improving Women’s and Girls’ Access to Improved Health and Nutrition Services in the Priority Areas Project – LAFIA-IYALI (P171767) Niger, Improving Women’s and Girls’ Access to Improved Health and Nutrition Services in the Priority Areas Project – LAFIA- IYALI (P171767) WESTERN AND CENTRAL AFRICA | Niger | IBRD/IDA | Investment Project Financing (IPF) | FY 2022 | Seq No: 9 | Archived on 19-Jun-2025 | ISR04078 1. OBJECTIVE 1.1 Development Objective Original Development Objective (Approved as part of Approval package on 23-Sep-2021) Increase the utilization of a quality RMNCAH-N package of services and improve key behaviors in targeted areas Has the Development Objective been changed since Board Approval of the Project Objective? No 2. COMPONENTS Name Increase coverage, utilization, and quality of integrated RMNCAH-N package:(Cost 88,000,000.00) Support demand for health and nutrition services:(Cost 27,000,000.00) Strengthen project management and institutional capacity:(Cost 10,000,000.00) Contingent Emergency Response Component (CERC):(Cost 0.00) 3. OVERALL RATINGS Name Previous Current Progress towards achievement of PDO Moderately Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Satisfactory Overall Risk Rating Substantial Substantial Jun 19, 2025 Page 1 of 10 The World Bank Implementation Status & Results Report Niger, Improving Women’s and Girls’ Access to Improved Health and Nutrition Services in the Priority Areas Project – LAFIA-IYALI (P171767) 4. KEY ISSUES & STATUS 4.1 Implementation Status and Key Decisions The World Bank Board of Directors approved on September 23, 2021, a 15-year multiphase program (MPA) to the Republic of Niger, including its phase 1 for the Improving Women’s and Girls’ Access to Improved Health and Nutrition Services-Lafia-Iyali Project. The Program aims to reduce stunting and adolescent fertility rates in Niger. The Program will use innovative and comprehensive health and behavioral interventions, complemented by nutrition-sensitive investments to improve health system efficiency, equity, and sustainability as well as boost girls’ and women’s empowerment. The project became effective on June 1, 2022 and was officially launched in Niamey on June 7, 2022. Institutional arrangements and project management arrangements are finalized. Implementation of activities in Maradi and Zinder, resumed with the resumption of disbursements on May 10, 2024. Progress towards achieving the Project Development Objectives (PDOs) is maintained as Moderately Satisfactory (MS), having been upgraded to MS from Moderately Unsatisfactory in the previous ISR from April 2024. Despite substantial delays in initiating project activities, implementation progress has been documented per the project’s Results Framework. Five of the six PDO indicators have shown notable progress in the last six months, including one that has already surpassed the end of project target (PDO 5: Children who have received curative services by community relays for children who suffer from pneumonia, uncomplicated malaria and diarrhea). Progress towards achieving the Intermediate Project Objectives (IRIs) is also moderately satisfactory. Among the sixteen IRIs, three have reached their targets. 4.2 MPA Program Development Objective Original MPA Program Development Objective (Approved as part of Approval (Seq. 1) package on 07-Oct-2024) Reducing stunting and adolescent fertility rates Current MPA Program Development Objective (Approved as part of (Seq. ) package on ) 4.3 Multiphase Programmatic Approach (MPA) Status (Public Disclosure) The World Bank Board of Directors approved on September 23, 2021, a 15-year multiphase program (MPA) to the Republic of Niger, including its phase 1 for the Improving Women’s and Girls’ Access to Improved Health and Nutrition Services-Lafia-Iyali Project. The Program aims to reduce stunting and adolescent fertility rates in Niger. The Program will use innovative and comprehensive health and behavioral interventions, complemented by nutrition sensitive investments to improve health system efficiency, equity, and sustainability, as well as boost girls’ and women’s empowerment. Given Niger’s context, improving health and nutrition outcomes, as well as empowering girls and women to accelerate the demographic transition as a contribution to human capital will require a transformational vision and commitment to a long-term effort. The longer-term engagement from the World Bank on this agenda sends a powerful signal of commitment to improve the lives of the poorest in a fragile context. Jun 19, 2025 Page 2 of 10 The World Bank Implementation Status & Results Report Niger, Improving Women’s and Girls’ Access to Improved Health and Nutrition Services in the Priority Areas Project – LAFIA-IYALI (P171767) 5. SYSTEMATIC OPERATIONS RISK-RATING TOOL Rating at Approval Last Approved Rating Risk Category Approval Package - ISR Seq. 08 - 25 Dec Proposed Rating 23 Sep 2021 2024 Political and Governance Moderate High High Macroeconomic Moderate High High Sector Strategies and Policies Substantial Substantial Substantial Technical Design of Project or Program Moderate Moderate Moderate Institutional Capacity for Implementation and Substantial Substantial Substantial Sustainability Fiduciary Substantial High High Environment and Social Substantial Substantial Substantial Stakeholders Substantial Substantial Substantial Overall Substantial Substantial Substantial Jun 19, 2025 Page 3 of 10 The World Bank Implementation Status & Results Report Niger, Improving Women’s and Girls’ Access to Improved Health and Nutrition Services in the Priority Areas Project – LAFIA-IYALI (P171767) 6. RESULTS 6.1 PDO Indicators by PDO Outcomes Increase the utilization of a quality RMNCAH-N package of services and address key behaviors Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year People who have received 0.00 May/2021 1,733,253 01-Oct-2024 1,733,253 01-Oct-2024 6,418,251.00 Jun/2026 essential health, nutrition, and population (HNP) services (Number) Number of children 0.00 May/2021 6,822,300 01-Oct-2024 6,822,300 01-Oct-2024 2,310,261.00 Jun/2026 immunized (Number) Number of women and 0.00 May/2021 804,277 01-Oct-2024 804,277 01-Oct-2024 3,286,630.00 Jun/2026 children who have received basic nutrition services (Number) Number of deliveries 0.00 May/2021 246,753 01-Oct-2024 246,753 01-Oct-2024 821,360.00 Jun/2026 attended by skilled health personnel (Number) Children (0-5 months) 19.75 May/2021 21.80 01-Jun-2024 21.80 01-Jun-2024 26.50 Jun/2026 exclusively breastfed Comments on No updated data due to SMART survey not being conducted since last ISR (Seq. 7). Planned (Percentage) achieving targets for 2025. Proportion of newborns aged 0 to 5 months who are exclusively breast-fed. Pregnant women who have 0.00 May/2021 644,308 01-Oct-2024 644,308 01-Oct-2024 1,508,015.00 Jun/2026 received iron and folic acid Comments on Pregnant women who have received iron and folic acid supplementation supplementation during a achieving targets minimum of six months (Number) Jun 19, 2025 Page 4 of 10 The World Bank Implementation Status & Results Report Niger, Improving Women’s and Girls’ Access to Improved Health and Nutrition Services in the Priority Areas Project – LAFIA-IYALI (P171767) 0.00 May/2021 413,421 01-Oct-2024 413,421 01-Oct-2024 2,464,193.00 Jun/2026 Couple-years of Protection in Comments on Amount of each method dispensed to patients multiplied by a conversion factor, which gives targeted areas (Number) achieving targets an estimate of the duration of contraceptive protection provided per unit of the method used. Children who have received 0.00 May/2021 749,237 01-Oct-2024 749,237 01-Oct-2024 191,613.00 Jun/2026 curative services by Comments on hildren 2-59 months old with pneumonia, uncomplicated malaria and diarrhea who received community relays for achieving targets curative services from community relays children who suffer from pneumonia, uncomplicated malaria and diarrhea (Number) Children under two receiving 0.00 May/2021 40 01-Jun-2024 40 01-Jun-2024 40.00 Jun/2026 essential community Comments on Number of children aged 0-23 months receiving nutrition services (Growth Monitoring nutrition in targeted areas achieving targets Promotion, screening, micronutrient supplementation) / number of children 0-23 months in (Percentage) project intervention areas 6.2 Intermediate Results Indicators by Components Increase coverage, utilization, and quality of integrated RMNCAH-N package Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Number of health facilities 0 Jan/2024 0 01-Oct-2024 0 01-Oct-2024 251 Jun/2026 (CSI) and district hospitals built or rehabilitated (Number) 0 Jan/2024 4,000 01-Oct-2024 4,000 01-Oct-2024 22,000 Jun/2026 Jun 19, 2025 Page 5 of 10 The World Bank Implementation Status & Results Report Niger, Improving Women’s and Girls’ Access to Improved Health and Nutrition Services in the Priority Areas Project – LAFIA-IYALI (P171767) Adolescent girls who have Comments on Number of adolescent girls who have benefited from at least one intervention in terms of benefited from at least one achieving targets schooling (scholarships, school kits, hygiene kits, excellence scholarships, support courses) intervention in terms of (number): schooling (scholarships, school kits, hygiene kits, excellence scholarships, support courses) (number) (Number) People receiving health 0.00 May/2021 0.00 01-Jun-2024 0.00 01-Jun-2024 7,120,910.00 Jun/2026 services free of charge in Comments on Number of vulnerable people, pregnant women, women giving birth and children under 5 targeted areas (Number) achieving targets supported free of charge through PBF in health structures in project intervention areas Women in postpartum using 0.00 May/2021 32,990 01-Jun-2024 32,990 01-Jun-2024 289,555.00 Jun/2026 modern contraceptive methods (Number) Quality average score of 0.00 May/2021 0.00 01-Oct-2024 0.00 01-Oct-2024 70.00 Jun/2026 district hospitals in targeted Comments on Average score calculated for hospitals on the basis of a quality of care assessment checklist areas (Percentage) achieving targets as part of the PBF program Community relays trained on 0.00 May/2021 0.00 01-Oct-2024 0.00 01-Oct-2024 40.00 Jun/2026 the complete package Comments on Community relays trained on the complete package (curative, preventive and promotional) / (curative, preventive and achieving targets expected number * 100 promotional) vis-à-vis the expected number (Percentage) Support demand for health and nutrition services Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Nutrition sensitive tested 0.00 May/2021 0.00 01-Oct-2024 0.00 01-Oct-2024 30.00 Jun/2026 community-based initiatives related to WASH to reduce Jun 19, 2025 Page 6 of 10 The World Bank Implementation Status & Results Report Niger, Improving Women’s and Girls’ Access to Improved Health and Nutrition Services in the Priority Areas Project – LAFIA-IYALI (P171767) vulnerability to water-borne diseases (Percentage) Mother of children under 0.00 May/2021 356,988 01-Oct-2024 356,988 01-Oct-2024 937,359.00 Jun/2026 two participating in nutrition Comments on Sum of the number of mothers of children 0-23 months benefiting from interpersonal behavior change activities achieving targets communication and number of mothers of children 0-23 months participating in educational (Number) chat sessions organized in project areas Adolescent girls and women 0.00 May/2021 500 01-Oct-2024 500 01-Oct-2024 351,860.00 Jun/2026 participating in Comments on Sum of girls and women benefiting from interpersonal communication (IPC) and empowerment behavior achieving targets participating in educational chat sessions organized in the project intervention areas change activities (Number) Adolescent students enrolled 0.00 May/2021 3,142 01-Oct-2024 3,142 01-Oct-2024 239,616.00 Jun/2026 in lower and upper Comments on Sum of boys and girls enrolled in secondary education (first and second cycles) who benefit secondary education achieving targets from at least one service included in the school health and nutrition package. receiving services from an integrated school-health and/or nutrition package (Number) Adolescent girls 0.00 1,024 1,024 104,875.00 enrolled in lower and Comments on Sum of girls enrolled in secondary education (first and second cycles) who benefit from at upper secondary achieving targets least one service included in the school health and nutrition package. receiving school health and / or nutrition services (Number) Functioning school health 0.00 May/2021 31 01-Oct-2024 31 01-Oct-2024 31.00 Jun/2026 clubs in targeted areas (Number) 0.00 May/2021 0.00 01-Oct-2024 0.00 01-Oct-2024 80.00 Jun/2026 Beneficiaries feedback Comments on Citizen Engagement Indicator. Number of beneficiaries of health centers and hospitals through community surveys achieving targets interviewed and satisfied with the quality of services provided in health centers and integrated to the inform hospitals / Number of beneficiaries of health centers and hospitals interviewed. Jun 19, 2025 Page 7 of 10 The World Bank Implementation Status & Results Report Niger, Improving Women’s and Girls’ Access to Improved Health and Nutrition Services in the Priority Areas Project – LAFIA-IYALI (P171767) changes in the PBF design (Percentage) Strengthen project management and institutional capacity Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Governmental multisectoral None May/2021 1 01-Oct-2024 1 01-Oct-2024 Fully Jun/2026 platform set up for anchoring functional the implementation of Comments on The platform will be officially established with clear mission and roles, with organization and interventions on health, achieving targets procedures to carry out its work, will be provided with necessary means for its operation and nutrition and women’s will produce an annual activity report empowerment (Text) Health centers health 0.00 May/2021 0.00 01-Oct-2024 0.00 01-Oct-2024 60.00 Jun/2026 committees that extend their areas of intervention to nutrition within their process for developing and executing their annual micro plan (Percentage) Technological and non- 0.00 May/2021 29 01-Oct-2024 29 01-Oct-2024 30.00 Jun/2026 technological innovations Comments on Proportion of project activities comprising technological and non-technological innovations implemented and tested to achieving targets that have been implemented and tested to inform the learning program and their scaling up inform the scale-up in the during later phases of the program. first and second phase of the program (Percentage) Jun 19, 2025 Page 8 of 10 The World Bank Implementation Status & Results Report Niger, Improving Women’s and Girls’ Access to Improved Health and Nutrition Services in the Priority Areas Project – LAFIA-IYALI (P171767) 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-D9040 Effective 50.00 47.75 0.00 26.73 20.43 56.68% IDA-69840 Effective 50.00 46.00 0.00 16.01 31.10 33.99% TF-B6336 Effective 25.00 25.00 0.00 2.16 22.84 8.63% 7.3 Key Dates (by loan) Jun 19, 2025 Page 9 of 10 The World Bank Implementation Status & Results Report Niger, Improving Women’s and Girls’ Access to Improved Health and Nutrition Services in the Priority Areas Project – LAFIA-IYALI (P171767) Loan/Credit/TF Status Approval Signing Effectiveness Orig. Closing Rev. Closing IDA-69840 Effective 23-Sep-2021 16-Dec-2021 01-Jun-2022 30-Jun-2026 31-Dec-2026 IDA-D9040 Effective 23-Sep-2021 16-Dec-2021 01-Jun-2022 30-Jun-2026 31-Dec-2026 TF-B6336 Effective 23-Aug-2021 16-Dec-2021 01-Jun-2022 30-Jun-2026 31-Dec-2026 8. KEY DATES Key Events Planned Actual Approval 23-Sep-2021 23-Sep-2021 Effectiveness 01-Jun-2022 01-Jun-2022 Mid-Term Review No. 01 01-Apr-2024 29-Apr-2024 Operation Closing/Cancellation 30-Jun-2026 9. RESTRUCTURING HISTORY Restructuring Level 2 Approved on 17-Sep-2024 10. ASSOCIATED OPERATION(S) There are no associated operations Jun 19, 2025 Page 10 of 10