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: 12 | Archived on 01-Oct-2024 | ISR01322 Implementing Agencies: Rwanda Biomedical Center 1. OBJECTIVE 1.1 Development Objective Original Development Objective (Approved as part of Approval package on 10-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? No 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 Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating Moderate Moderate Oct 01, 2024 Page 1 of 9 The World Bank Implementation Status & Results Report Rwanda Stunting Prevention and Reduction Project (P164845) 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 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. 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 61% as of July 2024. 5. SYSTEMATIC OPERATIONS RISK-RATING TOOL Rating at Approval Last Approved Rating Risk Category Approval Package - ISR Seq. 011 - 17 Jan 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 Other  Low Low Overall Substantial Moderate Moderate Oct 01, 2024 Page 2 of 9 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-Dec-2023 36.60 15-Jun-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 28.00 15-Dec-2023 27.03 01-Aug-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 34.60 15-Dec-2023 59.47 01-Aug-2024 50.00 Dec/2025 months old who are fed a diverse diet (Percentage) 45.00 Dec/2022 53.70 15-Dec-2023 66.10 15-May-2024 51.00 Dec/2025 Percentage of women who Comments on In the previous round, the ANC4 rate was recorded from the midline survey instead of the attended 4 or more ANC visits achieving targets defined HMIS source. This round reports the HMIS result. The stunting rate among children during their most recent under 2 years and the dietary diversity rate are preliminary midline survey findings, with pregnancy (Percentage) further checks and analyses underway to confirm the results. Page 3 of 10 The World Bank Implementation Status & Results Report Rwanda Stunting Prevention and Reduction Project (P164845) 6.2 Intermediate Results Indicators by Components Component 1: Prevention of Stunting at Community and Household Levels 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 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 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 Dec/2025 women (Number of Comments on The indicator has been removed from the Results Framework people) CRI achieving targets 215,460.00 Dec/2022 215,460.00 15-Dec-2023 215,460.00 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) services Number of children participating in ECDs in the 13 target districts (children aged 24-59 (Number) months): 431,498 Number of pregnant and lactating women enrolled in FBF program: 56,707 215,460.00 Dec/2022 215,460.00 15-Dec-2023 215,460.00 15-Dec-2023 506,124.00 Dec/2025 People who have received essential health, nutrition, Comments on In which: and population (HNP) services achieving targets Number of children participating in community height visualizations using length mats in the (Number) 13 target districts (children aged 0-23 months): 193,493 Number of children participating in ECDs in the 13 target districts (children aged 24-59 Page 4 of 10 The World Bank Implementation Status & Results Report Rwanda Stunting Prevention and Reduction Project (P164845) 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 215,460.00 15-Dec-2023 506,124.00 Dec/2025 children who have received basic nutrition services (Number) Percentage of home-based 64.00 Dec/2022 78.60 15-Dec-2023 78.60 15-May-2024 80.00 Dec/2025 ECD centers with satisfactory scores on quality score card (Percentage) Percentage of CHWs who 96.00 Dec/2022 94.00 15-Dec-2023 91 15-May-2024 90.00 Dec/2025 received a quarterly supportive supervision visit from health center (Percentage) Percentage of pregnant 73.00 Dec/2022 45.00 15-Dec-2023 52 15-May-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 82.00 15-Dec-2023 14.20 15-May-2024 90.00 Dec/2025 months old receiving micronutrient powders (Percentage) Percentage of children under 0.00 Dec/2022 87.00 15-Dec-2023 94 15-May-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-Dec-2023 8,656.00 15-May-2024 25,000.00 Dec/2025 households with improved latrines (from project Page 5 of 10 The World Bank Implementation Status & Results Report Rwanda Stunting Prevention and Reduction Project (P164845) interventions) (Number) Number of children enrolled 0.00 Dec/2022 0.00 15-Dec-2023 0.00 15-May-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-Dec-2023 0.00 15-May-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) 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 73.00 15-Dec-2023 68 15-May-2024 85.00 Dec/2025 5 with height measured and recorded at health facility (Percentage) Percentage of CHWs with no 95.00 Dec/2022 93.00 15-Dec-2023 94 15-May-2024 95.00 Dec/2025 stock out of Zinc for diarrhea treatment (Percentage) Percentage of fortified 86.00 Dec/2022 100.00 15-Dec-2023 57 15-May-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 11.00 15-Dec-2023 54 15-May-2024 85.00 Dec/2025 Page 6 of 10 The World Bank Implementation Status & Results Report Rwanda Stunting Prevention and Reduction Project (P164845) who received FBF in the last month (Percentage) Percentage of enrolled 73.00 Dec/2022 9.00 15-Dec-2023 64 15-May-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 06-Dec-2022 6,564.00 15-May-2024 138,362.00 Dec/2025 participating in ECD peer-to- peer model (Number) 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 Historical Disbursed IDA-61870 Effective 25.00 25.00 0.00 24.40 0.00 97.58% 25.00 TF-A6567 Effective 20.00 20.00 0.00 20.00 0.00 100.00 20.00 % TF-A6783 Closed 10.00 10.00 0.00 10.00 0.00 100.00 10.00 % TF-C0811 Effective 5.00 5.00 0.00 2.30 2.70 46.00% 5.00 Oct 01, 2024 Page 7 of 9 The World Bank Implementation Status & Results Report Rwanda Stunting Prevention and Reduction Project (P164845) TF-C0802 Effective 4.00 4.00 0.00 1.15 2.85 28.74% 4.00 IDA-72830 Effective 50.00 50.00 0.00 18.56 31.44 37.11% 50.00 IDA-72820 Effective 20.00 20.00 0.00 3.91 13.44 19.55% 20.00 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 01-May-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) Oct 01, 2024 Page 8 of 9 The World Bank Implementation Status & Results Report Rwanda Stunting Prevention and Reduction Project (P164845) There are no associated operations Oct 01, 2024 Page 9 of 9