The World Bank Implementation Status & Results Report Sindh Enhancing Response to Reduce Stunting (P161624) Sindh Enhancing Response to Reduce Stunting (P161624) SOUTH ASIA | Pakistan | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2017 | Seq No: 7 | ARCHIVED on 30-Jun-2020 | ISR42156 | Implementing Agencies: Government of Sindh, Planning and Development, Government of Pakistan, Economic Affairs Division Key Dates Key Project Dates Bank Approval Date: 26-May-2017 Effectiveness Date: 04-Oct-2017 Planned Mid Term Review Date: 14-Dec-2020 Actual Mid-Term Review Date: Original Closing Date: 31-Dec-2021 Revised Closing Date: 31-Dec-2021 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The Project Development Objective (PDO) is to contribute to the reduction of the stunting rate among children under 5 years of age by targeting the most affected districts in the Province of Sindh. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Component 1 : Expanding Access to a Multi-sectoral Package of Services for Reducing Stunting:(Cost $45.00 M) Component 2: Strengthening Key Cross-cutting Nutrition-related Interventions and Project Management:(Cost $16.62 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Unsatisfactory Moderately Unsatisfactory Overall Implementation Progress (IP) Moderately Unsatisfactory Moderately Satisfactory Overall Risk Rating Substantial Substantial Implementation Status and Key Decisions The Sindh Enhancing Response to Reduce Stunting Project is financed by a US$61.62 million equivalent IDA Credit for Sindh province. Project restructuring was finalized in March 2020 reflecting changes in: (i) institutional arrangements; (ii) Results Framework; and (iii) project activities under Components 1 and 2. The restructuring is expected to pave the way to more timely implementation by addressing various institutional, administrative and technical bottlenecks which had delayed the pace of project implementation. Third party verification for FY2017-18 and FY2018-19 disbursement linked indicators (DLIs) has been completed with several DLIs reported as achieved. Disbursements against these DLIs will be made following the Bank’s due diligence process. 6/30/2020 Page 1 of 10 The World Bank Implementation Status & Results Report Sindh Enhancing Response to Reduce Stunting (P161624) Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Substantial Substantial Substantial Macroeconomic Substantial Substantial Substantial Sector Strategies and Policies Moderate Moderate Moderate Technical Design of Project or Program Substantial Substantial Substantial Institutional Capacity for Implementation and Moderate Substantial Substantial Sustainability Fiduciary Substantial Substantial Substantial Environment and Social Moderate Moderate Moderate Stakeholders Moderate Moderate Moderate Other -- -- -- Overall Substantial Substantial Substantial Results PDO Indicators by Objectives / Outcomes contribute to reduction of stunting rate among children under 5 by targeting most affected districts IN00853938 ►Stunting prevalence (moderate/severe) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 48.00 48.00 48.00 43.00 Date 31-Dec-2014 31-Jan-2019 31-Jan-2019 31-Dec-2021 Percentage of children under age 5 who fall below minus two standard deviations (moderate and severe). Baseline information is based on the results of the Multi-indicator Cluster Survey (MICS) of 2014. The Comments: current values remain unchanged from baseline as they are contingent upon the results of the MICS 2018 being made public. IN00853939 ►Minimum acceptable diet (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 8.90 8.90 8.90 20.00 6/30/2020 Page 2 of 10 The World Bank Implementation Status & Results Report Sindh Enhancing Response to Reduce Stunting (P161624) Date 31-Dec-2014 31-Jan-2019 31-Jan-2019 31-Dec-2021 Percentage of children age 6-23 months who received appropriate liquids and solid, semi-solid or soft foods the minimum number of times or more during the previous day. Baseline information is based on the Comments: results of the Multi-indicator Cluster Survey (MICS) of 2014. The current values remain unchanged from baseline as they are contingent upon the results of the MICS 2018 being made public. IN00853940 ►Micro-nutrient sachet distribution (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 682,000.00 2,285,312.00 2,650,000.00 Date 30-Dec-2016 31-Jan-2019 30-Apr-2020 31-Dec-2021 Among children aged 6-24 months, the cumulative number who receive yearly a minimum of 90 Comments: micronutrient sprinkles sachets for three months in intervention areas Intermediate Results Indicators by Components Component 1 : Expanding Access to a Multi-sectoral Package of Services for Reducing Stunting IN00853961 ►Cumulative number of pregnant women who received 4 prenatal care visits, and counseling at community level (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 618,643.00 1,091,594.00 1,950,000.00 Date 30-Dec-2016 31-Jan-2019 30-Apr-2020 31-Dec-2021 IN00853963 ►Cumulative number of monthly supplies of IFA distributed to PLW (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,355,107.00 3,192,420.00 1,850,000.00 Date 30-Dec-2016 31-Jan-2019 30-Apr-2020 31-Dec-2021 IN00853965 ►Cumulative number of pregnant women who received TT2 (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 830,223.00 1,529,648.00 1,725,000.00 Date 30-Dec-2016 31-Jan-2019 30-Apr-2020 31-Dec-2020 IN00853966 ►Users of Modern Contraceptive Methods (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target 6/30/2020 Page 3 of 10 The World Bank Implementation Status & Results Report Sindh Enhancing Response to Reduce Stunting (P161624) Value 0.00 2,496,976.00 16,784.00 229,700.00 Date 30-Dec-2016 31-Jan-2019 30-Apr-2020 31-Dec-2021 Decrease from previous ISR figure of 2,495,975 is due to the restructuring of this indicator to include only Comments: interventions under SERRSP IN00853967 ►MUAC screening at community level (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,851,428.00 3,687,239.00 7,950,000.00 Date 30-Dec-2016 31-Jan-2019 30-Apr-2020 31-Dec-2021 IN00853968 ►Cumulative number of villages certified ODF (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 750.00 8,600.00 Date 30-Dec-2016 31-Jan-2019 30-Apr-2020 31-Dec-2021 IN00853969 ►Cumulative number of kitchen gardens established (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 90.00 1,927.00 2,600.00 Date 30-Dec-2016 31-Jan-2019 30-Apr-2020 31-Dec-2021 IN00853970 ►Cumulative number of households establishing backyard poultry raising and goat farming (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 822.00 10,785.00 26,000.00 Date 30-Dec-2016 31-Jan-2019 30-Apr-2020 31-Dec-2021 IN00853971 ►Cumulative number of children (36-59 months) attending Early Childhood Education (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 993,222.00 750,000.00 Date 30-Dec-2016 30-Jun-2018 30-Apr-2020 31-Dec-2021 IN00853972 ►Number of Mothers' Groups established (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target 6/30/2020 Page 4 of 10 The World Bank Implementation Status & Results Report Sindh Enhancing Response to Reduce Stunting (P161624) Value 0.00 3,964.00 4,194.00 3,900.00 Date 30-Dec-2016 31-Jan-2019 30-Apr-2020 31-Dec-2021 IN00853973 ►Pregnant/lactating women, adolescent girls and/or children under age 5 reached by basic nutrition services (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 2,037,107.00 2,037,107.00 7,950,000.00 Date 30-Dec-2016 31-Jan-2019 31-Jan-2019 31-Dec-2021 IN00853974 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 2,037,107.00 2,037,107.00 7,950,000.00 Date 30-Dec-2016 31-Jan-2019 31-Jan-2019 31-Dec-2021 IN00853975 Number of women and children who have received basic nutrition services (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 2,037,107.00 2,037,107.00 7,950,000.00 Date 30-Dec-2016 31-Jan-2019 31-Jan-2019 31-Dec-2021 IN00853976 ►Children between age of 6-59 months receiving Vitamin A supplementation (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 7,800,000.00 7,950,000.00 Date 30-Dec-2016 31-Jan-2019 31-Dec-2019 31-Dec-2021 Component 2: Strengthening Key Cross-cutting Nutrition-related Interventions and Project Management IN00853962 ►Provincial Nutrition Steering Committee functioning (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1.00 1.00 10.00 Date 30-Dec-2016 31-Jan-2019 31-Jan-2019 31-Dec-2021 IN00853964 ►Implementation of a system to strengthen coordination, collaboration and feedback between the AAP service providers and target beneficiary populations (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target 6/30/2020 Page 5 of 10 The World Bank Implementation Status & Results Report Sindh Enhancing Response to Reduce Stunting (P161624) Value No No Yes Yes Date 30-Dec-2016 31-Jan-2019 04-Jun-2019 31-Dec-2021 The project GRM is operational and focal persons for grievance redress have been appointed in each sector and implementing partner (NGOs). A variety of uptake channels (e.g. landline number; mobile/WhatsApp number; in-person visits to offices; written complaints) have been established and are being used. Details about contact information, time for resolution etc. has been disseminated across project districts. The Social Mobilization Specialist in the project secretariat has also provided training to Comments: all GRM focal persons. Admissible complaints received thus far have been resolved, and satisfaction with the complaints resolution process has been verified through a sample survey in select districts. The project also aims to provide support to all involved sectors to strengthen their departmental GRM systems and to develop a dashboard to monitor and track all complaints at the provincial level. Performance-Based Conditions IN00853977 ►PBC 1 Cumulative number of pregnant women who received 4 prenatal care visits, and counseling at community level (Number, Output, 7,000,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) 2020-2021 Value 0.00 618,643.00 1,091,594.00 1,525,000.00 Date -- 31-Jan-2019 30-Apr-2020 -- IN00853978 ►PBC 2 Cumulative number of women who received 4 ANC at primary and secondary health care facilities (BHU, THQ and DHQ) (Number, Intermediate Outcome, 7,000,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) 2020-2021 Value 0.00 143,646.00 673,811.00 1,000,000.00 Date -- 31-Jan-2019 30-Apr-2020 -- IN00853979 ►PBC 3 Cumulative number of children 6-59 mos who are screened (MUAC) for malnutrition at community level (Number, Intermediate Outcome, 7,000,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) 2020-2021 Value 0.00 1,851,428.00 3,687,239.00 5,280,000.00 Date -- 31-Jan-2019 30-Apr-2020 -- 6/30/2020 Page 6 of 10 The World Bank Implementation Status & Results Report Sindh Enhancing Response to Reduce Stunting (P161624) IN00853980 ►PBC 4 Cumulative number of malnourished children aged 6-59 months who are registered in Outpatient Therapeutic Program centers at health facilities and mobile health clinics (Number, Intermediate Outcome, 7,000,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) 2020-2021 Value 0.00 201,404.00 315,904.00 320,000.00 Date -- 31-Jan-2019 30-Apr-2020 -- IN00853981 ►PBC 5 Cumulative number of villages certified open defecation free (Number, Intermediate Outcome, 6,500,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) 2020-2021 Value 0.00 0.00 750.00 8,600.00 Date -- 31-Jan-2019 30-Apr-2020 -- PBC 5.1 Number of signed NGO contracts (Number, Output, 1,500,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) 2020-2021 Value 0.00 2.00 5.00 10.00 Date -- 31-Jan-2019 30-Apr-2020 -- PBC 5.2 Cumulative number of villages certified open defecation free (ODF) (Number, Intermediate Outcome, 5,000,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) 2020-2021 Value 0.00 0.00 750.00 8,600.00 Date -- 31-Jan-2019 30-Apr-2020 -- IN00853984 ►PBC 6 Introduction of nutrition and life skills curriculum/instructional materials in Grades 6-10 (Yes/No, Process, 2,000,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) 2020-2021 Value No Yes Yes Yes Date -- 31-Jan-2019 15-Jun-2020 -- 6/30/2020 Page 7 of 10 The World Bank Implementation Status & Results Report Sindh Enhancing Response to Reduce Stunting (P161624) IN00853985 ►PBC 7 Implementation of a province-wide, multi-sectoral media/communications campaign (Yes/No, Intermediate Outcome, 2,000,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) 2020-2021 Value No No Yes Yes Date -- 31-Jan-2019 15-Jun-2020 -- PBC 7.1 Adoption of BCC plan (Yes/No, Process, 500,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) 2020-2021 Value No No Yes Yes Date -- 31-Jan-2019 15-Jun-2020 -- PBC 7.2 Launch of campaign (Yes/No, Process, 1,500,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) 2020-2021 Value No No Yes Yes Date -- 31-Jan-2019 15-Jun-2020 -- IN00853988 ►PBC 8 Percentage of allocation nutrition financiing actually expended (Text, Output, 6,500,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) 2020-2021 Amount of nutrition related releases for AAP by June 30 (PKR). Disbursements will initially focus on the total amount of AAP allocation (1 billion PKR) and the proportion released Value 0.00 0.00 0.00 to the priority districts. Once the nutrition expenditure tracking system is established, disbursements will be based on the annual amount of nutrition-related AAP expenditures 6/30/2020 Page 8 of 10 The World Bank Implementation Status & Results Report Sindh Enhancing Response to Reduce Stunting (P161624) Date -- 30-Jun-2018 28-Jun-2019 -- PBC 8.1 Amount of nutrition related releases for AAP by June 30 (PKR) (Text, Output, 2,000,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) 2020-2021 Amount of nutrition related releases for AAP by June 30 (PKR). Disbursements will initially focus on the total amount of AAP allocation (1 billion PKR) and the proportion released Value 0.00 1,500,000,000.00 PKR 3,955,950,000 PKR to the priority districts. Once the nutrition expenditure tracking system is established, disbursements will be based on the annual amount of nutrition-related AAP expenditures. Date -- 30-Jun-2018 28-Jun-2019 -- PBC 8.2 Establishment of nutrition expenditure tracking system (Text, Process, 1,500,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) 2020-2021 Value not established not established not established system functional Date -- 31-Jan-2019 30-Apr-2020 -- PBC 8.3 Annual amount of nutrition-related expenditures by AAP sector (Text, Output, 3,000,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) 2020-2021 Annual amount to be calculated after the Value 0.00 0.00 0.00 nutrition expenditure tracking system is functional. Date -- 31-Jan-2019 30-Apr-2020 -- Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed 6/30/2020 Page 9 of 10 The World Bank Implementation Status & Results Report Sindh Enhancing Response to Reduce Stunting (P161624) P161624 IDA-60470 Effective USD 61.62 61.62 0.00 19.60 43.39 31% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P161624 IDA-60470 Effective 26-May-2017 26-Jul-2017 04-Oct-2017 31-Dec-2021 31-Dec-2021 Cumulative Disbursements PBC Disbursement Achievement Disbursed amount in Disbursement % PBC ID PBC Type Description Coc PBC Amount Status Coc for PBC Restructuring History Level 2 Approved on 15-Dec-2019 Related Project(s) There are no related projects. 6/30/2020 Page 10 of 10