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Implementation Completion Report (ICR) Review - Nutrition, Food Security, And Social Mobilization Project

1. Project Data:   
ICR Review Date Posted:
Project Name:
Nutrition, Food Security, And Social Mobilization Project
Project Costs(US $M)
 5.3  5.37
Loan/Credit (US $M)
 4.9  4.9
Sector, Major Sect.:
Central government administration, Micro- and SME finance, Health, Other social services,
Law and justice and public administration; Finance; Health and other social services; Health and other social services
Cofinancing (US $M)
 0  0
L/C Number:
Board Approval (FY)
Partners involved
Closing Date
10/31/2003 04/30/2005
Evaluator: Panel Reviewer: Division Manager: Division:  
Elaine Wee-Ling Ooi
Ronald S. Parker Alain A. Barbu IEGSG

2. Project Objectives and Components:

a. Objectives
The project objective, as described in the PAD, is to evaluate the effectiveness of specific activities (or components) combined into two different "prototypes" of programs, one urban and one rural, to reduce in a measurable way, child malnutrition in Mauritania. The project was designed to improve the nutritional status of mothers and children (0-6 years), and to increase the income of participating mothers. Four sets of evaluation criteria were to be used (prevalence of underweight children; micronutrient deficiency; number of female technicians trained; performance of microcredit subprojects) to determine which activities will be scaled up subsequently for national implementation.

b. Components (or Key Conditions in the case of Adjustment Loans):
i) Community Nutrition Program ($1 m planned; $2 m actual ) - growth monitoring of children (0-3 years), health education and counseling of mothers, and provision of nutritional supplements at selected rural and urban districts; operational linkages to be established between the women's cooperatives and existing nutrition centers/health posts;

ii) Microprojects ($1.9 m planned; $ 0.45 m actual) - eligible to those women cooperatives who participate in the nutrition program, to credits and grants for income generating projects;
iii) Social Mobilization/Rural Radio ($0.9 m planned; $0.19 m actual) - print and mass media to inform and sensitize the target population about the project activities and its benefits; and creation of a new broadcasting station in a rural area;
iv) External Evaluation ($0.3 m planned; $0.2 m actual) - impact evaluation of the project to be conducted by the National Statistical Office (ONS) and;
v) Project implementation and Management ($1.1 m planned; $2.79 m actual) - capacity building and strengthening of the Executive State Secretariat for the Promotion of Women (SECF) in planning, coordination, and M&E.

There was no formal revision of project components but some activities were added - staff training and the rehabilitation of nutrition centers (under Ministry of Health) that will treat severely malnourished children referred by the project - while the planned construction of the broadcasting station was dropped. The budget was reallocated accordingly among the components.

c. Comments on Project Cost, Financing, Borrower Contribution, and Dates
Total project costs at appraisal were estimated to be $5.3 million, with an IDA credit of $4.9 million. The government was to provide $0.3 million and the participating cooperatives $0.1 million. According to the ICR the financial data available is poor and inconsistent. Due to substantial devaluation of the local currency, credit funds were able to support more activities. In table 7, government expenditures amounted to $468,000 (unclear if this included the contribution from cooperatives). By IEG estimates, total project costs would be about $5.37 million. The project was extended twice due to slow implementation progress and closed 1 and 1/2 years late on 04/30/2005. )

3. Relevance of Objectives & Design:

The project's development objectives -- combating malnutrition, and the use and strengthening of the SECF and women's cooperatives to this end -- were relevant and consistent with the country's CAS. However, it is debatable the extent to which vulnerable women and children could benefit from the project since they are unlikely to belong to a cooperative (see Section 4).
The institutional weaknesses and inexperience of the primary counterpart (SECF) were identified during risk management. Nonetheless a complex and ambitious project (aiming for 30% reduction of both child malnutrition and micronutrient deficiency in project areas) was designed. The project attempted a variety of activities, the approach and implementation methodology for some of which were not clearly spelt out (as in the microprojects component); and not adequately linked to the nutrition program objectives. Capacity building up-front of all the implementation actors (ONS, SECF, NGOs and community nutrition workers {CNWs}) was not adequately provided for in the design. Finally the M&E system was inadequate for a LIL (see section 6 below). OED concurs with the ICR and QAS that the project QAE was unsatisfactory.

4. Achievement of Objectives (Efficacy) :

Evaluate the effectiveness of project activities to reduce, in a measurable way, child malnutrition (achievement was negligible.
Because of poorly designed M&E and the inability of the key actors to collect reliable data (described in section 6), it was difficult to determine what the project had accomplished. In fact during implementation no data was collected for micronutrient deficiencies.
The project performed badly due to i) poor project design; ii) lack of capacity of project implementers (SECF, NGOs, CNWs) - so few competent NGOs were available that the microprojects did not really take off until 2003; iii) lack of linkages between the microprojects and the community nutrition activities (growth monitoring and nutrition education); and iv) none of the profits generated from the microprojects were channeled back into nutrition activities as originally conceived. In fact, the women cooperatives did not prove to be a reliable mechanism to reach and benefit vulnerable women with children under 3 years. Vulnerable women lacked the time and financial resources to be members of cooperatives, thus did not benefit from the income generation opportunities. Additionally the cooperatives were less successful in mobilizing non-members to the growth monitoring / nutrition activities. Attendance of the more vulnerable women and children at these activities declined with time.

The impact study recorded a reduction in malnutrition of 16% in 2 urban areas. This figure overstates the impact because the baseline data had been collected during the "hunger" months, while the endline data had been collected during the normal season. Furthermore, in the project's rural areas, malnutrition had increased by 6 - 8 %. In addition,during the project period, Mauritania experienced a major drought, locusts, and a loss in agricultural and other farm based productivity. These conditions certainly aggravated malnutrition levels. It is, however, likely that in the absence of the project, malnutrition rates in project areas would have been more dire.

5. Efficiency:

No ERR or IRR was presented by the PAD or the ICR.
6. M&E Design, Implementation, & Utilization:

The expressed project objective was to evaluate the effectiveness of its activities, in order to reduce child malnutrition in a measurable way (by 30%). The project was also a LIL. For these reasons project M&E should have of superior quality. Instead there was a big disconnect between the actual quality and quantity of data collected versus that envisaged at appraisal. Inadequate provisions were made up-front by the project to i) build capacity of the ONS which was to conduct the independent evaluation of project impact; ii) identify appropriate outcome / performance indicators; and iii) capture project impact on mothers and children who do not belong to the cooperatives - thus reducing sampling bias. The ICR identified several design flaws in the ONS conducted impact evaluation on pages 6, 7, 11(overlap between case and control villages, lack of baseline data, and non-comparability of baseline and end-of-project data.)
Routine administrative data collected by the NGOs and nutrition workers were generally poor and rarely analyzed. Behavioral changes in mothers with respect to breast-feeding and weaning are important determinants of child nutrition, but there was no provision by the project to measure these. The PAD had instead identified output indicators such as the number of technicians trained.
Because of the weakness of project M&E and of the impact evaluation study, the learning and innovation envisaged could not be realized, and the achievement of the overall project objective was compromised.
7. Other (Safeguards, Fiduciary, Unintended Impacts--Positive & Negative):

The ICR reported the reimbursement of ineligible expenses. IDA's failure to stem this practice undermined overall project financial management, and encouraged the government's non-compliance with the credit's financial covenants (ICR pg 15).

8. Ratings:
ICR Review
Reason for Disagreement/Comments
Institutional Dev.: 
Bank Perf.: 
SatisfactoryUnsatisfactoryIEG finds bank performance "moderately" unsatisfactory. The primary reason for poor project outcome was its poor design - overly ambitious targets, inconsistent with the country's and implementing agency's capabilities. Inadequate provisions for capacity building and for M&E further compromised achievement of project objectives. Quality of IDA's financial oversight (see section 7) was also weak.
Borrower Perf.: 
Quality of ICR: 

- When insufficient information is provided by the Bank for IEG to arrive at a clear rating, IEG will downgrade the relevant ratings as warranted beginning July 1, 2006.
- ICR rating values flagged with ' * ' don't comply with OP/BP 13.55, but are listed for completeness.

9. Lessons:

Incentives should be more tightly linked to the desired project outcome. In this project the incentives offered through the income generation activities were poorly handled, and diverted the attention of the women's cooperatives from nutrition activities.
  • For LIL projects and those that aim to carry out project impact evaluation, adequate provisions should be made up-front to ensure that M&E capacity/capability is available in order that good quality baseline- and subsequent- data can be collected.
  • Growth monitoring has to be closely linked to counseling and nutrition education of mothers. Because the interpersonal and technical skills of the community nutrition workers were minimal they were not able to influence the child feeding behaviors of mothers.

10. Assessment Recommended?  No


11. Comments on Quality of ICR:

The ICR gives a thorough account of the project experience. However, some the project financing data presented are somewhat inconsistent and confusing. Annex 2 should provide total project costs reflecting contributions from all sources: government, IDA and the beneficiaries. For project achievements, data on child malnutrition rates at the national level could have been presented by the ICR to provide a context and some comparison with control sites.
Subsequent data was provided by the region (which were absent in the ICR) which helped clarify the difference in indicators selected to measure child malnutrition, and on the number of beneficiaries surveyed.

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