Indonesia: Nutrition Improvement through Community Empowerment

Sovereign Project | 38117-013

Summary

The ultimate goal of the Project is to help Indonesia achieve target 2 of Millenium Development Goal (MDG) 1: to halve the number of underweight children under five years of age by 2015 and related MDG goals. To achieve this, the Project aims to reduce the prevalence of underweight in children under five years of age, and pregnant and lactating women through strengthening the capacity of central and local governments in improving the management of nutrition services. Strengthening community-based services for children and women, and social mobilization for improved nutrition and hygiene is the centerpiece of the Project.

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Project Name Nutrition Improvement through Community Empowerment
Project Number 38117-013
Country Indonesia
Project Status Closed
Project Type / Modality of Assistance Loan
Technical Assistance
Source of Funding / Amount
Loan 2348-INO: Nutrition Improvement through Community Empowerment
Asian Development Fund US$ 50.00 million
TA 4963-INO: Independent Monitoring and Evaluation of Nutrition Improvement through Community Empowerment Project
Technical Assistance Special Fund US$ 500,000.00
Strategic Agendas Inclusive economic growth
Drivers of Change
Sector / Subsector

Health - Nutrition

Gender Equity and Mainstreaming Gender equity
Description

The ultimate goal of the Project is to help Indonesia achieve target 2 of Millenium Development Goal (MDG) 1: to halve the number of underweight children under five years of age by 2015 and related MDG goals. To achieve this, the Project aims to reduce the prevalence of underweight in children under five years of age, and pregnant and lactating women through strengthening the capacity of central and local governments in improving the management of nutrition services. Strengthening community-based services for children and women, and social mobilization for improved nutrition and hygiene is the centerpiece of the Project.

The Project is expected to cover about 4,000 villages in 18 districts, including poor urban areas in 6 cities, in 6 provinces. The participating provinces were selected and agreed upon between the Government, ADB and major stakeholders based on the following criteria: (i) prevalence of malnutrition, (ii) poverty incidence and (iii) local government commitment to contribute counterpart funding. The Project is expected to have a demonstration effect, which may lead to an expansion of nutrition interventions to other provinces.

Project Rationale and Linkage to Country/Regional Strategy The project reflects the existing Country Strategy and Program (2002) which lists Human Development as a strategic focus. Under this focus, the program will emphasize social service provision and reduction of gender inequalities; especially support for local government provision of public services, including education and health services complemented by social protection activities that seek to incorporate successful interventions mounted during the crisis. In the health sector, an important focus is on reproductive health and nutrition and bringing down the maternal mortality rate.
Impact Improved nutrition status of children under 5 years and pregnant and lactating women.
Project Outcome
Description of Outcome Improved utilization and quality of nutrition programs and services for at-rsik women and children in six project provinces.
Progress Toward Outcome

Number of children 0 to 5 years attending posyandu during last month increased from 48.5% in 2005 to 77.5% (from 75% target) in 2012.

Number of children under 6 months exclusively breastfed increased from an average of 10% in 2005 to 59.6% (target is 40%) in 2012.

Percentage of women receiving Iron tablet at puskesmas/midwife increased to 47.3% from the baseline.

Implementation Progress
Description of Project Outputs

1. Strengthened capacity for development of nutrition policies, programs and surveillance.

2. Improved quality of integrated nutrition services for women and children in project areas.

3. Enhanced community capability for, and implementation of, improved nutrition and hygiene interventions.

4. Expanded food fortification programs and nutrition communication.

5. Enhanced capacity for nutrition policy and programs institutionalized and monitoring and evaluation established in project areas.

Status of Implementation Progress (Outputs, Activities, and Issues)

Six Guidelines/protocols have been prepared: 1. Taburia fotification guidelines, 2. food security guidelines, 3. food sfaety guidelines for primary schools, 4. supplementary breastfeeding in emergency, 5. counseling modules for breastfeeding and supplementary breastfeeding, 6. severe malnutrition guidelines. Baseline for trained staff is not available. To date, a total of 40 staff from district hospitals and health centers from North Sumatra & West Kalimantan have been trained on management of severe malnutrition and breastfeeding counseling. 138 nutrition workers (TPG non-gizi) received training on nutrition & hygiene. As of 31 Dec 2012, all 6 Provinces and 17 out of 24 districts have established their RADPG.

No baseline data for #of trained personel. Training and equipment have been provided. All puskesmas at Project's regions were equiped with anthropometry and nutrition kits. The latest report showed that posyandus in project areas providing services at least once per month with average coverage of 75%-80% mothers attended posyandus in the last three months.

CNCs established in the end of 2010. More than 70% of CNC members are women. The first tranche released only in the last quarter of 2010. Currently, 100% of 1,800 villages have received the 1st and 2nd tranches and about 99% villages have received the 3rd tranche. 900 CFs were recruited, 67% are women. CFs have been in place since March 2010.

No data available for the percentage of fortified salt and wheat at retail level meeting mandated fortification standards, while the target is increased from 60% in 2003 to 90% in 2012.

One commercial brand of Micronutrient supplements (sprinkles) is available to cover community outside of project areas. The target is commercial basis in at least 30% of project provinces. The National data shows that in 2012 the exclusive breastfeeding increased to 59.6%.

No data available yet for the number of schools reached, latest report shows >50% primary schools were covered.

Reallocation has been approved on 26 October 2011. 3 month extension of project closing date to 31 Dec 2012 was approved.

Geographical Location The Project is expected to cover about 4,000 poor villages including poor urban areas of six cities in 18 districts in the provinces of West Kalimantan, South Sulawesi, North Sumatra, South Sumatra, East Nusa Tenggara and West Nusa Tenggara.
Safeguard Categories
Environment C
Involuntary Resettlement C
Indigenous Peoples C
Summary of Environmental and Social Aspects
Environmental Aspects The Project will not have significant adverse environmental effects. It will finance community-based interventions and basic health services, which have few by-products.
Involuntary Resettlement No resettlement, as defined by ADB's Involuntary Resettlement Policy will be required as a result of project activities.
Indigenous Peoples No Issue.
Stakeholder Communication, Participation, and Consultation
During Project Design
During Project Implementation Consultations have been carried out with potential beneficiaries in possible pilot urban areas including those in West Java.
Business Opportunities
Consulting Services All consultants to be financed from the proceeds of the loan will be selected in accordance with Guidelines on the Use of Consultants, consulting services will provide 7 international and 8 national of long-term and intermittent consultants for a total of 43 and 163 person-months (pm), respectively. The specific technical expertise are as follows: (i) Nutrition policy and program development/project management support (international 23 pm, national 60 pm) (ii) Institutional development (international 6 pm, national 12 pm) (iii) Nutrition surveillance (international 2 pm, national, 16 pm) (iv) Nutrition training specialists (international 4 pm, national, 12 pm) (v) Planning and budgeting specialist (national, 16 pm) (vi) Community empowerment (international 3 pm, national 24 pm) (vii) Food fortification (international 2 pm, national 8 pm) (viii) Advocacy and communication (international 3 pm, national 15 pm). Project implementation consultants will be hired through a firm using international quality cost based selection (QCBS) for contracts to cost the equivalent of $200,000 or more.
Procurement Procurement of goods and services financed under the Project and Community participation in procurement will be in accordance with ADB's Procurement Guidelines. Goods under the Project procured will include: nutrition-related equipment, food laboratory equipment, computers and related equipment, office equipment, and motorcycles. International competitive bidding (ICB) will be used for supply contracts for goods estimated at $500,000 or more for goods, and works estimated at $1.5 million and more. National competitive bidding (NCB) will be used for contract goods packages costing more than $200,000. Limited international bidding (LIB) will be used for goods costing more than $100,000. Shopping will be used for goods and works costing less $100,000. The management approved the proposed advance action for procurement and recruitment of consultants. The Executing Agency has been advised that the advance action must follow ADB's procedures. The Government also anticipates that it will incur Project- related costs prior to loan effectiveness. These costs may form a portion of the Government's counterpart contribution. However, the incurring of such costs does not commit ADB to approve the loan project and the Government has been so notified.
Responsible ADB Officer Wolfgang G. Kubitzki
Responsible ADB Department Southeast Asia Department
Responsible ADB Division Indonesia Resident Mission
Executing Agencies
The Directorate General of Community HealthDr. Minartocpmu_nice@yahoo.comMinistry of Health, Directorate General of Public Health, Jakarta, Indonesia
Ministry of HealthDr. Budihardja,Ministry of Health Jakarta, Indonesia
Timetable
Concept Clearance 04 Oct 2006
Fact Finding 02 Aug 2006 to 16 Aug 2006
MRM 04 Oct 2006
Approval 31 Aug 2007
Last Review Mission -
PDS Creation Date 01 Mar 2006
Last PDS Update 24 Sep 2013

Loan 2348-INO

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
31 Aug 2007 05 Oct 2007 10 Dec 2007 30 Sep 2012 31 Dec 2012 04 Feb 2014
Financing Plan Loan Utilization
Total (Amount in US$ million) Date ADB Others Net Percentage
Project Cost 71.40 Cumulative Contract Awards
ADB 50.00 31 Aug 2007 48.45 0.00 100%
Counterpart 21.40 Cumulative Disbursements
Cofinancing 0.00 31 Aug 2007 48.45 0.00 100%
Status of Covenants
Category Sector Safeguards Social Financial Economic Others
Rating Satisfactory Satisfactory - Satisfactory - Satisfactory

TA 4963-INO

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
31 Aug 2007 23 Nov 2007 23 Nov 2007 31 Mar 2012 31 Dec 2012 -
Financing Plan/TA Utilization Cumulative Disbursements
ADB Cofinancing Counterpart Total Date Amount
Gov Beneficiaries Project Sponsor Others
500,000.00 0.00 0.00 0.00 0.00 0.00 500,000.00 31 Aug 2007 392,831.47
Status of Covenants
Category Sector Safeguards Social Financial Economic Others
Rating Satisfactory Satisfactory - Satisfactory - Satisfactory

Safeguard Documents

See also: Safeguards

No documents found.

Evaluation Documents

See also: Independent Evaluation

No documents found.


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