Nepal: Reducing Child Malnutrition through Social Protection

Sovereign Project | 43103-012 Status: Active

Summary

The development objective of the project is to create capacity within the Government of Nepal to plan and execute social protection programs and projects for more inclusive and equitable social outcomes.

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Project Name Reducing Child Malnutrition through Social Protection
Project Number 43103-012
Country Nepal
Project Status Active
Project Type / Modality of Assistance Grant
Source of Funding / Amount
Grant 9157-NEP: Reducing Child Malnutrition through Social Protection
Japan Fund for Poverty Reduction US$ 1.60 million
Strategic Agendas Inclusive economic growth
Drivers of Change Governance and capacity development
Partnerships
Sector / Subsector

Health - Social protection initiatives

Gender Equity and Mainstreaming Some gender elements
Description The development objective of the project is to create capacity within the Government of Nepal to plan and execute social protection programs and projects for more inclusive and equitable social outcomes.
Project Rationale and Linkage to Country/Regional Strategy

ADB's Country Partnership Strategy (CPS) for Nepal (2005 ? 2009) rests on three pillars of which fostering inclusive social development is one. The three sub-sectors prioritized under this pillar are (i) education, (ii) water supply, sanitation and urban development, and (iii) social protection. While the strategy emphasizes on building social protection initiatives within the project design, it also identified the need to build capacity in social protection institutions in Nepal. The CPS is in line with ADB's Strategy 2020, which places emphasis on promoting greater access to opportunities by expanding human capacities through investments in education, health and basic social protections; as well as with the government's development strategy which has been increasingly expressing its deep commitment to social justice and equity and is striving to expand its safety net and social protection coverage. Nepal has had in place an old-age pension scheme and benefits to widows and the disabled since 1994. Since the current fiscal year, the government has expanded this coverage by lowering the age limit and expanding its cash-transfer scheme to certain caste/ethnic groups. The allowance has also been increased.

However, there are no child centered cash-transfer schemes at the moment despite strong evidence that child protection measures can have significant impacts on the health of children and their consequent contribution to society. Many studies on early child brain development, including a study done by ADB shows that child development is at the core of human development theory and that the most critical period of brain development is in the first three years of life, proper nutrition being a critical factor in healthy brain development. It is estimated that more than half of Nepal's under-five children are stunted for their age, and despite significant decrease in infant mortality rates, over 40,000 under-one children are still dying in Nepal every year. A study conducted in 1999 revealed that of the 95,000 under-five child deaths in Nepal every year, about 54% were attributed to moderate and severe malnutrition, with the "moderates" responsible for most of the deaths. It has been proven that mental stunting resulting from malnutrition is irreversible and the World Bank estimated in 2007 that malnutrition in children in Nepal causes a GDP loss of around 3% per year. Thus, studies have shown that the highest human capital rates of return can be achieved from social protection targeting pre-school children. Confounding to these problems is a recent food alert by the World Food Programme in Nepal, warning of an impending food shortage, particularly in the mid- and far-western hills of Nepal due to low winter precipitation. Undoubtedly, children would be impacted the most.

In 2008 UNICEF and WFP conducted an exploratory survey to see how child benefit cash transfers would be used by households. The study revealed that more than 40% of the money from cash transfers to mothers would be spent on supplementary food for children, around 30% on children's education and 11% or more on health care. Evidence from another ADB project also demonstrated that women who were provided cash transfers did have control over the money, and most of the allowance provided to cover "basic needs" was spent on food, house maintenance, medicine, education, clothing and household supplies, in that order of priority. Thus, the justification to provide a monthly cash allowance and its direct relevance to poverty reduction is more than evident for this project.

Impact Reduction in child malnutrition in the project districts

Project Outcome

Description of Outcome Enhanced execution of social protection programs
Progress Toward Outcome The envisaged outcome of the project is enhanced execution of social protection programs to be measured by (i) coverage of child grant increasing to at least 85% of eligible recipients in the project districts, and (ii) at least 70% of the cash received through the child grant is utilized for supplementary feeding of children, health, and/or educational expenses. The Project end-line survey carried out in 2015 reports about 83.7% of households in the five project districts received the child grant in the past 12 months. Further analysis reveals that the uptake of the child grant decreases rapidly for 0 12 months age group which is due to the current registration processes. The survey also revealed that 83.8% of the households responded utilizing the child grant money on food, 20.9% on education, and 26.2% on health related expenditure.
Implementation Progress
Description of Project Outputs

Enhanced capacity of local bodies in the project districts to deliver the child grant

Enhanced capacity of the government to design efficient and evidence-based social protection programs

Enhanced networking between local bodies, health facilities, and communities in the project districts for improving child nutrition

Status of Implementation Progress (Outputs, Activities, and Issues) Output 1: Five social protection Officers were mobilized in the project districts, who supported the district development committees (DDCs) in coordinating the ongoing social protection programs, assisted the district information and documentation center to manage demographic and poverty profiles, and supported the management information system (MIS) consultants in digitizing the cash transfer registry. The previously cash transfer registry which was maintained manually by the VDC secretaries has now been digitized. This database is now maintained by the Department of Civil Registration. Output 2: A five-day training program was conducted in December 2012 in which 42 Local Development Officers and other staff of the district development committees of the mid- and far-western development region took part. District level workshops focusing on raising awareness on birth registration and the child grant were also conducted in all five project districts which focused on strengthening the implementation of the child grant. A total of 75 government officials and 80 female community health volunteers and VDC secretaries participated in the workshops. A 5-day training program which benefited 37 mid-level government officials from various ministries implementing social protection programs was also conducted. A draft national protection framework has been prepared under the leadership and coordination of the National Planning Commission Secretariat. As the draft was prepared some time back, it is being updated with recent data and edited before submission to the National Planning Commission for endorsement. The child grant implementation guideline and the cash transfer implementation guideline were consolidated into one document. Output 3: The Project provided two rounds of infant and young child feeding training once between 2012 and 2013 and again in 2015. A total of 848 health workers and 2,309 female community health workers were trained on infant and young child feeding practices. The mid-line and end-line survey reveals that 80% of respondents in the project districts practiced exclusive breastfeeding of children up to 6 months of age. The mid-line and end-line surveys measured meal frequency on the basis of 2 times for breastfed children between 6 8 months, 3 times for children between 9 23 months, and 4 times for non-breastfed children aged 6 23 months. The end-line survey reveals that this ranged from 83% in Dolpa to 94% in Kalikot, which is a significant improvement from around 47% in 2010 (baseline survey). Against the indicator of at least 80% of mothers wash hand with soap after defecation, the end-line survey reveals that this ranges from 65% in Humla to 92% in Jumla. And for at least 90% of children being fully immunized the mid-line survey this has improved from 83% in 2010 to 86% in 2013.
Geographical Location Karnali Zone (Mid-Western Development Region)

Safeguard Categories

Environment C
Involuntary Resettlement C
Indigenous Peoples B

Summary of Environmental and Social Aspects

Environmental Aspects No adverse environmental impacts are anticipated as a result of project implementation.
Involuntary Resettlement The project will not cause any involuntary resettlement.
Indigenous Peoples The project will pay special attention to ensuring that the delivery systems will reach the indigenous and excluded groups.
Stakeholder Communication, Participation, and Consultation
During Project Design A fact finding mission was fielded intermittently from 21 October 2009 to 18 April 2010. The mission undertook a field visit to one of the Karnali districts (Dolpa) from 23 October 2009 to 5 November 2009 to assess the ground realities of implementing cash grants in the remote mountain districts of Nepal. A workshop was organized in Kathmandu on 11 December 2009 to debrief central government officials on the mission's field visit and to brainstorm on the ideas that had been proposed by the DDC staff and local villagers in Dolpa. Consultations were also held with development partners.
During Project Implementation - Inception mission (18 May - 04 July 2011)- Review mission (12 - 17 December 2011)- Special project administration mission (6 - 9 August 2012)- Midterm review mission (1 - 5 April 2013) - Review mission (7 - 19 July 2014)- Review mission (12 - 25 January 2016)

Business Opportunities

Consulting Services

International Social Protection Specialist - 5 person-months

National Social Protection Specialist - 36 person-months

Procurement Purchase of Computer equipment.

Responsible Staff

Responsible ADB Officer Arun Rana
Responsible ADB Department South Asia Department
Responsible ADB Division Nepal Resident Mission
Executing Agencies
Ministry of Federal Affairs and Local Development
SECRETARY@MLD.GOV.NP
Singha Durbar
Nepal

Timetable

Concept Clearance -
Fact Finding 24 Oct 2009 to 18 Apr 2010
MRM -
Approval 28 Feb 2011
Last Review Mission -
PDS Creation Date 02 Sep 2009
Last PDS Update 10 May 2016

Grant 9157-NEP

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
28 Feb 2011 08 Jun 2011 08 Jun 2011 08 Jun 2014 15 Jan 2016 -
Financing Plan Grant Utilization
Total (Amount in US$ million) Date ADB Others Net Percentage
Project Cost 5.77 Cumulative Contract Awards
ADB 0.00 28 Feb 2011 0.00 1.47 92%
Counterpart 4.17 Cumulative Disbursements
Cofinancing 1.60 28 Feb 2011 0.00 1.55 97%

Safeguard Documents See also: Safeguards

Safeguard documents provided at the time of project/facility approval may also be found in the list of linked documents provided with the Report and Recommendation of the President.

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Evaluation Documents See also: Independent Evaluation

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