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| Loan Name | Nutrition Improvement through Community Empowerment | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Country | Indonesia | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Loan Number | 2348 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Project Number | 38117- 01 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Fund Source/Amount[Approved] |
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| Thematic Classification |
Social Development
Gender Equity |
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| Project Outcome | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Description of Outcome | The Project will reduce and prevent underweight in 1.48 million children under the age of 5 years and 500,000 pregnant women. It will provide positive social and economic benefits, including the avoidance of costs associated with cognitive losses and lower productivity, and with higher morbidity and mortality. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Progress Toward Outcome | The Project commenced in January 2008 and individual consultants for CPMU mobilized in July 2008. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Implementation Progress | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Description of Project Outputs | 1. Strengthened capacity for development of nutrition policies, programs and surveillance.
2. Improved qualiy of integrated nutrition services for women and children in project areas. 3. Enhanced community capability for, and implementation of, improvement 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. |
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| Status of Implementation Progress (Outputs, Activities and Issues) | 1. Strengthened capacity for development and nutrition policies, programs and surveillance:
At least six revised draft nutrition policies, protocols and/or guidelines prepared by relevant authority in MOH by year 3 of project implementation - this is due in year 2010 Number of provincial, district hospital and puskemas staff trained in priority areas such as implementation of guidelines and nutrition surveillance increased by 30% over baseline by 009 (mideterm) and 50% by 2012 - this is due in year 2009 and in year 2012. 2. Improved qualiy of integrated nutrition services for women and children in project areas: Number of puskesmas with trained nutrition personnel, at least 50% women, and related equipment increased by 50% from baseline - to be monitored At least 90% of puskemas equipped with nutrition kits by 2012. By 2012, at least 90% of posyandus providing services at least once per month with coverage of 80% of all underfives in the catchment area (current national figure for monthly posyandu operations is estimated to be 48%. 3. Enhanced community capability for, and implementation of, improvement nutrition and hygiene interventions: CNCs established by the end of year 2. - due in 2009 At least 60% of CNC members are women. Community action plans approved for at least 70% of eligible villages by 2009. At least 70% of families with children 0-5 years benefit from CNP activities (growth monitoring, complementary feeding, etc.) by year 4. At least 60% of pregnant women in the project areas attend the posyandu monthly by the end of year 3. Proportion of primary schools and madrasah in participating villages with access to improved water and sanitation villages with access to improved water and sanitation increased from present levels to at least 50%. 4. Expanded food fortification programs and nutrition communication: Percentage of fortified salt and wheat at retail level meeting mandated fortification standards increased from 60% in 2003 to 90% in 2012. Micronutrient supplements (sprinkles) available on a commmercial basis in at least 30% of project provinces. National breast-feeding studies show improved rate of exclusive breast-feeding at 6 months from less than 10% in 2005 to 40% in 2012. 5. Enhanced capacity for nutrition policy and programs institutionalized and monitoring and evaluation established in project areas. A Review Mission visited Indonesia from 29 January to 6 February 2009. Counterpart funds were released only in July 2008, which implied that the CPMU, PPCUs and DPIUs received funding in August and September 2008, respectively. This also adversely affected the recruitment of staff consultants for PPCUs and DPIUs under QCBS. It was decided to recruit all staff consultants individually. The Executive Secretary was replaced because of ill health in October 2008. A National Community Empowerment Consultant prepared draft guidelines for community facilitators. The international consultant for policy development has prepared the outline of the baseline survey. The EA requested on 21 April 2009 a change in financing percentages for the project categories to accelerate implementation of project activities since there is no single activity with blended financing. The EA submitted to the Ministry of Finance the 2008 and 2009 budget using 100% ADB and 100% GOI financing of activities under each category without seeking prior ADB approval. On 30 April 2009, ADB approved the change in financing plan and to monitor the Government's counterpart funding, the EA was required to submit (i) quarterly financial report on the Government's counterpart expenditures; (ii) signed contracts for each procurement using counterpart funds; and annual audit report should provide a detailed report on the GOI's expenditures. A Special Loan Administration Mission visited Jakarta from 10-11 September 2009. Counterpart funds for the central level released in July and not yet released for the provincial level, implied that technical trainings could not commence. The Central Project Management Unit (CPMU), Consultant Selection Committee (CS) and Procurement Committee are not familiar with ADB procedures for the recruitment of consultants and procurement. This resulted that Community Facilitators and CPMU Consultant Team have not been recruited to date. Overall, there is a lack of supervision by the Project Director. The Mission requested the project management to ensure mobilization of additional procurement, finance and monitoring officers as soon as possible. |
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| 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. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 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
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| Environment | C | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Resettlement | C | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Indigenous People | C | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Summary of Environmental and Social Issues | The project will undertake support of interventions to improve the nutrition status of poor people. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Consultations Planned or Carried Out | Consultations have been carried out with potential beneficiaries in possible pilot urban areas including those in West Java. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Responsible ADB Officer |
Barbara Lochmann |
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| Responsible ADB Department |
Southeast Asia Department |
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| Responsible ADB Division |
Social Sectors Division, SERD |
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| Executing Agencies |
Ministry of Health Dr. Budihardj Director General Community Health Ministry of Health Jakarta, Indonesia The Directorate General of Community Health Dr. Ina Hernawati Project Manager Ministry of Health, Directorate General of Public Health, Jakarta, Indonesia cpmu_nice@yahoo.com |
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| Timetable | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Concept Clearance | 04 Oct 2006 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Fact-finding | 02 Aug 2006 to 16 Aug 2006 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Appraisal | 29 Nov 2006 to 14 Dec 2006 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Board Approval | 31 Aug 2007 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Last Review Mission | 10 Sep 2009 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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