World Bank Document · Food (EDF) production units, one each in Chincholi and Devdurga Blocks, have been identified and approved by the World Bank. Inputs for the food composition

The World BankKarnataka Multisectoral Nutrition Pilot (P149811)

REPORT NO.: RES33506

RESTRUCTURING PAPER

ON A

PROPOSED PROJECT RESTRUCTURING

OF

KARNATAKA MULTISECTORAL NUTRITION PILOT

APPROVED ON JUNE 25, 2014

TO

DEPARTMENT OF RURAL DEVELOPMENT AND PANCHAYATI RAJ, GOVERNMENT OF KARNATAKA

HEALTH, NUTRITION & POPULATION

SOUTH ASIA

Regional Vice President: Annette Dixon Country Director: Junaid Kamal Ahmad

Senior Global Practice Director: Timothy Grant EvansPractice Manager/Manager: Rekha Menon

Task Team Leader: Abeyah A. Al-Omair

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ABBREVIATIONS AND ACRONYMS

AG Adolescent GirlsANM Auxiliary Nurse MidwifeASHA Accredited Social Health ActivistBCC Behavior Change CommunicationEDF Energy Dense FoodFSSAI Food Standards and Safety Authority of IndiaICDS Integrated Child Development ServicesKSRLPS Karnataka State Rural Livelihoods Promotion SocietyPPP Public-Private-PartnershipSHG Women’s self-help groupVNV Village Nutrition Volunteer


BASIC DATA

Product Information

Project ID Financing Instrument

P149811 Investment Project Financing

Original EA Category Current EA Category

Partial Assessment (B) Partial Assessment (B)

Approval Date Current Closing Date

25-Jun-2014 31-Jul-2018

Organizations

Borrower Responsible AgencyDepartment of Rural Development and Panchayati Raj, Government of Karnataka

Karnataka State Rural Livelihoods Promotion Society (KSRLPS)

Project Development Objective (PDO)

Original PDOTo increase utilization of nutrition-improving services by under-three children, adolescent girls and pregnant and nursing women from poor households in the target areas.OPS_TABLE_PDO_CURRENTPDOSummary Status of Financing

TF Approval Signing Effectiveness ClosingNet

Commitment Disbursed Undisbursed

TF-17363 02-Jul-2014 15-Jul-2014 15-Jul-2014 31-Jul-2018 4.55 3.51 1.04

Policy Waiver(s)

Does this restructuring trigger the need for any policy waiver(s)?No


I. PROJECT STATUS AND RATIONALE FOR RESTRUCTURING

A. Project Status

The Karnataka Multisectoral Nutrition Pilot grant became effective on July 15, 2014 and has a Closing Date of July 31,

2018. To date, US$3.51 million of the total grant amount of US$4.55 million has been disbursed (77%). The project is

currently rated as Satisfactory for both progress towards the achievement of the project development objective (PDO) and

for implementation progress (IP).

The project was restructured on June 08, 2017 to extend the Closing Date for one year from July 31, 2017 to July 31, 2018.

The extension was needed to enable the project to make up for the initial significant procurement delays that prevented the

roll out of project activities for more than a year.

The project had a slow start up due to delays in completing several initial procurements critical to start implementation,

including the hiring of the implementing NGO without which the project cannot start. This process of hiring took longer

than expected on account of the fact that after the selection was made, it had to first get the clearance from the Government

of Karnataka, and as the Contract amount is of a high value, higher levels of approval in the State Government were required.

The Contract between Karnataka State Rural Livelihood Promotion Society (KSRLPS) and the NGO was signed in June

2015. The selection of beneficiaries took additional time, as the Socio Economic and Caste Census, 2011 was released in

Karnataka during August 2015 and additional verification had to be done for selection of beneficiaries, to ensure that they

matched with the Socio-Economic Survey. This took some additional time and the selection of beneficiaries was fully

completed in both Blocks only by December 2015.

During the months of January and February 2016, there was a local election going on and the Election Code of Conduct

was in operation from early January 2016 to February 2016. As a result, several preparatory activities got delayed as no

new project activities or appointments/selections could be done during this period.

Starting from March 2016, the NGO initiated the recruitment of Village Nutrition Volunteers (VNVs) and the community

outreach activities in all 421 target villages in Chincholi and Devdurga Blocks. VNVs have been trained on key nutrition

messages and growth monitoring of children, women and adolescent girls. The VNVs supported by block level teams have

collected and created a complete database of all beneficiary households with key nutrition information, using nutrition cards


that are used for monthly monitoring. Counselling on appropriate nutrition, health and hygiene practices has also been

initiated and on-going.

In collaboration with the Global Alliance for Improved Nutrition (GAIN), the NGO completed the procurement of

machinery for setting up production units for local Energy Dense Foods (EDFs). The sites for establishing Energy Dense

Food (EDF) production units, one each in Chincholi and Devdurga Blocks, have been identified and approved by the World

Bank. Inputs for the food composition have been sought from a number of technical institutions. A Self Health Group

(SHG) comprising of 10 women has been formed and trained to operate the EDF unit in each of Chincholi and Devdurga.

The EDF production units are now fully functional in both blocks (started in Nov.2016 in Chincholi, and in Jan 2017 in

Devdurga).

The Project Development Objective (PDO) is to increase utilization of nutrition-improving services by children under-three

years of age, adolescent girls and pregnant and nursing women from poor households in the target areas. As per the last ISR

(dated July 23,2018), The project has exceeded the targets for the three PDO results indicators as follow: (i) the percentage

of targeted under-three children, adolescent girls and pregnant and nursing mothers who receive nutritious supplementary

foods produced and supplied by the project surpassed its target of 80% and achieved 95%; (ii) the percentage of targeted

households who utilized social sector programs with a potential impact on nutrition (specifically ICDS, health services, and

water and sanitation services) surpassed its target of 60% and achieved 89%; and (iii) the percentage of targeted pregnant

and lactating women who practice core child nutrition and health care behaviors surpassed its target of 60% and achieved

100% . The Core child nutrition and health behaviors are defined as: (1) initiation of breastfeeding within one hour of birth;

(2) exclusive breastfeeding up to 6 months of age; (3) ensuring recommended immunizations; (4) complementary feeding

which includes breastfeeding up to 2 years of age and feeding with 3+ food groups a minimum number of times per day;

(5) diarrhea management; and (6) handwashing.

The project has three components and status of each component is as follows:

Component 1: Increase consumption of nutritious foods and improve household nutrition-related knowledge and behaviors:

The Energy Dense Food (EDF) production units in both blocks under the project, Chincholi and Devdurga, have been

established and started functioning in November 2016 and January 2017 respectively. The EDF manufacturing facilities in

both blocks have obtained a license from the Food Standards and Safety Authority of India (FSSAI) and are producing EDF

packets for all three groups of beneficiaries: children under three years, pregnant women and lactating mothers and

adolescent girls. Village Nutrition Volunteers (VNVs) engaged under the project in each village are supporting the delivery


of the EDF and other pilot activities at the village level with the support of grassroots groups, including women's self-help

groups and village health and sanitation committees. As of May 2018, 447 VNVs in the two implementation blocks were

covering a total of 34,431 beneficiaries and 27,484 households. The project has exceeded its targets of the three intermediate

results of this component as follow: (i) the percentage of targeted households receiving counselling on improved child care

and feeding behaviors (target 90% achieved 100%), (ii) the percentage of target beneficiaries weighed monthly by nutrition

volunteers (target 90% achieved 95%); and (iii) the percentage of planned nutrition volunteers in place (target 90%, achieved

107%).

The production of EDF peaked in the month of April 2018 surpassing the monthly target of 86,000 Kgs. Standards Operating

Procedures (SOPs) and protocols for quality check are fully implemented in the manufacturing units.

Furthermore, the project has developed IEC materials such as flip book, poster, wall paintings, radio jingles and TV

commercials with key messages to improve consumption of nutritious foods and improve household nutrition related

knowledge and behaviors. Use of folk media and quiz programs were also planned as part of the media campaign. However,

since the radio jingles and TV commercials were not very effective, these along with folk media and quiz programs have

been dropped from the media strategy. They are being replaced with short films and nutrition fairs (melas). The modified

media strategy is under implementation. The requested extension of closing date till September 30, 2018 will allow the

completion of activities under the modified media plan.

Component 2: Improve access to multi-sectoral interventions with an impact on nutrition. Multi-sectoral convergence.

Through this component, the project leverages interventions and services in different sectors that have an impact on the

nutritional status of the beneficiaries. As part of intersectoral convergence, 204 high school teachers and 69 middle school

teachers have been oriented on the project. This has helped in bringing hygiene practices in the schools and in ensuring

regular distribution of IFA tablets. Convergence with the health department has also progressed well and a total of 253

ASHAs and 22 Medical Officers have been oriented. VNVs are participating in community health programs such as

immunization, mass deworming, vitamin A supplementation and pulse polio while the Medical Officers are attending the

monthly meeting of VNVs. There has been good convergence with local self governments and about 976 gram panchayat

(GP)/taluk panchayat (TP) members have been oriented on the project. The trained GP/TP members in turn are motivating

the beneficiaries to consume EDF and adopt good hygiene practices. The project has surpassed its target of the intermate

result of the percentage of households who receive information about available social programs from nutrition volunteers

(target 90%, achieved 100%).

The planned extension for two months will allow the completion of a feasibility study to promote better access to markets,

to ensure competitiveness with established biofortified product companies, and identify opportunities to introduce low cost

EDF in the market.


Component 3: Project Management and Monitoring and Evaluation: This component supported management capacity for implementation of the project. The monitoring of the project through MIS has picked up substantially. The project has taken steps to improve data quality which was highlighted as an area of concern in earlier missions. This was done by adopting a two-tier approach for quality control at the level of the VNV supervisor and at the level of block level when data is entered into the system. The project has also started a qualitative study to evaluate specific components of the project through the National Institute of Nutrition, a reputed organization in the field of nutrition in India. This study will enable the project to document several aspects of the project and capture the lessons learned.

As this pilot project has the purpose of introducing innovative approaches and provide learning opportunity for potential scale up by the Government of Karnataka, the outcomes of the study should supplement the overall outcomes of the pilot and provide the basis for a decision by the Government of Karnataka to use domestic financial resources for any further continuation or scale up of this pilot.

B. Rational for Restructuring

The Government of Karnataka requested an extension of the Closing Date via a letter to the World Bank, dated July 18,

2018. The requested extension is for two months, from July 31, 2018 to September 28, 2018.

The extension is requested to provide time for the project to fully complete its intended activities. The extension would

enable the project to make up for the crucial three months (March-May 2018) that were lost due to the Karnataka state

elections code of conduct and induction of the new government. As mentioned above, there are two activities that have

already been initiated but are delayed due to the election and the extension is sought to allow extra time for them to be

finalized. These activities are: (i) the feasibility study of introducing low cost energy-dense food in the market (under

component 2); and (ii) the qualitative study to evaluate specific components of the project (under component 3).

II. DESCRIPTION OF PROPOSED CHANGES

The proposed restructuring of the Japan Social Development Fund (JSDF) financed Karnataka Multisectoral Nutrition Pilot

project entails an extension of the Closing Date for two months from July 31, 2018 to September 28, 2018. The extension

is requested in order to provide additional time for the project to fully complete its intended activities. This is the second

restructuring of the project, the first restructuring was approved on June 08,2017 to extend the Closing Date from July

31,2017 to July 31,3018.

Project implementation is currently on track and has already achieved the stated project development objective and results.

As mentioned above, there are two activities that have already been initiated but are delayed due to the election and the

extension is sought to allow extra time for them to be finalized. These activities are: (i) the feasibility study of introducing


low cost energy-dense food in the market (under component 2); and (ii) the qualitative study to evaluate specific components

of the project (under component 3). The Government of Karnataka has prepared an Implementation Action Plan to complete

the activities during the proposed extension period. The project is compliant with all fiduciary requirements. There are no

outstanding audits.

Note to Task Teams: The following sections are system generated and can only be edited online in the Portal.

III. SUMMARY OF CHANGES

Changed Not Changed

Change in Loan Closing Date(s) ✔

Change in Implementation Schedule ✔

Change in Implementing Agency ✔

Change in Project's Development Objectives ✔

Change in Results Framework ✔

Change in Components and Cost ✔

Cancellations Proposed ✔

Additional Financing Proposed ✔

Reallocation between Disbursement Categories ✔

Change in Disbursements Arrangements ✔

Change in Disbursement Estimates ✔

Change in Overall Risk Rating ✔

Change in Safeguard Policies Triggered ✔

Change of EA category ✔

Change in Legal Covenants ✔

Change in Institutional Arrangements ✔

Change in Financial Management ✔

Change in Procurement ✔

Other Change(s) ✔


IV. DETAILED CHANGE(S)

OPS_DETAILEDCHANGES_LOANCLOSING_TABLE

LOAN CLOSING DATE(S)

TF StatusOriginal Closing

Revised Closing(s)

Proposed Closing

Proposed Deadline for Withdrawal

Applications

TF-17363 Effective 31-Jul-2017 31-Jul-2018 28-Sep-2018 28-Jan-2019

Note to Task Teams: End of system generated content, document is editable from here.

Documents

World Bank Document · Food (EDF) production units, one each in Chincholi and Devdurga Blocks, have been identified and approved by the World Bank. Inputs for the food composition