The World Bank Implementation Status & Results Report India: ICDS Systems Strengthening & Nutrition Improvement Program (ISSNIP) (P121731) India: ICDS Systems Strengthening & Nutrition Improvement Program (ISSNIP) (P121731) SOUTH ASIA | India | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2013 | Seq No: 16 | ARCHIVED on 31-Dec-2019 | ISR40083 | Implementing Agencies: Ministry of Women and Child Development, Republic of India Key Dates Key Project Dates Bank Approval Date: 06-Sep-2012 Effectiveness Date: 26-Nov-2012 Planned Mid Term Review Date: 30-Jun-2014 Actual Mid-Term Review Date: 02-Feb-2015 Original Closing Date: 31-Oct-2015 Revised Closing Date: 30-Aug-2022 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) To support the Government of India and participating states to (i) strengthen the Integrated Child Development Services (ICDS) policy framework, systems and capacities, and facilitate community engagement, to ensure greater focus on children under three years of age; and (ii) strengthen convergent actions for improved nutrition outcomes. Has the Project Development Objective been changed since Board Approval of the Project Objective? Yes Board Approved Revised Project Development Objective (If project is formally restructured) To improve the coverage and quality of ICDS nutrition services to pregnant and lactating women and children under 3 years of age Components Table Name Component 1: ICDS Institutional and Systems Strengthening:(Cost $207.20 M) Component 2: Community Mobilization and Behavior Change Communication (BCC):(Cost $77.60 M) Component 4: Convergent Nutrition Action:(Cost $14.40 M) Component 5: Project Management, Monitoring & Evaluation:(Cost $18.40 M) Component 3: Performance Based Incentives:(Cost $82.40 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Moderately Satisfactory Overall Risk Rating Moderate Moderate Implementation Status and Key Decisions The project is on track to achieve the Project Development Objective (PDO) of improving the coverage and quality of ICDS nutrition services to pregnant and lactating women and children under 3 years of age. While progress against two PDO indicators will be reported during the mid-term 12/31/2019 Page 1 of 9 The World Bank Implementation Status & Results Report India: ICDS Systems Strengthening & Nutrition Improvement Program (ISSNIP) (P121731) review in June 2020 based on a population-based survey to measure nutrition practices, targets for the remaining three PDO indicators that are tracked through routine monitoring systems have been achieved. The project has reached approximately 58 million pregnant and lactating women and children under 3 years of age with ICDS services achieving Year 1 targets. Approximately 48% Anganwadi Workers (AWWs) are undertaking the minimum mandated home visits for maternal and child nutrition counselling to target households and 44% of Anganwadi Centre (AWCs) are delivering a minimum set of services (take home rations, growth monitoring and village health and nutrition days), achieving Year 2 targets for these indicators. The data for the minimum set of services, including home visits, is from the 4.6 lakh AWCs where the ICDS CAS has been fully rolled out. Despite these positive trends, implementation progress is slower than expected. This is primarily due to limited progress in the roll out of the ICDS- CAS due to delays in the procurement of smartphones for AWWs in the 11 priority states (in only 2 states - Maharashtra and Tamil Nadu is it fully operational). This has delayed the implementation of performance-based incentives for AWWs, the roll out of the online capacity building platform (i.e. e-ILA), and the tracking of supportive supervision by ICDS supervisory cadres, which are largely contingent on availability of smartphones by AWWs. The program areas that are progressing well include the Incremental Learning Approach (ILA) trainings and Community Based Events (CBEs). The roll out of ILA is progressing systematically, but variably, across all 11 priority states. There is an overall increase in knowledge levels of AWWs. All the 11 priority states are organizing CBEs at the AWC to create awareness on maternal nutrition practices (Godhbharai) and appropriate complementary feeding (Annaprasan) monthly or bi-monthly at the AWC. It is encouraging to note that Suposhan Diwas, an event introduced for orienting husbands on health and nutrition care for their wives and children is also being organized, except in 2 priority states (Uttar Pradesh and Karnataka). There is correspondingly an increased focus on home-visits as well since the previous mission, which is a significant positive shift in the program. Of the 11 priority states, the annual Jan Andolan plans of 9 states have been approved with the exception of Tamil Nadu and Karnataka. The development and implementation of the communication plan will be critical in creating an enabling environment around nutrition behavior change and needs to be systematically monitored by the MWCD. The revised supervisor’s application in the ICDS-CAS has also become operational. Of the 11 priority states, 8 states (except Jharkhand, Uttar Pradesh and Karnataka) have started using the supervisor’s application. If used effectively this application is expected to strengthen supervision such that key tasks of the AWWs can be adequately supported. In the coming months the project is expected to focus on completing procurement of smartphones, growth monitoring devices and helpdesk personnel in the pending 9 priority states, operationalizing performance-based incentives to AWWs and encouraging use of e-ILA in states where CAS has been rolled out, strengthening supervision across levels and using data more effectively for program management and decision making. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance -- Moderate Moderate Macroeconomic -- Moderate Moderate Sector Strategies and Policies -- Moderate Moderate Technical Design of Project or Program -- Moderate Moderate Institutional Capacity for Implementation and Sustainability -- Substantial Substantial Fiduciary -- Moderate Moderate Environment and Social -- Moderate Moderate Stakeholders -- Moderate Moderate Other -- -- -- Overall -- Moderate Moderate 12/31/2019 Page 2 of 9 The World Bank Implementation Status & Results Report India: ICDS Systems Strengthening & Nutrition Improvement Program (ISSNIP) (P121731) Results PDO Indicators by Objectives / Outcomes To improve the coverage of ICDS nutrition services to PLW and children under 3 years IN00788050 ►Cumulative number of pregnant/lactating women (PLW) and children under 3 years in project districts reached by ICDS services (Number (Thousand), Custom) Baseline Actual (Previous) Actual (Current) End Target Value 29,791.00 44,420.00 58,550.00 64,000.00 Date 01-Jan-2018 31-Mar-2019 30-Sep-2019 30-Aug-2022 This represents data from 30 States (excludes 6 States - Arunachal Pradesh, Sikkim, Goa, West Bengal, Manipur and Lakshadweep - who have not reported against this indicator). The data includes pregnant women, lactating women, children 0-6 months of age (same as lactating Comments: women), and children 6months-3 years as reported through the ICDS MIS. Reporting cumulative numbers is challenging, there we report the highest number of beneficiaries in these categories reached by ICDS services during the project period. This issue is expected to get resolved once the ICDS-CAS is universally rolled out. IN00788055 Cumulative number of (female) children under 3 years in project districts reached by ICDS services (Number (Thousand), Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 8,300.00 10,460.00 11,515.00 8,700.00 Date 01-Jan-2018 31-Mar-2019 30-Sep-2019 30-Aug-2022 IN00788056 ►Percentage of AWWs who meet at least 60% of their targeted number of home visits to pregnant/lactating women (PLW) and children under 3 years in the previous month (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 10.00 64.20 48.40 50.00 Date 01-Jan-2018 31-Mar-2019 30-Sep-2019 30-Aug-2022 This represents data from 466,922 AWWs across 21 States that have been using CAS for more than a month. These are AP, BH, CH, GJ, JH, TN, MP, MH, RJ, UP, UT, NG, MZ, D&D, TG, PD, A&N, MG, D&NH, CG and HP Comments: There is a dip in percentage of AWWs achieving this target since the previous mission (64%) when data from 173,896 AWWs was being reported. This is reflective of the recent scale up of CAS in many states, which will over the coming months stimulate an increased focus on home visits with built in nudges from the home visit scheduler in CAS To improve quality of ICDS nutrition services IN00788052 ►Percentage of children age 6-8 months receiving solid or semi-solid food and breastmilk (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target 12/31/2019 Page 3 of 9 The World Bank Implementation Status & Results Report India: ICDS Systems Strengthening & Nutrition Improvement Program (ISSNIP) (P121731) Value 42.70 42.70 42.70 55.00 Date 01-Jan-2018 01-Jan-2018 01-Jan-2018 30-Aug-2022 To be reported at mid-term. Mid-term due in June 2020. Comments: IN00788054 ►Percentage of children 6-23 months of age who receive foods from 4 or more food groups (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 19.90 19.90 19.90 30.00 Date 01-Jan-2018 01-Jan-2018 01-Jan-2018 30-Aug-2022 To be reported at mid-term. Mid-term due in June 2020. Comments: IN00788058 ►Percentage of AWCs that deliver a minimum set of services at AWCs in the last month (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 29.30 35.80 44.60 50.00 Date 01-Jan-2018 31-Mar-2019 30-Sep-2019 30-Aug-2022 This represents data from 466,922 AWWs across 21 States that have been using CAS for more than a month. These are AP, BH, CH, GJ, JH, TN, MP, MH, RJ, UP, UT, NG, MZ, D&D, TG, PD, A&N, MG, D&NH, CG and HP Comments: The minimum set of services include: (a) take home rations distributed for at least 21 days in the last month, (b) growth monitoring (weight) for at least 60 percent children under 3 years of age completed in the last month, and (c) village health and nutrition day organized in the last month. Original project PDO indicators (no further reporting on these) IN00788051 ►Percentage of targeted AWCs reporting key nutrition and service delivery indicators using ICT systems every month for the last 3 mon ths (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 60.00 60.00 60.00 Date 31-Dec-2015 30-Apr-2018 30-Apr-2018 29-Jun-2018 IN00788053 ►Percentage of project districts that have implemented the “incremental capacity building” system (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 80.00 Date 31-Dec-2015 30-Apr-2018 30-Apr-2018 29-Jun-2018 IN00788057 ►Number of project states in which “convergent nutrition action plans” have been developed by the district convergence committees in at least one district (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target 12/31/2019 Page 4 of 9 The World Bank Implementation Status & Results Report India: ICDS Systems Strengthening & Nutrition Improvement Program (ISSNIP) (P121731) Value 0.00 7.00 7.00 6.00 Date 31-Dec-2015 30-Apr-2018 30-Apr-2018 29-Jun-2018 Intermediate Results Indicators by Components Component 1: ICDS Institutional and Systems Strengthening IN00788059 ►Health personnel receiving training (number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 388,541.00 388,541.00 280,000.00 Date 31-Dec-2015 30-Apr-2018 30-Apr-2018 29-Jun-2018 This indicator is linked to the original project and project districts. No further reporting will take place Comments: against this indicator. IN00788064 ►Percentage of AWWs in project districts who have completed all online ILA modules (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1.70 18.00 60.00 Date 01-Jan-2018 31-Mar-2019 30-Sep-2019 30-Aug-2022 This represents 125,219 AWWs from 14 States - AP, ArP, BH, CH, CG, D&NH, D&D, GJ, JH, MP, MH, RJ, TN and UP. Comments: Reporting by States is not limited to 315 Phase 1 districts, as the program has been scaled up across all districts. The denominator however remains 690,167 Phase 1 project AWCs. IN00788067 ►Percentage of Block Resource Groups (BRGs) and sectors that conducted at least four monthly learning and review meetings on ILA themes in the last six months (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 63.40 94.60 60.00 Date 01-Jan-2018 31-Mar-2019 30-Sep-2019 30-Aug-2022 This represents data from 22 States – AP, BH, CH, GJ, JH, TN, MP, MH, RJ, UP, UT, NG, MZ, D&D, TG, PD, MG, D&NH, CG, HP, HR, TR - that have completed at least 4 monthly trainings. States have scaled Comments: up ILA across all blocks and sectors, not limiting themselves to the 315 Phase 1 districts. IN00788069 ►Percentage of targeted AWCs reporting using ICDS-CAS systems every month for the last six months (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 5.00 18.10 25.60 60.00 Date 01-Jan-2018 31-Mar-2019 30-Sep-2019 30-Aug-2022 12/31/2019 Page 5 of 9 The World Bank Implementation Status & Results Report India: ICDS Systems Strengthening & Nutrition Improvement Program (ISSNIP) (P121731) This represents data from 18 States (176,980 AWCs) - AP, BH, CH, JH, TN, MP, RJ, UP, UT, NG, D&D, TG, PD, A&N, MG, D&NH, CG and HP – and is not limited to Phase 1 Project AWCs as States have Comments: scaled up across all AWCs. The denominator however remains 690,167 Phase 1 project AWCs. IN00788071 ►ICDS Personnel recieved training on ICDS-CAS (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 60,000.00 178,679.00 476,513.00 560,000.00 Date 01-Jan-2018 31-Mar-2019 30-Sep-2019 30-Aug-2022 A total of 466,922 AWWs and 9591 ICDS Supervisors have been trained in all 4 phases of ICDS-CAS. This includes 21 States - AP, BH, CH, GJ, JH, TN, MP, MH, RJ, UP, UT, NG, MZ, D&D, TG, PD, A&N, Comments: MG, D&NH, CG and HP – and is not limited to Phase 1 Districts. IN00788073 ►Number of states with strengthened grievance redress system (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 25.00 Date 01-Jan-2018 31-Mar-2019 30-Sep-2019 30-Aug-2022 The GRS call centre has become fully functional from November 2019. Data on this indicator will become Comments: available from January 2020. IN00788074 ►Percentage of project districts with district resource groups trained to implement the incremental capacity building system (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 62.00 100.00 100.00 95.00 Date 31-Dec-2015 30-Apr-2018 30-Apr-2018 29-Jun-2018 This indicator is linked to the original project and project districts. No further reporting will take place Comments: against this indicator. IN00788075 ►Percentage of targeted AWWs trained on the ICT based management, monitoring and communication system (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 76.94 76.94 80.00 Date 31-Dec-2015 30-Apr-2018 30-Apr-2018 29-Jun-2018 This indicator is linked to the original project and project districts. No further reporting will take place Comments: against this indicator. Component 2: Community Mobilization and Behavior Change Communication (BCC) IN00788060 ►Percentage of AWCs in project districts that have implemented at least 4 CBEs focusing on agreed MIYCN themes in the last 6 months (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target 12/31/2019 Page 6 of 9 The World Bank Implementation Status & Results Report India: ICDS Systems Strengthening & Nutrition Improvement Program (ISSNIP) (P121731) Value 40.00 66.40 96.00 65.00 Date 01-Jan-2018 31-Mar-2019 30-Sep-2019 30-Aug-2022 This represents data from 27 States (891035 of a total 920985 AWCs) – AP, BH, CH, GJ, JH, TN, MP, MH, RJ, KA, UP, UT, NG, MZ, J&K, D&D, PD, A&N, AS, MG, D&NH, CG, OD, HP, PJ, HR and TR. This is Comments: not limited to Phase 1 AWCs. IN00788065 ►Percentage of CBEs implemented in project districts in the last 6 months that focus on community influencers (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 20.48 22.00 15.00 Date 01-Jan-2018 31-Mar-2019 30-Sep-2019 30-Aug-2022 This represents data from 27 States – AP, BH, CH, GJ, JH, TN, MP, MH, RJ, KA, UP, UT, NG, MZ, J&K, Comments: D&D, PD, A&N, AS, MG, D&NH, CG, OD, HP, PJ, HR and TR. This is not limited to Phase 1 AWCs. IN00788068 ►Number of project states where at least one mid-media campaign was deployed in the past year (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 24.00 24.00 20.00 Date 01-Jan-2018 31-Mar-2019 30-Sep-2019 30-Aug-2022 The deployment of mid-media plans here primarily refers to campaigns during POSHAN Maah. Comments: IN00788070 ►Percentage of Anganwadi Centers (AWCs) in project districts implementing monthly community-based processes focused on nutrition andhealth counselling (at least 5 events in the past 6 months) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 61.67 61.67 80.00 Date 31-Dec-2015 30-Apr-2018 30-Apr-2018 29-Jun-2018 This indicator is linked to the original project and project districts. No further reporting will take place Comments: against this indicator. Component 3: Performance Based Incentives IN00788063 ►Percentage of AWWs provided with ICDS-CAS training, who – in the last six months – received their monthly performance incentive at least 4 times (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 6.56 6.10 60.00 Date 01-Jan-2018 31-Mar-2019 30-Sep-2019 30-Aug-2022 Only 11 States - AP, BH, JH, MP, NG, D&D, TG, PD, MG, D&NH and CG - have started releasing Comments: performance incentives to AWWs Component 4: Convergent Nutrition Action IN00788061 12/31/2019 Page 7 of 9 The World Bank Implementation Status & Results Report India: ICDS Systems Strengthening & Nutrition Improvement Program (ISSNIP) (P121731) ►Percentage of project districts that operationalised convergent nutrition action plans among those that developed them in the past year (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 60.00 Date 01-Jan-2018 31-Mar-2019 30-Sep-2019 30-Aug-2022 Convergent nutrition action plans for this FY 2019-20 have been developed by 29 States. Their Comments: operationalization will be assessed at the end of the FY in April/May 2020. Component 5: Project Management, Monitoring & Evaluation IN00788062 ►Percentage of ICDS supervisors who complete at least 60% of mandated supervision visits to AWCs in the last month (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 32.00 50.00 Date 01-Jan-2018 31-Mar-2019 30-Sep-2019 30-Aug-2022 Only 16 out of the 30 States who submit the results framework reported on this indicator - AP, BH, GJ, JH, MP, RJ, D&D, PD, A&N, MG, D&NH, CG, HP, PJ, HR and TR. With the operationalization of the Comments: governance dashboard, this data will become available for all States at the central level by the next mission. IN00788066 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 44,419,858.00 58,550,000.00 64,000,000.00 Date 01-Oct-2016 31-Mar-2019 30-Sep-2019 30-Aug-2022 This represents data from 30 States (excludes 6 States - Arunachal Pradesh, Sikkim, Goa, West Bengal, Manipur and Lakshadweep - who have not reported against this indicator). The data includes pregnant women, lactating women, children 0-6 months of age (same as lactating women), and children 6months-3 years as reported through the ICDS MIS. Reporting cumulative numbers Comments: is challenging, there we report the highest number of beneficiaries in these categories reached by ICDS services during the project period. This issue is expected to get resolved once the ICDS-CAS is universally rolled out. IN00788072 Number of women and children who have received basic nutrition services (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 44,419,858.00 5,855,000.00 64,000,000.00 Date 01-Oct-2016 31-Mar-2019 30-Sep-2019 30-Aug-2022 Data on Financial Performance Disbursements (by loan) 12/31/2019 Page 8 of 9 The World Bank Implementation Status & Results Report India: ICDS Systems Strengthening & Nutrition Improvement Program (ISSNIP) (P121731) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P121731 IBRD-88390 Effective USD 200.00 200.00 0.00 63.14 136.86 32% P121731 IDA-51500 Effective USD 106.00 106.00 0.00 90.44 1.97 98% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P121731 IBRD-88390 Effective 30-Mar-2018 07-May-2018 11-Jun-2018 30-Aug-2022 30-Aug-2022 P121731 IDA-51500 Effective 06-Sep-2012 05-Nov-2012 26-Nov-2012 31-Oct-2015 30-Aug-2022 Cumulative Disbursements Restructuring History Level Approved on 15-Apr-2013 ,Level 2 Approved on 21-Oct-2013 ,Level 2 Approved on 08-Sep-2015 ,Level 2 Approved on 30-Mar-2017 ,Level 2 Approved on 21-Jul-2017 ,Level 2 Approved on 28-Feb-2019 Related Project(s) P165493-National Nutrition Mission (also known as ICDS Systems Strengthening and Nutrition Improvement Project: Additional Financing 12/31/2019 Page 9 of 9