ESMS for CHNP i

Environmental and Social Management System (ESMS)

Community-Based Health and Nutrition to Reduce Stunting Project

Millennium Challenge Account – Indonesia (MCA-Indonesia)

March 2016

ESMS for CHNP ii

ESMS for CHNP iii

Table of Contents

1. INTRODUCTION ................................................................................................. 1

2. BACKGROUND .................................................................................................. 2

2.1 Overview of the MCA Indonesia ESMS Policy Statement ............................... 2

2.2 Environmental and Social Safeguards and the ESMS ....................................... 3

2.2.1 MCA-Indonesia’s ESMS Framework ........................................................................................ 3

2.2.2 IFC Performance Standards .................................................................................................... 4

2.2.3 ESMS Framework ......................................................................................................................... 5

3. OVERVIEW OF THE COMMUNITY-BASED HEALTH AND NUTRITION TO REDUCE STUNTING PROJECT ............................................................................................ 7

3.1 Project Activities and Implementation Structure.................................................... 7

3.2 Tier-2 ESMS for the Community Based Health and Nutrition Project .......... 13

3.2.1 Environmental and Social Legal Framework for CHNP ................................................. 14

3.2.2 Prohibited Activities .................................................................................................................. 16

3.2.3 Screening Checklist ................................................................................................................... 16

3.2.4 Identification of Environmental and Social Impacts and Risks .................................. 18

4. ACTIVITY 1: COMMUNITY PROJECT ACTIVITY AS DEMAND SIDE .......... 23

4.1 Implementation of Activity 1 ........................................................................................23

4.2 Sharing of Information with Activities 2 and 3 .....................................................23

5. ACTIVITY 2: SUPPLY SIDE ACTIVITY ........................................................... 25

5.1 Implementation of Activity 2 ........................................................................................25

ESMS for CHNP iv

5.2 Training health service providers and facilitators ................................................25

5.2.1 Environmental and Social Management ............................................................................. 25

5.2.2 Stakeholder Engagement and Social Inclusion............................................................... 26

5.2.3 Grievance Mechanism .............................................................................................................. 26

5.2.4 Environmental and Social Reporting ................................................................................. 26

5.3 Micronutrient Provision ................................................................................................. 27

5.3.1 Environmental and Social Management ............................................................................. 28

5.3.2 Social Inclusion and Stakeholder Engagement .............................................................. 29

5.3.3 Grievance Mechanism .............................................................................................................. 29

5.3.4 Environmental and Social Reporting ................................................................................. 30

5.4 Sanitation and Hygiene ................................................................................................ 30

5.4.1 Environmental and Social Management ............................................................................ 30

5.4.2 Stakeholder Engagement and Social Inclusion ............................................................... 31

5.4.3 Grievance Mechanism.............................................................................................................. 32

5.4.4 Environmental and Social Reporting ................................................................................. 32

6. ACTIVITY 3: COMMUNICATIONS, MANAGEMENT AND EVALUATION ... 33

6.1 Environmental and Social Management .................................................................. 33

6.2 Stakeholder Engagement and Social Inclusion ................................................... 33

6.3 Grievance Mechanism ................................................................................................... 34

6.4 Environmental and Social Reporting ...................................................................... 34

7. CHNP-WIDE ENVIRONMENTAL AND SOCIAL ACTION PLAN .................. 35

7.1 Social and Gender Integration Plan .......................................................................... 38

7.2 Grievance Mechanism ................................................................................................... 38

7.3 Occupational Health and Safety ............................................................................... 39

ESMS for CHNP v

7.4 Land Acquisition and Resettlement ........................................................................ 39

7.5 Indigenous People .......................................................................................................... 40

8. INSTITUTIONALIZATION OF THE CHNP ESMS............................................ 41

8.1 Implementation and Management of CHNP ........................................................... 41

8.2 Roles and Responsibilities for the CHNP ESMS ................................................... 43

8.3 CHNP Internal Capacity Assurance .......................................................................... 43

8.4 Budget Requirements for Effective CHNP ESMS Implementation ............... 44

8.5 Capacity Development and ESMS Roll-Out .......................................................... 44

8.6 Compliance and Environmental Audit .................................................................... 45

8.7 Reporting of Environmental and Social Performance ....................................... 45

8.8 Review and Revision of ESMS for CHNP ................................................................ 45

APPENDIX

A. Multiple Micronutrient Product (MMNP) Traceability Guidance ...................... 47

B. Indigenous Peoples Plan Framework (IPPF) .......................................................... 50

C. Example of Statement Letter for Land Donation ................................................. 55

D. List of Available Operational Guidelines for the CHNP ...................................... 56

ESMS for CHNP vi

Abbreviations

BPOM : Badan Pengawasan Obat dan Makanan (Food and Drugs Authority)

CHNP : The Community-Based Health and Nutrition to Reduce Stunting

ECOPs : Environmental and Social Code of Practices

ESMS : Environmental and Social Management System

ESP : Environmental and Social Performance

ESAP : Environmental and Social Action Plan

ESMP : Environmental and Social Management Plan

GOI : Government of Indonesia

GSC : Generasi Sehat dan Cerdas (Health and Smart Generation)

IFC – PS : International Finance Corporation Performance Standards

IPPF : Indigenous Peoples Planning Framework

IPP : Indigenous Peoples Plan

ISO : International Organization for Standarization

MCA-Indonesia: Millennium Challenge Account Indonesia

MCC : Millennium Challenge Corporation

M&E : Monitoring and Evaluation

PNPM : Program Nasional Pemberdayaan Masyarakat (The National Program

for Community Empowerment).

PS : Performance Standard

PSF : PNPM Support Facility

PTO : Petunjuk Teknis Operational (Technical Operational Manual)

QA&QC : Quality Assurance and Quality Control

SNI : Standar Nasional Indonesia (National Indonesia Standard)

STBM : Sanitasi Total Berbasis Masyarakat (Community LedTotal Sanitation)

TTD : Tablet Tambah Darah (Iron Pills)

WHO : World Health Organization

ESMS for CHNP

1

1. Introduction

The Community-based Health and Nutrition to Reduce Stunting Project or “CHNP” is

one of three main projects under the Indonesia Compact funded by the Millennium

Challenge Corporation (MCC) and implemented by the Millennium Challenge Account

Indonesia (MCA-Indonesia). CHNP is subject to comply with environmental and social

safeguards described in the MCC Environmental Guidelines. To achieve this, MCA-

Indonesia has developed the MCA-Indonesia Environmental and Social Management

System (ESMS) Framework as the main reference for environmental and social

management in MCA-Indonesia and to act as the Tier-1 main policy and

implementation framework for the tiered approach ESMS in the Indonesia Compact.

The Tier-1 ESMS served as the basis for development of ESMS’ for the three compact

projects, referred to as Tier-2 ESMS or Project-level ESMS. For CHNP, the Project ESMS

is described in this document. The CHNP ESMS describes the commitment of the

Project, and describes how the activities under the Project will conform to

environmental and social performance requirements of the Compact. This ESMS has

been tailor-made to the nature and scale of CHNP. This draft also acknowledges the

project design decisions and tools developed by CHNP initiated as a result of previous

drafts of the ESMS and discussions between the Project team and ESP.

The ESMS applies to all three core activities1 of the CHNP, namely: (i). Community

Project Activity as the Demand Side; (ii). Supply Side Activity, and (iii).

Communications, Management and Evaluation; as well as to all parties involved in

implementation of the activities.

Where applicable, the CHNP ESMS document shall be supplemented by a series of

guidelines, manuals and tools to provide clear operational guidance for all parties. This

document may be modified from time to time with the mutual agreement of the MCC

and MCA-Indonesia and will be available in the MCA-Indonesia website (www.mca-

indonesia.go.id) for public access.

For the Community Project Activity component, besides this ESMS, the project

activities will also adhere to the Technical Guideline for Environmental and Social

Safeguards Policy of the Generasi Sehat dan Cerdas (GSC). The guideline is attached

in the GSC Technical Operational Manual or Petunjuk Teknis Operasional (PTO) 2016.2

The guidelines will be available on the GSC website3.

1 Described in the “Gambaran Umum PKGBM (Proyek Kesehatan dan Gizi Berbasis Masyarakat)”, Millennium Challenge Account Indonesia, December 2013. 2 When this ESMS developed, the GSC Technical Operation Manual or Petunjuk Teknis Operasional (PTO) have obtained approval or no objection from the World Bank and has been socialized to the Provincial and District levels. Currently, the Safeguards Guideline is available only in Bahasa Indonesia version. 3 The GSC website still under construction when this ESMS developed.

ESMS for CHNP

2

2. Background The Millennium Challenge Corporation (MCC) has entered into a Compact with the

Government of Indonesia (GoI) to support the Government’s development objectives

in three important areas: green growth, health and nutrition, and procurement. The

Compact is managed as three separate projects, namely the Green Prosperity Project

(GP Project), the Community-based Health and Nutrition to Reduce Stunting Project

(CHNP) and the Procurement Modernization Project (PM Project). GoI established a

trust institution – the Millennium Challenge Account Indonesia (MCA-Indonesia) – to

manage and implement the Compact and its three projects on behalf of the GoI. The

Compact entered into force on April 2, 2013 and its five-year timeline will conclude on

April 1, 2018.

2.1 Overview of the MCA Indonesia ESMS Policy Statement MCA-Indonesia has established an Environment and Social Management System

(ESMS) for the overall Compact, called the MCA-Indonesia ESMS Framework (Tier 1

ESMS Framework). The Tier 1 ESMS Framework sets the tone and spirit for MCA-

Indonesia’s programs, and is intended to ensure that all operations and investments of

MCA-Indonesia comply with the relevant laws and regulations of the Government of

Indonesia, MCC Environmental Guidelines, and the MCC Gender Policy, and are

consistent with the International Finance Corporation (IFC) Performance Standards

(PS)4.

The objectives of the ESMS Framework are as follows:

1. To ensure all activities and actors anticipate and take action to avoid adverse impacts or risks to communities and the environment;

2. To identify and evaluate environmental and social risks and impacts of the project;

3. To adopt a mitigation hierarchy to anticipate and avoid, or where avoidance is not possible, minimize, and, where residual impacts remain, compensate/offset for risks and impacts to workers, affected communities, and the environment;

4. To promote improved environmental and social performance of all actors and activities through the effective use of management systems;

5. To ensure that grievances from affected communities and external communications from other stakeholders are responded to and managed appropriately;

6. To promote and provide means for adequate engagement with affected communities throughout the project cycle on issues that could potentially affect them and to ensure that relevant environmental and social information is disclosed and disseminated;

7. To ensure all activities and actors consciously foster positive environmental and social impacts and benefits through proactive planning and project design.5

4As described in the Millennium Challenge Compact between the United States of America, acting through the Millennium Challenge Corporation, and the Republic of Indonesia, Annex 1. 5 MCA-Indonesia, Environmental and Social Management System Framework, Tier 1, February 2013.

ESMS for CHNP

3

Based on the Tier 1 ESMS Framework, a second tier ESMS developed for each of the

three projects, including for CHNP. This CHNP ESMS was prepared through desk

review of relevant materials (developed by MCC, MCA-Indonesia and consultants, as

well as relevant with Program Nasional Pemberdayaan Masyarakat (PNPM) Generasi

and PNPM Rural documents), review of Indonesian regulations and references from

the International Finance Corporation Performance Standards, discussions with MCA-

Indonesia and consultants, as well as participation in site visits.

To ensure that the ESMS Framework is well established and integrated into MCA-

Indonesia operations, MCA-Indonesia has tasked the Environmental and Social

Performance (ESP) unit in MCA-Indonesia (led by the ESP Director) to provide overall

oversight and support to MCA-Indonesia and each of the three main Project. The ESP

Unit will also provide technical inputs and reviews to project activities, serve as cross-

cutting expert on ESP management and act as representative and primary point of

contact with regards to environmental and social safeguards of the Compact.

The MCA-Indonesia Environmental and Social Performance (ESP) Director will be

responsible for ensuring that all investments and operations comply with the ESMS

Framework, while the MCA-Indonesia Executive Director (Chief Executive Officer) is

ultimately held accountable for upholding the environmental and social policy.

2.2 Environmental and Social Safeguards and the ESMS

2.2.1 MCA-Indonesia’s ESMS Framework

The first tier ESMS developed for the overall compact is called the MCA-Indonesia

ESMS Framework and acts to guide environmental and social performance for MCA-

Indonesia. The MCA-Indonesia ESMS Framework presents a policy statement from

MCA-Indonesia on environmental and social performance and sets the tone and spirit

for environmental and social management in MCA-Indonesia projects and activities,

and is intended to ensure that all operations and investments of MCA-Indonesia

comply with the relevant laws and regulations of the Government of Indonesia, MCC

Environmental Guidelines and MCC Gender Policy, and are consistent with the

International Finance Corporation Performance Standards (IFC Performance

Standards).6

MCA-Indonesia ESMS Framework Policy Statement

MCA-Indonesia investments and operations aim to maximize environmental and social benefits for the people of Indonesia (including women and marginalized groups), and minimize the adverse impacts to the environment and society. As such, all MCA-Indonesia investments and operations shall comply with the ESMS Framework, which is based on laws and regulations of the Government of Indonesia, MCC Environmental Guidelines and Gender Policy, and the IFC Performance Standards on Environmental and Social Sustainability.

6As described in the Millennium Challenge Compact between the United States of America, acting through the Millennium Challenge Corporation, and the Republic of Indonesia.

ESMS for CHNP

4

The Tier 1 ESMS Framework has established six elements required of all MCA-Indonesia

investments, projects and operations. The six elements intended to guide the design

of the project and the institutional arrangement at the Project level. The six

environmental and social safeguard elements in the MCA-Indonesia ESMS are shown

in Figure 1 below.

Figure1: The six elements of MCA-Indonesia’s ESMS Framework

The principle elements will be addressed in this CHNP ESMS. It is worth noting that the

early drafts of the CHNP ESMS had informed the design of the CHNP activities, and

influenced the development of documents and operational tools for the CHNP

activities. Therefore, element E1 will not be further elaborated in this document.

The ESMS thus also guides CHNP to conform to the Compact-wide systems that exist

or are developed outside of this ESMS. For element E3, Disclosing Information and

Engaging Stakeholders, the CHNP is expected to follow the MCA-Indonesia

Stakeholder Engagement Plan, and the Information Disclosure Policy. For element E5,

the CHNP is expected to utilize the MCA-Indonesia Grievance Mechanism developed

for the entire Compact.

This CHNP ESMS document, will therefore, focus its discussion on the following

elements:

E2: Understanding of Risks and Benefits

E4: Designing and Implementing Environmental and Social Action Plans

E6: Compliance Monitoring, Reporting and Evaluation.

2.2.2 IFC Performance Standards

At the activity-level, IFC Performance Standards (IFC PS) provide more specific

principles to abide by, depending on which performance standards are triggered by

an activity. The IFC Performance Standards are based on the IFC Sustainability

Framework effective 1 January, 2012 and consist of the following:

Environmentally and Socially Sensitive Project Design

Understanding of Risks and Benefits

Disclosing Information and Engaging Stakeholders

Designing and Implementing Environmental and Social Action Plans

Developing and Instituting Grievance Mechanisms

Compliance Monitoring, Reporting and Evaluation

ESMS for CHNP

5

Performance Standard 1: Assessment and Management of Environmental and

Social Risks and Impacts

Performance Standard 2: Labor and Working Conditions

Performance Standard 3: Resource Efficiency and Pollution Prevention

Performance Standard 4: Community Health, Safety, and Security

Performance Standard 5: Land Acquisition and Involuntary Resettlement

Performance Standard 6: Biodiversity Conservation and Sustainable

Management of Living Natural Resources

Performance Standard 7: Indigenous Peoples

Performance Standard 8: Cultural Heritage

PS1 (Assessment and Management of Environmental and Social Risks and Impacts)

applies to all activities, and overlaps with E2: Understanding of Risks and Benefits, and

will be discussed further in this document. Identification of risks and impacts will

determine which of the other performance standards apply to an activity. Relevance

of PS2 to 8 to an activity is determined at the risk/impact identification process.

Compliance with GoI laws and regulations is part of IFC PS and is also embedded into

this ESMS. A detailed reference to the IFC PS Sustainability Framework, guidance

notes, and handbooks can be obtained through the IFC website at http//www.ifc.org.

2.2.3 ESMS Framework

A typical ESMS will generally consist of the following components: 1) policy statement

and framework; 2) environmental and social analysis and assessment; and 3)

environmental and social management plan as shown in Figure 2 below.

Figure 2: Typical ESMS Components

Policy

Assessment & Analysis

Management Plan

ESMS for CHNP

6

Policy: The policy, or policy statement, will state the environmental and social

safeguard policies, standards, framework, and/or guidelines that the project adheres

to. The policy must outline policies, guidelines, etc. that are at par or are more stringent

than that stipulated in the MCA-Indonesia ESMS Framework and outlined in previous

sections above.

Assessments and Analysis: Initial or primary due diligence, environmental audits, gap

analysis, screening and/or scoping shall be conducted where applicable to identify and

recommend any required environmental and social assessments, analysis or studies

based on identified risks and impacts, or triggered performance standards. These

assessments, analyses and studies may include the need for a full or partial

Environmental (and potentially Social) Impact Assessments (EIA/ESIA) or a

supplementary EIA/ESIA, and, if needed, specific studies/supplementary studies (e.g.

studies on Indigenous Peoples (IP), Cultural Heritage (CH), land acquisition and

resettlement, audit, etc.).

The above assessments, analysis and studies combined will lead to the development

of a set of environmental and social action plans (ESAP) to mitigate any potential

environmental risks or impacts. Ultimately all the above will also contribute and/or lead

to the requirement to fulfill environmental permits (Ijin Lingkungan). Under Indonesian

law, an environmental permit is prerequisite for applying for other technical permits.

Management Plan: Each level ESMS that results in a set of action plans should be

followed through with the development of an Environmental and Social Management

Plan (ESMP). The ESMP will consist of the comprehensive management of the

implementation and monitoring of all environmental and social risk and impact

mitigation measures, derived from all assessment and study efforts conducted on the

project. This must also include the budgeting of costs to cover mitigation measures,

which will then input into the project costing or feasibility study.

ESMS for CHNP

7

3. Overview of the Community-based Health and

Nutrition to Reduce Stunting Project

3.1 Project Activities and Implementation Structure The project objective is to reduce and prevent low birth weight, childhood stunting

and malnourishment of children in project areas, and to increase household income

through cost savings, productivity, growth and higher lifetime earnings. The project

has three core components7 that are interlinked, namely: (i). Community Project

Activity as Demand Side; (ii). Supply Side Activity, and (iii). Communications,

Management and Evaluation. The CHNP is implemented through partnerships with the

Ministry of Health and the PNPM Support Facility (PSF). Project activities will be

implemented in 499 sub-districts, spread over 64 districts in 11 provinces, namely West

and East Java, West and East Nusa Tenggara, Gorontalo, Maluku, North and West

Sulawesi, West and Central Kalimantan, and South Sumatra.

Below is an overview of the three activities of the CHNP.

i). Community Project Activity as Demand

Side

The objective of this activity is to develop

sustainable community demand for nutrition

and health services. The activity includes

providing community facilitators,

participatory planning, and community block

grants. This activity is implemented in

partnership with the GOI’s Program called

Program Generasi Sehat dan Cerdas

(hereafter referred to as GSC).

The three sub-activities are complementary.

The participatory planning is aimed to

improve the capacity of communities and

local government officials to plan and manage community-based development

activities. Facilitators are assigned to assist the participatory planning process.

Development activities resulting from the participatory planning will be financed

through community grants delivered through the Community Direct Aid (Bantuan

Langsung Masyarakat).

7 Described in the “Gambaran Umum PKGBM (Proyek Kesehatan dan Gizi Berbasis Masyarakat)”, Millennium Challenge Account Indonesia, December 2013.

Stunting

Community Project

Activity as Demand

Side

Supply Side Activity

Communication, Management

and Evaluation

ESMS for CHNP

8

ii). Supply Side Activity

The objective of this activity is to strengthen capacities of health providers to be able to provide better quality and coverage of health and nutrition services. Supply Side Activity involves both service providers and the private sector.

The key interventions under the Supply Side activities are described below.

a. Training for health service providers and facilitators 8

Training activities will be held in 11 provinces to improve knowledge and skills of

health service providers and government officials at project locations. The

topics include food for pregnant mothers, infants and toddlers; growth

monitoring, sanitation triggering; and training for facilitators.

To complement the Growth Monitoring Training, the Project will supply

anthropometry Kits to Puskesmas in project locations. The objective is to

support growth monitoring by measuring the length or height of children in the

project locations.

b. Provision of Micronutrients

The project will provide micronutrients to children in selected locations in three

provinces, namely South Sumatra Selatan, West and Central Kalimantan. If

proven successful following a 6 month pilot period, the distribution of

micronutrients may be expanded to other project locations. In addition,

micronutrient supplements will also be provided to pregnant women in 11

provinces.

Micronutrients for children – Micronutrients will be given to children of the age

of 6 to 24 months, following the specifications stated in the Ministry of Health’s

regulation No 41, 2013 on Micronutrient Standards. Micronutrients will be made

available in sachets, and to be given to children in the project locations every

other day. The micronutrients, known by the name Taburia, will be distributed

to the community through the District-level Pharmaceutical Warehouse, the

Puskesmas and Posyandu in three provinces.

Micronutrients for pregnant women – Pregnant women in project locations will

be given iron pills (Tablet Tambah Darah/TTD), containing Iron equivalent to 60

mg of elemental iron, and Folic Acid 400 micrograms (.4 mg), in accordance

with the most recent Government regulation (Permenkes No. 88, 2014). Every

pregnant woman is expected to consume 90 tablets during her pregnancy. The

pills will be distributed to the community through the District-level

Pharmaceutical Warehouse, the Puskesmas and Posyandu in 11 provinces.

c. Sanitation and Hygiene Behavior

MCA-Indonesia plans to support the GOI’s Community Led Total Sanitation

(CLTS)9 program as a means to support anti-stunting initiatives. The project is

collaborating with the Government’s efforts to improve sanitation through the

8 Source: “Gambaran Umum PKGBM (Proyek Kesehatan dan Gizi Berbasis Masyarakat)”, Millennium Challenge Account Indonesia, December 2013. 9 Or known by the Indonesian acronym STBM (Sanitasi Total Berbasis Masyarakat).

ESMS for CHNP

9

implementation of the Sanitasi Total Berbasis Masyarakat (STBM) approach.

The approach aims at changing community behaviour (e.g. reducing open

defecation) and encouraging them to develop their own facilities. The project

will not provide financial support (subsidy) for physical infrastructure, but will

instead support a range of capacity building activities to be undertaken at the

communities targeted for intervention.

The activities to be conducted are as follows: a) socialization at the Province,

District and Sub-District levels; b) training activities for sanitarians and village

cadres; c) triggering at the village level for interested villages; d) post-triggering

monitoring; e) incentives for health service providers10, f) training and mentoring

of sanitation entrepreneurs.

d. Private Sector Response Activity

This activity will establish areas of collaboration with private sector partners

through the lens of market gaps that have resulted in poor access, affordability

and/or awareness of, sanitation and hygiene. The objective is to catalyse greater

private sector investment and support public-private partnerships that develop

market driven solutions to address community needs for, better hygiene

practices, safe water and sanitation. The activity plans to award grants to

private companies, NGOs and/or trade/industry associations, covering a wide

range of activities, in sanitation and hygiene.

iii). Communications, Management, Monitoring and Evaluation

a. Communications

The project will conduct a public awareness campaign that reaches the national

level and village level, using mixture of media. A formative study has been

conducted and resulted in a National Nutrition Communication Campaign

Strategy (dated April 2015) that is referenced here.

The National Nutrition Communication Campaign (NNCC) Strategy identified

the following target groups:

Primary

target

audience

Young mothers between 18 and 35 years of age with children

under two years of age, living mostly in rural and semi–urban

areas.

Secondary

target

audience

Husbands; predominantly conservative men who still think that

child health care and nutrition is a women's affair

Mothers or mothers in–law of the primary target audience;

generally women in the 50 years range or older. Many are very

traditional and still believe in superstition and myths with regards

to health care, child care and nutrition.11

10 This activity and others might not be included in the final implementation of the project. However, this ESMS is intended to cover the possibility of activities included in the earlier documents on the project design. 11 National Nutrition Communication Campaign Strategy Design, draft March 2015.

ESMS for CHNP

10

Messages will be delivered through an integrated mix of the following

approaches:

interpersonal and group communication activities, (group meetings,

one–one–one interactions, and advocacy targeting key stakeholders)

using sets of professionally developed communication materials; and

professionally produced electronic mass media (mainly television) for

dissemination via national and regional media outlets, as well as

production of posters and banners;

complemented by the use of web–based platforms (i.e., Facebook,

Twitter, and an NNCC website). Given the high level of cell phone

ownership, the use of SMS will be used as an effective way to push short

messages to specific target groups.

Television placement will have a national reach, while other activities will focus

on three districts, one district in each of the three provinces: West and Central

Kalimantan and South Sumatra.

b. Management

This activity is designed to ensure proper management of the three activities.

More discussion is provided in the text below.

c. Monitoring and Evaluation

Monitoring of project progress and evaluation of project achievements will be

done by the Implementing Entity, MCA-Indonesia and MCC. Indicators will be

developed and agreed upon to ensure consistency and continuity.

Implementation of the CHNP is managed through partnerships with the following:

Community Project Activity, with the Generasi Sehat dan Cerdas program,

coordinated by the PSF and the Ministry of Villages, Disadvantaged Regions

and Transmigration12;

Supply Side Activity, with the Ministry of Health;

Communications, Management, Monitoring and Evaluation, with the Ministry

of Health.

For the latter two activities, MCA-Indonesia and Ministry of Health have signed an

Implementing Entity Agreement with the Ministry of Health (initially signed in October

2013, and amended in March 2015). This Implementing Entity Agreement establishes

MCA-Indonesia as the accountable entity responsible for implementation of the

Compact Program, and describes the division of roles and responsibilities between

MCA-Indonesia and Ministry of Health, as its Partner Agency to implement the CHNP.

Within the MCA-Indonesia organization, the Agreement identifies CNHP as responsible

for the implementation of the Project, with support from other divisions. This

document will make reference to MCA-Indonesia as the entity responsible for

implementation, consistent with the Implementing Entity Agreement.

12 Previously, the key government agency in charge of PNPM was the Ministry of Home Affairs. Since the Joko Widodo Administration and the establishment of the Ministry of Villages, Disadvantaged Regions and Transmigration, PNPM management has been moved to this Ministry and change the program name to Generasi Sehat dan Cerdas (GSC). This document will continue to refer to the GSC name, as it relates to a body of knowledge that uses this name; even if, in the future, there is a change in the name of the program.

ESMS for CHNP

11

ESMS for CHNP

12

CHNP Locations

CHNP activities will be conducted in a total of 64 districts across 11 provinces. Eight

provinces are existing GSC program locations, while three provinces are new additions

to the GSC. The new provinces are South Sumatera, West Kalimantan and Central

Kalimantan.

Community Project Activities, the training component of the Supply Side Activity and

distribution of iron supplements will cover all 64 districts in 11 provinces, while the

provision of Taburia micronutrients and village-level communications activities will be

concentrated in the 22 districts in the three new provinces.

The table and map below show the districts covered by the CHNP.

Table 1. Location of CHNP Activities

Name of Province

No. of Districts

Name of District Name of Province

No. of Districts

Name of District

South Sumatera

5

Musi Banyuasin Banyuasin Ogan Komering Ilir Empat Lawang Ogan Komering Ulu Selatan

NTB (West Nusa

Tenggara) 8

Lombok Tengah Lombok Timur Lombok Utara Lombok Barat Sumbawa Barat Sumbawa Dompu Bima

West Kalimantan

9

Kapuas Hulu Sintang Melawi Ketapang Sekadau Kayong Utara Kubu Raya Landak Bengkayang

NTT (East Nusa

Tenggara) 9

Manggarai Manggarai Timur Sumba Timur Rote Ndao Kupang Timor Tengah Utara Belu Lembata Flores Timur

Central Kalimantan

8

Kapuas Pulau Pisang Gunung Mas Barito Utara Murung Raya Katingan Seruyan Lamandau

North Sulawesi

3 Kep. Talaud Kep. Sangihe Minahasa Utara

West Java 7

Sukabumi Cianjur Bandung Barat Subang Sumedang Garut Kuningan

Gorontalo 4

Gorontalo Gorontalo Utara Baelemo Pohuwato

West Sulawesi

3 Polewali Mandar Majene Mamuju

East Java 5

Magetan Trenggalek Nganjuk Malang Pamekasan

Maluku 3

Maluku Tenggara Barat Maluku Tenggara Maluku Tengah

ESMS for CHNP

13

Figure 3. Geographical Scope of CHNP Activities

3.2 Tier-2 ESMS for the Community Based Health and Nutrition

Project This document (the CHNP ESMS) is a Tier-2 ESMS developed specifically for the CHNP

and addresses the environmental and social management requirements of the CHNP.

The ESMS shall be aligned with the Social and Gender Integration Plan (SGIP) as well

as the Compact-wide Stakeholder Engagement Plan and Grievance Mechanism.

The CHNP ESMS identifies potential risks and impacts for the overall CHNP and

outlines requirements for mitigation. The ESMS makes reference to guidelines or tools

that will be applied to specific sub-activities, where potential impacts or risks are

anticipated.

The Compact describes the CHNP as Category D (through a financial intermediary).

This particularly applies to the Community Project Activity, whose funding is

channeled directly to the PSF. The two other activities have been categorized in the

MCA-Indonesia Tier-1 ESMS Framework as Category B or C13. Potential impacts/risks

will be discussed in this document.

13 Refer to page 9 of the Tier-1 ESMS Framework.

ESMS for CHNP

14

3.2.1 Environmental and Social Legal Framework for CHNP

The Community Based Health and Nutrition Project is designed to support the

Government of Indonesia’s commitment to reduce the incidence of childhood stunting

and improve sanitation standards. This aligns with the National Mid-Term Development

Plan that includes programs to reduce stunting prevalence and to achieve open-

defecation free status and improved access to water supply. The GOI policies that

serve as the basis of the CHNP and that address potential impacts are as follows:

CHNP Activities

Relevant GOI regulations/ policies

Community Project Activity as Demand Side

Act No. 6, 2014 on Village

Act No. 2, 2012 on Land Acquisition for Development of Public Interest

Act No. 36, 2009 on Health

Act No. 14, 2008 on Public Information Disclosure

Act No. 32, 2004 on Regional Autonomy

Act No. 39, 1999 on Human Rights

Act No.39, 1999 on Human Rights

Presidential Regulation No. 42 year 2013 on National Movement for Nutrition Improvement

Presidential Decree No. 111/1999 regarding Development of Isolated Traditional Community (KAT)

Social Ministry Decree No. 06/PEGHUK/2002 regarding Implementation Guidelines of Isolated Traditional Community Empowerment

Supply Side Activity

Act No. 36, 2009 on Health

Act No. 32, 2009 on Environmental Protection & Management

Act No. 14, 2008 on Public Information Disclosure

Act No. 39, 1999 on Human Rights

Act No. 32, 2004 on Regional Autonomy

Act No. 8, 1999 on Consumer Protection

Presidential Regulation No. 42 year 2013 on National Movement for Nutrition Improvement

Regulation of the Minister of Health (Permenkes) No. 41, 2013 Revision of Permenkes 028, 2012 and Permenkes No. 2409 of 2011 on the Standar Bubuk Tabur Gizi Regulation of the Minister of Health (Permenkes) No. 88, 2014 on the Standard for Iron Supplement Tablets for Women in Reproductive Age and Pregnant Women

Government Regulation No. 28, 2004 on Food Safety, Quality and Nutrition.

Government Regulation No. 27, 2012 on Environmental Permit

Decree of Ministry of Health No. 852/Menkes/SK/IX/2008 on National Strategy on STBM (Sanitasi Total Berbasis Masyarakat) Government Regulation No. 69, 1996 on Food Labelling and Advertisement

Regulation of the Head of the Food and Drug Supervision Agency (BPOM) No. Hk 03.1.33.12.12.8195 Year 2012 on Technical Guidelines for on Good Manufacturing of Drugs

Regulation of the Head of the Food and Drug Supervision Agency (BPOM), No Hk. 03.1.34.11.12.7542 Year 2012 on Technical Guidelines for Good Distribution of Drugs

Communications, Management and Evaluation

Act No. 36, 2009 on Health

ESMS for CHNP

15

CHNP Activities

Relevant GOI regulations/ policies

Act No. 14, 2008 on Public Information Disclosure

Besides Government regulations, the CHNP is expected to comply with policies and

guidelines adopted by the various programs it is attached to, as well as those adopted

by the MCC and MCA-Indonesia. This section provides a description of programmatic

policies and guidelines that are relevant for safeguards of the CHNP.

The Category D determination for the Community Project Activity leads to the use of

the intermediary organization’s policies and safeguard requirements. This is described

in the Project Appraisal Document (PAD) dated July 2011. The PAD describes how

Generasi Plus will take advantage of the implementation structures already in place

within PNPM Rural, including the policy, administrative and fiduciary infrastructure14.

This approach applies specifically to the Community Project Activity, which is

implemented through the Generasi Sehat dan Cerdas Program.

Thus, for the Community Project Activity, the following programmatic safeguard

guidelines shall apply:

The GSC Technical Guideline for Environmental and Social Safeguards Policy,

which attached in the Technical Operational Manual or Petunjuk Teknis

Operasional (PTO) 2016, which provides detailed instructions and template

forms for community engagement, gender integration, environmental and social

safeguards, and monitoring15.

The GSC standard procedures for stakeholder engagement and information

disclosure, grievance redress mechanisms.

The GSC safeguard guidelines are based on the World Bank’s policies on

Environmental Assessment and Indigenous Peoples, and demonstrate PNPM’s

extensive experience applying such policies across the country. The environmental

assessment portion of the guidelines might not be as relevant (as the social portion)

to the GSC, since this activity does not involve any construction of village

infrastructure. However, the social portion of the safeguard guidelines is very

applicable to GSC.

The safeguard guidelines include social code of practices that address indigenous

peoples, gender and vulnerable groups in various regions of Indonesia. The guidelines

shows an institutional ability to understand, anticipate and respond to the complexity

of social issues in the country, particularly as it pertains to vulnerable people, gender,

cultural heritage and indigenous people. This institutional infrastructure will enable the

Community Project Activity to comply with the requirements of the MCA-Indonesia

Tier 1 ESMS.

14Paragraph 43, Project Appraisal Document, Generasi Plus Project. “Reducing Stunting Rates among Children in Indonesia through Improved Nutrition, Health, ECD and Hygiene Interventions through the PNPM Generasi Program”. Bappenas – Ministry of Health – MCC – World Bank, July 2011. 15Petunjuk Teknis Operasional, Generasi Sehat dan Cerdas, Kementerian Desa, Pembangunan Daerah Tertinggal dan Transmigrasi, 2016.

ESMS for CHNP

16

The Supply Side Activity and the Communications, Management and Evaluation

Activity will be implemented by MCA-Indonesia in partnership with the Ministry of

Health. Therefore, the programmatic policies and guidelines that apply will be those

issued and enforced by the Ministry of Health and its partners. These include Ministry

of Health regulations, technical guidelines, operational manuals related to: a)

production, packaging and distribution of drugs and supplements, b) sanitation and

hygiene activities associated with the STBM (Sanitasi Total Berbasis Masyarakat)

program, c) training of health service providers. The CHNP is adopting various

technical manuals (PTO’s or petunjuk teknis operasional) that will guide

implementation of the activities. A list of the operational guidelines available at the

time of preparation of this ESMS is provided in Appendix E.

3.2.2 Prohibited Activities

In line with the MCA-Indonesia Tier-1 ESMS, MCA-Indonesia shall not provide funds or

assistance for any project that is likely to cause signification environmental, health and

safety hazards. An illustrative list of prohibited activities is available in Appendix 3 of

the MCA-Indonesia Tier-1 ESMS Framework.

3.2.3 Screening Checklist

Individual sub-activities shall undergo screening to identify environmental and social

impacts that need to be addressed in the design and implementation. Activities under

Community Project will utilize the GSC safeguard guidelines and tools, including

screening checklist and project categorization. Activities under the other two projects

shall utilize the following checklist:

Yes No IFC-PS

Triggered

ESMS

Guidance

A. Environmental, Health and Safety – Will sub-projects:

1. Create a risk/potential of contamination related to provision

of food, beverage products or supplements?

2. Create a risk/potential of diseases such as diarrhea?

3. Result in the production of solid or liquid waste, or result in

an increase in waste production, during construction or

operation?

4. Create a risk/potential of safety issues?

5. Cause any physical or economic displacement of households

in the community?

If the answer to any of the questions 1-5 is “Yes”, please include an

Environmental and Social Action Plan (ESAP) and/or simple Environmental and

Social Code of Practices (ECOPs) with the sub-project application.

ESAP

and/or

ECOPs

B. Indigenous Peoples:

6. Are there social-cultural groups present in or use the project

area who may be considered as “indigenous

peoples”/”ethnic minorities”/tribal groups” in the project

area?

7. Members of the indigenous groups in the area who could

benefit from the project?

8. Do such groups self-identify as being part of a distinct social

and cultural group?

ESMS for CHNP

17

9. Do such groups have a close attachment to ancestral

territories and to the natural resources in the project area?

10. Do such groups have customary cultural, economic, social,

or political institutions?

11. Has such groups been historically, socially and economically

marginalized, disempowered, excluded, and/or

discriminated?

If the answer to any of the questions 6 - 11 is “Yes”, please consult the ESMS

and, if needed, prepare an Indigenous Peoples Planning Framework (IPPF)

and/or Indigenous People Plan (IPP) with the activity/sub-project application.

IPPF/IPP

Screening has been conducted for the overall project design, and has resulted in

identification of potential risks and impacts that are addressed in this CHNP ESMS.

The screening tool shall be complemented by the use of Government of Indonesia’s

regulations and technical guidelines on environmental permit and environmental

assessments, to determine whether formal environmental and social assessments are

required. Sub-activities that may require an environmental assessment16 (and thus

environmental permit) are limited to some sub-projects funded by Activity 1’s block

grant (depending on type of activity and location), and possibly communal sanitation

facilities should Activity 2’s sanitation and hygiene lead to community’s decision to

build such a facility.

The screening process shall be done by the CHNP staff and/or project implementers,

with support from the MCA-Indonesia ESP staff. Decisions regarding the need to

prepare an action plans or assessments will be consulted with the MCA-Indonesia ESP

Director.

If a sub-activity or sub-project requires a formal environmental assessment, CHNP shall

ensure that such studies are conducted in accordance with the regulations, and

sufficiently address the issues covered in the IFC-Performance Standards. CHNP shall

also ensure that environmental permits are approved by the appropriate level of

Government, in accordance with pertinent regulations. Issues not covered by the

formal environmental assessments may be supplemented by studies done under the

GSC framework. Identification of gaps shall be done by the CHNP team with assistance

from MCA-Indonesia ESP team.

Any environmental or social risks or impacts identified in the previous screening

process will lead to determination of impact management and mitigation measures

and actions to ensure activities and sub-activities comply with pertinent regulations

and standards. These measures or actions shall be documented to allow

communication to parties involved and stakeholders, as well as to allow consistency in

monitoring. For sub-projects that have an environmental permit, the management/

mitigation measures will be described as part of the environmental management and

monitoring plans attached to the environmental permit. For sub-projects that are not

16 Given the expected size of the community projects, few or none are expected to require an AMDAL study. Some projects may require a UKL-UPL.

ESMS for CHNP

18

governed by an environmental permit, the CHNP shall develop an environmental and

social action plan17 that defines the specific impact minimization and mitigation

measures, performance indicators, as well as the role and responsibility of relevant

parties associated with each impact or risk.

3.2.4 Identification of Environmental and Social Impacts and Risks

All components of the CHNP are designed to benefit communities in the target

locations. The project activities also follow community-based approaches designed for

both the GSC and the STBM programs, which are founded on principles of full

community participation, social inclusion and stakeholder engagement. Therefore, the

positive impacts of the CHNP to the communities are expected to be significant. The

health and nutritional impacts are expected to be long-term and support broader

educational, economic and social benefits for the communities.

Nonetheless, some of the activities, if not properly managed, have the potential of

causing adverse negative impacts. Potential impacts are identified in the following, and

discussed further in subsequent chapters.

Following the MCC Environmental Guidelines, the CHNP’s impacts are risks that are

likely to fall under Category B and C.18 Where potential adverse impacts are identified,

CHNP must ensure that mitigation measures are incorporated into the design and

implementation of the activities. The table below provides an overview of the potential

environmental and social risks and impacts anticipated for the CHNP.

17 Such an action plan may include an overall Environmental and Social Action Plan necessary for carrying out a suite of mitigation measures or thematic action plans such as resettlement action plan or indigenous people action plan. Action plans may be plans designed to fill in the gaps of existing management programs to ensure consistency with the Performance Standards, or they may be stand-alone plans that specify the project’s mitigation strategy (adapted from IFC Performance Standards on Environmental and Social Sustainability, page 10, footnote 22, 2012). 18 Category B is defined as: if the potential environmental and social impacts are less adverse than those of Category A projects. Typically, these impacts are site-specific, few if any are irreversible, and mitigation measures are more readily available. Category C is defined as: if the project is unlikely to have adverse environmental and social impacts.

ESMS for CHNP

19

Table 2: Potential Environmental and Social Risks and Impacts associated with the CHNP

Project Activities Description Potential

Environmental & Social Risk and Impact

Mitigation Measures

Community Project Activity as Demand Side

Providing community facilitators that includes equal number of women and men.

Assign trained facilitators to work with communities. Recruitment process of facilitators need to promote gender balance.

Social impacts may be negative, if women and marginalized groups are not recruited as facilitators, who could assist women and vulnerable groups in participatory planning, by raising their concerns. Similarly, language difference may hamper participation of marginalized groups. No environmental risks or impacts expected.

Ensure social inclusion by recruiting women and representatives of marginalized groups. In conservative societies, women of the community may need to have separate meetings initially to raise their concerns. Similarly, facilitators from certain groups can help reduce language and cultural barriers.

Gender and socially inclusive Participatory planning

Conduct participatory planning process to identify development projects to be proposed for community block grant funding. Participatory planning should capture men’s, women’s and vulnerable group’s different concerns and priorities.

Social impacts are positive, as gender and socially inclusive participatory planning expected to result in village project proposals that suit needs and priorities of women, men and marginalized groups. Process must ensure social inclusion.

Ensure gender and social inclusion in participatory planning process, including vulnerable/marginalized groups, gender balance, and indigenous peoples. Adopt stakeholder engagement, grievance mechanism, and indigenous people framework (in relevant locations). Ensure men’s, women’s and other vulnerable group’s concerns and priorities, so that benefits for all, especially for marginalized groups are well captured in planning process, if necessary through separate forums for women and marginalized groups in all community planning activities.

Community block grants

Funding for community projects proposed through gender and socially inclusive participatory planning process.

To be determined for each village project. Projects should have positive social impacts; but may have localized environmental impacts.

Allocate financial resources to address socio-cultural constraints, including gender gaps identified during project assessment. Include activities so that women and vulnerable groups have equal access and able to avail benefits from the block grant provided. Adopt screening process to identify potential environmental risks and impacts of individual projects. And develop ESMP where necessary.

Supply Side Activity

Training for health service providers and facilitators

Implementation of training courses for health service providers and facilitators in 11 provinces. Courses expected to involve up to 6,000 participants.

Health, safety and security of training participants, related to travel to/from training locations as well as venues/facilities.

Adopt health, safety and security policy and procedures that apply to travel of training participants and selection of course venues/facilities. Ensure safe child care facilities for women facilitators with infants.

Provision of micronutrients

Provision of iron folate tablets to pregnant women, and Taburia

Unexpected health impacts of Taburia in areas where malaria,

Guidelines to address coordination with existing malaria, TB, parasite prevention

ESMS for CHNP

20

supplement to infants in 3 provinces.

parasitic infections and tuberculosis are prevalent.19 Potential risk of micronutrient supplements being damaged during distribution and storage, related to Indonesia’s tropical climate; thus affecting mothers and infants. Potential risk of double dosage from other programs, such as: regular program from national/local government or other institutions Potential risk of pollution from improper disposal of post-consumer packaging.

programs when promoting Taburia in areas where malaria, parasitic infections and tuberculosis are prevalent. Adopt quality assurance and control throughout supply chain. DHO and Puskesmas ensure no duplication in terms of beneficiaries that receive micronutrients Adopt adequate waste management of post-consumer packaging, especially for Taburia sachets.

Sanitation and hygiene behavior

Implementation of CLTS activities in 11 provinces. Includes training, triggering, post triggering monitoring and incentives for health service providers. The CLTS process need to ensure that all social groups, including women, men and marginalized groups can equally participate in CLTS activities.

Social impacts are expected to be positive. However, approach to indigenous people (where present) must be more tailored. Environmental impacts overall expected to be positive. However, if communal sanitation facilities20 are to be constructed, they may require limited land acquisition/ donations. Furthermore, improved sanitation may require more changes in water access/use patterns. Triggering activities that rely on public shame may lead to marginalization of some community members.

Define culturally appropriate approach for indigenous people (where present). Ensure equal opportunity for women, men and marginalized groups in the management and implementation arrangements of CLTS activities. Take into account any adverse impacts or risks that may affect equal access to/participation in/equal benefit from project activities. Properly assess and plan land acquisition/donation for communal facilities. Properly assess water availability and access; and design appropriate sanitation facilities accordingly. Use gender and socially inclusive participatory process and develop and agree on a

19 World Health Organization, e-Library of Evidence for Nutrition Actions, Multiple Micronutrient Powders for Home

Fortification of Foods Consumed by Children 6-23 Months;

http://www.who.int/elena/titles/guidance_summaries/micronutrientpowder_infants/en/

20 There are no plans to construct communal sanitation facilities in the current design of the CHNP Project. However, if local conditions do not allow construction of household toilets, there is a possibility that CHNP may collaborate and enlist the support of other government programs to develop communal facilities. Should this be the case, this ESMS shall be referenced as well.

ESMS for CHNP

21

social action plan for 100% ODF village Triggering should encourage social integration, and be sensitive to the use of shame in changing behavior.

Entrepreneur training and mentoring

Training and mentoring to selected entrepreneurs at project locations. Promote a socially inclusive process so that all social groups, including women, men and marginalized groups can equally participate in training.

Social impacts may be negative if gender and socially inclusive process is not undertaken for raising awareness and agreement on ODF.

Ensure equal opportunity for women, men and marginalized groups in training, so that communities can work together for ODF.

Private sector response activity

Competitive grant award for interventions in fortification or sanitation, safe water and hygiene

Risks and impacts unknown; depend on the types of activities proposed that includes participatory situational analysis for understanding demand and willingness to pay for such services and selected for grant award.

Properly assess potential risks and impacts at project appraisal and/or selection process.

Communications, Management, Monitoring and Evaluation

National Nutrition Communications Campaign

Communication campaign at the national (electronic media) and local levels.

Positive social and environmental impacts are expected. However, where vulnerable/ marginalized groups and indigenous peoples are present in target locations, communications strategy may need adjustment.

Ensure social inclusion of vulnerable/marginalized groups, gender balance in communications approach. Incorporate messages tailored to local cultural, religious, gender and situational needs. Involve local women and men, leader, elders from the beginning for wider acceptance, use and outreach of the communication campaign.

Monitoring Monitoring of project outputs and outcomes. Gender and socially disaggregated data should be collected. Gender targets and indicators should be developed. Promote community monitoring for local estimation of their progress, especially include women, men, educated youth, and

Without gender and socially disaggregated data, it will be difficult to measure progress by different social groups, and increase support for lagging groups.

Gender and socially disaggregated data should be collected. Promote community monitoring for local estimation of their progress, especially include women, men, educated youth, marginalized groups in monitoring process

ESMS for CHNP

22

marginalized groups in monitoring process.

Evaluation Evaluation against project objectives. Ensure that all social groups, including women, men and marginalized groups can equally participate in evaluation. The evaluation report should include an assessment of gender equality results and impacts.

Evaluation may not indicate correct impacts if all social groups are not included

Ensure that all social groups, including women, men and marginalized groups can equally participate in evaluation.

More detailed guidance is provided in the subsequent chapters for each activity.

ESMS for CHNP

23

4. Activity 1: Community Project Activity as Demand Side

4.1 Implementation of Activity 1 This activity is fully implemented by the GSC institutional infrastructure, and expected

to the use of the GSC policies and safeguard requirements and tools. This is described

in the Project Appraisal Document (PAD) dated July 2011, stating that Generasi Plus

(now change to Generasi Sehat dan Cerdas) will take advantage of the implementation

structures, including the policy, administrative and fiduciary infrastructure21.

Screening will use the environmental impact identification process and verification

process of the GSC, as well as other GSC safeguard guidelines and support tools to

ensure village projects do not cause adverse environmental and social impacts.

Reporting and monitoring shall also utilize the mechanisms already developed and

implemented under GSC. MCA-Indonesia shall obtain such reports, and ensure relevant

information in the reports are communicated to the CHNP team, including consultants

and contractors in the field.

4.2. Sharing of Information with Activities 2 and 3 Generasi Sehat dan Cerdas standard operating procedures address stakeholder

engagement, social inclusion, indigenous peoples, and land acquisition/donation. In

many cases, GSC has developed and communicated with village leaders and

communities, the standards, procedures and tools that are used to address the above

matters. Since the target communities in the CHNP Activities 2 and 3 are one and the

same as target communities under Activity 1, assessments and approaches developed

for Activity 1 are highly relevant for Activities 2 and 3. These include the following:

results of social mapping, which identify presence of vulnerable or marginalized

groups, and the poorest members of the community;

results of identifying possible presence of indigenous peoples or adat

communities, which may require specifically targeted consultations and

interventions;

results of gender assessments, which identifies specific gender-related issues

that must be followed up in the activity plans;

results of community health studies, which identify prevalent diseases in the

area (including malaria, HIV, tuberculosis, other parasitic infections) and

nutritional status among children and pregnant mothers;

standard instruments (letters, agreements, etc.) for land donations, involving

heirs of current land owners);

21Paragraph 43, Project Appraisal Document, Generasi Plus Project. “Reducing Stunting Rates among Children in Indonesia through Improved Nutrition, Health, ECD and Hygiene Interventions through the PNPM Generasi Program”. Bappenas – Ministry of Health – MCC – World Bank, July 2011.

ESMS for CHNP

24

grievance redress mechanism or complaints handling system that allow

community members to voice their dissatisfaction about project activities.

Sharing of information and study results will allow micronutrient provision, sanitation

and hygiene as well as communications activities to adapt activities accordingly (to

suit the socio-cultural conditions of the target communities). Sharing of information is

most efficiently achieved at the district level, where CHNP district consultants, GSC

facilitators and Puskesmas interact. MCA-Indonesia shall promote such communication

and information sharing.

ESMS for CHNP

25

5. Activity 2: Supply Side Activity

5.1 Implementation of Activity 2 The Supply Side Activity is implemented through partnership with the Ministry of

Health, as described in the Implementing Entity Agreement. A National Secretariat

Team has been established as part of the Project Implementation Unit, with a role to

manage the Project on a daily basis and to coordinate and provide reports to the

Technical Team. Most activities will be conducted using the institutional arrangements

of the Ministry of Health and provincial/district health agencies. The health agencies

at the provincial and district levels will be assisted by consultants, working under the

supervision of the National Secretariat Team.22

Training activities will be conducted by Ministry of Health, through its existing

programs.

Micronutrient supplements will be procured by MCA-Indonesia through competitive

bidding from private sector suppliers. Distribution responsibility will be shared

between the supplier and the health services network. This will be determined in the

TOR for the bid.

Sanitation and hygiene activities will be implemented using the existing STBM network,

involving facilitators and existing pool of health services providers and cadres in each

location. Entrepreneur training and mentoring will involve provision of molds for latrine

construction to participating district governments.

5.2 Training health service providers and facilitators This sub-activity is expected to involve the mobilization of approximately 6,000

individuals (health cadres, sanitarians, health officials, midwives, etc.) to attend

training courses held at the district or provincial level.

5.2.1 Environmental and Social Management

Mobilization of training participants in large numbers poses potential risk of accidents

or incidents that may result in health and safety concerns. Training courses are

expected to be held in remote locations, with limited facilities and some degree of

difficulty in access. Many individuals (training participants and instructors) will require

travel requiring multiple modes of transport, such as boat, motorcycle, bus/car or air

travel.

MCA-Indonesia shall ensure that individuals are covered under a health, safety and

security policy that ensures safe travel and logistics associated with the training

programs. In the absence of an MCA-Indonesia health, safety and security policy23 that

can be applied to these individuals, MCA-Indonesia must ensure that Ministry of Health

has included the training participants in relevant Government programs that provide

22 Source: RFP for Human Resources Management Firm to Recruit and Manage Provincial and District Health Consultants and Training Consultants in the Implementation of Supply Side Activities, MCA- Indonesia, 2015. 23 The MCA-Indonesia health, safety and security policy has not been finalized at the time of preparation of this ESMS document.

ESMS for CHNP

26

health and safety coverage. The details of how MCA-Indonesia and its Partner Agency

will achieve this shall be described in an Environmental and Social Action Plan (see

Section 7). In addition, an operational guideline for logistics of the training program

shall be developed and communicated to all parties involved in the selection of training

venue/facilities and in the organization of the training courses.24

Delivery of training materials should be sensitive to gender and culture, and thus

ensure materials are delivered without offending any gender or group. Should there

be concerns related to delivery of training materials or demonstrations, such concerns

shall be conveyed to MCA-Indonesia to be addressed for subsequent training sessions.

In addition, there should be a mechanism to ensure equal opportunity for women, men

and other social groups to participate in awareness activity and training.

5.2.2 Stakeholder Engagement and Social Inclusion

The training activities are already designed to engage various health service

stakeholders, and thus not required to conduct further stakeholder engagement.

However, MCA-Indonesia shall ensure that training instructors provide sufficient

guidance to participants about ensuring equitable access to health information and

services to the different social groups present in target areas. MCA-Indonesia shall

ensure that the training instructors are informed of the MCA-Indonesia Stakeholder

Engagement Plan and the social and gender integration plan, as well as results of the

gender assessment entitled “Gender equality as a key dimension for improved

maternal and child nutrition to reduce stunting”. MCA-Indonesia shall also ensure that

training participants are aware of relevant information obtained through GSC studies25,

and that they consider the study results in providing health services to the community.

The details of how MCA-Indonesia and its Partner Agency will achieve this shall be

described in an Environmental and Social Action Plan (see Section 7).

5.2.3 Grievance Mechanism

The training activity shall utilize the MCA-Indonesia Grievance Mechanism to channel

complaints or inquiries related to the implementation of the training courses. Should

complaints regarding this activity be received via the Ministry of Health’s complaint or

whistle-blowing system, such complaints shall be cross-registered in the MCA-

Indonesia Grievance Mechanism. The Environmental and Social Action Plan can

provide more detail on how the grievance mechanism will engage Ministry of Health

and/or the GSC grievance mechanism.

5.2.4 Environmental and Social Reporting

The training activity is not expected to prepare separate environmental and social

reports. However, the National Secretariat Team is encouraged to report any accidents

or incidents related to travel of participants to and from training venues. Such reports

shall be included in the routine quarterly and annual reports submitted to MCA-

Indonesia.

24 The guideline shall address the minimum requirement of training venues and accommodations, and accessibility of location; as well as describe start and finish time of training sessions, and other issues that may affect the health of safety of all personnel expected to be present at the training course. 25 As described in Section 4.2.

ESMS for CHNP

27

5.3 Micronutrient Provision Multiple Micronutrient (MMN) is a strategy adopted by MCA-Indonesia to combat

stunting among children and anemia in pregnant woman in Indonesia. CHNP plans to

distribute and promote micronutrient sprinkles (known by the local trade name

“Taburia”) to be given to infants aged 6-24 months, and iron folic acid (IFA) tablets to

pregnant women. Provision of both nutritional supplements will be implemented

through the Ministry of Health.

Taburia Program

CHNP plans to fund the procurement and distribution of nutritional supplement in

the form of sprinkles, known as Taburia. The composition of the supplement follows

the Minister of Health Regulation No. 41, 2013 Revision of Permenkes 028, 2012 and

Permenkes No. 2409 of 2011 on the Standar Bubuk Tabur Gizi. Taburia will be

distributed to selected districts in three provinces, namely South Sumatra, West

and Central Kalimantan. Distribution will be channeled through the District

government’s pharmaceutical warehouse to reach the Puskesmas and Posyandu in

target locations. Mothers are expected to provide Taburia to their infants aged 6-

24 months every two days; requiring distribution of 15 sachets per child per month.

The Taburia program will initially be piloted in selected provinces; and depending

on the results of the pilot, distribution may be extended within the three selected

provinces.

It is noted here that Taburia is a relatively new program for the Government of

Indonesia. Although it has been piloted in a number of districts with a number of

international partners, Taburia distribution has not been adopted as a national

program. Lessons learned from the previous pilots are being considered in the

development of the program and in preparing this ESMS.

Iron Folic Acid Program

CHNP plans to fund the procurement and distribution of nutritional supplement in

the form of iron folic acid (IFA) tablets. The provision of IFA supplementation is

recommended as part of the antenatal care package to reduce the risk of low birth

weight, maternal anemia and iron deficiency. Composition of the IFA tablets will

follow the Minister of Health’s Regulation Permenkes No. 88 by 2014. A total of 90

IFA tablets will be provided to every pregnant woman in project areas. CHNP plans

to procure sufficient tablets for distribution over a two year period, in 11 provinces,

namely West and East Java, West and East Nusa Tenggara, Gorontalo, Maluku,

North and West Sulawesi, West and Central Kalimantan, and South Sumatra. MCA-

Indonesia plans to engage a supplier/manufacturer/distributor that will be

responsible for producing, packaging, distributing and conducting product

traceability and monitoring in project areas.

Distribution of IFA supplementation has been quite widespread in Indonesia.

Experience with production, distribution and consumption of IFA tablets is well

established. However, it is noted that UNICEF has recently updated its Technical

Bulletin on packaging for iron/iron folic acid tablets, aimed at preventing accidental

ESMS for CHNP

28

consumption by children and ensuring better product quality.26 This ESMS

considers past lessons learned gained through discussions in MCA-Indonesia.

5.3.1 Environmental and Social Management

This ESMS focuses on ensuring that Taburia and IFA tablets are safe at the time of

human consumption, which requires adequate control of food safety hazards

throughout the supply chain27. The ESMS also ensures that post-consumption, Taburia

packaging waste does not cause adverse impacts to the environment (soil, waterways)

in and around the areas where Taburia is distributed28.

MCA-Indonesia shall thus develop, adopt and communicate a set of guidelines for

quality assurance and control of the micronutrient supplements. The guidelines shall

be based on good drugs/supplements manufacturing and distribution procedures, as

well as reflect the existing capacity and infrastructure for distribution and storage of

food and drugs.29

The guidelines shall address the following issues: a) shelf-life of the products, b)

packaging, c) distribution and storage criteria, considering Indonesia’s climatic

conditions, d) traceability of poor quality products, e) disposal of post-consumer

packaging, f) reporting of adverse reactions related to the product. The guidelines

shall ensure that duplication of dosage is prevented, recognizing that other programs

in the area may distribute the same or similar supplements; and that supplements are

given with caution in areas with known malaria and other diseases. The guidelines shall

also refer to existing technical guidelines also in use in the health sector, such as the

Cara Pembuatan Obat yang Baik (CPOB) and Cara Distribusi Obat yang Baik (CDOB)30,

international specifications or guidelines31 or other tools commonly used in the food

and drug industry in Indonesia.

Such guidelines shall be communicated through tender documents for and contracts

with third-party suppliers and consultants. The guidelines will apply also to any sub-

contractors that support third-party suppliers/contractors in fulfilling their legal

obligation to MCA-Indonesia.

The guidelines shall also be developed with the Ministry of Health32, and all efforts will

be made to ensure that all parties within the health network are committed to

maintaining the quality of the micronutrient supplements along the supply chain, and

to manage packaging waste appropriately. Therefore, guidelines shall reach health

officials at the District and Sub-District levels, and health service providers at the

26 UNICEF Technical Bulletin No. 20 (March 2015) on “Change of Pack Size for Iron Tablets and Iron and Folic Acid Tablets. This document promotes safety measures in packaging, such as use of blisters or child-proof lock on bottle packs, and smaller number of tablets in each package. 27 This invokes IFC-PS 4 on Community Health, Safety and Security. 28 This invokes IFC-PS 3 on Resource Efficiency and Pollution Prevention. 29 At the time of preparation of this ESMS document, the guidelines are still under preparation. Discussions and visits related to preparation of the guidelines have received significant contributions from the ESP units of MCC and MCA-Indonesia, reflecting on the contents of the previous draft of the CHNP ESMS 30 Both issued by the Indonesian food and drug agency, BPOM. 31 Such as the UNICEF Technical Bulletin No. 20, March 2015. 32 The MOH Implementing Entity Agreement states that MCA-Indonesia will “develop project operations manual, based upon the Operational Technical Guidelines”, developed by the Partner Agency.

ESMS for CHNP

29

Puskesmas and Posyandu level, especially those directly interacting with pregnant

women, infants’ mothers and other caregivers.

Each party involved in the above process shall have clear responsibilities and user-

friendly instruments to fulfill the tasks, such as check-lists, chain-of-custody forms,

informational posters, etc. Responsibility of private sector producers and service

providers (transport, packaging, and disposal) shall be included in bidding documents

and contracts. Contracts shall also define the oversight responsibility of third-party

contractors when/if they involve sub-contractors to fulfill their MCA-Indonesia

obligations.

In addition, MCA-Indonesia shall also ensure that Taburia is not consumed by children

who may have malaria, tuberculosis, HIV and parasitic infection -- following the

guidelines of the World Health Organization.33 In areas where the above diseases are

prevalent, Taburia promotion and distribution should be done with caution, focusing

on areas where prevention/ treatment programs exist and are effective. MCA-

Indonesia shall ensure that project guidelines provide clear approach for Taburia

distribution in areas that are known to have malaria, tuberculosis, HIV and parasitic

infections.

5.3.2 Social Inclusion and Stakeholder Engagement

The CHNP shall refer to and utilize reports/results of GSC social assessments to ensure

all social groups are adequately involved in consultations and decision-making, and

equitably benefit from the provision of micronutrients. The project shall also consult

the list of adat communities under the AMAN (Aliansi Masyarakat Adat Nusantara)

network. District consultants contracted to assist in implementing the CHNP shall have

sufficient understanding of the socio-cultural dimension of the areas they work in, and

implement their activities with appropriate socio-cultural sensitivity. Details on how

the Project will achieve this shall be described in the Environmental and Social Action

Plan for the CHNP.

5.3.3 Grievance Mechanism

The micronutrient provision program shall utilize two grievance redress mechanisms.

At the level of implementation (districts, Puskesmas and Posyandu), the GSC

grievance mechanism shall apply, since community members and health service

providers are most familiar with this system. However, for production and distribution

(up until the district level), the MCA-Indonesia grievance mechanism will likely be

utilized. MCA-Indonesia must ensure that complaints or grievances from both systems

are handled appropriately and feed into decisions of the program. The Environmental

and Social Action Plan can provide more detail on how the grievance mechanism will

engage Ministry of Health and/or the GSC grievance mechanism.

33 World Health Organization, e-Library of Evidence for Nutrition Actions, Multiple Micronutrient Powders for Home Fortification of Foods Consumed by Children 6-23 Months; http://www.who.int/elena/titles/guidance_summaries/micronutrientpowder_infants/en/

ESMS for CHNP

30

5.3.4 Environmental and Social Reporting

The CHNP Director is expected to immediately report to the ESP Director any incident

or complaint related to micronutrient provision, to allow the ESP Director to guide and

monitor any mitigation measures that are put into effect.

In addition, CHNP shall include in its annual report on environmental and social

performance the level of compliance of the micronutrient provision sub-activity with

respect to the requirements laid out in this ESMS and the quality assurance/control

guidelines. The report shall include, but not be limited to, the following:

Incidents of complaints/grievances related to micronutrient provision, and how

they were resolved;

Incidents of batches of Taburia or IFA reported/found to be of poor quality

(sub-standard), including information on batch, location where it was

distributed, source of report, and how situation was handled by the CHNP

infrastructure and/or local health authorities;

Incidents of toxicity or adverse reactions related to Taburia or IFA

administration;

Issues/problems encountered in relation to disposal or destruction of unusable

batches (due to poor quality or expiration) and post-consumer packaging of

Taburia;

Good practices and lessons learned on project outcomes/ outputs or activities

that promote social inclusion and gender equality

Lessons learned from the above.

5.4 Sanitation and Hygiene Sanitation and hygiene activities will be conducted in 11 provinces, covering 64

districts, 1600 villages and 704 Puskesmas. The activities consist of three components,

namely enabling environment, demand creation, and sanitation and hygiene supply.

The first component, enabling environment, is largely an awareness and capacity

building activity, and thus not expected to cause significant adverse environmental or

social impact. The demand creation will involve a series of cascading training events

that precede a village triggering process, and subsequent post-triggering follow-up.

The third component, sanitation and hygiene supply, involves improving the

availability of sanitation products and development of sanitation entrepreneurs. The

latter two components will be discussed further in this ESMS document.

5.4.1 Environmental and Social Management

This sub-activity is not expected to require any formal environmental assessment or

environmental permit. However, if a triggered community decides to construct

communal sanitation facilities, there is a need to conduct screening to determine any

potential adverse impacts. Possible impacts may relate to location of the communal

facility (risk of erosion, flooding, etc.), need to secure land owned by private

individuals, availability of water to support the facility, as well as potential river and

groundwater contamination if septic tanks are not in full operation.

ESMS for CHNP

31

Furthermore, the selection of sanitation technology can minimize environmental and

social impacts, and shall be considered in this sub-activity. Considerations are as

follows:

Plans to use appropriate technology should consider site-specific conditions,

such as:

o Availability of water to support flushing of toilets and clean water for

hand-washing. In some areas in West and East Nusa Tenggara, water may

be very scarce in many months of the year or even throughout the year.

o Design of toilets/latrines in areas where the water table is high. In parts

of West and Central Kalimantan, toilets will have to be designed

appropriately as to not cause more (rather than less) water-borne

diseases related to fecal matter.

o Design of toilets/latrines in areas that are covered by water, such as in

communities living on rivers, tidal flats and/or ocean. In such areas,

latrines must be designed so as to not increase water pollution, yet

ensure safe and comfortable use by individuals.

o Design of toilets/latrines should consider the needs and concerns of

women and people with disabilities.

Should project activities lead to construction of community sanitation facilities,

the project should ensure that land used for the facility does not cause physical

or economic displacement of any person or families. Land donated or purchased

should be documented properly (following the GSC guidelines), and

agreements reached so as not to adversely affect individuals of families in the

area.34

Should activities be conducted in areas where indigenous people are present,

appropriate sanitation technology and/or other culturally-sensitive approaches

shall be selected?

Should project activities lead to the provision of awareness and capacity

building activities, the project should ensure all social groups are adequately

involved in consultations and decision-making, and equitably benefit from the

provision of project activities.

5.4.2 Stakeholder Engagement and Social Inclusion

The demand creation activities shall refer to reports/results of GSC social assessments

to ensure all social groups are adequately involved in consultations and triggering, and

equitably benefit from the sanitation and hygiene activities. The activity shall also

consult the list of adat communities under the AMAN (Aliansi Masyarakat Adat

Nusantara) network. Presence of indigenous communities or adat groups is

particularly likely in Central Kalimantan, West Kalimantan, Central Sulawesi, West Nusa

Tenggara and East Nusa Tenggara.

Facilitators in the field shall have sufficient understanding of the socio-cultural

dimension of the areas they work in, and implement their activities with appropriate

socio-cultural sensitivity. MCA-Indonesia shall ensure that district consultants are well

34 This will prevent application of IFC-PS5 on Land Acquisition and Involuntary Resettlement. Please refer also to Section 8.4 for more discussion on land acquisition and donation.

ESMS for CHNP

32

informed and advised. Details on the project’s approach can be described in the

Environmental and Social Action Plan.

5.4.3 Grievance Mechanism

The sanitation and hygiene sub-activity shall utilize two grievance redress

mechanisms. At the level of implementation (districts, Puskesmas and Posyandu), the

GSC grievance mechanism shall apply, since community members and health service

providers are most familiar with this system. In addition, the MCA-Indonesia grievance

mechanism shall also be available to accommodate grievances and complaints. MCA-

Indonesia shall ensure that complaints or grievances from both systems are handled

appropriately and feed into decisions of the program. The Environmental and Social

Action Plan can provide more detail on how the grievance mechanism will engage

Ministry of Health and/or the GSC grievance mechanism.

5.4.4 Environmental and Social Reporting

CHNP shall include in its annual report on environmental and social performance the

level of compliance of the sanitation and hygiene sub-activity with respect to the

requirements laid out in this ESMS. The CHNP’s approach to monitoring and reporting

shall be elaborated in the ESAP.

The report shall include, but not be limited to, the following:

Sanitation technology selection in areas of scarce water and high water table;

Sanitation technology and triggering approach used for indigenous

communities or adat groups, and in what areas they were applied;

Communal sanitation facilities built (if any), and the environmental/social

assessments conducted and permits obtained, incidents of land

acquisition/donation and handling of approval documentation, sanitation

technology used (including sludge handling);

Any grievances or complaints received in relation to the sanitation and hygiene

sub-activity, including how these complaints were handled by MCA-Indonesia;

Good practices and Lessons learned on project outcomes/ outputs or activities

that promote social inclusion and gender equality.

Lessons learned from the above.

ESMS for CHNP

33

6. Activity 3: Communications, Management and

Evaluation

This ESMS will only discuss the Communications component of Activity 3. The overall

objectives of the national nutrition communication campaign are:

1. Increase awareness and understanding of the causes, symptoms, long–term

implications, and prevention of stunting among parents, community members,

health personnel, government officials, and the general public;

2. Gain commitment from a broad array of stakeholders in the public and private

sectors to tackle the problem of stunting;

3. Foster individual and community behavior change related to health and nutrition

among parents, other caregivers, and MOH personnel who deliver community

health/nutrition services. 35

The main target audience is women of reproductive age, mothers, fathers and other

family members who are involved in child care. On the ground communication

activities will be conducted in three provinces, namely West and Central Kalimantan

and South Sumatra. The use of television will have national reach.

The national communication strategy states that interventions will include an

integrated mix of: a) interpersonal communications through group meetings and one-

on-one interactions; b) use of mass media, mainly television, for national scope; c)

web-based platforms (i.e., Facebook, Twitter, and an NNCC website) and short-

message service (SMS).

6.1 Environmental and Social Management The sub-activity does not require any formal environmental assessments. Adverse

impact on the environment is expected to be minimal, especially as a result of the

heavy reliance on electronic media. Social impacts are expected to be positive and

have long-term benefits for the health and social welfare of the target communities.

To ensure social inclusion, the project activity should confirm all social groups are

adequately involved in consultations and decision-making, and equitably benefit from

the communications approach.

6.2 Stakeholder Engagement and Social Inclusion The national communications campaign shall refer to reports/results of GSC social

assessments to ensure the campaign reaches and benefits all social groups in the

target locations. The campaign shall also consult the list of adat communities under

the AMAN (Aliansi Masyarakat Adat Nusantara) network. Where indigenous

communities or adat groups are present (likely in Central Kalimantan, West

Kalimantan, Central Sulawesi, West Nusa Tenggara and East Nusa Tenggara), the

campaign shall develop culturally appropriate communication messages and delivery

mechanisms.

35 MCA- Indonesia, “National Nutrition Communication Campaign Strategy Design, Draft 1, March 2015

ESMS for CHNP

34

Consultants, facilitators or other parties involved in the communications campaign at

the field level shall ensure that content of messages and conveyance thereof are

appropriate for the socio-cultural setting in the target areas. MCA-Indonesia is

responsible for ensuring these individuals are well informed and advised. Details on

how to achieve this shall be described in the Environmental and Social Action Plan.

6.3 Grievance Mechanism The communications campaign sub-activity shall utilize two grievance redress

mechanisms. At the level of implementation (districts, Puskesmas and Posyandu), the

GSC mechanism shall apply, since community members and health service providers

are most familiar with this system. In addition, the MCA-Indonesia grievance

mechanism shall also be available to accommodate grievances and complaints. MCA-

Indonesia shall ensure that complaints or grievances from both systems are handled

appropriately and feed into decisions of the program. The Environmental and Social

Action Plan can provide more detail on how the grievance mechanism will engage

Ministry of Health and/or the GSC grievance mechanism.

6.4 Environmental and Social Reporting CHNP shall include in its annual report on environmental and social performance the

level of compliance of communications campaign sub-activity with respect to the

requirements laid out in this ESMS. The CHNP’s approach to monitoring and reporting

shall be elaborated in the ESAP.

The report shall include, but not be limited to, the following:

Specialized communications approach to indigenous communities or adat

groups in specific areas, including a description of their response/reaction to

the communications effort;

Good practices and lessons learned on project outcomes/ outputs or activities

that promote social inclusion and gender equality.

Any grievances or complaints received in relation to the communications

campaign, including how these complaints were handled by MCA-Indonesia.

ESMS for CHNP

35

7. CHNP-Wide Environmental and Social Action Plan

CNHP of MCA-Indonesia is responsible for preparing a CHNP-wide Environmental and

Social Action Plan (CHNP ESAP). The ESAP will present the specific mitigation or

management actions that will be taken to comply with the requirements of this CHNP

ESMS. Since earlier drafts of the ESMS have influenced the design of the CHNP

activities, the ESAP shall focus on the implementation phase. This section provides

some guidance on preparation of the ESAP.

At a minimum, the ESAP shall contain the following:

Description of impact mitigation/management actions, including specific

interventions, locations (if not all areas), and timeframe. If CHNP has

developed/issued technical or operational guidelines to address the potential

impacts, these guidelines shall be referred to in the text and attached to the

ESAP;

Parties responsible for each mitigation actions, identifying the particular office

or unit within the CHNP implementation structure;

Description of monitoring efforts to ensure that impact mitigation/management

is effective and to ensure that no unanticipated impacts arise. This should also

describe which parties are responsible for monitoring, and what documentation

and reporting is required, as well as frequency of monitoring and reporting. If

monitoring and reporting utilizes the GSC and/or STBM systems, this should be

stated in the ESAP. Monitoring and reporting outside of the GSC and/or STBM

systems shall also be described.

Specific roles and responsibilities of MCA-Indonesia, consultants, contractors,

and the National Secretariat Team at the Ministry of Health, as well as others

involved to ensure compliance with this ESMS.

Budget line items to be included in annual work plans and budget of the CHNP.

Specific timelines for tasks identified above.

CNHP shall develop the Environmental and Social Action Plan, in consultation with the

ESP team. The format of the ESAP shall be agreed upon between the two teams.

Should it be deemed necessary (to be agreed upon by the ESP Director and CHNP

Director), the ESAP may be supplemented by an annual Environmental Social

Management Plan (ESMP), which will serve as the basis for supervision by the ESP

Director. The ESMPs shall describe in detail the expected management and monitoring

activities, timeframe (schedule), roles and responsibilities, and reporting content and

channels.

To guide the preparation of the ESAP for CHNP, the following table provides a

summary of the risks and impacts that need to be addressed in the ESAP. The relative

magnitude of the risk/impact is indicated in the table, and can be used to identify

appropriate actions and measures.

ESMS for CHNP

36

Table 3. Summary of Anticipated Risks and Impacts of the CHNP

Project

Activities

Potential Risks And

Adverse Impacts

Level Of

Risk/Impact*

Critical Items For ESAP

Preparation

Community Project Activity as Demand Side

Participatory

planning

Social jealousy from

community members not

fully engaged in participatory

planning

Low Ensure equal opportunity for

participation across all

groups, especially the poor,

female headed households

and marginalized groups.

Community

block grants

Localized environmental

impacts from projects

selected by communities

Low to Moderate Community projects with

moderate environmental

impacts may require permits

and/or environmental

management plans.

Allocate financial resources

to address socio-cultural

constraints, including gender

gaps identified during

project assessment.

Supply Side Activity

Training for

health service

providers and

facilitators

Health, safety and security

associated with training

program, especially related

to travel to/from training

locations and venue/facilities

where training is held.

Limited participation of

women and other

marginalized groups to

training activity.

High Guidelines for logistical

arrangement of training

program shall include health

safety and security of

training participants at the

training location,

accommodations and travel

to and from the location.

Ensure safe daycare facilities

for trainees with infants

Delivery of some materials

offend particular gender or

cultural sensitivities.

Low to moderate Ensure delivery of materials

are gender- and culturally-

sensitive.

Provision of

micronutrients

Adverse effects of Taburia

consumed by children with

malaria, HIV, tuberculosis and

parasitic diseases.

Moderate Guidelines must ensure

Taburia distribution in areas

with prevalent malaria, HIV,

tuberculosis and parasitic

diseases is done following

WHO recommendations.

Damaged micronutrient

supplements during

distribution and storage; thus

affecting mothers and

infants.

High Guidelines for quality control

and assurance of

micronutrient supplements

must be strictly followed.

ESMS for CHNP

37

Accidental ingestion of iron

tablets by children

Low to moderate Selection of packaging to

prevent easy access to

children, following UNICEF

technical bulletin (2015)

Double dosage of

supplements given to

beneficiaries.

Low to moderate Ensure local health agencies

are aware of other programs

distributing supplements to

the communities.

Pollution from improper

disposal of post-consumer

packaging

Moderate Guidelines for disposal of

post-consumer packaging

must be strictly followed.

Sanitation and

hygiene

behavior

Sanitation technology used

not suitable for ecological

and social context

Low to moderate Ensure sanitation technology

is suitable for different

ecological features (water

tables and water availability)

and cultural characteristics

Economic or physical

displacement if communal

sanitation facilities (if

applicable) require land

acquisition/ donations

Low GSC guidelines for land

acquisition/donation must

be strictly followed.

Change in water access or

water use patterns with

improved sanitation

Low to moderate

(depending on

location/

community)

Level of risk depends on

existing patterns of water

use and availability and

accessibility of water to the

communities.

Triggering activities that rely on public shame lead to marginalization of some community members.

Low to moderate Guidelines should aim at

social integration and

prevent marginalization of

certain community

members.

Entrepreneur

training and

mentoring

Limited participation of

women and other

marginalized groups to

training activity.

low Ensure equal opportunity for

women, men and

marginalized groups to

participate in training.

Private sector

response

Risks and impacts unknown;

depend on the types of

activities proposed and

selected for grant award

Low to moderate Screening must be done for

proposed or selected

activities.

Communications, Management, Monitoring and Evaluation

National

Nutrition

Communications

Campaign

Vulnerable/ marginalized

groups and indigenous

peoples excluded from

campaign activities, in

locations where they are

present.

Low Social mapping and social

inclusion approaches of GSC

to be utilized.

*Risk level indicated assumes that the basic community-based approaches of GSC and STBM are

already implemented.

ESMS for CHNP

38

The following sub-sections provides further guidance on other elements to be

addressed in the ESAP.

7.1 Social and Gender Integration Plan In defining project beneficiaries and affected communities, CHNP shall consult and

apply the Social and Gender Integration Plan (SGIP) and any gender assessment

conducted for CHNP. This includes consideration of differentiated needs, concerns and

societal and gender norms related to maternal health and child nutrition. Among

others, enhancing the role and responsibility of men in improving maternal and child

health and nutrition shall be considered. 36 The project should collect gender

disaggregated data to track gender equality result and assess gender impacts.

Additionally, the project should also incorporate mechanism of gender balance to

ensure gender balanced representation and participation in project activities and

decision making. In monitoring and evaluation, the project should develop gender

specific targets or performance indicators that track gender equal result and impact

and make sure women, men and vulnerable/marginalized groups are able to

participate in monitoring and evaluation process.

7.2 Grievance Mechanism MCA-Indonesia has developed a formal mechanism for efficiently and effectively

recording and resolving complaints or disputes related to the community-based health

and nutrition project design, implementation and impacts. Such a grievance

mechanism fulfills the ESMS requirement on Developing and Instituting Grievance

Mechanisms (E5). The mechanism can be found online in the MCA Indonesia webpage.

See http://mca-indonesia.go.id/en/mekanisme-pengaduan/.

The MCA-Indonesia grievance mechanism will allow recording of complaints or

grievances related to CHNP, including those submitted to the GSC grievance

mechanism, and even if such grievances are already handled and resolved by the GSC

system. Should follow-up be required by MCA-Indonesia, the grievance mechanism

shall record actions taken and responses provided to the involved parties.

The MCA-Indonesia grievance mechanism shall be widely communicated to the

communities in the districts targeted for CHNP, and shall allow use of the most

prevalent/ accessible communication methods or technologies in these areas. For

example, the grievance mechanism is expected to receive text messages from mobile

phones, or for areas where mobile phone use is low, and post office service is not

available, MCA-Indonesia is expected to ensure the creation of village-level hubs for

information relay to MCA-Indonesia or relevant CHNP staff/consultants at the district

level. Care shall be taken to ensure that the methods or technologies used are sensitive

to the needs and customs of women and marginalized groups, including indigenous or

adat communities.

MCA-Indonesia is expected to assign a person(s) to manage the grievance process,

including:

36 MCA- Indonesia, “Gender Equality as a Key Dimension for Improved Maternal and Child Nutrition to Reduce Stunting”, July 2011.

ESMS for CHNP

39

Relaying grievances to the appropriate organization or unit in MCA-Indonesia;

Where the content of the grievance is unclear, seek more information;

Assigning a timeframe for responding to the grievance, and reminding the

responsible unit when the deadline is near;

Following-up on grievance response, especially for issues that cannot be

resolved immediately (e.g. requiring changes in project activity or coordination

with other stakeholders);

Responding to the source of the grievance. This response is best done in writing

or, at least, recorded in writing. Where necessary and/or appropriate, the

response shall be officially raised with or witnessed by the community or village

leader;

Managing documentation of grievances and grievance responses, as required

by the MCA Indonesia document management system.

Prior to Compact closure, grievance management will be handed over to

appropriate institutions, based on an assessment of capacity and sustainability.

Such hand-over shall be planned from Year 4 of Compact implementation.

7.3 Occupational Health and Safety The CHNP activities may pose health and safety risks to those involved in

implementation. The risks may derive from travel activities, remoteness of activity

locations, and occupational hazards related to construction of village facilities.

To ensure safe and healthy working conditions, all CHNP activities will be required to

follow health and safety guidelines acceptable to MCA-Indonesia, or referring to the

MCA-Indonesia Health and Safety Guidelines. For activities that fall under the GSC

framework, the health and safety guidelines and procedures of GSC shall be applied.

For activities implemented through the Ministry of Health, the MCA-Indonesia Health

and Safety Guidelines shall apply; or relevant Government of Indonesia programs that

provide health and safety coverage. At the very least, training participants should

obtain proper briefing on transportation safety, advised on how to prevent accidents

and respond to emergency situations.

7.4 Land Acquisition and Resettlement CHNP is unlikely to require involuntary resettlement and land acquisition, since none

of its activities require construction of facilities at a significant scale. The only possible

sub-activity where some economic or physical displacement may be encountered is

the sanitation and hygiene (under Supply Side Activity), if a community

decides/wishes to construct communal sanitation facilities. In such cases, there may

be a need to utilize private land for siting of the communal facility.

If land is donated by a family (private owner), the MCA-Indonesia shall ensure that

proper documentation is prepared and signed, following the PTO of GSC for land

donation. A sample of the land donation letter is provided in Appendix D. MCA-

Indonesia shall also ensure that no other community members are adversely impacted

by the use of the land. This is considered sufficient to cover the IFC-PS 5, especially

since decisions on land transfer/use are made collectively, involving the land owner as

ESMS for CHNP

40

member of the community. No further land acquisition and resettlement plans need to

be prepared.

7.5 Indigenous People The CHNP may support activities across several provinces and districts where

indigenous or adat communities may be present. This includes Central and West

Kalimantan, West Sulawesi, West Nusa Tenggara and East Nusa Tenggara. As the

presence of indigenous people triggers the application of IFC-PS 7; some general

principles and procedures are presented in Appendix C (Indigenous Peoples Plan

Framework).

In principle, MCA-Indonesia shall ensure that indigenous communities are identified,

consulted with, have equal opportunity to benefit from, and are not adversely

impacted by the project. Since all of CHNP locations are also GSC locations, Activities

2 and 3 of CHNP shall build upon the knowledge, information and practices of GSC in

relation to indigenous peoples. Upon commencing activities, GSC’s village facilitators

conduct social mapping/ assessments and identification of indigenous peoples,

marginalized and vulnerable groups. Similar information is usually possessed by health

officer/service providers in Puskesmas. MCA-Indonesia shall ensure that Puskesmas

staff and GSC village facilitators agree on the composition of the local communities

they service, and work from a common list and/or understanding.

CHNP is not expected to prepare a separate indigenous people plan for each locality.

However, it is expected to report activities and locations where indigenous people

have participated in consultations, received micronutrient supplements, took part

triggering and sanitation/hygiene activities. These reports would be incorporated in

the routine project implementation reports submitted by the Puskesmas to CHNP

district consultants and back to MCA-Indonesia.

ESMS for CHNP

41

8. Institutionalization of the CHNP ESMS

8.1 Implementation and Management of CHNP MCA-Indonesia, led by the Executive Director, has two main divisions, i.e. the

Operations Support Division and the Programs Division. Each division is led by a

Deputy Executive Director. The CHNP Director reports to the Deputy Executive

Director for Programs.

CHNP receives operational support from the Operations Support Division (including

Legal, Finance, Procurement, Human Resources, Communications), as well as technical

support and oversight from cross-cutting units under the Program Divisions (i.e.

Environmental and Social Performance, Social and Gender Assessment, and

Monitoring and Evaluation units).

The implementation of CHNP is organized through different institutions, namely the

PNPM Support Facility, the Ministry of Health network, and MCA-Indonesia and its

contractors. The diagram below shows the implementation structure developed for

the CHNP37:

37 Described in the Millennium Challenge Account Indonesia Stakeholder Engagement Plan. This diagram has been updated in accordance with changes in management of Generasi Sehat dan Cerdas Program.

ESMS for CHNP

42

Figure 4. Institutional Set-up of CHNP

As described in the Implementing Entity Agreement (IEA) between MCA-Indonesia

and the Ministry of Health, the Ministry of Health serves as the Partner Agency to

implement CHNP. The Ministry of Health is responsible for establishing and managing

the Project Implementation Unit that consists of a Steering Committee, a Technical

Team and a National Secretariat Team. The latter plays a vital role in the day-to-day

operations of CHNP. The National Secretariat Team will comprise of a team of

consultants assigned to the province and district levels. Implementation of the Supply

Side Activity will involve the district level health agency (Dinas Kesehatan) and the

Puskesmas, Posyandu, as well as health service providers and cadres. Implementation

of the communications campaign will involve a third-party contractor

(communications firm), which will recruit district level coordinators. The coordinators

will support communication cadres identified by the third-party contractor and MCA-

Indonesia.

GSC – National Task Force

Secretariat

GSC OVERSIGHT TEAM (Pokja Pengendali)

GSC – National Coordinator Team

District Coordination Team

Project Manager

(PJOK)

Provincial Coordination Team

Ministry of Villages, Disadvantaged

Region, and Transmigration

ESMS for CHNP

43

At the field level, Puskesmas will serve as the anchor for all three activities of CHNP. It

will be involved in the community-projects, training activities, micronutrient provision,

and (to a lesser extent) the sanitation/hygiene activities. The knowledge and expertise

of the Puskesmas staff, health cadres, sanitarians, and midwives are expected to

ensure the three CHNP activities are synergized and bring benefits to the community.

8.2 Roles and Responsibilities for the CHNP ESMS MCA-Indonesia is responsible for upholding the environmental and social management

requirements as stated in this ESMS. Due to the complexity of the institutional

structure of CHNP, the Health and Nutrition Director will ensure clear assignment of

responsibilities related to execution of this ESMS.

CHNP shall assume the overall responsibility of executing the ESMS at all levels of

project implementation. This includes assigning roles and responsibilities for the

National Secretariat Team and the communications campaign contractor, recruiting

consultants to conduct specific studies or implement specific tasks, and ensuring

constructive information sharing between GSC (Activity 1) and parties involved in

Activities 2 and 3. CHNP is also responsible for communicating the ESMS to all parties

involved in implementing the project. Assistance from the ESP unit can be sought.

Contractor’s roles and responsibilities in relation to this ESMS shall be described in

contracts and other legally binding documents, and will be monitored as part of the

contract performance monitoring. This is particularly crucial for contracts with the

suppliers of the micronutrient supplements and their sub-contractors; as well as for

the third-party contractor assigned to implement the communications campaign.

The ESP Director will maintain oversight responsibility for implementation of the CHNP

ESMS. Where needed, the ESP unit shall provide technical support to CNHP.

8.3 CHNP Internal Capacity Assurance MCA-Indonesia shall ensure there is capacity within the MCA-Indonesia organization

and all third-party organizations38, as well as sufficient resources to implement this

ESMS (described in the ESAP). This includes sufficient resources allocated in MCA-

Indonesia budgets and in contracts with contractors/consulting firms, in other

agreements with other third-party organizations.

Where MCA-Indonesia delegates some of its authority to contractors or other entities,

the agreements or contracts that govern their relationship shall incorporate the

entity’s or contractor’s obligations, roles and responsibilities with regard to

implementation of this ESMS. Where possible, the contracts or agreements shall

contain sanctions for failure in or inadequate performance of said duties.

For the micronutrient provision sub-activity, MCA-Indonesia shall conduct a capacity

assessment as part of the due diligence process prior to finalization of the project

design and bidding documents for micronutrient suppliers. Should severe deficiency

be identified, MCA-Indonesia shall obtain assurances that the organization will enhance

their capacity to ensure conformance with their obligations. Should sub-contractors

38 This includes contractors, consulting firms, Government health agencies and services.

ESMS for CHNP

44

be involved, the main supplier is responsible for ensuring the sub-contractor adheres

to the same quality assurance and control standards utilized by the main supplier, and

agreed to with MCA-Indonesia.

MCA-Indonesia, through the ESP Director and CNHP, shall also ensure that district

government agencies, Puskesmas and Posyandu are prepared to execute their roles

and responsibilities related to this ESMS and detailed in the ESAP. This includes

monitoring and reporting, as well as grievance management. The CHNP team is

responsible for communicating the roles and responsibilities, and integrating them into

the routine workflow of the project.

8.4 Budget Requirements for Effective CHNP ESMS

Implementation MCA-Indonesia shall ensure that sufficient budget is allocated annually and throughout

the entire Compact period to implement and institutionalize the CHNP ESMS, as well

as to conduct evaluation and revision of the requirements, as necessary.

Budgets required for environmental and social performance activities shall be

reflected and secured in the Quarterly Disbursement Request (QDR), disbursement

and procurement plans, and made ready for use in each respective quarter of the

CHNP implementation.

8.5 Capacity Development and ESMS Roll-Out The MCA-Indonesia ESP Director is responsible for ensuring that all relevant parties

are aware of the ESMS and the CHNP ESMS. The ESP Director will work with the Health

and Nutrition Director to develop an ESMS roll-out/communication plan, which is

integrated or dovetailed with the rolling out of the Social and Gender Integration Plan.

This plan shall include:

Development and delivery of workshops/ training sessions for MCA-Indonesia

officers and staff;

Development and delivery of workshops/ training sessions for contractors,

consultants or other entities assigned to implement portions of CHNP;

Development and delivery of workshops/ training sessions for Ministry of

Health, and district health agencies, and Puskesmas;

Assignment of responsibilities in the CHNP Management and ESP Management

of MCA-Indonesia to implement the plan;

Schedule for preparation of tools and commencement of workshops/training

sessions.

Any capacity development activity related to implementation of this ESMS shall also

consider the appropriateness of materials and/or delivery to women and marginalized

target groups.

ESMS for CHNP

45

8.6 Compliance and Environmental Audit MCA-Indonesia and the CHNP may be subject to a technical audit that may include

environmental (and social) audits, as described in the Audit Guidelines. Compliance

shall be verified by means of regular project monitoring or audit. ESMS compliance

shall be a contractual obligation for the suppliers of the micronutrient supplements.

Should MCA-Indonesia (or its contractors) discover ESMS-related violations or non-

compliance, MCA-Indonesia shall issue a warning letter to the parties involved, and

develop plan of action to ensure compliance. As is the case with breaches of other

contracts, sanctions or reprimands for ESMS non-compliance shall be enforced in line

with MCA-Indonesia policies.

8.7 Reporting of Environmental and Social Performance The MCA-Indonesia ESP Director is responsible for reporting environmental and social

performance to the MCA-Indonesia Executive Director on an annual basis. Such a

report shall be prepared jointly with the Social and Gender Director. The environmental

and social performance reports shall be compiled from reports prepared by the three

Compact Projects. The CHNP, reports shall consist of information gathered from

Project’s monitoring and evaluation framework.

On a quarterly basis, the MCA-Indonesia ESP Director (with the Social and Gender

Director) and the CHNP Director shall meet to evaluate the Project’s environmental

and social performance, and identify issues regarding non-compliance, capacity

development needs and progress, and other factors that hinder positive performance.

The ESP Director shall develop environmental and social indicators to be included in

the CHNP’s monitoring and evaluation framework. Such indicators shall be inserted

into the monitoring and reporting obligations of MOH, as the Partner Agency, and as

described in the Implementing Entity Agreement. Where appropriate, the ESP Director

shall also extract information from the GSC’s reporting (and M&E) cycle, minimizing

duplication of data collection, analysis and reporting.

For the micronutrient production, MCA-Indonesia shall ensure that private producer(s)

receiving financial support from MCA-Indonesia complies with reporting requirements

under their environmental permit. As much as possible, the private producer’s

environmental and social monitoring program shall be synchronized with MCA-

Indonesia’s monitoring framework to minimize duplication of data collection, analysis

and reporting. Ministry of Health (as Implementing Entity) is responsible for ensuring

that the private producer is in compliance with GOI regulations.

8.8 Review and Revision of ESMS for CHNP Evaluation of CHNP’s environmental and social performance may lead to findings

regarding weakness of or inappropriate requirements and/or procedures in the ESMS

for CHNP. This may include problems with cumbersome procedures, inappropriate or

ineffective division of roles and responsibilities, and/or requirements that are too

stringent for the scope or level of activities.

ESMS for CHNP

46

Should there be such findings, the ESP Director shall decide whether this ESMS for

CHNP should be modified or revised. In making this decision, the ESP Director shall

consult the Social and Gender Director and the CHNP Director, and will seek advice/

support from MCC.

Revision of the requirements or procedures of this ESMS for CHNP must still comply

with the overall ESMS Framework for MCA-Indonesia and, particularly, must not violate

the Policy Statement in the Tier 1 ESMS Framework or the laws and regulations of the

Government of Indonesia.

ESMS for CHNP

47

Appendix A

A. Multiple Micronutrient Product (MMNP) Traceability

Guidance Community-based Health and Nutrition Project

1. Background

The CHNP will provide micronutrients to children and pregnant women. The

micronutrients will be distributed to the community through the District-level

Pharmaceutical Warehouse, the Puskesmas and Posyandu at project locations. To

anticipate the negative impact of providing micronutrient, it is necessary to build a

traceability system.

Product traceability systems allow for complete and up to date histories of all batches

of micronutrient product from the premix/bulk material to the complete final product.

Identification and status of material is provided by a unique and controlled numbering

system. The system can be interrogated to provide a report/record for an individual

dose to trace its course to its point of origin.

2. Objectives

The objectives of this guidance are:

a. To ensure all multiple micronutrient products will be appropriate identified

during the product’s processing, packaging, storage, distribution and

consumption at the community/users level.

b. To ensure the products can be traceable in cases of adverse events following

their consumption at the community/users level.

3. Authorities and Responsibilities

Indonesia Ministry of Health (MoH) as implementer of the MMNP project will be

responsible for day-to-day implementation of the distribution of MMNP. MCA

Indonesia will hire a consultant for the overall preparing and run the traceability system

for MMNP project. The specific task for the consultant will be provided in the TOR.

4. Control Measures

Premix/bulk production. The multiple micronutrient premix/bulk product should have

a unique batch number given by the producer’s laboratory. The producer’s quality

assurance team (QA team) will maintain the nutrient ingredients in MMN product. Each

ESMS for CHNP

48

ingredient in the premix/bulk product should meet the specification mentioned in the

Indonesia Pharmacopeia and/or US Pharmacopeia or European Union Pharmacopeia,

or if these standards are not available, other recognized international standard. In

preparing the premix/bulk normally an extra proportion of the micronutrient is added

as an ‘overage’ in order to compensate for anticipated losses or degradation during

storage.

Finished Product. The finished product for MMNP should be done under proper Good

Manufacturing Practices (GMP) conditions, such as adequate level of industrial

hygiene, adequate processing conditions in well-maintained and state-of-the-art

equipment, full traceability back to the raw material, Hazard Analysis and Critical

Control Point (HACCP) procedures implemented according to Codex Alimentarius and

ISO 22000.

Certificate of Analysis Testing. The producers of multiple micronutrient premix/bulk

product should obtain a Certificate of Analysis from a certified laboratory, showing the

content of the product. Upon receiving all administrative submission BPOM will

physically inspect the factory using the GMP criteria checklist. License will be obtained

within 3 months process after fulfilling all the BPOM criteria. Beside the license from

BPOM, the producers should also provide the Halal Certificate from the country of

origin or by Majelis Ulama Indonesia (MUI).

MMNP Packaging. The Ministry of Health, through Regulation No.

2409/MENKES/PER/2011 on Nutrient Sprinkle Standard (Standar Bubuk Tabur Gizi),

has specified the materials for the packaging of MMNP (Taburia) which has already

proved to be robust packaging. But, from the producers’ point of view, the packing of

every 15 sachets into zip-lock plastic bag is not efficient because it is done manually.

Producers suggest to pack the 15 sachet in common sealed plastic bag and the

producer still will provide separate empty zip-lock for every 15 sachets. Mothers will

use the zip lock to keep the sachets after open the plastic bag. The Ministry of Health

also has specified the standard labeling and expiry date for Taburia that should be

followed by anybody who wish to produce standard Taburia.

Batch Number. Batch numbers should appear on each sachet of MMNP/Taburia. Each

batch number is an eight digit number in the format YYXXZZZZ, starting with the last

two digits of the year, followed by two digits of the month. A consecutive four digits

number is assigned up to 9000 sachet of batches starting from 0001.

Quality spot check. Inspection and spot checks should be done at various levels

(District Warehouse, Puskesmas, Posyandu and Community/users) to verify the

quality of the products.

Storage. The storage data must follow the First In-First Out (FIFO) and First Expires

– First Out (FEFO) principles.

Documentation and Recording. Full traceability is assured through issuing

appropriate documentation and maintaining records that accompany every step in

batch manufacturing...

ESMS for CHNP 49

MMNP supply chain traceability model:

TRACKING

Process Premix

Producer

Packager/

Distributor

District

Warehouse Puskesmas Posyandu

Community/Us

ers

Product

Identificatio

n Method

Premix/Bu

lk batch

number

Proper batch

number on each

sachets and

product ID on each

box (small and big

box)

Proper batch

number on each

sachets and

product ID on

each box (small

and big box)

Proper batch number

on each sachets and

product ID on each

box (small and big

box)

Proper batch

number on

each sachets

Proper batch

number on

each sachets

Traceability

Records

Producer

quality

control

procedure

s and

quality

control

records

Batch number

records

BPOM – Certificate

Analysis Testing

Distribution plan

Distribution form

Distribution

plan

Receipt and

Distribution

form

Distribution plan

Receipt and

Distribution form

Receipt and

Distribution

form

Receipt and

Distribution

form

Users/benefici

aries list

Premix

Producers

Packager/

Distributor

District

Warehouse Puskesmas Posyandu

Community/Us

ers

TRACING

ESMS for CHNP 48

ESMS for CHNP 50

Appendix B

B. Indigenous Peoples Plan Framework (IPPF)

1. Introduction

Since CHNP components may support activities/specific-projects across several

provinces in the country, they are likely to affect Indigenous People (IP) or ethnic

minority in a number of Specific-project areas in participating provinces such as Jawa

Barat, Jawa Timur, Nusa Tenggara Barat, Nusa Tenggara Timur, Gorontalo, Maluku,

Sulawesi Utara, Sulawesi Barat, Kalimantan Barat, Kalimantan Tengah, and Kalimantan

Selatan.

This IPPF is prepared in order to provide some general principles and procedures that

will be applied during Specific-project preparation and implementation, if IP are to be

affected. In the CHNP activities, therefore, the purpose of the framework is for ensuring

consultation, giving IP a voice, and an opportunity to benefit from the program.

Objective

The primary objectives of the IPPF are to ensure that:

such groups are afforded meaningful opportunities to participate in planning

that affects them;

opportunities to provide such groups with culturally appropriate benefits are

considered;

any project impacts that adversely affect them are avoided, to the extent

possible. If unavoidable, mitigation measures should be developed.

This is in line with the national objective in empowering indigenous community

(Komunitas Adat Terpencil - KAT), in which to grant of authority and belief to KAT to

self-determine their own destiny and various development activity programs available

within their location and their necessity through protection, reinforcement,

development, consultancy and advocating to improve their social prosperity level.

2. Definition

The national legislation, Presidential Decree No. 111/1999 sets the criteria as follows: a)

in form of small, closed and homogenous community; b) social infrastructure

supported by familial relationships; c) in general geographically remote and relatively

difficult to reach; d) in general live in subsistence economy; e) its Government of

Indonesia equipment and technology is simple; f) dependency to local environment

and natural resources are relatively high; g) limited access to social, economic, and

political service.

ESMS for CHNP

51

The terms “indigenous people”, “indigenous ethnic minorities” and “tribal groups”,

describe social groups with a social and cultural identity distinct from the dominant

society that makes them vulnerable to being disadvantaged in the development

process. For the purposes here, “indigenous people” is the term that will be used to

refer to these groups.

Indigenous peoples are commonly among the poorest segments of a population.

According to the IFC Performance Standard and World Bank policy, the term

“Indigenous Peoples” is used in generic sense to refer to a distinct, vulnerable, social

and cultural group processing the following characteristics in varying degrees: a) a

close attachment to ancestral territories and to the natural resources in these areas; b)

self-identification and identification by others as members of a distinct cultural group;

c) an indigenous language, often different from the national language; and d) presence

of customary cultural, economic, social or political institutions.

For the purpose of this Framework, the definition of IP will try to follow both the

criteria of the IFC/World Bank and the national legislation.

3. Screening for indigenous people among the affected populations

Initial screening of the potential presence of IP in the specific-projects area will be

conducted by using combination criteria of IFC Performance Standard and World Bank

and national legislation identification. All specific-project areas which have IP

communities will be visited (at the time of first consultation with communities) by a

project implementing unit and relevant local authorities, including personnel with

appropriate social science training or experience. Prior to the visit, respective project

implementing unit will send notice to the communities informing their leaders that they

will be visited for consultation. The notice will request that the communities invite to

the meeting representatives of community livelihood (i.e. farmers, fishermen, etc.),

women associations and village leaders for discussion on the Specific-project. During

the visit, the community leaders and other participants will be consulted and present

their views with regards to the Specific-project.

At this visit, personnel with social science training or experience will undertake a

further screening for IP population with the help of local leaders, local authorities, and

NGO as necessary. The screening will check for the following: (a) names of IP groups

in the affected village; (b) total number of IP in the affected villages; (c) percentage of

IP in affected villages; (d) Number and percentage of indigenous households within a

described zone of influence of the proposed Specific-project.

If the results show that there are IP communities in the zone of influence of the

proposed specific-project, a social assessment will be planned for those areas.

4. Social Assessment (SA) and Consultation

During the preparation of the Specific-project proposal and/or Specific-project

approval, a social assessment process will be undertaken to define the Information

dissemination to all members of the IP community will be conducted specifically

ESMS for CHNP

52

targeting appropriate message routes in accordance with prevailing customs and

traditions, including using the commonly used IP language in every meeting, minutes,

brochures, etc.

5. Indigenous People Plan

Free, prior and informed consultations will be conducted through a series of meetings,

including separate group meetings: indigenous village leaders; indigenous men; and

indigenous women, especially those who live in the zone of influence of the proposed

work under Specific-project. Discussions will focus on Specific-project impacts,

positive and negative; and recommendations for design of Specific-projects. If the SA

indicates that the proposed Specific-project will cause adverse impact or that the IP

community rejects the proposal, the Specific-project will not be approved (and

therefore no further action is needed). If the IP supports the Specific-project

implementation an IPP will be developed to ensure that the IP will receive culturally

appropriate opportunities to benefit from the Specific-project activities.

The IPP is prepared in a flexible and pragmatic manner, and its level of detail varies

depending on the specific project and the nature of effects to be addressed. It will

include the following elements, as needed:

a. A summary of Social Assessment (SA);

b. A summary of results of the free, prior, and informed consultation that was

carried out during Specific-project preparation;

c. A framework for ensuring free, prior, and informed consultation with the

affected indigenous communities during project implementation.

d. An action plan of measures to ensure that the Indigenous Peoples receive social

and economic benefits culturally appropriate;

e. The cost estimates and financing plan for the IPP;

f. Accessible grievance mechanism, which takes into account the availability of

customary mechanism;

g. Monitoring, evaluation and reporting mechanism

The GSC is expected to prepare IPP under the Community Project Activity, and

expected to share the IPP and findings of the social assessment with the Supply Side

Activity and Communications, Monitoring and Evaluation Activity. The Supply Side

Activity and Communications Campaign are expected to report the presence of

indigenous peoples, the project approach taken at the field level and any unexpected

reactions towards project activities. Such a report will be submitted to the CHNP

Director, with copy to the ESP Director and SGA Director on a regular basis.

ESMS for CHNP

53

The IPP should be disclosed publicly so that accessible to the affected indigenous

community.

Upon agreement between the CHNP Director and ESP Director, for the specific-

projects that work utilize community-decision making process, a stand-alone IPP may

not be required. The process to ensure that the IP are included as beneficiaries and

participate in any activities will be incorporated in the specific-project design.

6. Principles if a Specific-project affects indigenous peoples

There are a number of measures to be applied when the IP are presence in the Specific-

project area and are part of the beneficiaries, in relation to the development of

indigenous peoples plan.

Project implementation unit or proponent (PIU) will ensure that free, prior and

informed consultations are undertaken, in a language spoken by, and location

convenient for, potentially affected IP. The views of IP are to be taken into

account during preparation and implementation of any Specific-project, while

respecting their current practices, beliefs and cultural preferences. The outcome

of the consultations will be documented into the Specific-project documents.

If the IP conclude that the Specific-project will be beneficial to them, and that

any minor adverse impacts, if any, can be mitigated, a plan to assist them will

be developed based on consultation with the IP and local representatives. The

community should also be consulted to ensure that their rights and culture are

respected. The assistance may also include institutional strengthening and

capacity building of indigenous villages and community groups working with

the Specific-project.

In the issue of access restriction to the natural resources, the IP will participate

in the zoning and mapping activities in order to fully benefit from the project. In

full consultation with the IP groups, the zoning and mapping activities will define

the areas with customary rights of the local IP and reflect the issues in the IPP

with particular actions to protect or compensate the groups.

Where indigenous people are identified that represent a sufficiently large

interest, efforts will be made to ensure that the group is represented and that

regular and formal communication is established with the group.

Where the indigenous people speak a language different from Bahasa

Indonesia, relevant brochures and documents will be translated in the

appropriate language. Provision has been made in the project budget to allow

for additional translations of relevant project documents as well as preparation

of pictorial materials (brochures, posters, etc.).

These steps will be aimed at ensuring that indigenous peoples participate fully in the

project, are aware of their rights and responsibilities, and are able to voice their needs

during the social/economic preliminary survey/exercise and in the formulation of the

Specific-projects and operational policies. In addition, they will be encouraged to

submit Specific-project proposals that cater to their group's needs, if necessary.

ESMS for CHNP

54

7. Reporting, Monitoring and Documentation

Besides specific attention to IP issues in supervision and monitoring, PIU will include

these matters in their progress reporting. The MCA-I (through CHNP and ESP unit)

supervision missions will periodically pay special attention to ensure that that the

Specific-projects affecting IP afford benefits to them and no adverse impacts on them.

8. Implementation Arrangement

The PIU will be responsible for training the respective project implementing unit or

local authorities to undertake the work of consultation, screening, social assessment,

analyses and preparing IPPs and addressing any grievances.

PIU of individual Specific-projects and local authorities are responsible for

implementing IPP (arrange adequate staff and budget).

ESMS for CHNP

55

Appendix C

C. Example of Statement Letter for Land Donation

I, the undersigned:

Name :

Occupation :

Address :

Herewith declare that I voluntarily donate my land or assets affected for the project /

Specific-project ……………………………………………………………………………………………….. (Write the

name of project / Specific-projects to be constructed)

Location of land :

Size of land :

Current land use :

Status of ownership :

With reasons :

Map/sketch of donated land with borders :

............................................................................................................................. ................................................

....................................................................................................................................................... ......................

.............................................................................

This statement was made in good faith without any coercion.

Place, date of the agreement

Knowing,

Landowner Signature Acknowledgement by Head of Village,

Name: ................................ Name: ................................

Signature of heirs and witnesses:

1. Name: ............................................ Signature:

2. Name: ............................................ Signature:

3. Name: ............................................ Signature:

ESMS for CHNP

56

Appendix D

D. List of Available Operational Guidelines for the

CHNP39

MCA-Indonesia, Technical Operation Manual for Child Growth Monitoring Training,

Community Based Health and Nutrition Program (CHNP), Revised January 2015.

MCA-Indonesia dan Kementerian Kesehatan Republik Indonesia, Pedoman

Pelaksanaan Sanitasi Total Berbasis Masyarakat, Proyek Kesehatan dan Gizi Berbasis

Masyarakat (PKGBM), 2015.

Ministry of Health of The Republic of Indonesia, Directorate General of Nutritional

Health and Mother and Child Health, Technical Operation Manual Training for

Counseling on Infant and Young Child Feeding (IYCF), 2014.

MCA-Indonesia and the Ministry of Health of the Republic of Indonesia, Technical

Operation Manual Community Led Total S

anitation, Community Based Health and Nutrition Project (CHNPP), 2015.

Ministry of Health of The Republic of Indonesia and MCA-Indonesia, Guideline for the Management

Of Distribution And Quality Control of Micronutrient Powder For Children 6-24 Months, 2015

Ministry of Health of The Republic of Indonesia and MCA-Indonesia, Guidelines For Iron And

Folic Acid Supplements Distribution And Quality Control Program For Pregnant Women, 2015.

Guideline for the Management of Distribution and Quality Control of Micronutrient

Powder for Children Age 6-24 Months in Community-based Health and Nutrition

Program Areas, 2016

Guidelines For Iron And Folic Acid Supplements Distribution And Quality Control

Program For Pregnant Women In Community-based Health and Nutrition

Program Areas, 2016

Technical Specifications and Requirements Provision and distribution of Iron Folic Acid

Tablets for pregnant women (undated).

Other Relevant Guidelines

World Health Organization, e-Library of Evidence for Nutrition Actions, Multiple Micronutrient

Powders for Home Fortification of Foods Consumed by Children 6-23 Months;

http://www.who.int/elena/titles/guidance_summaries/micronutrientpowder_infants/

en/

39 List updated in February 18, 2016. Documents subsequently produced/ finalized will require update of this list.