Document of

The World Bank

FOR OFFICIAL USE ONLY

Report No. 11905-BO

STAFF APPRAISAL REPORT

BOLIVIA

INTEGRATED CHILD DEVELOPMENT PROJECT

JUNE 7, 1993

Country Department IIIHuman Resources Operations DivisionLatin America and the Caribbean Region

This document has a restricted distribution and may be used by recipients only in the performance oftheir official duties. Its contents may not otherwise be disclosed without World Bank authorization.

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CURRENCY EQUIVALENTS

Currency Unit = Boliviano (Bs)Bs 1.00 = US$0.25US$1.00 = Bs 4.0

FISCAL YEAR

January 1 - December 31

FOR OFFICIAL USE ONLY

PRINCIPAL ABBREVIATIONS AND ACRONYMS USED

CONAPSO Consejo Nacional de Politica Social(National Social Policy Council)

DHS Demographic and Health SurveyEC European CommunityEIH Encuesta Integrada de Hogares

(Integrated Household Survey)EMSO Economic Management Strengthening OperationESF Fondo de Emergencia Social

(Emergency Social Fund)ETARE Equipo Tecnico de Apoyo a la Reforma Educativa

(Technical Team for Education Reform)IHDP Integrated Health Development ProjectINE Instituto Nacional de Estadfsticas

(National Institute of Statistics)JNSDS Junta Nacional de Solidaridad y Desarrollo Social

(National Agency for Solidarity and Social Development)MEC Ministerio de Educaci6n y Cultura

(Ministry of Education and Culture)MPC Ministerio de Planeamiento y Coordinaci6n

(Ministry of Planning and Coordination)MPSSP Ministerio de Previsi6n Social y Salud Publica

(Ministry of Social Assistance and Public Health)NGO Non-Governmental OrganizationONAMFA Organismo Nacional del Menor, Mujer y Familia

(National Organization of Minors, Women and Family)PIDI Proyecto Integral de Desarrollo Infantil

(Integrated Child Development Project)SAFCO Sistema Integrado de Administraci6n Financiera y Control

(National Law for an Integrated System of FinancialAdministration and Control)

SIP Social Investment FundSIG Sistema Informaci6n Gerencial

(Management Information System)SSS Social Strategy StatementSVEN Sistema de Vigilancia Epidemiol6gica Nacional

(National System of Epidemiological Surveillance)UDAPSO Unidad de Analisis de Polftica Social

(Social Policy Analysis Unit)UNDP United Nations Development ProgrammeUNICEF United Nations Children's FundUSAID United States Agency for International DevelopmentWFP World Food Programme

This document has a restricted distribution and may be used by recipients only in the performanceof their official duties. Its contents may not otherwise be disclosed without World Bank authorization.

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BOLIVIAINTEGRATED CHILD DEVELOPMENT PROJECT

STAFF APPRAISAL REPORT

Table of Contents

Page No.

BASIC DATA SHEET ....... .................... vi

CREDIT AND PROJECT SUMMARY ................. x i

1. BACKGROUND ....... .................... 1

2. SECTORAL CONTEXT ............ 1A. The Status of Women and Children in Social

Development ....... .................... 1B. Food Aid ......... .................... 3C. The Institutional Setting ................... 3

3. SECTOR ISSUES AND GOVERNMENT STRATGY.... 6A. Issues. 6B. Govenment Sectoml Policy .10

4. ASSISTANCE STRATEGY FOR THE SECTOR ....... 11A. Bank's Role and Strategy .................... 11B. IDA Experience and Lessons Leamed .... ........ 12

5. THE PROJECT ............................ 15A. Project Objectives and Concept ................ 15B. Scope and Target Population .................. 16C. Detailed Project Description .................. 18

This report is based on the findings of preparation missions which visited Bolivia inSeptember and November 1992, and January 1993, led by Mr. Xavier Coil (LA4HR) andconsisting of Messrs./Mmes. Jacques van der Giag, Nuria Homedes (LA3HR), Julie VanDomelen (LA4HR), Alan Berg (PHN), Jean Paul Faguet (Resident Mission), Angel Gonzalez-Malaxechovurrfa (LATPS) and Robert Myers (Consultant). An appraial mission visited Boliviain May 1993, consisting of Messrs./Mmes. Xavier Coil (mission leader, LA4HR), KarenLashman (LA3HR), Jean Paul Faguet (Resident Mission) and Robert Myers (Consultant).Support for report preparation was provided by Mmes. Maria Victoria Lister and Neily Vergara.The local preparation team, headed by Maria Gil de Liebers (Executive Director of ONAMFA)received valuable support in the preparation of the project proposl from Dr. Fernando Vfo,Mr. Santiapo Friedmann, Ms. Judith Evans, and a team from the Instituto Colombiano deBienestar Familiar (ICBF) composed of Mmes. Ruth Patino, Teresa Medina, Raquel Diaz Ortizand Francia Restrepo. Peor reviewers are Messrs. Alan D. Berg (PHN) and Laurence Wolff(MNIPH). Messrs. Jacques van der Gaag and Yoshiski Abe were, respectively, the managingDivision Chief and Department Director.

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Page No.

6. PROJECT COST AND FINANCING PLAN ... ....... 31A. Project Costs . ......................... 31B. Recurrent Costs and Project Sustainability .... ..... 32C. Financing Plan ........ .................. 33

7. PROJECT IMPLEMENTATION ....... .......... 34A. Project Management and Coordination .... ........ 34B. Institutional Arrangements ..... .............. 36C. Implementation Schedule ...... .............. 36D. Procurement ......... .................. 37E. Disbursements and Accounts ..... ............. 39F. Financial Management, Accounting and Audits ... ... 40G. Project Monitoring, Evaluation and Supervision ... ... 41H. Environmental Impact ...... ................ 42

8. EXPECTED BENEFITS AND RISKS ..... ......... 42A. Benefits .............................. 42B. Risks ................................ 42

9. AGREEMENTS REACHED ANDRECOMMENDATION .43

ANNEXES

Annex 1: Organizational Structure of ONAMFA

Annex 2: Project Coverage Objectives

Annex 3: Sector Policy and Management Strengthening Component(Matrix of Objectives, Outputs and Costs and Timeline)

Annex 4: The Bolivian Civil Service Reform Program and ONAMFAPositions to be Financed under the Credit

Annex 5: Home Rehabilitation Component

Annex 6: Management Information System and Impact EvaluationSystem

Annex 7: Detailed Project Cost Summary and Financing Plan by Year

Annex 8: Supreme Decree No. 23415 (March 5, 1993)

Annex 9: Organizational Stnrcture of the Integrated ChildDevelopment Project

Annex 10: Studies to be Carried Out by ONAMFA

Annex 11: Implementation Schedule

Annex 12: Disbursement Forecast and Disbursement Allocations

Annex 13: Supervision Schedule and Implementation Indicators

Annex 14: Selected Documents and Data Available in the Project File

MAP: IBRD No. 24922

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BOLIAINTEGRATED CHILD DEVELOAMENT PROJECT

Basi Dab S

DATA YEAR SOURCE

A. GENERAL COUNTRY DATA:

1. Total Area (Sq. Km.) 1,099 1992 WDR

2. Total Population (Millions) 7.2 Mid- WDR1990

3. Urban Population as % of Totdal 51 1990 WDR

4. Pulation in Capital Citya a % of Urban 34 1990 WDRas % of Total 17 1990 WDR

S. Overall Incidonce of Urban Poverty (%) 55 1990 IHS

6. Women's Paricipation in the Labor Force,Primarily in thebnformal Sector (%) 44 1986 DHSof wbich Employmeat in Marginal Urban Ares 80 1986 DHS(%)

7. GNP per Capita (USS) 652 1991 UEM

B. POPULATION DATA

1. Cnrde Birth Rate (Per 1000 Populaon) 36 1990 WDR

2. Cfude Deaih Rate (Per 1000 Populaon) 10 1990 WDR

3. Total Friy Rate (Births per Womn) 4.8 1990 WDR

4. Women of Chilbeaing Age " % of All 47 1990 WDRWomen

S. Coruacpve Pvalence(% of Women 15-49) 18 1988 WDR

6. Wome's Risk of Dying of PregnancyAssociated Cases (S) 10 1988 DHS

7. Averag Annual Population Growth 2.5 1990 WDR1989-2000 (%)

S. Population Age Strcturm (S of Total)14 and under 42.5 1990 WDR15-64 54.1 1990 WDR

C. HEALTH DATA

1. Life Expecn at Birth (Yea)Overa 60 1990 WDRFemale 62 1990 WDRMale S8 1990 WDR

2. Infant Mortality Rate (Per 1000 Live Birds) 96 1988 DHS

3. Maen Motlity Rate (per 100,000 Live Birbas) 480 1980 WDR

4. Under-S Motality Rate (per 1000 Live Births)Female 109 1990 WDRMale 127 1990 WDR

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BOLIVIAINTEGRATED CHILD DEVELOPMENT PROJECT

Basic Data Sheet

DATA YEAR SOURCE

5. Population per Physician 1,530 1984 WDR

6. Population per Nurse 2,470 1984 WDR

7. Birth Attended by Health Staff (X) 36 1985 WDR

8. Babies with Low Birth Weight (%) 15 1985 WDR

9. Total Health Expenditures as Share ofTotal Public Expenditures (%) 2,3 1990 WDR

D. NUTRITION DATA

1. Daily Calorie Supply (Per Capita) 1,916 1989 WDR

2. Children between 3 months and 3 years age groupUnderweight (%) 13 1988 DHSStunted (%) 38 1988 DHS

E. EDUCATION DATA

1. Total Adult Illitercy Rate (%) 23 1990 WDRof which Female 29 1990 WDR

2. Total Primary School Enrollment (%) 81 1989 WDRof which Female (%) 77 1989 WDR

3. Primry Pupil Teacher Ratio 25 1989 WDR

4. Total Secondary School Enrollment (%) 34 1989 WDRof which Female (%) 15 1989 WDR

5. Total Tertiary Education Enrollment (%) 23 1989 WDR

6. TotAl Education Expenditures as Share of TotalPublic Expenditurs (%) 18 1990 WDR

SOURCES: World Development Report (WDR), World Bank, 1992; Integrated HouseholdSurvey (IHS), Bolivia, 1990; Demographic and Health Surveys (DHS), Bolivia,1989; Updating Economnic Memorandum (UEM), World Bank, 1992.

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BOLIVIAINTEGRATED CHILD DEVELOPMENT PROJECT

STAFF APPRAISAL REPORT

CREDIT AND PROJECT SUMMARY

Borrower: The Republic of Bolivia

Beneficiary: Organismo Nacional del Menor, Mujer y Familia (ONAMFA)

Credit Amount: SDR 35.8 million, or US$50.7 million equivalent

Terms: Standard IDA terms, with 40 years maturity

Project Objectives: The proposed project supports the Social Strategy Statement (SSS) of theGovernment of Bolivia (GOB) and its Ten-Year Action Plan for Children andWomen. It seeks to contribute toward poverty alleviation and human capitaldevelopment objectives by supporting the initiation of the Proyecto Integral deDesarrollo Infantil (PIDI), thus expanding coverage and improving quality ofchild development programs in poor urban and peri-urban areas of the 34 largestcities. The specific objectives of the proposed project are to: (a) improvechildren's readiness to succeed in school and beyond by facilitating their physical,emotional, social and cognitive development; (b) enhance the status of women byincreasing their employment opportunities, and expanding their knowledge ofeducation, health and nutrition; and (c) increase community and private sectorparticipation in the social development process. An associated objective of theproject is to assist the GOB to strengthen its capacity to formulate and evaluatesocial policy.

Project Description: The project comprises three main components:

(1) The Sector Policy Development and Management Strengtheningcomponent (US$4.0 million equivalent) would enhance the public sector'scapacity to formulate and evaluate social policy by supporting: (a) studies andtechnical assistance to permit the broadening of policy foundations in the areas offood security and nutrition, refinement of measures of child development, andextension of integrated child development services to rural areas, includingfinancing for pilot projects; and (b) consolidation of ONAMFA's recentmodernization efforts and its incorporation into the Civil Service ReformProgram (CSRP). Funding would be provided for technical assistance;incremental salaries for 33 key ONAMFA positions to be brought under theCSRP (on a declining basis); and computer and office equipment, and training.

(2) The Service Delivery Support component (US$133.6 million equivalent)would support the delivery of integrated child development services to poorchildren 6 months to 6 years of age by placing in operation over the project lifesome 8,600 non-formal, home-based day-care centers, each of which wouldprovide integrated services to about 15 children by two to three caregivers

(depending on the age-mix of the children) who would be selected from thecommunity. Caregivers would receive a monthly stipend for their services(roughly equivalent to a minimum salary) and beneficiaries would contribute amonthly user charge. Communities to participate in the project would be selectedon the basis of poverty maps, and the children within them on the basis ofdistinct household socioeconomic criteria, with highest priority assigned tomalnourished children. The component specifically would: (a) further developand strengthen the project's operational structure at the central and regionallevels; (b) refine mechanisms for targeting beneficiaries and selecting caregivers;(c) provide initial and in-service training to caregivers to respond to earlyeducation, nutrition and health service needs of the children; (d) promote theformation and build the capacity of parents' associations to assist in projectadministration; (e) finance, via a mixed grant-loan, the rehabilitation of thosecaregivers' homes which are to serve as day-care sites; (f) directly providechildren with nutrition supplementation and a basic package of integrated earlyeducation services and, through cooperative agreements with local (public orprivate) referral health centers, ensure their access to key preventive and curativehealth services; and (g) for pregnant women who are caregivers or have childrenparticipating in the project, secure preferential user fees for services, thusincreasing their access to appropriate maternity care, family planning educationand services, and health and nutrition services. To these ends, the proposedproject would finance furniture, equipment and supplies for the day-care centers;home rehabilitation; technical assistance; caregivers' stipends (on a decliningbasis), training and supervision; vehicles, equipment and supplies for projectadministration; a health fund (on a declining basis) to help finance diagnostic andtreatment services for malnourished children from extremely poor families; foodcommodities (not IDA financed); and salaries of incremental positions fornational and regional project teams (on a declining basis).

(3) The Monitoring and Evaluation component (US$2.6 million equivalent)would support close project performance monitoring and impact evaluation bydeveloping and implementing: (a) a management information system to monitortimeliness in achieving coverage targets and quality of services delivered; and theoverall soundness of project administration and financing; and (b) an impactevaluation system, based on data generated from the Integrated Household Survey(EIH) and special modules on health, nutrition and child development status, andthe conduct of special longitudinal studies and sociological surveys. The projectwould finance requisite technical assistance and computers and equipment for theoperation of these systems.

Project Benefits: By the end of the proposed project life, an installed capacity of some 8,600 day-care centers would exist to annually provide non-formal, home-based, integratedchild development services to 130,000 of the country's poorest pre-schoolchildren, 6 months to 6 years of age; and cumulatively, by project end, givenanticipated promotions of six year olds, more than 200,000 children are expectedto have benefitted. Women also would be direct beneficiaries through projectcontributions to expanding employment opportunities (employing caregivers

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and, via access to day-care, enabling mothers of participating children to work)and improving their knowledge of education, health and nutrition. Specifically,by its completion, the project would have trained and employed some 21,000caregivers, most of whom are expected to be women. Approximately 8,600 ofthese caregivers also would benefit from access to credit to upgrade their homesand, via direct beneficiary contributions, assistance in the payment of basic utilitybills to help offset the cost of using their homes for day-care centers. Significantimprovements also are expected in the health and nutritional status of anestimated 16,000 pregnant women who either have children participating in theproject, or are caregivers, as project-secured preferential user fees would increaseutilization of pre- and post-natal care, safe deliveries, and family planning, andhealth and nutrition education and services. An additional benefit would be theGOB's strengthened ability to formulate and evaluate social policy, particularly inearly childhood development, and food and nutrition.

Project Risks: Principal risks relate to: (a) the possibility that the extensive projectimplementation demands might outstrip ONAMFA's managerial andadministrative capacities; (b) uncertainties over the continuity of the GOB's initialcommitment to absorb fully project-generated recurrent costs over the project life,crucial to its sustainability; and (c) the danger that desired improvements inchildren's nutritional status will not be achieved because of failure to maintainadequate dietary intake at the household level. With regard to (a), this riskshould be minimized by: direct project support for ONAMFA's modernizationinitiative; ONAMFA's planned full incorporation into the CSRP, thus facilitatingrecruitment and retention of high quality staff; anticipated active assistance ofNGOs and community groups in project implementation; project-supportedcontracting of external supervision staff to permit ONAMFA's close, continuousoversight of day-care activities; a very conservative implementation timetable,based on moderate increases in coverage objectives during the first half of theproject, and annual and mid-term project reviews to assess implementationprogress and adjust the pace and scope of implementation, as needed. Withregard to (b), the GOB has committed itself to a solid financing plan and togradually assuming recurrent costs on a clearly specified annual basis, includingthose generated by the CSRP. To help ensure continuing commitment to thisplan, the GOB will review annually with IDA an updated financial plan for thesuccessive three years of project implementation. In addition, the GOB willreview with IDA at the project's Mid-Term Review its overall social sectorinvestment plan to ensure that adequate provision is made for project financing.The issuance of the March 1993 Supreme Decree committing counterpartresources to the project also should minimize this risk. And with regard to (c),intensive health and nutrition education activities targeted toward parents ofchildren participating in the project seek to minimize this risk.

BOLIVIA

INTEGRATED CHILD DEVELOPNENT PROJECT

1. BACKGROUND

1.1 The economic policy, adopted by the Government of Bolivia in 1985,has been highly successful in stabilizing the economy and in reducing internaland external imbalances. As a result of the adjustment program, the publicsector deficit was lowered and inflation was brought under control. For thefirst time in nearly a decade, the economy attained a positive Gross DomesticProduct (GDP) growth rate of 2.6 percent in 1987, and continuous prudentmacroeconomic management permitted the recovery to be sustained withsteady annual GDP growth of 2.7 percent on average through 1990. During1991 and 1992, the economic situation continued to improve, with GDPgrowth of 4.1 percent and 3.8 percent, respectively.

1.2 Despite good economic management in recent years, Bolivia aces adifficult set of development challenges. Per capita Gross National Product(GNP) of US$652 (1991) is among the lowest in Latin America, and theeconomic situation remains fragile. Moreover, the major macroeconomicadjustments of the last decade have not been accompanied by correspondingreductions in the levels of poverty or improvements in social indicators.Distribution of the economic and social benefits of growth remains highlyskewed. While the 1976 census indicated that 80 percent of all householdswere poor, data from the 1990 Integrated Household Survey (EIH) revealedan overall incidence of urban poverty of approximately 55 percent, with aneven worse situation in certain cities, such as El Alto and Potosf, where 70percent of the households are deemed poor. Preliminary data from the 1992census suggest that severe poverty remains pervasive. Key social indicatorsare among the worst in the Region, with about one-quarter of the adultpopulation illiterate, and life expectancy at birth of only 60 years (1990), orbelow the average for lower middle-income economies.

2. SECTORAL CONTEXT

A. The Status of Women and Children in Social Development

2.1 Women and young children are disproportionately represented amongthe poor and face especially difficult circumstances. Women are twice aslikely to be illiterate as men, have limited access to child care, facediscrimination in hiring practices and in wage determination, have virtuallyno access to credit from official or formal financial institutions, and arerestricted by law from engaging in some productive activities. With

increased migration to cities, women's participation in the labor force rosefrom 27 percent in 1976 to 44 percent in 1989. This employment isprimarily in the informal sector (representing over 80 percent of female jobsin marginal urban areas). While most women are forced to work to helpsupport their families, social norms dictate that they remain the principalcaretakers of their children. The difficulty of maintaining this dual role isexacerbated in urban areas where extended family arrangements typical ofrural areas are not prevalent. Given limited access to day-care, many womenmust either leave their children alone at home or opt for relatively lowpaying jobs where their children can accompany them. As a result, bothwomen and children suffer.

2.2 Maternal mortality rates are excessive. According to recent estimates,a woman's lifetime risk of dying of pregnancy-associated causes is 10percent. Poor women rarely have access to health care and their utilizationof services is low: 53 percent of women receive no prenatal or postnatalcare, and only about 40 percent deliver in health facilities. High fertility isone of the principal contributing causes to poor health status of both womenand infants. In 1990, the total fertility rate was estimated at 4.8 children.Modem contraceptive methods are used by only 18 percent of women ofreproductive age, and abortion (induced or spontaneous) accounts for morethan one-fourth of all maternal deaths.

2.3 Infants and young children are exceptionally vulnerable to illness anddeath. No reliable data on infant mortality exist. Recent estimates rangefrom 96 per 1000 live births, based on a Demographic and Health Survey(DHS) carried out in 1988, to 102 per 1,000 live births according to datafrom the public health system--among the highest infant mortality rates inLatin America. Importantly, large differentials in health status persist acrossincome groups. Health risks, already high because of the pathogenicenvironment in which much of the population live, are compounded by thelimited coverage of preventive health services. For example, just 7 percentof infants have completed the full vaccination regimen by the end of the firstyear of life, and only 19 percent of children between 12 and 23 months ofage are fully immunized.

2.4 Malnutrition is pervasive, contributing to excessive morbidity andmortality. According to the DHS, 13 percent of children in the 3 months to3 years age group are underweight (i.e., low weight-for-age) and 38 percentare stunted (i.e., short height-for-age), reflecting chronic malnutrition. Datasuggest that much of the nutritional deterioration occurs after the first 6months of age, coinciding with the weaning period when breastfeeding shouldbe supplemented by solid foods to meet nutritional needs. Both the extent ofmalnutrition and its distribution among different degrees remained fairlyconstant over the 1988-1991 period, despite substantial food aid and increasesin commodity assistance. This strongly suggests that such aid has not beenadequately targeted to the highest risk groups.

B. Food Aid

2.5 Food aid has become an integral part of Bolivia's social developmentprograms. According to Government estimates, such external assistanceslightly exceeds total national health expenditures and represents three timesthe Treasury's annual budgetary support to the Ministry of Social Assistanceand Public Health (MPSSP). In 1992 alone, food aid was on the order of300,000 metric tons, with a value of about US$116 million. The UnitedStates, the World Food Programme (WVFP), the European Community (EC),Canada, Spain, France, Holland and Argentina are the major sources of foodassistance. U.S. food aid for Bolivia has increased strikingly over the pasttwo years, from US$40.9 million in 1991 to US$97.9 million in 1992,currently representing 83 percent of all commodity aid. It is channeled bythe U.S. Agency for International Development (USAID) via two mainprograms. Title U provides food and/or money (from the monetization offood) to some 1.6 million poor through NGO-administered programsincluding school feeding (48 percent), mothers' clubs (20 percent), food-for-work (17 percent), pre-school milk centers (12 percent), with the balance inclinic-based food supplementation programs and assorted other programs.The second conduit of U.S. food aid, the Title III program, supports broadfood security objectives via use of policy conditionality and local currencyprogramming, to finance food imports.

2.6 Administration of such substantial inflows of food aid presentsnumerous challenges, from its adequate transportation, storage anddistribution, and local financing thereof, to prevention of spoilage, anddiversion. To date, in depth evaluations of the effectiveness of targeting andoverall impact of food aid have been generally lacking. The proposed projectseeks to provide a coherent framework for targeting food aid to the neediestsubgroups, through both the formulation of a national food and nutritionpolicy, and the rechannelling of a substantial share of existing food aid tochildren participating in child development activities.

C. The Institutional Setting

2.7 In 1971, the Junta Naional de Desarrollo Social (JNSDS) wascreated as an autonomous agency to provide protection and social assistanceto children and the elderly, particularly those from the most vulnerablesocioeconomic groups. Presided over by the spouse of the President of theRepublic, children's services provided by JNSDS (since March 1993, theOrganismo Nacional del Menor, Mujer y Familia--ONAMFA) have included:health care, nutrition supplementation, provision of clothing and housing,legal advice, psychological counseling, training, and care for the disabled.Its family- and community-based programs have encompassed communitykitchens, multi-purpose clinics, family legal assistance, training in productive

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activities, community greenhouses, provision of day care, shelter for abusedwomen, and assistance programs for the elderly. The agency's servicedelivery network includes 109 children's homes, 20 homes for the elderly, 9health clinics, 14 family legal centers, and 22 day-care centers. As part ofits mandate, JNSDS/ONAMFA also has been overseeing the inplementationof laws pertaining to children, including adoptions, evaluations to determinecustody of children, matters pertaining to social problems and abuse, andlegal infractions committed by minors.

2.8 To carry out these programs, the agency employs a staff ofapproximately 1,200 distributed between its central and 9 regional and 74sub-regional offices. Its organizational structure is highly decentralized.Less than 10 percent of its personnel are located in its central headquarters.Fifty-six percent of its staff are involved in direct service delivery, includingdoctors, nurses and educators assigned to health clinics, multi-purposecenters, and homes for children and the elderly. In the past, the ability ofthe institution to effectively manage its programs was limited by a lack oftechnical and administrative capacity, by an emphasis on charity oversustainable social programs, and by a dearth of leadership. This situationreduced its ability to attract internal and external resources and led to adeterioration in the quality of service provision.

2.9 The Restructuring of the JNSDS. In 1989, subsequent to acomprehensive institutional analysis, JNSDS initiated a major restructuringprogram designed to increase efficiency, attract external resources, and focusmore effectively on the needs of vulnerable groups. The principal elementsof this restructuring include: (a) modernization of its organizationalstructure, reducing the number of departments and divisions, andstreamlining its personnel complement; (b) implementation of computerizedfinancial and administrative control systems; (c) adoption of personnelpolicies to improve the quality and distribution of staff; (d) a programmaticshift to community-based preventive programs; and (e) increased cooperationwith non-governmental organizations (NGOs) and community groups, andrelatedly a reduced role in the direct management of facilities.

2.10 As part of its reorganization, with UNICEF support, JNSDS adopteda revised administrative and financial structure. Revisions were made in keysystems including accounting, budgeting, inventory, warehouses, assetcontrol, and personnel to comply with the new national law requiring anIntegrated System of Financial Administration and Control (the SAFCOLaw). Computerization of these systems at the central and regional levelshas resulted in substantial gains in transparency and efficiency. Notably,budget execution increased from 73 percent in 1988 to 95 percent in 1991.In addition, JNSDS's improved image and financial control systems helpedmobilize US$9 million in external resources over the 1990/1991 period.Improvements notwithstanding, administrative capacity remains weak,particularly in its smaller regional offices. Future efforts to consolidateONAMFA's progress in strengthening its administrative systems must focus

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on the full implementation of these systems at the regional level, includingrecruitment and training of administrative and financial personnel.

2.11 During the restructuring process, JNSDS adopted policies to improvethe quality and distribution of its staff. The number of personnel wasreduced from 1,548 to 1,200 while, concomitantly, better trained technicalstaff were recruited at higher salaries. A cornerstone of its revised personnelpolicy is the agency's incorporation into the initial phase of the Civil ServiceReform Program (CSRP). This program, executed through the Ministry ofFinance, seeks to create a stable and high quality core of civil servantsthrough staffing of key positions at competitive salary levels to be selectedthrough a transparent, merit-based process. To qualify, a public agency mustsatisfy a number of prerequisites, including having comprehensive operationalmanuals, computerized administrative systems, and detailed job descriptions,including qualifications. JNSDS/ONAMFA was among the first agencies tomeet these prerequisites (para. 3.4).

2.12 JNSDS/ONAMFA also reoriented its programmatic goals to placegreater emphasis on community level preventive services. To this end,JNSDS has entered into management service contracts with local andinternational NGOs for the administration of its shelters for orphans,abandoned children and the elderly. By the end of 1992, over 80 percent ofits homes for children and the aged had been delegated to NGOadministration. This arrangement has leveraged additional resources fromNGOs and improved the management of facilities.

2.13 The centerpiece of JNSDS' restructuring has been the drafting of theMinor's Law (C6digo del Menor), approved by Congress in December 1992.This law redefines the nature of the JNSDS and its operations under a newname, the Organismo Nacional del Menor, Mujer y Familia (NationalAgency for Minors, Women and the Family--ONAMFA). ONAMFA's neworganizational structure at the central and regional levels is presented inAnnex 1. The law sets overall policy on issues pertaining to children and thefamily (e.g., the rights of minors, judicial processes applicable to minors,adoption procedures, and conditions by which NGOs may provide socialassistance services). ONAMFA remains an autonomous agency under thePresidency, but will not necessarily be managed by the First Lady. The lawfurther stipulates that the President of ONAMFA will be appointed by thePresident of the Republic from a list of three candidates approved by a two-thirds majority of Congress.

2.14 ONAMFA will be managed by a Board of Directors comprised ofnine members, including: (a) four representatives from governmentministries; (b) one representative from the Bolivian Workers' Union (COB);(c) two representatives from NGOs; and (d) ONAMFA's President andExecutive Director (the latter of whom has a voice but no voting power).The Board of Directors will set overall policies and strategies, review theannual work plan and budget, approve intemal regulations and appoint the

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executive Director. ONAMFA's clout and capacity to guide social policyformulation has been strengthened by its recent incorporation into theNational Social Policy Council (CONAPSO).

2.15 Following the adoption of the Minor's Law, a Decreto Reglamentariowas approved in March 1993 which further defines ONAMFA'sadministrative and operational regulations as well as the intemal structure andfunctions of its central and regional levels. The approval of the DecretoReglamentario constituted a condition of appraisal of the proposed project.

3. SECTOR ISSUES AND GOVERNMENT STRATEGY

A. Issues

3.1 Institutional Capacity. Most public institutions in the social sectorsface common institutional constraints to meeting poverty alleviationobjectives, including: (a) structures characterized by highly centralizeddecision-making, weak planning and policy making capacity, over-staffing ofadministrative jobs, low salaries and inadequate personnel training; and (b)inadequate attention to demand-driven programs and, relatedly, beneficiaryparticipation.

3.2 If national programs effectively are to target the most vulnerablegroups, institutional capacity to formulate policy and coordinate itsimplementation is critical. In the past, this capacity has been weak due toseveral factors: (a) poor communication with and little planning input fromregional and local levels; (b) absence of ability or power to coordinate theplethora of donor and NGO interventions; (c) a proliferation of self-containedproject implementation units virtually independent from the coordinatingministry, yet carrying out line functions; and (d) a general dearth of soundpolicy units at the center. The result has been duplication of projects incertain areas and complete absence of intervention in others. Manyministries have become totally ineffective in fulfilling their intendednormative role. Sub-national levels of government have little authority orresources to fill the service coverage gap.

3.3 In response to a recognized lack of leadership in formulation of socialsector policies, the National Council on Social Policy (CONAPSO) wascreated in 1989. Chaired by the President of the Republic, it is comprised ofthe Minister of Planning and Coordination (MPC), and Ministers of SocialAssistance and Public Health, Education and Culture, and Labor. In 1992,to provide technical support to CONAPSO, the Government created a SocialPolicy Analysis Unit (UDAPSO) within the MPC. CONAPSO and UDAPSOare steps in the right direction. Nevertheless, their technical capacity mustbe strengthened to consolidate policies, analyze information and designpriority interventions in the areas of poverty alleviation, education, health

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and nutrition. Still in its nascent stage, UDAPSO has been well staffed andis beginning to play an influential role. The proposed project would supportUDAPSO's objective to develop a comprehensive national food and nutritionpolicy as well as strengthen its project evaluation capacity.

3.4 Social programs cannot be successful if institutions responsible fordelivering services are characterized by inefficiency and inadequate humanresources. The public sector long has been a haven for surplus employmentof poorly qualified technical staff who in tum receive low basic salaries.Compounding these difficulties are the distortions created by bothGovernment and donor provision of salary supplements and non-salarybonuses. In 1988, in response to a persistent public sector managementcrisis, and with the assistance of United Nations Development Programme(UNDP) and IDA, the Government prepared a Public Sector ManagementStrengthening Program. This program aimed at rationalizing the unevenwage structure and creating conditions of stability within the civil service.Institution of the first phase of this program was financed by IDA through anEconomic Management Strengthening Operation (EMSO) and resulted in theformulation of the Civil Service Reform Program (CSRP) under the overallmanagement of the Ministry of Finance. Its second phase, delineated inSupreme Decree 2336 approved in November 1992, establishes CSRP'sobjectives and procedures and provides the framework for the selection intoCSRP of govermment agencies and ministries. In January 1993, the Ministryof Finance approved ONAMFA's incorporation into the CSRP.

3.5 The failure of the public sector to carefully listen to social welfareneeds, as defined by the communities, and to systematically seek directparticipation of community organizations and NGOs, hampers successfulimplementation of targeted social service programs. Increased efforts mustbe made to ensure the capacity of local organizations be effectively combinedwith those of government and community groups. The proposed projectactively promotes the creation and strengthening of local community groups,(e.g., parents' associations), and emphasizes their and/or NGOs directinvolvement in integrated child development programs, through eitherassisting ONAMFA in the administration of project activities in a givengeographic area, or their participation in discrete project components (e.g.,training and supervision).

3.6 The new Minor's Law and the internal restructuring programspecifically address the need to enhance ONAMFA's institutional capacityand operational focus, the lack of which have beleaguered its effectiveness inthe past. New procedures for appointment of central and regional levelmanagers, pursuant to its incorporation into the CSRP, are expected to helpONAMFA secure more highly qualified technical staff and continuity in keypersonnel. Nevertheless, ONAMFA's capacity, particularly at the regionallevel, to administer a large program is untested. Therefore, the project seeksto reinforce its central and regional offices through a managementstrengthening component.

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3.7 Service Delivery and Support. Inadequate coverage, low quality andpervasive inefficiencies in the operation of basic social services in many low-income areas can seriously undermine achievement of child developmentobjectives. The paucity of potable water and sanitation services in most ofthe proposed project areas is a key underlying cause of poor overall healthstatus, increasing the incidence of diarrheal diseases and, thus, contributingto malnutrition. At any given time, some 30 percent of children under theage of five suffer from diarrhea, mainly related to poor water quality. Inaddition, health outreach services in most poor urban and peri-urban areasare either absent or non-functional. Not only are preventive services limitedin scope and coverage, but their impact is limited due to often ill-conceivedcost recovery policies, poor definition and execution of priority interventions,and excessive dependence on bilateral assistance programs not necessarilycoordinated or set within a national social development policy framework.

3.8 The proposed project aims to stimulate the demand for basic socialservices by: (a) promoting community initiatives to formulate and submitproject proposals for water and sanitation services to institutions such as theSocial Investment Fund (SIF); (b) establishing criteria for continuedbeneficiary participation in the project that include full immunization of allchildren within six months of program enrollment, and securing preferentialfees to facilitate utilization of pre- and post-natal care and safe deliveries forall pregnant women with participating children; and (c) signing of formalinter-institutional agreements between ONAMFA and MPSSP (both at thenational and the service delivery levels) or with private health institutions thatguarantee provision of a basic package of health and related services toproject beneficiaries.

3.9 Coverage and Quality of Public Health Services. Even in urbanand peri-urban areas where a substantial network of public health facilitiesexists, service provision is minimal in terms of both quantity and quality. Inrural areas, the paucity of access to care is critical. In fact, only about one-third of the total population receives adequate health care. This stems frominadequacies at all stages of programming, from health sector planning andfinancing to actual delivery and monitoring of services. The public healthsystem also is characterized by inadequate organization, management andcoordination. Excessive centralization of the MPSSP has precludedassumption of its intended normative, policy formulation and coordinativerole. The lack of firm sector leadership contributes to a fragmentation ofresponsibilities between the MPSSP, the Bolivian Institute of Social Securityand the private sector, including NGOs.

3.10 Given the importance of a well functioning local health system to theoptimal operation of integrated child development programs, several stepshave been taken to address sectoral weaknesses and, thus, support theproposed project. First, as a corollary to its direct project support, UNICEFhas agreed to target its activities to upgrade matemnal/child health serviceswithin public health facilities in communities to be served by the project.

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Such upgrading will include provision of essential equipment,pharmaceuticals and supplies (e.g., scales), and training of personnel inprimary health care provision. Second, ONAMFA is actively promotingoperational alliances with NGOs and community groups to assist and closelymonitor operations of local health facilities. Third, where available andappropriate, private health facilities will be contracted by ONAMFA toprovide core maternal/child health services to program beneficiaries, buildingon successful experiences during the project's pilot phase.

3.11 Nutrition Policy and Programs. Despite the extent and severity ofmalnutrition, Bolivia has neither a national nutrition nor food security policy.Nutrition interventions are generally untargeted and dispersed among a vastnumber of implementing agencies, have inconsistent and sometimescontradictory objectives, and fail to ensure continuity of services. TheGovernment lacks a focal point to coordinate such programs and, in theabsence of an ongoing evaluation system, has only fragmentary knowledge ofprojects under implementation. Though the amount of food aid is significant,the Government has little control over how this food is used. In addition,minimal attention has been given in the past to the issues of general foodconsumption and availability. Typically, social sector initiatives (e.g.,nutrition surveillance, micronutrient supplementation) and agricultureproduction have been disconnected. The proposed project would supportestablishment and consolidation of the Government's capacity to formulatefood and nutrition policy, and monitor its implementation.

3.12 Design of Early Child Development Programs. To be effective,design of early child development programs must pay careful attention toseveral issues. First, programs should precisely target communities andfamilies within them whose children are at high risk of delayed or inadequatedevelopment. Attaining the desired impact is directly related to setting strictparticipation criteria. Second, early childhood development programs requirea comprehensive and integrated strategy. Child development encompassesmuch more than solely cognitive development. It crosses disciplinary andsectomal lines, involving the equally important areas of physical, social andemotional development. Third, experience suggests that family andcommunity participation increases the chances of program impact andsustainability as well as increases overall resources. Since mobilizing suchparticipation requires time, it often conflicts with pressures to rapidlyincrease coverage. Hence, special attention must be given to securing realparticipation. Fourth, programs should aspire to deliver high qualityinterventions. The measure of quality transcends provision of adequatefacilities and materials. Indeed, its most important determinant is the qualityof field workers in terms of both their selection criteria as well as their day-to-day technical capacity, a product of initial and continuing training, thelatter of which is intimately linked to supervision. Fifth, programs should beflexible and adjusted, as necessary, to local conditions and distinct culturalneeds. Active participation of NGOs and community groups from the designstage through program implementation and evaluation is a crucial mechanism

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to guarantee cultural appropriateness and relevance. Sixth, programs shouldtry to reach the largest possible number of children at risk, while taking intoaccount actual implementation capacity and quality objectives. The design ofthe proposed project systematically has explored and incorporated features torespond to each of these areas.

B. Government Sectoral Policy

3.13 The Government's sectoral policy is defined in its Social StrategyStatement (Estrategia Social Boliviana--SSS) of September 1991. SupremeDecree 22964 of November 1991 provides the policy's legal framework.SSS stresses the need to concentrate government action on human capitaldevelopment by increasing social investment allocations, strengthening theinformnation base for social policy decision-making, and increasing efficiencyof resource use through sectoral reform, better targeting of policies andprograms, and improved coordination with NGOs. The Privatization Lawrequires that net resources generated from privatization efforts be used forregional social and economic infrastructure projects; and the Governmentexpects that these initiatives will increase substantially the availability ofpublic funds for the social sectors.

3.14 The creation of CONAPSO and UDAPSO has enhanced governmentcapacity to analyze and formulate social policy. UDAPSO is expected toconduct applied policy research in the following areas: health, education,food policy and nutrition, women in development, micro-enterprises,poverty, and social statistics. Based on 1992 Census data, and with technicalsupport from the National Institute of Statistics (INE), UDAPSO now iselaborating a detailed poverty map.

3.15 A technical team attached to the MPC, the Equipo Tecnico de Apoyoa la Reforma Educanva (ETARE), was established in June 1991 to design aneducation reform proposal to improve the quality and overall efficiency of theeducation system. The reform directives, which call for a completeinstitutional re-structuring of the education system, received support in July1991 of all political parties in the country.

3.16 Following guidelines set forth in the SSS, a Ten-Year Action Plan forChildren and Women (Plan Decenal de Acci6n para la Ninez y la Mujer) waselaborated by an inter-ministerial and multidisciplinary team. Thisoperationally-oriented Plan focuses on regional interventions primarily in theareas of health and nutrition, education, water and sanitation, children indifficult circumstances, and women. Among its key programmatic areas are:the National Program for Women, and the Proyecto Integral de DesarrolloInfanhil (Integrated Child Development Project--PIDI). The Governmentviews the implementation of PIDI as a central strategy of the Plan Decenal'sobjective to enhance the welfare of young children and women.

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4. ASSISTANCE STRATEGY FOR THE SECTOR

A. Bank's Role and Strategy

4.1 IDA's country assistance strategy focuses on supporting the economicreform program, including the Government's efforts to: streamline the publicsector and, concomitantly, strengthen its performance; promote private sectordevelopment; enhance aid coordination; and ameliorate poverty by improvingthe overall coverage and quality of social services. With regard to the latter,highest priority is assigned to building the institutional capacity of the socialsectors, and relatedly to alleviating poverty, especially among the mostvulnerable subgroups--infants, children and female heads of household--byassisting selective well-targeted interventions.

4.2 In 1990, IDA completed an assessment of the extent of poverty aswell as government initiatives in poverty alleviation. The report (8643-BO)examines the macroeconomic policies and their effects on the poor, reviewsinstitutional constraints to poverty alleviation, and assesses the presentsituation and initiatives in the areas of health, education, agriculture andtransportation. Conclusions support the Government's medium- and long-term objectives of defining policies in the social sectors that improveefficiency and remove inequities in spending. In health, the reportrecommends that priority be given to implementing maternal health and childsurvival programs and shifting expenditures towards more cost-effectiveinterventions such as immunizations, pre- and post-natal care and safedeliveries, family planning, and nutrition supplementation and education.Other recommendations include addressing institutional constraints throughimprovements in financial management and staffing.

4.3 IDA has previously extended support for an Emergency Social Fund(ESF), the Social Investment Fund (SIF), and a health project. Since 1990,it also has been supporting preparation of an Education Reform project. In1986, the Government created the ESF as its primary mechanism for directlyimproving the condition of the poor and for addressing the deterioration insocial conditions stemming from economic adjustment measures. ESFachieved great success by relying on a demand-driven approach andestablishing a close cooperative relationship with NGOs and other privategroups working at the local level. While some limitations existed intargeting resources to the neediest groups, the ESF proved to be highlysuccessful in providing temporary employment to individuals displaced by theeconomic crisis and in strengthening the country's social infrastructure. IDAsupported the ESF with two credits (1829-BO, of US$10 million equivalent,intended as a pilot project, and 1882-BO of US$27 million equivalent,intended as support for the main phase of ESF operations). ESF was closedin March 1991.

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4.4 Drawing on the ESF experience, SIF (supported by Credit 2127-BO)was created in 1990 as an institution capable of attracting and effectivelychanneling external resources to help address the country's health andeducation development needs. Rather than adopting ESF's central goal ofemployment generation, SEF has focused on providing financing for sub-projects aimed at improving the health and education status of the poorestcommunities. A recent mid-term review of SIF is expected to guide futureinvestments in this area. The Integrated Health Development Project(IHDP), supported by Credit 2092-BO which was approved in 1989, supportsMPSSP's institutional development, improved training and distribution ofhuman resources, and the implementation of a comprehensive health caremodel in the cities of Santa Cruz, Cochabamba, and La Paz/El Alto. It hassuffered considerable implementation delays owing both to frequent projectmanagement turnover, and more generally to weaknesses in institutional,financial and procurement systems in the public health sector. Theseproblems were addressed in a recent Country Implementation Review, andactions were agreed with Government to ensure recruitment and retention ofhigh quality staff for key project management positions.

4.5 The proposed Education Reform Project would support theGovernment's objective to restructure and strengthen the education sector. Itwould provide financing for developing the MEC's capacity to establishpolicy guidelines; strengthening the qualifications of teachers at the primaryand secondary level; preparing the basis for a curriculum reform; and layingthe basis for improving access to education for the most disadvantagedgroups (i.e., women and rural populations).

4.6 The proposed project is consistent with the IDA country strategy,supports one of the core programs of the Government's Social StrategyStatement, and complements ongoing and planned IDA-supported operations.

B. IDA Experience and Lessons Learned

4.7 Overall, project design builds on, and has benefitted extensively fromlessons learned in numerous social programs across a wide spectrum ofcountries in terms of levels of socioeconomic development, and institutionalcapacity, as captured in four principal sources of information: (a) review ofresearch literature; (b) international context and experiences; (c) Bank-wideeducation and nutrition sector experience; and (d) early childhooddevelopment experiences in Bolivia.

4.8 Review of Research iUterature. In preparation for the recentlyapproved Initial Education Project in Mexico (Loan 3518-ME), a researchreview was carried out, summarized in a Bank Green Cover Report (No.10129-ME; February 1992)--The Initial Education Strategy. Early childhooddevelopment experiences are also reviewed in an LATBR document (A View

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from LATHR No.32--Early Childhood Development Programs in LatinAmerica: Towards Definition of an Investment Strategy, August, 1992), andin Report No. EDT69, "The Eleven Who Survive: Toward a Re-Examination of Early Childhood Development Program Options and Costs'(March 1987). These documents underscore that both scientific evidence andprevious project experience provide strong evidence for investing inintegrated attention to care and development of young children.

4.9 International Experiences and Lessons Leared. In recent years,three intemational events have catalyzed renewed interest and commitmentsby the intemational donor community and governments to expand access andenhance the quality of early childhood education. First, the Convention onthe Rights of the Child was adopted by the United Nations Assembly inNovember 1989. Second, the World Conference on Education for All, heldin March, 1990 in Thailand under the sponsorship of the World Bank,UNDP, the United Nations Education, Scientific and Cultural Organization(UNESCO), placed special emphasis on the expansion of early childhoodcare and development through family involvement and communityinterventions, especially for poor and disadvantaged children. Third, theWorld Summit for Children, held at the United Nations in September 1990,promoted such initiatives.

4.10 Non-formal early childhood development interventions have been amajor area of innovation worldwide, especially in Latin America. The mostrelevant experiences come from: (a) India, Integrated Child DevelopmentServices Project, with Bank support (Loan No.3253-IN); (b) ColombiaHogares de Bienestar Infantil, supported by the Bank-financed CommunityChild Care and Nutrition Project (Loan No.3201-CO); (c) Mexico, InitialEducation Project, with Bank support (Loan No.3518-ME); (d) Kenya,Harambees--Let's pull together--movement); (e) Brazil (CrechesComunitarias, or Community Nurseries); (f) the United Kingdom(Playground Movement); and (g) Venezuela (Hogares de Cuidado Diario, orDay-Care Homes). Experience from integrated nutrition projects (e.g., theTamil Nadu Nutrition Project--Loan No.2158-IN) is also relevant to thedesign of early childhood development projects.

4.11 Lessons learned from these international experiences include:(a) child development projects are cost-effective, with the costs of the earlyintervention more than offset by the savings resulting from the reduction inprimary school repetition in the first and second grades; (b) non-formal childdevelopment approaches appear to focus more effectively on intended targetgroups, demonstrate a wider spectrum of long-lasting benefits, and are morecost-effective than formal modalities; (c) high supervision ratios are key toproject quality and success; (d) sustainability of activities and benefitsdepends on effective community participation; and (e) effective childdevelopment requires the integration of education, health and nutritionservices.

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4.12 The Hogares de Bienestar Infantil project in Colombia is the closestin purpose and design to the proposed project and has demonstrated that it isfeasible to mount an early childhood development project on a large scale(current enrollment figures suggest coverage of some 800,000 childrenbetween 2 and 7 years of age). An evaluation of the project was carried outin 1992 and concluded the following. First, the project appears to bereaching the target population. Second, positive effects on beneficiarychildren are found with respect to the development of gross and fine motorskills, language, social skills and general development, despite a lack ofsignificant effect on nutritional status. Third, the project improvedemployment opportunities for women. The evaluation estimates that about 25percent of women (i.e., caregivers and mothers of participating children)changed employment from (mainly) homemaking, domestic service andhandicrafts to (mainly) employment as caregivers and work in "commercial"jobs. Finally, the utilization of health services by beneficiaries substantiallyincreased. The lack of effect on nutritional status is associated with problemsin ensuring the constant and timely availability of food, and the fact thatchildren do not receive food supplements in the evenings and weekends. Theevaluation points out that, if the project were to have achieved betternutritional effects, the psychosocial effects would have been even greater.Some of the evaluation's recommendations relevant to the proposed projectare that: (a) food availability needs to be constant and timely, educatorsshould be trained to identify malnourished children and supplement their foodintake, and malnutrition-related infections have to be diagnosed and treated;and (b) it is insufficient solely to sign agreements with the health sector toguarantee that a minimum package of services is provided--monitoring andregular follow up is required at the local level to make those agreementsoperational.

4.13 Early Child Development Experiences in Bolivia. In the past, mostearly child development programs (with a varied mix of nutritionsupplementation, health and early education activities) have been carried outthrough the MPSSP. The largest program, Asistencia Integral a MN'tos Pre-Escolares de Zonas Deprimidas de Bolivia, was initiated in 1987 with supportfrom the WFP, the United Nations Fund for Children and Families(UNICEF) and the Pan American Health Organization (PAHO). Theprogram's coverage objectives of 95,000 children were never attained; at theend of 1992, less than 20 percent of the target population was covered.

4.14 The program consisted of three service delivery modalities. TheChicolac Children's Centers began as a pilot project in 1985 and expandedbetween 1987 and 1990 to cover approximately 71,000 children. It focusedon delivery of powdered milk and a piece of corn bread to groups of between50 and 300 children. Parents took turns preparing and distributing food andwere to receive training. In 1990, a total of 707 centers were operating infive peri-urban areas covering about 70,000 children. The program wassuspended following an evaluation that pointed to a general lack of nutritionaland developmental effects due to an insufficient production capacity andspotty delivery of food, and grave deficiencies in the implementation of childdevelopment and community participation activities.

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4.15 The second modality is Integrated Child Care Centers--based onprevious experiments with Guarderfas Infannles Populares (1982-84), andthen Centros Infantiles Populares (1984-87). About 136 of these centerswith a total enrollment of 6,305 children are in operation in urban marginalareas of five cities. Each center attends between 30 and 90 children who are8 months to 6 years of age. The staff, which consists of one caretaker perten children, receives payment in food (donated by WFP). An evaluation ofthe program has shown that family and community participation is relativelygood and, despite problems in attendance, that cognitive development andnutritional status of children have improved.

4.16 The third modality of the program is the Home Child Care Centers,initiated in 1989. This modality involves use of a private home in which 10or more children are cared for at least five hours daily by two mothers. Aswith the Integrated Child Care Centers, the caregivers are paid with donatedfood. These centers are managed through NGOs. In 1992, 1,350 childrenwere being attended by about 230 caregivers in 82 child care homesdispersed across five cities. A 1992 evaluation indicated that attendance washigh, but the hours were short, and the conditions and quality of care wereminimal.

5. THE PROJECT

A. Project Objectives and Concept

5.1 The proposed project supports the Government's Social StrategyStatement and the 10-Year Action Plan for Children and Women. It seeks tocontribute toward poverty alleviation and human capital developmentobjectives by supporting the initiation of the Proyecto Integral de DesarrolloInfantil (P11)I) in the 34 largest urban areas, and establishing a basis fordevelopment of long-term policies and programs to provide early childhooddevelopment services, including in rural areas. The specific objectives areto: (a) improve children's readiness to succeed in school and beyond byfacilitating their physical, emotional, social and cognitive development;(b) enhance the status of women by increasing their employmentopportunities, and expanding their knowledge of education, health andnutrition; and (c) increase community and private sector participation in thesocial development process. A secondary objective is to help theGovernment strengthen its capacity to formulate and evaluate social policy.

5.2 To achieve these objectives, the proposed project reflects a three-pronged strategy, inter alia: (a) support for development of national policiesin the areas of early child development, food security and nutrition, whileconcurrently strengthening ONAMFA's management capacity to fulfil itsintended role to help guide social policy formulation; (b) assistance for thedelivery of integrated child development services in poor urban and peri-urban areas via a non-formal, home-based day-care center modality; and (c)establishment of an ongoing system for monitoring and evaluating projectimplementation performance.

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B. Scope and Target Population

5.3 The proposed project reflects the Government's goal to provideservices to the most disadvantaged subgroups. As IDA's poverty assessmentunderscores, rural areas suffer the most extreme poverty. However, povertyis a pervasive and expanding problem in marginal urban areas. In the inter-censal period 1976 to 1992, the percentage of the population living in urbanareas increased from 42 to 58 percent. Rapid growth in major and secondarycities has brought a series of new challenges for delivery of basic socialservices. For instance, only 35 percent of urban dwellers have sanitationservices. It also is estimated that about 140,000 children are malnourished inthe country's four major cities alone. Logistic and service delivery problemsin the health, nutrition, education, and water and sanitation areas areexacerbated by cultural challenges, as rural and ethnic populations attempt totransfer traditional practices and beliefs to the city. For the most part, thesenew urban settlers face special problems because of the general loss ofsupport systems, i.e., extended families, that helped care for their families inrural areas.

5.4 Strong financial and operational justifications also exist forconcentrating proposed project activities, at least in this initial phase, in poorurban and peri-urban areas. Rural population is highly dispersed, presentingserious logistical problems for expanding access to basic social services,including day-care, early education, and health and nutrition care. The costof delivering targeted, caregiver home-based child development services tothese populations on a massive scale would be extremely high and arguablynot culturally/technically appropriate. In contrast, the heavy concentration ofthe urban poor provides important economies of scale to service delivery.Nevertheless, the project will finance both an in depth analysis of theconstraints and potential faced by existing program initiatives to expand suchservice coverage to rural areas; and based on this analysis, will identify andpilot test promising modalities for delivering integrated child developmentservices in rural areas.

5.5 The proposed project specifically will target poor households in urbanand peri-urban areas with populations over 10,000. According to preliminaryresults of the 1992 census, 34 cities, thus, would qualify for projectparticipation, representing in aggregate 3.3 million persons or about 48percent of the country's total population (Annex 2, Table 1). The projectseeks, by the end of its sixth year, to have attained an installed capacity of8,670 day-care centers to provide non-formal, home-based, integrated childdevelopment services to 130,050 children aged 6 months to 6 years annually,or about 16 percent of all children living in those urban areas. Cumulatively,taking into account expected promotions of six year olds, 203,547 childrenare expected to have benefitted over the project life (Annex 2, Table 2).Anticipated coverage levels, disaggregated by city, represent about 5, 18 and47 percent of children at risk at the end of the second, fourth, and sixthyears, respectively, of project implementation (Annex 2, Table 3).

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5.6 In the selection of cities for phasing-in of the project, priority will beassigned to those with the highest prevalence of malnutrition. The relativelymodest coverage targets over the first half of the project respond to the needto ensure the high quality of project content, systematically and thoroughlyaddress evolving implementation issues, strengthen ONAMFA's institutionalcapacity at the national and regional levels, and refine logistical mechanisms,with special attention to the timely flow of critical program inputs, includingfood. Experiences from similar child development projects indicate that toensure quality and the ultimate success of the project, expansion of coverageshould occur slowly in the start-up phase, and then accelerate onceadministrative procedures have been tested and are fully operational.

5.7 Women also would be direct beneficiaries. The project wouldcontribute to enhancement of women's status by increasing their employmentopportunities through taining and participation of caregivers, and expandingaccess to day-care for mothers, and by improving their knowledge ofeducation, health and nutrition. Further, by expanding substantially access today-care, the project would free women's time to seek work or to improvetheir jobs. The overall health and nutritional status of women also is likelyto improve for an estimated 16,057 pregnant women (based on presentfertility rates) who either are caregivers or have children participating in day-care centers, as project-secured access to preferential user fees increasesutilization of pre- and post-natal care, safe deliveries, and family planningand health and nutrition education and services (Annex 2, Table 4). Byproject completion, the proposed project would have trained and providedemployment to an estimated 20,808 caregivers (most of whom are expectedto be women) who would receive a monthly stipend equivalent to theminimum salary (Annex 2, Table 2). Approximately 8,600 of thesecaregivers also would benefit from other complementary project inputs,including access to credit to upgrade their homes and, via direct beneficiarycontributions, assistance in the payment of basic utility bills, i.e., electricityand water, to help offset the costs associated with using their homes for day-care centers.

5.8 The planned inter-city distribution of day-care homes according to theextent of malnutrition provides only one, albeit important measure to ensurethat project benefits are targeted to the most vulnerable groups.Complementary targeting mechanisms include: (a) a geographical selectionof urban and peri-urban neighborhoods for program sites based on povertymapping; and (b) and child-specific selection criteria for such neighborhoods(para. 5.18).

5.9 Given wide variations in poverty levels within urban centers, theproject would disaggregate cities by poverty zones. During the first year ofproject execution, targeting would be based on SIF's "Urban Prioritization1991" which defines four levels of poverty area based on service deliveryindicators (i.e., coverage levels of water supply, sanitation and electricity),complemented with malnutrition prevalence data from the National System ofEpidemiological Surveillance (SVEN). To refine the targeting of priorityneighborhoods, utilizing 1992 census data, UDAPSO will develop updated

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poverty maps of all urban areas, disaggregated by census zones (comprisingapproximately 1,000-2,000 homes per zone). These poverty maps areexpected to be finalized by the end of 1993.

C. Detailed Project Description

5.10 The proposed project consists of the following components:

(a) Sector Policy Development and Management Strengthening:enhance the public sector's capacity to formulate and evaluatesocial sector policy by supporting: (a) studies and technicalassistance to permit the broadening of policy foundations in theareas of food security and nutrition, and refinement ofmeasures of child development, and extension of integratedchild development services to rural areas, including financingfor pilot projects; and (b) consolidation of ONAMFA's recentrestructuring efforts and its incorporation into the CSRP.

(b) Service Delivery Support: support the delivery of integratedchild development services in poor urban and peri-urban areasby implementing a non-formal early child development modelin 34 cities, providing care through some 8,600 home-basedday-care centers to about 15 children per center by two tothree caregivers (depending on the age-mix of beneficiaries)selected from the local community. To this end, building on asuccessful pilot project experience, the project would:(a) further develop and strengthen the project's operationalstructure; (b) refine mechanisms for targeting of beneficiariesand selection of caregivers; (c) provide initial and in-servicetraining to caregivers to enable them to respond to earlyeducation, nutrition, and health needs of the children;(d) promote the formation and build the capacity of parents'associations to assume select administrative functions withinthe program; (e) on a mixed loan-grant basis, finance therehabilitation of the caregiver's home to serve as the actualday-care site; (f) directly provide children with nutritionsupplementation and a basic package of integrated earlyeducation services, and through cooperative agreements withlocal health centers, ensure their access to key preventive andcurative health services; and (g) for pregnant women whoeither are caregivers or have children participating in theproject, secure preferential fees for service, thus, increasingtheir access to maternity care and family planning services,and health and nutrition education and services.

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(c) Monitoring and Evaluation: support close projectperformance monitoring and impact evaluation by developingand implementing: (a) a management information system tomonitor timeliness in meeting programmed targets, and theoverall technical quality, administration and financing ofoperations under the project; and (b) an impact evaluationsystem, to include addition of special modules to the IntegratedHousehold Survey (EIH), and the conduct of speciallongitudinal studies and sociological surveys.

Sector Policy Development and Management Strengthening Component(proposed outlay, US$4.0 million equivalent, including contingencies)

5.11 Sector Policy Development. The project would assist theGovernment in the formulation of sound policies and programs to enhancethe welfare of disadvantaged children, women and their families.Specifically, the project would help broaden policy foundations in the areasof food security and nutrition, extend early child development services torural areas, and refine measures to assess child development. To this effect,the project would finance studies supported by about 25 person-months oftechnical assistance, and select operating costs for conduct of pilot projects totest alternative delivery models, which activities would be concentrated in thefirst three years of the project. It is expected that, on the basis of thestudies' recommendations, the Government would: (a) establish a focal pointto coordinate food security and nutrition interventions, rationalize food aidand better integrate agriculture production and social sector programs;(b) develop and test a delivery model for the extension of early childhooddevelopment activities to rural areas; and (c) refine child developmentmeasures.

5.12 Management Strengthening. This sub-component focuses on twodiscrete but related activities. First, it would further efforts to modernizeONAMFA's administration and operations. Second, it would supportONAMFA's incorporation into the CSRP.

5.13 Since JNSDS/ONAMFA initiated its restructuring in 1989, significantstrides have been made in improving the efficiency and transparency of itsoperations. Building on experience to date, the project would seek toconsolidate the modernization process. The project would support thestrengthening of ONAMFA's administrative and financial operations in thefollowing areas: accounting, personnel management, budgeting,asset/inventory control, warehouse management and procurement.

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5.14 To this end, the project would finance:

(a) technical assistance (36 person-months concentrated in the firstthree years of the project) to support and oversee themodernization process. The consultant would work directlywith ONAMFA's Executive Director and the chiefadministrative and financial officers at the central and regionallevels;

(b) the implementation of information systems, involving (i) theinstallation of computer equipment in each regional office andin the main administrative sections of the central office;(ii) training in systems operation for an estimated 170 staff;and (iii) technical assistance (4 person-months/year) to assist inthe implementation of these systems and to introduce designmodifications, as needed;

(c) a mid-term technical and administrative evaluation ofONAMFA to assess progress in its modernization process andprovide recommendations for further improvements (involvingabout 15 person-months of technical assistance); and

(d) a mid-term evaluation of progress made in implementation ofinformation systems that would include the design of a Five-year Information Systems Plan to guarantee ONAMFA'scapacity to manage information beyond the life of the project(involving about 3 person-months of technical assistance).

A matrix of objectives, outputs and timing of activities, and draft terms ofreference of technical assistance related to this sub-component are providedin Annex 3.

5.15 Experience has shown that institutional strengthening measures whichdo not address the issues of capacity and continuity of staff are notsustainable. The success of ONAMFA's modernization process depends ingreat part on the ability to build a stable and weil qualified team ofmanagerial and technical staff. To this end, ONAMFA has been accepted bythe Ministry of Finance into the CSRP. Based on the overall agreementbetween the Ministry of Finance and ONAMFA signed in January 1993, theproject would support the inclusion into CSRP of 33 key managerial andtechnical line positions. The incremental costs represented by the differencebetween current salaries and CSRP salaries would be financed by the projecton a declining basis. Annex 4 provides an overview of the CSRP rationale,criteria for agency participation and personnel selection procedures, andimplementation progress to date, as well as a list of positions to be financedunder the proposed project and their financing levels. Additionally, theproject would support the creation of a permanent division within ONAMPAto implement the project, and to support early child development programs(pam. 7.1). At negotiations, assurances were obtained from the Government

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that: (a) ONAMFA would maintain management with qualifications andexperience satisfactory to IDA; and (b) the annual audit report would includea separate opinion as to whether CSRP criteria for selection of personnelhave been observed in the choice of staff for project-financed CSRPpositions.

Service Delivery Support Component (proposed outlay, US$133.6 millionequivalent, including contingencies)

5.16 Programmatic Model. The programmatic model to be adopted bythe project includes provision of integrated early child development services(including education, nutrition and health) by two to three trained caregivers,depending on the age-mix of the beneficiaries. Typically, two caregivers willwork in each day-care center. In centers with enrollment of three or morechildren under two years of age, a third caregiver will be employed. Nocenter, however, will enroll more than five children under two. One of thecaregivers also is the owner of a home within the given urban or peri-urbanarea in which the day-care center operates. Each such center will serve agroup of 15 children between 6 months and 6 years of age, selectedaccording to precise criteria (para. 5.18). The typical center will operate 8hours per day, 5 days a week, and 12 months per year. The project offersaccess to funds on a mixed grant-loan basis to the owners of the house forbasic rehabilitation to meet minimum acceptable standards of security, spaceand services for day-care activities.

5.17 Stipends to Caregivers and Beneficiary Charges. Each caregiverreceives a monthly stipend, the costs of which would be financed under theproject. The stipend is roughly equivalent to the minimum salary (calculatedon the basis of US$4.5 equivalent per child per month). IDA would financesuch costs on a declining basis. Costs associated with the day-to-dayoperation of the center would be covered by parents' payments equivalent toUS$2.25 per month per child, declining to US$2 and US$1.75 equivalent forone and two additional siblings, respectively, attending the center. Thesebeneficiary/user fees are expected to generate about US$8.8 million over theproject life.

5.18 Targeting areas and potential beneficiaries. Subsequent to theselection of participating cities and neighborhoods based on the criteriadefined above (paras. 5.5 and 5.9), a beneficiary selection process would becarried out. In principle, all children 6 months to 6 years living in theselected geographic area are eligible to participate in the project. However,priority would be given to those children who are, in order of importance:

(a) malnourished;(b) under the care of only one person (e.g., children of single

parents);(c) from families with parents employed and without child care

and, thus, child at risk of abandonment; and(d) from high parity families (i.e., with five or more children).

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5.19 Selecting caregivers among community women. Concurrent withthe selection of children, ONAMFA staff will undertake project promotionefforts in the local community, including identification and elaboration of alist of potential caregivers. Priority would be given for pre-selection to thoselocal residents who:

(a) are between 18 and 50 years of age;(b) have writing, reading and basic mathematical skills (though not

an exclusionary factor, as long as at least one of the two tothree caregivers per center meets these requirements);

(c) have obtained an initial certificate of good health, includingresults of three laboratory exams (blood test, urinalysis, andbacilloscopy) and have annual checkups thereafter;

(d) have demonstrated full-time availability to work under theproject;

(e) are accepted by the community, as well as have obtainedwritten consent from their spouse to participate in the project;and

(f) have demonstrated a capacity to work well with children(though not necessarily having children of his/her own)

5.20 Training. Training is crucial to the quality and success of theproject. Training activities would be directed at the following levels: (a)technicians at the national and regional level; (b) caregivers; (c) parents'associations; and (d) as local programs permit, health, nutrition and relatedpromotion activities, including encouragement of breastfeeding, for womenwhose children attend the day-care centers. ONAMFA has prepared acomprehensive training plan including an implementation timetable. Draftterms of reference for technical assistance have been finalized.

(a) Training of technicians would take place at the national levelthrough: (a) technical assistance (approximately 10 person-months) to the team in the areas of health and nutrition, qualitycontrol of food and menu preparation, food distribution anduse of the pre-school child development scale; and(b) attendance at workshops, courses and seminars (at thenational and international level). In addition, the projectwould finance selectively study tours to other ongoingsuccessful child development projects (e.g., visits to theHogares de Bienestar Infantil program in Colombia).

(b) At the regional level, training of the technical teams wouldinvolve: (a) an orientation session, involving a 2-daypresentation in La Paz of the nature and scope of the project,its objectives and rationale and overall implementationarrangements; (b) a follow-up session at the regional level (twoweeks after the initial orientation), where more specific project

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contents are presented, including: mechanisms for theselection of educators and children, implementationarrangements, training of educators, accounting andadministrative procedures and monitoring and evaluationrequirements; and (c) a supervision/training visit from thenational team at least every two months.

(c) Caregivers would receive an initial training session of 40 hoursdivided into the following modules: health, nutrition, earlychild education, fostering of community organization andparticipation through parents' associations, promotion of therole of women, and basic accounting and administrationprocedures. Each initial training sessions would include amaximum of 25 caregivers who would ultimately provide thebase from which staff for 10 day-care centers would beselected, as well as potential back-ups should some of thoseinitially chosen not prove able to carry out the job.

(d) Training of parents' associations would involve thedissemination of information by the regional project teams onthe objectives of the project and would include modules inaccounting and administration procedures so that, wherefeasible, such associations could assist ONAMFA in local day-care centers' management functions.

5.21 Supervision. Prior to the initial training session for a potential groupof caregivers, the regional team would select and contract an externalsupervisor (e.g., from a local NGO or university) who has completed, at aminimum, two years of secondary education. The external supervisor wouldprovide support to the regional team during the sessions and would beacquainted with specific details and requirements for project supervision.

5.22 A detailed supervision plan has been developed. During thepreparatory phase for opening a group of day-care centers, representing aperiod of approximately two months, a local architect would follow up houserehabilitation activities, while a regional technical officer would follow up theinitial training of caregivers. During the subsequent four-month start-upphase, a member of the regional technical team would be assigned to eachgroup of 10 centers. Together with an external supervisor, he/she wouldcarry out regular bi-weekly training/supervision visits during the initial twomonths. For the next two months, the external supervisor would visit eachcenter once a week. In the subsequent six-month follow-up phase, theexternal supervisor would visit each center twice a month, and the regionaltechnician would visit each center at least once a month to oversee the workof the supervisor. In the subsequent consolidation phase, the regionaltechnician would visit each center at least once every two months, and theexternal supervisor (responsible for a maximum of 20 centers) would carryout, at a minimum, one monthly visit to each center. To ensure adequate

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oversight, a member of the regional technical team would be responsible forno more than two external supervisors.

5.23 Home rehabilitation. The project would finance, on a mixed grant-loan basis, the costs of rehabilitation of the homes of those caregivers whoseresidences will serve as day-care sites. The objective of this sub-componentis to: (a) ensure that all day-care sites meet minimum acceptable standardsof security, space and services for conduct of their activities; (b) create afinancial incentive for caregivers to remain in the project once rehabilitationis completed; (c) recover a portion of the private gains accruing to thecaregivers from home rehabilitation; and (d) help develop a loan repaymentdiscipline among participating caregivers.

5.24 This sub-component would operate as a revolving fund, with initialcapital and replenishment paid by the project, from which funds would bedrawn for individual rehabilitation activities, and into which repayments (i.e.,partial cost recovery) would be made. The project would support this fundby contributing to it on an annual basis based on estimates of that givenyear's projected financing needs for rehabilitation, and the previous year'scost recovery amount. The balance remaining in this fund at the end of theproject would revert to the Treasury. Contracting of construction materialsand necessary labor would be the responsibility of the individual caregiver.ONAMFA's regional architects would be responsible for certifying that workhas been completed in accordance with original designs and specifications.

5.25 The amount of the home rehabilitation grant-loan available to a givencaregiver would be subject to a ceiling which is the equivalent of US$500.Repayments would be made over a maximum period of 24 months, andwould be set by a scale according to the original rehabilitation grant-loanamount (Annex 5). This scale is designed to control the caregiver's monthlypayments. A caregiver would repay approximately 50% of the originalrehabilitation grant-loan amount in a period ranging from 6 to 24 months.Monthly payments are set so as to not exceed one-third of the caregiver'smonthly stipend, and will be deducted directly from his/her monthly stipendto facilitate repayment.

5.26 The project would finance basic goods to equip each day-care center,including: furniture, kitchen stoves and equipment, toys, educationalmaterials, refrigerators (one for each center in warm regions of Chaco andOriente) and a first-aid kit. The initial investment for these goods has beenestimated at US$2,100 per center. Pre-determined replacement rates andcosts would be used to replace used or damaged furniture, equipment andmaterials.

5.27 Nutrition Services and Commodity Distribution. AU childrenattending the day-care centers who are either not malnourished or mildlymalnourished would receive at least 70 percent of their daily age-adjustednutritional requirements. The average amount of calories and proteinsrecommended to cover 70 percent of age-adjusted requirements are: children

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6 months to 23 months of age: 931 calories and 19 grams of protein per day;and children 2 to 6 years of age: 1200 calories and 22.4 grams of protein perday. These supplements would be provided at the day-care center via threemeals daily: breakfast, lunch, and an afternoon snack, providing 30 percent,50 percent, and 20 percent, respectively, of the daily ration. To respond todistinct culturally-based dietary habits and, relatedly, the availability of freshfoods, seasonal and regional diets will be elaborated by the regional projectteam with technical assistance to be financed under the project. Nutritionalvalue and costs of menus across regions will be standardized. Twenty-fourhour recall studies of household food consumption and parents' nutritioneducation activities would be carried out to ensure that all participatingchildren receive a complete diet and, hence, that appropriate levels of foodintake occur within the home in the evenings and during weekends, so as tonot compromise project beneficiaries' nutritional status.

5.28 Children with moderate and severe malnutrition will receive at theday-care center 100 percent of daily age-adjusted nutritional requirements viasix meals per day. The caregiver, with support from ONAMFA's regionalnutritionist, would be responsible for the special treatment of these children.The caretaker would be trained to supervise food intake by malnourishedchildren, to ensure each is weighed by the local health referral center on aweekly basis to monitor his/her nutritional status progress, and to carry outhome visits to assess environmental or socioeconomic conditions which maybe underlying causes of the malnutrition. Children with mild malnutritionwould also be monitored (i.e., recordation of their weight-for-age) by thereferral health center on a weekly basis, but would only be provided 100percent of daily caloric and protein requirements at the day-care center ifthey experienced no weight gain between monitoring visits.

5.29 In addition to confirming the malnutrition diagnosis and monitoringthe child's progress in follow-up visits, the physician at the referral healthcenter would carry out a complete check-up (including basic laboratory tests)of all malnourished children to identify any morbidity associated with theirmalnutrition. For those parents in extreme poverty who, thus, are unable toafford the costs of these laboratory exams and/or recommended treatment formalnutrition-associated morbidity in their children, financial assistance wouldbe made available to them, via a project-financed health fund. However,financing from this fund would be limited to a monthly ceiling of US$5.00equivalent per functioning day-care center. It is recognized that due tobudgetary constraints, the proposed project can only provide seed money forthis fund. To complement project-financed support to this health fund, therespective regional team will seek to mobilize additional resources from localparents' associations and/or patrons of the project (e.g., church groups,NGOs). The operation of the fund would be evaluated on a monthly basisvia data from the project's management information system to ensure theequitable distribution of project-provided funds between regions.

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5.30 Food (not IDA financed) would be made available to the projectthrough two modalities: (a) distributed dry food commodities from food aidsupport, provided either in food, or via monetization, by local purchase; and(b) local purchase of perishable commodities. The first modality involves aquarterly assessment of food requirements by ONAMFA's regional offices,requests to donor agencies to guarantee availability of food for the followingquarter, and the collection of food from warehouses by ONAMFA's regionaloffice, NGOs, or where existent, local parents' associations. The secondmodality involves the direct transfer of funds to ONAMFA's regional office,NGOs providing support to ONAMFA in the administration of select day-carecenters, or parents' associations, where existent, which would be responsible forpurchase and overseeing distribution of fresh food. In this latter case, theresponsible party would enter into six-month contracts with local suppliers, to beawarded on a competitive basis; the selected supplier would distribute such freshfood weekly to each day-care center.

5.31 Health Services. An agreement has been signed between ONAMFA andMPSSP specifying MPSSP's responsibilities in provision of a minimumacceptable package of services to project beneficiaries. These services will notbe financed by IDA but rather via preferential user fees to be available tobeneficiaries to obtain specific diagnostic, preventive and curative services. Thenational agreement would be supplemented by local agreements with each healthreferral center defining more detailed operational and logistical arrangements forthe delivery of health and related services in support of project objectives.These local agreements should not be limited to the public sector and couldinvolve private providers of health care services. The project also would financetraining activities with the personnel of referral health centers to guarantee thatagreed administrative procedures are followed, and that a minimum package ofquality health and nutrition services is provided to project beneficiaries.

5.32 The basic package of preventive services includes, for all childrenenrolled in day-care centers, completion of their full immunization regimenwithin six months of their entry into the project. In addition, the followingservices would be provided to specific subgroups:

(a) monthly check-ups for normal and mildly malnourished children,to include: nutrition assessment (including measurement andrecordation of weight-for-age); and detection of diarrheal andrespiratory diseases and of other common illnesses.

(b) for all children with mild malnutrition who have not gained weightbetween control visits, and all children with moderate and severemalnutrition, weekly nutrition surveillance; medical check-ups formorbidity diagnosis (including laboratory tests); and treatment viabi-monthly medical visits with the doctor at the referral healthcenter.

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(c) for pregnant women, including mothers of participating childrenand caregivers (for a preferential fee of US$2.5 equivalent), fourprenatal control visits, including evaluation of obstetric risk,tetanus vaccine and iron supplementation; provision of a "cleanpacket" for home-based delivery, together with promotion of theuse of hospital-based delivery services' (at a preferential fee ofUS$15-20); and at least one postnatal control visit, includingbreastfeeding promotion and family planning education.

5.33 The health referral system needs to be well defined and known by thecaregivers at each day-care center to ensure that health centers provide theagreed minimum acceptable package of services to project beneficiaries. Atnegotiations, assurances were secured from the Government that, prior toopening any given group of day-care centers, an agreement would befinalized between ONAMFA and the respective public or private referralhealth center to ensure availability to project beneficiaries of a minimumacceptable package of health and nutrition services.

5.34 While parents of project participants are to continue to assume overallresponsibility for referral and payment for curative services for theirchildren, the caregiver would: (a) accept a sick child in the center in caseswhere an authorized physician has evaluated the child and allowed itsattendance with clear directions for treatment; (b) take care of a child thathas become sick while attending the center until the parents arrive; and (c) beresponsible for referring the child to a health facility in emergency cases.For mild conditions, where beneficiary-provided resource pools exist, thecaregiver would assume responsibility for payment of such treatment forchildren under his/her care.

5.35 Early Education. The project would support early educationactivities to promote the psychosocial development of participating childrenthrough the stimulation of their cognitive, social, emotional, motor andcommunication capacities. Education activities would be based on adiagnosis of the prevailing child rearing practices in the community. Thisdiagnosis would serve to establish the abilities and needs of caregivers andhelp refine the plan of activities required for each day-care center andparticipating child. Building on this initial diagnosis, a program of educationactivities would be defined centered on play (free and directed play, and"working corners"). Each center would be equipped with play andeducational equipment and materials, based on a standard list developed byONAMFA's technical team.

1 Notably, hospital-based deliveries presently represent only about 40 percent of all annualbirths. Through project-supported education, and improved utilization of the health system,it is expected that this proportion will increase among women with children in the day-cacenters, and caregivers.

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5.36 To assess the individual development of each child, a "ChildDevelopment Chart' would be applied by the caregivers. This chart has beendeveloped and successfully tested and applied by a Bolivian NGO.Additionally, in order to monitor and evaluate the project's impact on childdevelopment, a Pre-School Development Scale would be administered by thetechnical supervisors within the first three months of the child's enrollment inthe center, and thereafter: (a) every three months for children under one yearof age; and (b) every six months for children in the 1 to 6 year age group.The pre-school development scale adopted would be that developed for asimilar program in Colombia, and successfully used in this project's pilotphase. Project financing would be provided within the sector policy sub-component to further evaluate this development scale and refine it, asneeded.

Monitoring and Evaluation Component (proposed outlay, US$2.6 millionequivalent, including contingencies)

5.37 The proposed project would finance the implementation of amonitoring and evaluation component consisting of a managementinformation system (Sistema de Informaci6n Gerencial--SIG) and an impactevaluation system. The management information system would provideproject management with a continuous flow of key indicators to measureproject implementation performance, as measured by: (a) the actual pace atwhich key inputs are put in place vis-a-vis programmed coverage targets;(b) the extent of project compliance with established technical and operationalnorms and standards, essential to ensure constant delivery of high qualityservices to beneficiaries; and (c) overall trends which reveal whether theproject is attaining desired intermediate objectives, without which theintended project impact is not likely to be achieved.

5.38 The impact evaluation system would document the effects of theproject in three key areas: (a) how well it targets children, women andfamilies at highest risk; (b) how participation affects the development andwell-being of children, women and communities; and (c) the extent to whichparticipation in this pre-school project improves the subsequent progress andperformance of children in primary school. Concurrently, the impactevaluation will seek to ascertain whether and how the age of entry in day-care, length of participation, and/or differences in the relative efficiency andquality of day-care provided between centers, result in varying effects onparticipating children and their families; and whether synergistic effects existbetween expected improvements in the status of women and communities asa result of the project, and the overall well-being of the children. A keymeasure of impact would be comparison, over time, of the developmentalstatus of children enrolling in project-supported day-care centers fromJanuary-June 1994 with two matched control groups to be drawn from theIntegrated Household Survey (EIH). Development progress of these threegroups of children would be monitored via semi-annual EIH surveys, to

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include additional modules on health and nutritional status, and childdevelopment. In both the management information and impact evaluationsystems, both quantitative and qualitative measures would be used. Annex 6contains detailed information on the variables, indicators, and instruments tobe used for data collection, the party responsible for data registration, andthe frequency with which the indicators will be analyzed for the SIG; and thevariables and methodological framework to be used for the impact evaluation.The project would finance the costs associated with the contracting ofconsultants from the National Institute of Statistics (INE) and other agenciesselected to carry out the additional modules of the EIH, and the processingand analysis of project performance monitoring and evaluation data. Termsof reference for technical assistance needs have been finalized. Atnegotiations, assurances were obtained from Government that: (a) the agreedevaluation and monitoring systems would be under implementation no laterthan March 31, 1994; and (b) annual reports on progress and results of themonitoring and evaluation component would be prepared by ONAMFA andsubmitted for IDA review.

5.39 Monitoring. The management information system would provideindicators to monitor project implementation performance. The majority ofthese indicators would be generated for ONAMFA's SIG from regularreports of caregivers, project supervisors, and the Regional Technical Teams.Indicators for performance monitoring include:

(a) existing levels of key project inputs, i.e., net number offunctioning day-care centers, staff on regional technical teams,supervisors, caregivers, and children enrolled, as well as theextent and causes of turnover in such inputs, compared toprogrammed project coverage targets;

(b) measures of the extent of compliance with technical andoperational norms of the project, and the overall soundness ofproject administration and financing, including indicators onthe adequacy of: (i) targeting and selection of communities,children and caregivers participating in the project;(ii) community promotion activities; (iii) initial training ofpotential caregivers; (iv) functioning of the day-care centers,including actual delivery of programmed health, nutrition andeducation interventions; (v) payment of user charges;(vi) administration of the project with regard to the operationand financial status of the Rehabilitation and Health Funds, andacquisition of requisite food, materiel and equipment for theday-care centers; (vii) functioning of parents' associations;(viii) inter-institutional coordination with NGOs, MPSSP, andthe Ministry of Education and Culture; and (ix) actuallyreceived versus committed resources from food donor agenciesand other project financiers; and

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(c) trends in attaining coverage of key interventions essential toachieve intended project impact, with a view toward ensuringthat the project, over time, is resulting in: (i) an increase in theproportion of participating children with full immunizationcoverage within six months of enrolling, and who receiveregular health care and nutrition surveillance; (ii) a reductionin the prevalence of child malnutrition, particularly ofmoderate and severe degree; (iii) a diminution in theproportion of children who score at the lower end of the Pre-school Development Scale; (iv) a decrease in the extent of non-attendance at day-care centers due to illness; (v) an increase inthe proportion of project beneficiaries entering primary schoolupon reaching 6 years of age; and (vi) an augment in pregnantwomen's utilization of pre- and post-natal care and, relatedly,safe deliveries, and health and nutrition education and services.

5.40 In addition to regular monitoring activities, the project would financespecial evaluations to better document the quality of the nutrition, health andchild development interventions being delivered via the project. Theseevaluations include: child growth and monitoring activities, an evaluation ofthe use of the child development chart, child development activities, theamount and quality of food intake by children, and the treatment of childrenwith nutritional problems.

5.41 Impact Evaluation. The project would finance the costs of ongoingevaluation of the impact of the project on the status of participating children,women and families. An ancillary objective is to evaluate changes in thequantity and quality of community development activities in participatingneighborhoods. The key tool for evaluating impact would be analysis of datato be generated from periodic application of the EIH (a Living StandardsMeasurement/LSMS-type survey) to project beneficiaries and two carefullymatched control groups. Commencing in January 1994, and semi-annuallythereafter, the EIH's household interview-based survey, including newmodules to be developed specifically under this proposed project to measurechildren's health, nutritional and child development status, would be appliedto all families with children who enroll in project-supported day-care centersas well as the two matched control groups.

5.42 One control group would be selected from the overall EIH sample ofhouseholds that have children under six years of age, and have comparablesocioeconomic characteristics to families who are project participants.Another control group would be drawn from households located inneighborhoods where the project has been implemented but who have notenrolled their children in the day-care centers. A sub-sample of childrenidentified in each of the three groups would be followed-up on a quarterlybasis to document changes in the respective children's health and nutritionalstatus and development.

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5.43 To confirm results from the quarterly assessments of a sub-sample ofchildren in the three control groups (and in view of anticipated high mobilityof families within the control groups and, hence, difficulties in locating themover time), a follow-up EIH would be conducted in 1996 on the samehouseholds included in the initial 1994 survey. It is expected that the EIH-based impact evaluation system would continue to be carried out during thelast three years of the project. The system, however, would be thoroughlyreassessed at the time of the project's Mid-term Review, i.e., no later thanNovember 30, 1996, to permit introduction of changes, as deemed desirable,to improve its methodological approach and statistical soundness.

5.44 In addition to the EIH-based impact evaluation system, the projectwould finance four special studies to assess: (a) the impact of the project onwomen, including caregivers; (b) the impact of the project on communitydevelopment; (c) the cost-effectiveness of the project; and (d) the projectimpact on schooling and school performance. These studies would use acombination of methods including in-depth interviews, focus groupdiscussions, analysis of data from the project SIG, and review of minutesfrom meetings of community groups. Draft terms of reference for thesespecial studies have been finalized.

5.45 Project Preparation Facility (PPF). An advance of US$750,000 wasapproved by IDA on August 22, 1992 to finance project preparation activitiesand the implementation of pilot day-care centers in the cities of La Paz/ElAlto, Tarija and Santa Cruz to test different delivery modalities andoperational arrangements. The Government has submitted to IDA anevaluation of the pilot phase, including a detailed analysis of findings andrecommendations for modifications to the program that have beenincorporated into the final project design.

6. PROJECT COST AND FINANCING PLAN

A. Project Costs

6.1 The total project cost is estimated at US$140.2 million equivalent,including taxes (US$5.7 million equivalent) and physical and pricecontingencies with a foreign exchange component of about US$16.9 million,or about 12 percent of total project cost. Project costs by component aresummarized in Table 6.1. Detailed cost tables are provided in Annex 7.

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6.2 Contingency Allowances. Total contingencies of US$8.3 millionequivalent represent 6.3 percent of base costs and include physicalcontingencies of US$200,000 equivalent for equipment, furniture, vehiclesand educational materials. Price contingencies (US$8.1 million equivalent),representing 6.2 percent of base costs assume: (a) a projected local inflationrate of 6.46 percent for 1994, 5.5 percent for 1995, 5.18 percent for 1996and 1997, 5.11 percent for 1988, and 5.03 for 1999; and (b) a projectedprice increase for foreign costs estimated in US dollars at 3.1 percent. Costcalculations also assume a nominal exchange rate of 4.290 for 1994, 4.412for 1995, 4.256 for 1996, 4.639 for 1997, 4.756 for 1998 and 4.875 for1999.

Table 6.1: Project Cost Summary By Component

Local Foreign Total % Foreign % TotalExchange Base

Costs---------US$ million--------

A. Sector Polic Devpt. 3.2 0.7 3.9 18.5 3.0Management Strengthening

B. Service Delivery Support 112.2 13.4 125.6 10.7 95.3

C. Monitoring & Evaluation 1.4 0.9 2.3 39.6 1.7

Total Baseline Costs 116.4 15.0 131.3 11.4 100.0Physical Contingencies 0.1 0.1 0.2 45.2 0.1Price Contingencies 6.4 1.7 8.1 21.3 6.2

Total Project Costs 123.3 16.9 140.2 12.3 106.3

B. Recurrent Costs and Project Sustainability

6.3 Project incremental recurrent costs are generated by expenditures foradministrative support, supervision and training activities, caregivers'stipends, equipment replacement, expenditures associated with the healthfund, salary supplements for civil service positions, compensation ofincremental personnel directly involved in project implementation at thenational and regional level, and food commodities. Food-related coststotalling about US$52.0 million (representing 37 and 58 percent of total andrecurrent costs, respectively) although recurrent, carry little financial burdenfor the government since most food needs are expected to be secured throughcurrent and anticipated food aid programs.

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6.4 Incremental recurrent costs generated by the project at the end of yearsix would amount to US$33.2 million, distributed as follows: (a) food, 58percent; (b) caregivers' stipends, 20 percent; (c) minor expenses associatedwith the operation of centers, 10 percent (financed by the beneficiaries);(d) administrative costs, 7 percent; (e) external supervision, 3 percent;(f) health fund, 1 percent; and (g) civil service-related expenditures, 1percent.

6.5 The proposed project enjoys broad political support. Projectsustainability rests principally on the Government's ability to find "fiscalspace" for the proposed project's incremental recurrent costs. During thefirst three years of implementation (1994-96), given the conservative scale ofproposed project operations, the net fiscal impact will not be significant.However, in the latter years (1997-99), in which coverage is programmed toincrease rapidly, the incremental recurrent costs rise significantly,representing at the end of the project and annually thereafter US$33.2 millionequivalent (about 1.5 percent of total projected public current expenditures,and about 0.5 percent of expected GDP). The actual fiscal burden should notbe excessive, however, since the majority (i.e., 58 percent) of these recurrentcosts are attributable to the project's food requirements, virtually all of whichare expected to be met from external sources via food aid. The priorityassigned by Government to the project is reflected in a Governmentagreement to allocate annually minimum amounts of domestic and externalresources to the project (para. 6.6). This commitment is reinforced by theGovernment's Supreme Decree 23415 of March 5, 1993, already mandatingthe allocation of a significant share (i.e., US$48.2 million equivalent) of thefood aid required by the proposed project (Annex 8).

C. Financing Plan

6.6 The proposed loan of US$50.7 million equivalent would finance 36percent of the total project cost. It would cover US$16.6 million equivalentor 96 percent of foreign exchange expenditures, and about US$34.1 millionequivalent or 30 percent of the estimated local costs. The Government wouldfinance US$21.0 million equivalent or about 15 percent of total costs. TheWorld Food Programme (WFP) and the EC would finance about US$11.93and US$1.86 million equivalent, respectively, in food donations. UNICEFwould finance US$1.28 million equivalent, principally for training activities.Beneficiary contributions would represent US$8.8 million. USAID and theSocial Investment Fund contributed, in aggregate, about US$0.6 million forproject preparation activities and implementation of the pilot phase. Afinancing gap of about US$44.1 million to cover food requirements in thesecond half of the project is expected to be financed by food aid frombilateral agencies. During the appraisal mission, interest in financing foodwas expressed by USAID and Canada. Table 6.2 summarizes the project'sfinancing plan. Annex 7 includes the detailed financing plan per project

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year. The Government has submitted to IDA projections of social sectorinvestments for the 1994-99 period delineating all social sector projects to befinanced both from domestic and external sources. These projections suggestsufficient "fiscal space' for the proposed project. At negotiations, assuranceswere obtained that the Government would allocate in its annual budget, forthe years 1994 through 1999, and each year thereafter, the followingminimum amounts (representing its direct budgetary contribution and thefinancing to be sought from donors) for the financing of project expenditures:(a) US$1.039 million for CY94; (b) US$2.287 million for CY95;(c) US$5.38 million for CY96; (d) US$10.58 million for CY97;(e) US$17.78 million for CY98; (f) US$27.73 million for CY99; and (g)US$33.2 million for each year thereafter. A condition of credit effectivenesswould be that ONAMFA has received from the Treasury an amountequivalent to not less than US$340,000 for purposes of implementing theproject during CY93.

Table 6.2: Fmancing Plan

US$(million) %

Government 21.0 15]DA 50.7 36World Food Programme 11.9 9European Community 1.8 1UNICEF 1.3 1Beneficiaries 8.8 6USAID/SIF 0.6 1Other Cofinancing 44.1 31TOTAL 140.2 100

7. PROJECT IMPLEMENTATION

A. Project Management and Coordination

7.1 ONAMFA would be responsible for the overall implementation of theproject. Since the project represents a new programmatic initiative, thetechnical and administrative structures necessary to implement the projecthave been added to the organization at the central and regional levels as apermanent program structure (i.e., Proyecto Integral de Desarrollo Irfandl-PIDI or Integrated Child Development Project). An organizational chart ofthe central and regional program offices and their integration withinONAMFA's structure is presented in Annex 9. At the national level, theprogram is headed by a national coordinator and complemented by seventechnical staff in the areas of health and nutrition, education, project

- 35 -

implementation, community outreach, administration, managementinformation systems, and internal auditing.

7.2 ONAMFA would establish project teams in all eight of its regionaloffices. The teams would be fully integrated into ONAMFA's regionalstructure, with supervision by the regional Executive Director and supportfrom the regional administrative systems. The regional teams include aregional coordinator, an education specialist, a health and nutrition specialist,a social worker, a management information systems operator, a procurementofficer, an accountant and a secretary. Technical officers would be added tothe regional teams for promotion and supervision of centers based on anestimated ratio of one technical officer per forty centers. Additionaladministrative support would be hired as necessary as the program expands.Architectural services would be contracted by the regional offices for therehabilitation of caregivers' homes to be used as day-care sites, based on thevolume of work. In addition, an accountant would be placed in thoseONAMFA sub-regional offices where a NGO is assisting ONAMFA in theadministration of a group of centers.

7.3 The project would finance the establishment and operation of the PIDIcentral and regional offices, including: (a) equipment, (i.e., computers,other office equipment and furniture); (b) vehicles (three four-wheel drive forthe central level, one pick-up truck for each regional office, and one four-wheel drive for each five regional-level technicians); (c) salaries forincremental positions, and other operating expenses, on a declining basis;(d) training activities; and (e) technical assistance. The project would financeother operating expenditures, including materiel, transportation, maintenanceand communication.

7.4 To support project implementation, the project would financetechnical assistance in the areas of: (a) management information systems,(b) administrative and financial systems, and (c) adjustments necessary forthe consolidation and expansion of the PIDI program as it scales up. Draftterms of reference for technical assistance have been finalized. In addition,technical assistance would finance the services of an external procurementagent (see para. 7.10) and an external auditor (see para. 7.20).

7.5 ONAMFA has prepared two basic documents to guide projectimplementation: an Administrative Manual (Manual Administradvo, June 1,1993), and an Operations Manual (Manual de Normas y Procedimientos,June 1, 1993). The Administrative Manual includes: (a) organizationalarrangements; (b) terms of reference for all project staff; (c) disbursementand procurement arrangements; and (d) internal and external audit TOR andscope. The Operations Manual incorporates all the technical contents of theproject's components and sub-components, and financial and administrativeimplementation arrangements. Final versions of the manuals have beencompleted by Government and reviewed and approved by IDA.

- 36 -

B. Institutional Arrangements

7.6 NGO Involvement. To ensure that coverage and quality objectivesare reached and that the project is sustainable, ONAMFA would requirebroad involvement of and support from national and international NGOs withexperience in the implementation of women and children projects. Whilecoverage of most NGOs is limited and their institutional and operationalcapacity vary substantially, their knowledge of local conditions andcommunity involvement is generally strong. ONAMFA has defined threebroad modalities for NGO involvement: (a) support in the implementation ofall project components in a given area; (b) support in the execution ofspecific project components nationwide (e.g., it is expected that an NGOwould be involved in the nationwide training of the national and regionalPIDI teams in women instruction methodologies); and (c) staffing for externalsupervision activities.

7.7 MPSSP Involvement. The proposed project is also encouraginginterinstitutional arrangements with MPSSP and private providers of healthservices to ensure that project beneficiaries have access to a minimumpackage of quality preventive, diagnostic and curative health services (para.5.32).

C. Implementation Schedule

7.8 The project is planned to be implemented over a six-year period (i.e.,the end of 1993 through the middle of 1999). Implementation of the ServiceDelivery Support component would be slow during the first half of theprogram and, as coverage expansion intensifies at the beginning of the fourthyear, would rapidly accelerate in the second half of the project. The smallcoverage in the first half responds to a need to guarantee quality of contents,address implementation issues gradually, strengthen institutional capacity, andrefine logistical mechanisms. Similar experiences from other childdevelopment projects demonstrate that, in order to ensure quality and notoverextend institutional capacity, coverage expansion needs to be slowlyphased-in during the start-up phase and accelerate once administrativeprocedures are tested and fully operational.

7.9 Studies to be carried out under the project's Sector PolicyDevelopment and Management Strengthening, and Monitoring and Evaluationcomponents will be completed in accordance with the timetable outlined inAnnex 10. During negotiations, assurances were secured that theGovernment would submit for IDA review the results of, andrecommendations deriving from, studies to be carried out under the SectorPolicy Development and Management Strengthening Component and the

- 37 -

Monitoring and Evaluation Component, in accordance with an agreedtimetable.

D. Procurement

7.10 Arrangements for procurement and limits by type are summarized inTable 7.1. Annex 11 shows a procurement timetable (Project ImplementationSchedule). Bolivia's procurement procedures require that, for contractsabove Bs. 200,000 equivalent, public institutions use internationalprocurement agents. The procurement of goods utilizing Local CompetitiveBidding (LCB) and International Competitive Bidding (ICB) procedureswould be carried out through one of these agents. The credit would financethe fee of the procurement agent to be retained using terms of reference andfollowing procedures satisfactory to IDA. The Government has prepared adraft contract for the procurement agent, specifying timing requirements forprocurement actions. The use of Bank Group standard bidding documentswould be mandatory for the procurement of goods under ICB. Standardbidding documents already approved by IDA for the Social Investment Fundwould be used for the procurement of goods under LCB. Bolivianmanufacturers may be granted a margin of preference for bid evaluationpurposes under ICB, in accordance with Bank Group guidelines.

Goods

7.11 Contracts for vehicles, and office technology equipment are expectedto total about US$1.7 million equivalent, would be combined in packagesvalued at not less than US$100,00 equivalent and would be awarded on thebasis of ICB procedures.

7.12 Contracts for furniture and equipment for the home-based centers andONAMFA's national and regional offices are expected to total aboutUS$32.3 million equivalent. To the extent possible, contracts for goods(principally office equipment, furniture and kitchen stoves) would becombined in packages of US$100,000 equivalent or more, and contractswould be awarded on the basis of ICB. LCB would apply for contractsbetween US$25,000 and US$100,000 equivalent, up to an aggregate amountof US$10 million equivalent. Local shopping procedures could be used forcontracts of US$25,000 equivalent or less up to an aggregate amount ofUS$4.5 million equivalent. Direct contracting procedures could be permittedfor contracts of US$5,000 equivalent or less up to an aggregate amount ofUS$1.0 million equivalent for the purchase of small quantities of locallyproduced materials, and where shopping procedures are not practical.

- 38 -

Table 7.1: Summary of Proposed Procurement Arrangements(US$ million equivalent)

PROJECT ELEMENT ICB | LCB I Other NBF. Total Costs

1. Rehabilitation Fund 2.86 2.86(2.86) (2.86)

2. Goods

2.1 Vehicles & Office Technology 1.74 1.74(1.63) (1.63)

2.2 Furniture and Equipment 16.82 10.00 5.50 a/ 32.32(13.50) (8.00) (4.36) (25.86)

2.3 Food Commodities 51.44 51.44(0.00) (0.00)

3. Consultancies b/

3.1 Studies & Technical Assistance 4.56 4.56(3.65) (3.65)

3.2 External Supervision 2.79 2.79

(0.94) (0.94)

4. Salaries & Operating Expenditures

4.1 Civil Service Support 2.31 2.31(1.10) (1.10)

4.2 Salaries 6.58 6.58(2.37) (2.37)

4.3 Administrative Costs 3.42 3.42(1.45) (1.45)

4.4 Stipends to the Caregivers 17.36 17.36(7.32) (7.32)

4.5 Operating Costs of Centers 8.88 8.88(0.00) (0.00)

4.6 Health Fund 1.29 1.29(0.67) (0.67)

4.7 Training 2.66 2.66(2.10) (2.10)

5. Miscellaneous

5.1 PPF Refinancing 2.19 2.19(0.75) (0.75)

TOTAL COSTS 18.56 10.00 51.52 60.12 140.20(15.13) (8.00) (27.57) (0.00) (50.70)

Note: Numbers in parenthlesis reflect IDA financing.a/ For goods: local shopping, of which direct contracting may be allowed up to an aggregate

of US$1.0 million equivalent.b/ In accordance with Bank Group guidelines for the use of consultants.

- 39 -

Consultants

7.13 Consultants required for the project would be hired in accordance withIDA's guidelines for the use of consultants. Except as IDA shall otherwiseagree, time-based consultants should be employed under contracts using thestandard form of contract for consultant services issued by the World BankGroup.

IDA's Review

7.14 Prior review by IDA in accordance with IDA guidelines would becarried out for all contracts for goods to be procured under ICB, and forcontracts for goods valued at US$75,000 equivalent and above under LCB.It is estimated that during the life of the project, about 80 contracts andaward recommendations, representing about 52 percent of the total value ofcontracts, would require prior review by IDA. IDA would review ex-post,on a selected basis, contracts and bid evaluations for goods purchased underlocal shopping procedures and would carry out a selective review of arepresentative sample of contracts under direct contracting for goods. Thesereview arrangements are considered appropriate in view of the nature of thegoods to be procured, and the required use of standard bidding documents.

7.15 At negotiations, assurances were secured from Government thatONAMFA, through the procurement agent, would submit to IDA for priorreview, bidding documents and award recommendations for all contracts forgoods to be procured under ICB, and for contracts for goods valued atUS$75,000 equivalent and above to be procured under LCB.

E. Disbursements and Accounts

7.16 The proposed credit would be disbursed over a six-year period,typical for other IDA projects in the social sectors. The project completiondate would be June 30, 1999 and the project closing date would beDecember 31, 1999. Annex 12, Table 1 contains the estimated disbursementforecast.

7.17 Annex 12, Table 2 contains the disbursement allocations.Disbursements would be made against the following categories ofexpenditures: (a) 100 percent of expenditures for the home rehabilitationfund; (b) 100 percent of foreign expenditures and 80 percent of localexpenditures for goods; (c) 100 percent of expenditures for studies, technicalassistance and training; (d) for recurrent expenditures associated with projectimplementation, according to decreasing percentages as defined in Annex 12,Table 2. Credit funds would not pay for food rations. Withdrawalapplications for goods with a contract value of US$75,000 equivalent or morewould be supported by full documentation. Contracts of less than US$75,000

- 40 -

equivalent, disbursements against expenditures not undertaken by contract,and disbursements made under the home rehabilitation subcomponent, wouldbe made on the basis of Statements of Expenditures (SOEs). Supportingdocumentation for these expenditures would be retained by ONAMFA andmade available for periodic review by IDA staff. For home rehabilitation,this would include approved rehabilitation plans and detailed budget,certification of the completion of work, and a legalized copy of the contractsbetween ONAMFA and the caregivers.

7.18 Special Account. To facilitate timely project implementation, theGovernment would establish, maintain and operate, under terms andconditions satisfactory to IDA, a Special Account in US dollars at the CentralBank. IDA would make an initial deposit of US$2.5 million, equivalent tothe average four-month project financing requirement.

F. Financial Management, Accounting and Audits

7.19 A financial management evaluation of JNSDS/ONAMFA was carriedout by IDA prior to the pre-appraisal mission. The evaluation includeddocumentation and orientation in all aspects of accounting and financialsystems, organizational structure, internal controls and audit. The evaluationconcluded that from a general management, accounting and auditingperspective, the proposed project was "clean".

7.20 ONAMFA's accounts would be available for inspection by IDA.Annually audited accounts would be submitted to IDA no later than sixmonths following the end of ONAMFA's fiscal year. The annual auditreports would include: (a) an audit of ONAMFA covering the financialposition and results of operations focusing on its soundness and financialmanagerial capability under a "going concern" perspective; the scope of theaudit is an examination of the external auditor of the basic financialstatements and related supplementary financial information; (b) an audit ofthe project, including (i) a statement of sources and applications of funds;(ii) a statement of assets and liabilities; and (iii) supplementary financialinformation containing a matrix of project accumulated performance, asummary of significant bids processed and awarded, a list of maincontractors and contracts, and a status of the financial execution of technicalassistance; (c) an auditor's opinion on the eligibility of expenses submittedthrough Statement of Expenditures-SOE; (d) compliance opinions of thefinancial-managerial covenants in the Credit and of the most significant lawsand regulations affecting ONAMFA's activities or the execution of theproject; (e) an audit of the special account; (f) a management letter; and (g) adisclosure of the audit procedures utilized. The audit would be performed bya private firm of independent auditors acceptable to IDA. Terms ofreference were reviewed and approved during IDA's financial managementevaluation. At negotiations, assurances were secured from Government thatthe annually audited project accounts, in accordance with IDA guidelines,

- 41 -

would be submitted to IDA no later than six months following the end of theGovernment's fiscal year.

G. Project Monitoring, Evaluation and Supervision

7.21 The proposed project incorporates a comprehensive monitoring andevaluation component (paras. 5.37 and 5.38). Overall monitoring andevaluation of the project would be ONAMFA's responsibility. ONAMFAwould contract institutions such as the National Institute of Statistics (INE) tocollect EIH data and other public and/or private entities for the analysis ofimpact evaluation data. Specific tasks of ONAMFA include: (a) preparingquarterly reports on implementation progress; (b) preparing an annualimplementation progress report, work plan for the upcoming year, andfinancial plan for the successive three years; and (c) preparing a ProjectCompletion Report (PCR) that would be submitted to IDA no later than sixmonths after the closing date of the Credit. At negotiations, assurances wereobtained that ONAMFA would submit to IDA quarterly progress reports onMarch 31, June 30, September 30, and December 31 each year, and that thequarterly report of September 30 each year shall include: (a) an assessmentof overall implementation progress over the past year, includingimplementation indicators; (b) a detailed work plan for the forthcoming year;and (c) an updated financial plan for the successive three years of projectimplementation.

7.22 The Government and IDA would hold Annual Reviews no later thanNovember 30 each year. In addition, the Government and IDA would hold aMid-Term Review no later than November 30, 1996 to evaluate, amongother things: (a) the status of execution of the institutional strengthening ofONAMFA; (b) the status of preparation of the sector policy developmentstudies; (c) the implementation progress in terms of coverage objectives,adequacy of targeting and beneficiary selection criteria and quality of servicesprovided; (d) the impact of project implementation on the status of children,women and the community and the adequacy of the impact evaluationvariables and methodology; (e) the adequacy of available and programmedproject financing, including the sustainability of the project in the context ofthe Government's social sector investment plan; (f) the compliance withprocurement and disbursement arrangements; and (g) the results of annualproject audits. On this basis, the Mid-Term Review would determinewhether adjustments in project arrangements and/or coverage targets shouldbe made. At negotiations, assurances were secured from the Governmentthat annual reviews with IDA would take place no later than November 30each year; and that no later than November 30, 1996 a Mid-Term Reviewwould be held to carry out a comprehensive assessment of: theimplementation of the PIDI program and the project, including an assessmentof performance against agreed implementation indicators; project financing;and the Government's social sector investment plan. Annex 13 provides anestimated Supervision Plan for the project and the implementation indicators

- 42 -

to be examined during the annual and mid-term reviews. At negotiations,final agreements were reached with the Government on the implementationindicators and targets to be reviewed during the annual and mid-terrnreviews.

H. Environmental Impact

7.23 The proposed project does not present environmental risks. It hasbeen assigned a "C" environmental classification.

8. EXPECTED BENEFITS AND RISKS

A. Benefits

8.1 By the end of the proposed project life, an installed capacity of some8,600 day-care centers would exist to annually provide non-formal, home-based, integrated child development services to some 130,000 of thecountry's poorest pre-school children, 6 months to 6 years of age; andcumulatively, by project end, taking into account anticipated promotions ofsix year olds, more than 200,000 children are expected to have benefitted.Women also would be direct beneficiaries through project contributions toexpanding employment opportunities (employing caregivers and, via access today-care, enabling mothers of participating children to work) and improvingtheir knowledge of education, health and nutrition. Specifically, by itscompletion, the project will have trained and employed some 21,000caregivers, most of whom are expected to be women. Approximately 8,600of these caregivers also would benefit from access to credit to upgrade theirhomes and, via direct beneficiary contributions, assistance in the payment ofbasic utility bills to help offset the costs of using their homes for day-carecenters. Significant improvements also are expected in the health andnutritional status of an estimated 16,000 pregnant women who either havechildren participating in the project, or are caregivers, as project-securedpreferential user fees would increase utilization of pre- and post-natal care,safe deliveries, and family planning, health and nutrition education andservices. An additional benefit would be the Govermnent's strengthenedability to formulate and evaluate social policy, particularly in early childdevelopment, and food and nutrition.

B. Risks

8.2 Principal risks relate to: (a) the possibility that the extensive projectimplementation demands might outstrip ONAMFA's managerial andadministrative capacities; (b) uncertainties over the continuity of the GOB'sinitial commitment to absorb fully project-generated recurrent costs over the

- 43 -

project life, crucial to its sustainability; and (c) the danger that desiredimprovements in children's nutritional status will not be achieved because offailure to maintain adequate dietary intake at the household level. Withregard to (a), this risk should be minimized by: direct project support forONAMFA's modernization initiative; ONAMFA's planned full incorporationinto the CSRP, thus facilitating recruitment and retention of high qualitystaff; anticipated active assistance of NGOs and community groups in projectimplementation; project-supported contracting of external supervision staff topermit ONAMFA's close, continuous oversight of day-care activities; a veryconservative implementation timetable, based on moderate increases incoverage objectives during the first half of the project, and annual and mid-term project reviews to assess implementation progress and adjust the paceand scope of implementation, as needed. With regard to (b), the GOB hascommitted itself to a solid financing plan and to gradually assuming recurrentcosts on a clearly specified annual basis, including those generated by theCSRP. To help ensure continuing commitment to this plan, the GOB willreview annually with IDA an updated financial plan for the successive threeyears of project implementation. In addition, the GOB will review with IDAat the project's Mid-Term Review its overall social sector investment plan toensure that adequate provision is made for project financing. The issuance ofthe March 1993 Supreme Decree committing counterpart resources to theproject also should minimize this risk. And with regard to (c), intensivehealth and nutrition education activities targeted toward parents of childrenparticipating in the project seek to minimize this risk.

9. AGREEMENTS REACHED AND RECOMMENDATION

9.1 During negotiations, the Government provided assurances that:

(a) ONAMFA would maintain management with qualifications andexperience satisfactory to IDA; and the annual audit reportwould include a separate opinion as to whether CSRP criteriafor selection of personnel have been observed in the choice ofstaff for project-financed CSRP positions (para. 5.15);

(b) prior to opening any given group of day-care centers, anagreement be finalized between ONAMFA and the respectivepublic or private referral health center to ensure availability toproject beneficiaries of a minimum acceptable package ofhealth and nutrition services (para. 5.33);

(c) the agreed evaluation and monitoring systems have beenestablished and are under implementation no later than March31, 1994; and that annual reports on progress and results ofthe monitoring and evaluation component would be preparedby ONAMFA and submitted for IDA review (para. 5.38);

-44 -

(d) it would allocate in its annual budget, for the years 1994through 1999, and each year thereafter, the followingminimum amounts (representing its direct budgetarycontribution and the financing to be sought from donors) forthe financing of project expenditures: (a) US$1.039 millionfor CY94; (b) US$2.287 million for CY95; (c) US$5.38million for CY96; (d) US$10.58 million for CY97;(e) US$17.78 million for CY98; (f) US$27.73 million forCY99; and (g) US$33.2 million for each year thereafter (para.6.6);

(e) it would submit for IDA review the results of, andrecommendations deriving from, studies to be carried outunder the Sector Policy Development and ManagementStrengthening Component and the Monitoring and EvaluationComponent, in accordance with an agreed timetable (para.7.9);

(f) ONAMFA, through the procurement agent, would submit toIDA for prior review bidding documents and awardrecommendations for all contracts for goods to be procuredunder ICB, and for contracts for goods valued at US$75,000equivalent and above to be procured under LCB (para. 7.15);

(g) the annually audited project accounts, in accordance with IDAguidelines, would be submitted to IDA no later than sixmonths following the end of the Government's fiscal year(para. 7.20);

(h) ONAMFA would submit to IDA quarterly progress reports onMarch 31, June 30, September 30, and December 31 eachyear; and that the quarterly report of September 30 each yearshall include: (i) an assessment of overall implementationprogress over the past year, including implementationindicators; (ii) a detailed work plan for the forthcoming year;and (iii) an updated financial plan for the successive threeyears of project implementation (para. 7.21); and

(i) annual reviews with IDA would take place no later thanNovember 30 each year; and that no later than November 30,1996 a Mid-Term Review would be held to carry out acomprehensive assessment of: the implementation of the PIDIprogram and the project, including an assessment ofperformance against agreed implementation indicators; projectfinancing; and the Government's social sector investment plan(para. 7.22).

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9.2 At negotiations, final agreements were reached with the Governmenton the implementation indicators and targets to be reviewed during the annualand mid-term reviews (para. 7.22).

9.3 A condition of credit effectiveness would be that ONAMPA hasreceived from the Treasury an amount equivalent to not less thanUS$340,000 for purposes of implementing the project during CY93 (para.6.6).

9.4 Recommendation. With the above agreements and assurances, theproposed project would constitute a suitable basis for an IDA credit of SDR35,800,000 (US$50.7 million equivalent) to the Republic of Bolivia.

Annex 1-46 -

BOLIVIAiNTEGRATED CHLD DEVELOPMENT PROJECT

ORGAN IZAT IONAL STRUCTUREORGANISI4O RACIONAL DEL WENOR. MUJER Y FAMILIA "ONAMFA J

(CEIITRAL OFFICE)

r BOARD OF

DIRECTORS

PRESIDENT ..............

PLANNIIIIOI

|COMMITTEE

EXECUTIVE

DIRECTOR

INSTITUTIONAL

ANo SY T EMS

|ACTlo N "LAN| EA

FORTIONALE CHI D CMMUIYIOES FIVPS AOT

ANO WOMEN

OAFAGr OF OF R OANGER OF PROGR ----------------- ----------- AOMI NIST ATION ----------- ___-__ --- t " rGR HLDREN. 1------ ------- _---------------

ACCOUNTIN SUDOET ASE MNATERAL RE. NATND E NL || M

I or rlNANcc ADSINISTR^TION A l OEtT oErT | OCeT | | ocrT g } oIIT | N

| I or I I or 11 or 1 l or 1 l or Tol'ol Dor ITI,

| r R~~~~~~~~~~~~~~~~~~~~IE310OWAL II ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~~~~~C .. CO LTAT IVE I

I g ~~~~~~~~~~~~~~~~COUNCILS |

8 | ~~~~~~~~~~~~~~~~REOIObAL | - ----------------------------------- ------------- 1 XCTV ----------- ---------- EEUIE---------------------------------- 'DIRECTORS

47 - Annex 1

BOLIVIAINTEGRATED CHILD DEVELOPMENT PROJECT

[ ORGAN I ZAT I ONAL STRUCTURE 1ORGANISMO NACIONAL DEL MENOR, MUJER Y FAMILIA "ONAMFA"

(REGIONAL OFFICES) ;

REGIONALCONSULTATIVE

COUNCIL

REGIONALEXECUTIVEDIRECTOR

LEGAL

ADVISOR

[ MANAGERt OF |4MANAGER OF PROG.AO 1 INISTA AT[ON | FOR CHILDREN,AND F,INANCE lWOMEN AND FAMILY

CHI LO C....NITY WOMENS PIvU.A:C'OVU'N:' ~ ~~~~~~~EVEL OUTREACH PROGRtAM CEERFU DEPT. DEPT. DEPT. DEPT.

PIDI

OF|MATERIALS

-48 - Annex 2

BOLIVIAINTEGRATED CHILD DEVELOPMENT PROJECT

Table 1: POPULATION PROJECTIONS FOR THE 34 LARGEST CITIES

cITE. POPULATtON I1 POPULATIN O UONTtS TO S nYAS6 morths to

Corwus Total' 6 yearst t 1993 1994 1995 1996 1997 1991 1999

I LaPaz 711,038 772,865 127,020 129,226 131,470 133,753 136.076 138,439 140,843 143.2s92 EtAlto 404,367 439,529 72,237 79,057 96,523 94,692 103,634 113,419 124,129 135.8503 Vlachs 19,002 20,654 3.395 3,536 3,684 3,839 3,998 4,165 4,338 4,519

4 Sata Cruz 694,616 755,017 124,097 132,117 140,665 149,771 159,464 169,794 180.772 192,471S MorAero 54,731 59,490 9,777 10,180 t0,599 11,036 11,491 11,964 12.457 12.9716 Carnlrl 28,079 30,521 5,015 5,132 5,250 5,371 5,495 5,622 5,751 5,9947 S.l.Valmsco 12,616 13,713 2,254 2,391 2,537 2,691 2,855 3,029 3,214 3,4099 Mlnromg 11,114 12,080 1.995 2,058 2,132 2,210 2,290 2,373 2,459 2,5499 Wernes 10,979 11,934 1,961 2,090 2,206 2,339 2,491 2,631 2,790 2.959

10 Robore 10,359 11,260 1,851 1,899 1,950 2,001 2,054 2,109 2.164 2,22t11 PSuarez 10,240 11,130 1.929 1,933 2,042 2,157 2.279 2,407 2.543 2,687

12 Trlja 90,115 97,951 16,099 16,966 17,890 19,843 19,859 20,928 22,056 23,24513 YaLiItle 31,049 33,749 5,547 5,925 6,330 6,762 7,224 7,717 9,244 9,eo714 4eemi o 21,313 23,166 3,807 3,959 4,114 4,277 4,446 4,622 4,904 4,994tS V11morteu 11,009 11,965 1,966 2,043 2,122 2,205 2,290 2.379 2,471 2,567

:G^-:.-: -: .: :.i$,": :- : : 42;3s: :: : : 239 :: : 4; ... :::2,ei ... . 28;0 36 ,l :::X

16 8je 130,952 142,339 23.393 24,473 25,602 26,784 29,020 29,313 30,665 32,081

17 Colubanba 404,102 439,241 72,189 75,324 79,596 82,009 85.570 89,297 93,164 97,2101S EleOullIollo 29,661 31,153 5,120 5,374 5.641 5,921 6,215 6,523 6,947 7,19719 9 uQbIbLaolo 42,153 45,918 7,530 7,904 9,296 8,708 9,140 9,594 10,070 10,57020 Pe Sacaba 21,830 23,728 3,900 4,155 4,427 4,717 5,026 5,355 5,705 6,07921 Sacaba 15,318 16,650 2,736 2,916 3,106 3,310 3,526 3,757 4,003 4,26522 Puruta 12,729 13,936 2,274 2,305 2,336 2,368 2,400 2,432 2,465 2,499

Q - -Q 3*29...ss,aX. -.,! ....... ...... 3........ 3523 Oruro 193,194 199,124 32,726 33,530 34,355 35,199 36,084 36,951 37,959 38,79024 Hi'urdn 14,313 15,558 2,557 2,527 2,498 2,469 2,440 2,412 2,394 2,368

:P.O1, ... . ............ .......... ....... : .......... 2 6j g :: ,14;4::::35. ; ........ 94::3.5.

25 Potosl 112,291 122,055 20,060 20,532 21,015 21,509 22,016 22,534 23,064 23,60726 Vllbon 23,400 25,435 4,190 4,348 4,519 4,697 4,893 6,077 5,279 5,48727 Ualmua 23,215 25,234 4,147 4,147 4,146 4,145 4,145 4,144 4,144 4,14329 Tuplz 20,195 21,951 3,609 3,754 3,906 4,064 4,228 4,400 4,578 4,76329 LMurd 11,301 12,294 2,019 2,049 2,078 2,109 2,139 2,171 2,202 2,235

30 Trta 56,919a 61,867 10,168 10,641 11,136 11,656 12,197 12,765 13,359 13,96131 Rlbermlta 41,584 45,200 7,429 7,846 8,297 8,753 9,245 9,764 10,313 10,89232 Guyarartn 26,779 29,107 4,784 5,016 5,261 5,517 5,7s5 6,067 6,382 6,67133 S.A.Yaaurre 14,731 16,012 2,632 2,900 2,979 3,169 3,372 3,587 3,917 4,061

............ ........... .:****.:.,~* ~: * * k'.... ,P .:: .. ::-::::;4::: ... 4 : ::1; 2-::: e7: ........ 2s51::: I.... I :: ... I.... .. : ............ :34 Cob&I 9,973 10,840 1,792 1,897 2,020 2,151 2,291 2,439 2,597 2,766

TOTAL 3,314,262 592,063 619,772 646,981 676,596 707,753 740,539 775,043 811,362* Asmr ta Ms COneus cmMited OM 9% of dthe Popagon -

*! ChMn I mcnVh b yews represert 16.43% of thI Popuaicn

BOLIVIAINTEGRATED CHILD DEVELOPMENT PROJECT

Table 2: PROJECT TARGETS

Total Day-Care Centers Opening Year

1994 1995 1996 1997 1998 1999

Period New Cumulative New Cumulative New Cumulative New Cumulative New Cumulative New Cumulative

PPF 250

January - April 151 401 246 949 392 1,833 624 3,241 696 5,185 697 7,276

May - August 151 552 246 1,195 392 2,225 624 3,865 697 5.882 697 7,973

September - December 151 703 246 1,441 392 2,617 624 4,489 697 6,579 697 8,670

TOTAL 453 738 1,176 1,872 2,090 2.091-~. - - - - -. - '

Total Beneficiary ChildrenNear

1994 1995 1996 1997 1998 1999

Period New Cumulative New Cumulative New Cumulative New Cumulative New Cumulative New Cumulative

PPF 3.750

January - April 2.265 6.015 3,690 14.235 5.880 27,495 9.360 48.615 10,440 77,775 10,455 109,140

May - August 2,265 8,280 3,690 17,925 5,880 33,375 9,360 57,975 10.455 88.230 10,455 119.595

September - December 2.265 10,545 3.690 21,615 5,880 39,255 9,360 67,335 10,455 98,685 10,455 130,050

TOTAL 6.795 11,070 17,640 28,080 31,350 31,365

Annual Promotion 2,109 4,323 _ 7,851 13,467 1 19.737 26,010

Cumulative Promotion 2,109 _ 6,432 14.283 . 27,750 47,487 73,497

Total Coverage 12,654 28,04? 53,538 95,085 146,172 203,547

Total Caregivers/Year

1994 1995 1996 1997 1998 1999NNew TCumulativ New |Cumulative Now |Cumulatives New ICumulativel New |Cumulative| New iCumulativel

TOTAL 1,6871 1,887 1,7711 3,458 2,8221 8,280 4,4941 10,7741 6,0181 15,790 5,018| 20,808

TOTAL 3vdse~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~I

- 50 -~~~~~~~~~Anex 2

BOLIVIAINTEGRATED CHILD DEVELOPMENT PROJECT

Table 3: POPULATION AT RISK I Malnourished Children Ages Six Months to Six Years)

M ALNOURISHED POPULATiON (S months tog years)

Pr.valwmc of

CITIES Malnutrition 1992 1993 1994 1995 1996 1997 1998 1999

.L P.. ..:.::::::: ,::::: ........ ..........:.:..: :: a 8381.:.83,26? :62. 6 .....9,56 s.9. ;as4:**.. 99,..7:1 La Paz 48,636 49,481 50,340 51,214 52,104 53,008 53,929 54,865

2 El Alto 27,659 30,271 33,129 36,258 39,681 43,429 47,529 52,0173 Viacha 1,300 1,354 1,411 1,469 1,531 1,595 1,661 1,731

iSANTA CRU 2g ::: ::9.q:18%: : .,s2t::.:..::44,6ss::::47,s7i:.::0,87. 54::3~9B.I.::.51,504< : Si 25:, s:65:.2;3:

4 Santa Cruz 34,968 37,231 39.640 42,206 44,937 47,845 50,942 54,2395 Moraero 2,755 2,869 2,987 3,110 3,238 3.372 3,510 3,6556 CanIri 1,414 1,446 1,479 1,514 1,548 1.584 1,621 1,6597 S.I.Volasoo 635 674 715 75ii 805 854 906 961a Minorco 559 580 601 623 645 669 693 7189 Warnes 553 596 622 659 699 741 786 934

10 Robor? 521 535 549 564 579 594 610 626

II P.Suarez 515 545 575 609 642 678 717 7S7

A .iJA ::.... .. 30.58% 8,385 8,881. .. 3,406 ., 9,963. tO,553 . ill 7 :. 0t1,839.: 125912 Tarlis 4,923 s.188 5,469 5,762 6,073 6,400 6,745 7.10913 Yaajiba 1,696 1,812 1,936 2,068 2,209 2,360 2,521 2,693

14 Beramjo 1,164 1,210 1,258 1,308 1,360 1,413 1,469 1,52715 Vlllamrrones 601 625 649 674 700 727 756 79s

Bf&JUlSACA:---::: :::33 sN:::9,0s23:::9.::439:.:.. sB7:: .10,30 :::: t097. 1? : :l:30oe :3:1:t.628 :.:12!7a:716 Sucre 9,023 9,439 9,875 10,330 1 0,807 11,306 11,928 12,373

suc..~ ~~~~~~~~~....... . .. 2

. . . . .. . . . .. .... . . . ... . . . . . . . . . .. . . ..CQCF AAMBA.... 3s.3sr- : 3,178. :i::::a4: 3 6.saa: ~,58. :39a;22 .. 4a349.:~ 42,372 .: 44,486 :.::e717 Cochabamba 25,s48 26,657 27.815 29,023 30,283 31,s99 32,971 34,40319 El. Oullaoollo 1,812 1.902 1,996 2,095 2.199 2,309 2,423 2,54319 ouliltalIo 2,665 2.797 2,936 3,082 3,235 3,395 3,564 3,741

20 Ei Sacaba 1,380 1,470 1,567 1,669 1,779 1,895 2,019 2,15121 Sacraba 968 1,032 1,099 1,171 1,249 1,330 1,417 1,50922 Punats 805 816 827 838 849 861 872 984

~RUR~. *::. .39.33%. :....:t3~77.: : 1:977..:: .138.. ..... ... 77.... . .. ..... :... .8. .. ... .... ...... ...23 Oruro 12,671 13,188 13.512 13,644 14,184 14,533 14,890 15.25624 Huanirn 1,006 994 9s2 971 960 949 937 927

F2 O:.::.::::::::4342 ' ':.:::e?s:::!,s:::sA3::abq::.627::l, t3:.::::: 0e:::::.is

25 PotosI 9,690 1,s94 9,104 9,319 9,s37 9,762 9,991 10,22626 Villazon 1,811 1,883 1,957 2,035 2,115 2,199 2,286 2,37727 Uallagua 1,797 1,796 1,796 1,796 1,796 1,795 1.795 1,79529 Tupiza 1,563 1,626 1,692 1,760 1,632 1,906 1,983 2,06329 Uyunr 875 e97 900 913 927 940 954 969

BE .::...::: .. ::. .. : . .:.:.:: ..... : ::: 7. 451.............. .. . .........: 3.::. : . :. .9809 .:. . . .. : 9848 ::!. ::: . ... . t30 TrInIdad 3,029 3,170 3,318 3,472 3,634 3,803 3,980 4,16531 Rberalia 2,213 2,337 2,469 2,607 2,754 2,909 3,072 3,24532 Guayaramerin 1,425 1,494 1,567 1,643 1,723 1,907 1,9ss 1,987

33 S.A.Yacura 784 834 s87 944 1,004 1,069 1,137 1,210

...... :::: ................. 09.......42...... ... 7...5 6S.. ::::::qs..4::.:::.::.5.. 7...34 Cobila 449 478 509 542 577 615 654 697

TOTAL 206,613 215,526 224,885 234,714 245,037 255.882 267,275 279,249

- 51 -

Annex 2

Table 4: Beneficiary Pregnant Women 15 - 49 Age Group

Potential Pregnant Women 15 - 49 Age GroupCITIES 1992 1993 1994 1995 1996 1997 1998 1999

LA PAZ 7,417 7,751 8,113 8,501 8,919 9,370 9.857 10,381.1. La Paz 4,649 4,729 4,811 4,895 4,980 5,067 5,155 5,2442. El Alto 2,644 2,893 3,167 3,466 3,793 4,151 4,543 4,9723. Viacha 124 129 135 140 146 152 159 165

SANTA CRUZ 3,106 3,295 3,496 3,707 3,936 4,174 4,429 .4,7014. Santa Cruz 2,591 2,759 2,937 3,127 3,330 3,545 3,775 4,0195. Montero 204 213 221 230 240 250 260 2716. Camiri 105 107 110 112 115 117 120 1237. S.1 Velasco 47 50 53 56 60 63 67 718. Mineros 41 43 45 46 48 50 51 539. Wames 41 43 46 49 52 55 58 6210. Robor 39 40 41 42 43 44 45 4611. P. Suarez 38 40 43 45 48 50 53 56

TARIJA 618 652 687 724 763 804 . .. 848 89412. Tanla 363 383 403 425 448 472 498 52413. Yacuibo 125 134 143 153 163 174 186 19914. Bermejo 86 89 93 96 100 104 108 11315. Villamontes 44 46 48 50 52 64 56 58

CHUQUISACA 712 745 779 815 853 892 933 .-976.16. Sucre 712 745 779 815 853 892 933 976

COCHABAMBA 2,949 3,082 3,220 3,365 3,517 3.677 3,745 - -. 4.:401917. Cochabamba 2,270 2,369 2,472 2,579 2,691 2,808 2,930 3,05718. Eie Qillacollo 161 169 177 186 195 205 215 22619 Quillacolo- 237 249 261 274 287 302 217 33220. Ee Sacaba 123 131 139 148 158 168 179 19121. Sacaba 86 92 98 104 111 118 126 13422. Punata 72 72 73 74 75 76 78 79

ORURO 1,279 . 1,307 1,336 1,364 - 1.395- 1,426 - -1,458:- 1.491123. Oruro 1,186 1,215 1.245 1,275 1,307 1,339 1,372 1,40624. Huanuni 93 92 91 89 88 87 86 85

POTOSI 1,247 1,277 1,308.- 1,339 1.372: .. 1,406: 1441 1,47625. Potosi 736 753 771 789 808 827 846 86626. Villazon 163 159 168 172 179 186 194 20127. Llallagua 152 152 152 152 152 152 152 16228. Tupiza 132 138 143 149 155 161 168 17629. Uyuni 74 75 76 77 78 80 81 82

BENI 625 657 690 727 764 805 .. :..846 88930. Trinidad 254 266 278 291 305 319 334 34931. Riberatta 186 196 207 219 231 244 258 27232. Guyaramerin 119 125 131 138 144 152 159 16733. S.A. Yacuma 66 70 74 79 84 90 95 101

PANDO 38 .40 43 45.. .48 ..2 -: 5534. Cobrp.- 38 40 43 45 48 62 66 58

TOTAL' 17,991 18,806 19,672 20,587 21,667 22,606 23,612 24,886

TOTAL PROJECTBENEFICIARIESk(umJadvef' 67 347 1,081 2,375 4,528 7,695 11,609 16,057

COVERAGE(%)' 0.4 1.9 5.5 11.7 21.3 34.7 50.2 66.6

BOLIVIAINTEGRATED CHIILD DEVELOPNMENT PROJECT

SECTOR POLICY AND MANAGEMENT STRENGTHENING COMPONENT

Modernization of ONAMFAMatrix of Objectives, Outputs and Costs

TimingArea ObjcAtives Activilies/Output (IProjcct Ycar) Costs (base cost)

1. Technical Assistaice to Supervise To provide continuity and technical Appointment of Advisor PY 1-3 36 months local consultant = USS72.000Modemrizaticn Program supervisicn for modrenization activities, position to coordinate

including civil service reform process restructuring activitics…-- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - -_ _ - - - - - - - - - - - - - - - - - - - - - - -_ _ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

2. Consolidation of Administrative To achieve an efficient and transparentand Financial Sysenms control of the administrative and

financial operations of ONAMFA.specificaly in the reas or:accounting personnel. budgeting.assetinventory, warehouses, andprocuremnent

A. Monitoring and Verification To ensure that key systems Annual studies of: PY 1-6 4 months local consultantsof Systems are adequately designed and - functicnal mnalysis of die each ycar of project = $48,000

are functioning according to implementation of thelegal and administrative norms key systemsand procedures - Design of .gpecifications

for system improvcnients- Manitoring of applicalions

B. Maintenance/implenmentaticn To incorporate a process tIihat Annual impienciication of PY 1-6 Annually, 100 programs revised (USS5.000)of Design Modificaticns allows for modifications and design recommendations into US$30,000

fine-tuning as necessary existing computer programs

C Training To ensure that technical staff Exumal services contracted to PY 1-3 Annually, US$3(Wtrainee = USS21,000are capable of system use train 70central and regionaland maintenance staff in the operation

of the six key systems(PYI-40, PY2-20, PY3-10)

la'tcrnal services contracted to PY 1-3 Annually. US$20tVtrainee = US$20.000 .train 100 central and regionalstaff in basic software I(d-base) applications(I'YI-50, PY2-25. I'Y2-25)

BOLIVIAINTEGRATED CHILD DEVELOPMENT PROJECT

SECTOR POLICY AND MANAGEMENT STRENGTHENING COMPONENT

Modernization of ONAMFAMatrix of Objectives, Outputs and Costs

TuningArea Objectives Activities/Output (Project Year) Costs (base cost)

D. Equipment To increase the lechnical Installation of appropriate PY I USS188,500capacity and efficiecicy of computer capacity in cach (including procurement fce)information management departmental office and in tle

main administrative areasin the central office of ONAMFA

----------------------- _------------------------------------------__---------__---------------------------------

3. Technical/Administrative To obtain indicators that An evaluation of the stiructure, PY 3 US$45,000Evaluation of ONAMrIA describe the degree of policies and systems of the

administrative development of ONAMIFA, specifically in theONAMFA areas of planning. personnel,

intensal management, productivity,cost structures, and tlhe abilityto carry out programmatic goals

4. Analysis of Information To evaluate the information 'Plan Inforniatico' for lhe PlY 3 USSIQ.000Systems of ONAMrA systems in place and next five year period

specify tie needs of; ONAMrAover the next rwe year periodin terms of further automatizaticn,integration of syslems, networkpossibilities, and an investmentplan to update technologies

-------------------------------------------------------------- __-------------_.-------------------------------------

5. Implementation of Civil Service To ensure a core ofhigh-caliber and Incorporaticn of 33 kcy ONAMFA PY 1-6 US$1,095,038Reform Program within ONAMFA stable staff in key managerial and technical positions within the CRSP, per

positions to increase the efFiciency agreement with the Ministry ofand effectiveness of ONAMFA Financt on tinuing and procedures

Total Cost: US$1,529,538

BOLIVIAINTEGRATED CHILD DEVELOPMENT PROJECT

SECTOR POLICY AND MANAGEMENT STRENGTHENING COMPONENT

Modernization of ONAMFA - Timeline of Activities

Actvity Year 1 Year 2 Year 3 Year 4 Year 5 Year 6

1. Technical Assistance x) )))3)to Supervse Implementation(advisor position)

2. Administrative/FinancialSystems:

A. Monitoring and X L

Verification of Systems

S. Maintenance/Implementationof Design Mocifications

C. Training

D. Installation of Equipment-Procurement X

- nstallation

3. Technical/AdministrativeEvaluation of ONAMFA

4. Analysis of InformationSystems/Needs;Presentation of Plan

5. Civil Service Reform Programx

- 55 -Annex 4

BOLUVIA1NTEGRATED CHILD DEVELOPMENT PROJECT

The Bolivian Civil Service Reform Program

1. The Program Prior to Mid-1992. The Public Sector ManagementStrengthening Program (PSM), first presented to the donor community in July 1988, markedthe Bolivian Government's initial effort to rationalize and professionalize public service.Only the first stage of the original PSM was ever developed. This introductory stage, to beimplemented in 3 to 5 years, incorporated approximately 500 "key positions" (at the directorto mid-level manager level in the core central Government agencies) into a new and higherpaying "civil service"--i.e., the program created a high-status elite/senior executive service.However, at the same time, important progress was made towards completing technicalbackground studies required to design and implement a more comprehensive civil servicereform. Included among these were reviews of staffing and functions in a number of keyministries, studies examining personnel policies and career development, and studies todetermine an appropriate administrative and personnel management system. In addition,personnel recruitment and selection procedures were developed, tested and refined throughpilot civil service exercises.

2. Progress since Mid-1992: The Administrative Reform Program. Based on theresults of these studies and pilots, in mid-1992 the Government re-focused its efforts toreform public service. The new focus recognizes the need to take a comprehensive andlonger-term view of the civil service within the overall framework of an institutional andadministrative reform. Such a view--expressed in the Government's document Programa deReforma Administrativa en Bolivia: El Sistema de Servicio CYvil--includes: (a) an acceptableconceptual definition of "civil service"; (b) the civil service requirements within a context ofan overall reform of the state--including a need to adapt (both in terms of number andquality) the civil service towards the new role of the state (i.e., a leaner, yet moresophisticated role); (c) normative and administrative frameworks for a comprehensiveprogram; (d) a strategy and procedures for implementation and for system management bothin the transitory period and afterwards; and (e) rough economic and financial implications ofsuch a reform.1 ' A Civil Service Unit (CSU) in the Ministry of Finance has been maderesponsible for the design and implementation of this comprehensive Civil Service ReformProgram (CSRP) which was legitimized by Supreme Decree No. 23336 published onNovember 11, 1992.

3. The CSRP, to be implemented in 10 years, will incorporate the central publicadministration which contains approximately 12,200 persons. The major purpose of thereform is to improve the quality and efficiency of public personnel at all levels byimplementing a system that will attract, select, hire, retain and develop highly technical andcompetent staff. As a by-product of the reform, it is anticipated that the central

I/ This document was presented to the donor community during the Meeting of the Consultative Group forBolivia, held October 28-30, 1992 in Paris.

- 56 -Annex 4

administration would be reduced to about 7,200 (a 40% reduction) primarily through majorchanges in staffing ratios resulting from extensive organizational reviews; i.e., thetechnical/support staff ratio will change from 2:5 to 3:2. Under the program, public sectorsalaries are being substantially increased and financing will be provided by the Boliviantreasury (TGN) with support from external sources on a declining basis. In the middle yearswhen the costs are the greatest, the TGN would finance approximately 85 % of the totalcosts, and will assume the entire cost burden of the program after the tenth year.

4. Implementation Strategy. The new initiative was launched in March 1993.During the first half of 1993, five new institutions will begin to be incorporated into theprogram--the Ministries of Planning and Coordination, and Finance, the National StatisticsInstitute (INE), the Organismo Nacional de la Mujer y Familia (ONAMFA), and SecretariaNacional del Medio Ambiente (SENMA)--and the program will continue to be implementedin two institutions which participated in pilot phases--the Ministerio de Agricultura y AsuntosCampesinos (MACA) and Direccion General de Impuestos Internos (DGII). Institutions arenot automatically accepted into the civil service program; each institution must qualify bymeeting the eligibility requirements. To be included, an institution must be: (a) activelyparticipating in a sectoral or the overall state reform program; (b) designated as aGovernment priority; and (c) implementing an institutional restructuring program which hasbeen designed and evaluated using common methodologies established by the CSRP.

5. Personnel Selection Procedures. Once an institution is accepted into theprogram, an implementation plan is designed by the CSU and the institution. Personnelselection procedures--specifically designed to preserve the transparency and credibility of theprogram--are rigorous and time consuming taking a minimum of two months to implement.The selection process begins with a civil service position declared as vacant and publiclyadvertised on a national level. This means that the incumbent must resign and compete forthe position with all others who have completed the civil service application forms. Eachapplication is first reviewed by a Primer Comitd, which consists of four members--theimmediate supervisor of the vacant position, another representative of the institution, arepresentative of the CSU, and a representative from the international donor community.This committee evaluates both the academic and work experience of each applicant. If atleast three applicants are found qualified, the application is passed onto the Segundo Comite--otherwise, the job is re-advertised. This second committee--consisting of at least onerepresentative of the institution (usually at the level of Subsecretary), a donor representative,a representative of the CSU, and at least one technical expert--interviews all qualifiedcandidates on technical matters and assesses other qualities, such as reasoning/problemsolving abilities and ability to work in teams. After all candidates are interviewed andevaluated, the committee must reach a consensus on which candidate is the most qualifiedand only then an offer is extended.

6. Follow-up. For the purposes of receiving IDA support, the experience ofONAMFA will be considered a pilot exercise. A specific audit will be performed examiningthe application of the above civil service procedures and rules in the selection of personnelfor the ONAMFA positions.

- 57 - Annex 4

BOLIVIAINTEGRATED CHILD DEVELOPMENT PROJECT

ONAMFA POSITIONS TO BE FINANCED UNDER THE CREDIT

Directorate/Position Title Nwnber Grade Level Annualof (CSRP) Salary

Positions Assumption(USS equivalent)

Administrative-Financial Directorate

Director 1 D, 23,400Chief, Department of Administration 1 E3 11,700Chief, Personnel Division I E, 10,400Chief, Financial Department I E3 11,700Chief, Division of Fixed Assets 1 E4 10,400Chief, Division of Accounting I E4 10,400Chief, Division of Warehouses I E4 10,400

Directorate of the Woman and Family

Director 1 D2 26,000Chief, Department of Community Attention I E, 13,000Technical Expert on Minors 1 P7 9,100Technical Expert on the Elderly I PJ 9,100Chief, Department of Centers I E& 13,000Technical Expert, Public Facilities I P7 9,100Technical Expert, Private Facilities 1 P7 9,100Chief, Department of Adoptions I E2 13,100Legal Advisor I P7 9,100Social Worker I P7 9,100

Regional Offices

Administrative-Financial Director 8 E3 11,700Director of the Woman and Family 8 E2 13,000

TOTAL 33

- 58 - Annex 5

BOLIVIAINTEGRATED CHILD DEVELOPMENT PROJECT

Home Rehabilitation Component

Fee Schedule for Grant-Loan Repayment

Actual PercentageTotal Amount of Number of Amount of Amount of of Grant-

Gr-ant-Loan Payments Monthly Grant-Loan LoanPayment to be Rcvr

Recovered

US dollars US dollars

100 6 8 48 48.00

150 9 8 72 48.00

200 12 8 96 48.00

250 14 9 126 50.40

300 18 8 144 48.00

350 20 9 180 51.40

400 24 8 192 48.00

450 24 9 216 48.00

500 24 10 240 48.00

BOLIVIA

INTEGRATED CHILD DEVELOPMENT PROJECT

Management Information System (SIG)

PartyResponsible Frequency of

Instrument for for Data AnalysisObjectives Variable Indicators Data Collection Registration

Evaluate the Day-Care Centers * No. of functioning Form 06 Regional Monthlyfulfillment of (pidis) pidis Worksheet 06-1 Technicalprogrammned * No. of new pidis Management Teamscoverage targets 0 No. of pidis closed, by Info System

cause (SIG)* No. of pidis under

rehabilitation* No. of pidis

completely equipped

Regional Technical Team 0 No. of technical staff Form 00 Regional Monthlyon the regional team SIG Coordinator

* No. of new technicalstaff

* No. of technical staffwho have left theproject, by cause

* No. of technical staffin_training l

I.

PartyResponsible Frequency of

Instrument for for Data AnalysisObjectives Variable Indicators Data Collection Registration

Supervisors * Total No. of Form 00 Regional MonthlySupervisors SIG Technical

Team

* No. of newsupervisors

* No. of supervisorswho have left theproject, by cause

* No. of supervisors intraining

Caregivers * Total No. of Form 00 Regional MonthlyCaregivers SIG Technical

Team* No. of new caregivers

* No. of caregivers whohave left the project,by cause

* No. of caregivers whohave not repaid theirtotal rehabilitation loan

* No. of caregivers intraining _ _ _ _

PartyResponsible Frequency of

Instrument for for Data AnalysisObjectives Variable Indicators Data Collection Registration

Children Total no. of children Form 11 Technical Monthlyenrolled: Worksheet 11 -2 staff in(a) by age SIG charge and(b) by sex caregiver* No. of children who left

the project, by cause* No. of children enrolled

for 6 months or more* No. of child-days per

month of non-attendanceby cause

* No. of child-days permonth

* No. of functioning daysEvaluate the extent of 1. Targeting and Selection of day-care centerscompliance withestablished technical (a) Selection of 0 Category of the Form 01 Regional Quarterlyand operational communities to community, according SIG Technicalnorms of the project participate in project to the Poverty Map Team

(b) Selection of children * Nutritional status: Worksheet II-I Technical Quarterlyfor day-care centers SIG staff in(pidis) * Normal or degree of charge

malnutritionSocial Risk Factors:(a) Working parents

without child care(b) Under care of one

person (e.g., singleparent)

(c) Family of 5 or morechildren l

PartyResponsible Frequency of

Instrument for for Data AnalysisObjectives Variable Indicators Data Collection Registration

(c) Selection of Age Form 04 Technical QuarterlyCaregivers Level of Education Worksheet 04-1 staff in

| _______________ _ .Training SIG charge

2. Community Promotion * No. of community Form 01 Regional Quarterlyorganizations contracted, SIG Technicalby community Team

* No. of community Form 01 Regional Quarterlyorganizations that SIG Technicalparticipate in the Teamproject, by type

3. Initial Training * No. of candidates Form 07-1 Regional and Quarterlyenrolled SIG National

Technical* Knowledge of Teams

participants

(a) Average test scoreon entry to training

* (b) Average test scoreupon completion oftraining

* No. of persons selected Form 07-b Participants Quarterlyas caregivers SIG

* Satisfaction ofparticipants with training(average score)

PartyResponsible Frequency of

Instrument for for Data AnalysisObjectives Variable Indicators Data Collection Registration

4. Functioning of the Day-Care Centers

(a) Health Monitoring of Children Form 14 Technical MonthlyWorksheet 14-1 staff in

* No. of children with SIG chargehealth card

* No. of children withhealth card up-to-dateand correctly completed

* No. of children with fullvaccination. Regimencompleted within 6months of entry to day-care center

Monitoring of Preznant and Form 15 Technical MonthlyLactating Women Worksheet 15-1 staff in

SIG charge* No. of pregnant and

lactating women withchildren participating inthe project

* No. of pregnant and Technical Monthlylactating women who staff inhave received health chargecontrol visits

0%

PartyResponsible Frequency of

Instrument for for Data Analysis

Objectives Variable Indicators Data Collection Registration

* No. of well- and mildly- Form 13 Technical Monthlymalnourished children Worksheet 13-1 staff inweighed and measured SIG chargemonthly

(b) Nutrition * No. of children who Form 13are mildly Worksheet 13-2malnourished and have SIGnot gained weightbetween control visits,and moderately andseverely malnourishedchildren who:

(a) are weighed weekly(b) have had a medical

control visit twice amonth by a doctorat the referralhealth center

* No. of children, Form 13 Technical Monthlyaccording to their Worksheet 13-1 staff innutritional status: SIG charge

(a) Normal(b) Mildly

malnourished(c) Moderately

malnourished(d) Severely

malnourished

PartyResponsible Frequency of

Instrument for for Data AnalysisObjectives Variable Indicators Data Collection Registration

(c) Education Children* No. of children with Form 12 Technical Quarterly

development chart that Worksheet 12-1 staff inis up-to-date SIG charge

* No. of children towhom the ChildDevelopment Scale hasbeen applied

* No. of childrenaccording to theirdevelopment status:

AlertMedian

* No. of children who,upon reaching 6 years ofage, enter primaryschool

Evaluation of caregiver's Form 08 Technical Quarterlyperformance, by functional SIG staff in

l_____________________ areas charge

5. Payment of User Charges * No. of parents who have Worksheet 09-1 Caregiver Monthlypaid the full user fee, by SIGday-care center

* Total amount of userfees received by monthin each day-care center

o~

PartyResponsible Frequency of

Instrument for for Data Analysis

Objectives Variable Indicators Data Collection Registration

6. Administration

(a) Rehabilitation Fund * No. of caregivers Form 03 Technical Monthlyreceiving support for Worksheet 03-1 staff inrehabilitation of their SIG chargehomes

* Total amount disbursedfor rehabilitation

' Total amount recoveredl _________________ ________________________ for rehabilitation

ON0h

o.

PartyResponsible Frequency of

Instrument for for Data AnalysisObjectives Variable Indicators Data Collection Registration

(b) Food, Materiel & * No. of dry-rations Form 03 Technical MonthlyEquipment received by day-care Worksheet 03-3 staff in

center charge

* Quantity of fresh food Worksheet 03-1received by day-carecenter

* Quantity of materials Worksheet 10-1received by day-carecenter

* No. of day-care centers Worksheet 10-2which receivereplacement ofequipment

Expenditures per day-care Worksheet 10-3center from funds receivedby parents, by type ofexpenditure

(c) Health Fund Monthly average SIG Regional Monthlyexpenditure, by region Technical

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ~~~~~~ ~ ~ ~ ~~~~~~Team _ _

PartyResponsible Frequency of

Instrument for for Data AnalysisObjectives Variable Indicators Data Collection Registration

7. Functioning of Parents' * No. of parents' Form 05 Technical QuarterlyAssociations associations formed staff in

charge or* No. of day-care centers Form 10 supervisor

with associated parents'associations

* No. of training courses Worksheet 05-1provided to managers ofparents' associations

* Fulfdilment of Worksheet 06-2presentation of periodic SIGreports of parents'associations o

00S. Interinstitutional

Coordination

(a) NGOs * No. of agreements Form 01 Regional Quarterlysigned, according to Form 02 Technicalnwdality SIG Team

* No. of day-carecenters operating withassistance of NGOs

* No. of agreementsrescinded, by cause

(b) Ministry of Social No. of health centers that Form 01 Regional QuarterlyAssistance and Public provide assistance to day- SIG TechnicalHealth (MPSSP) care centers according to Team

their agreement Ei

PartyResponsible Frequency of

Instrument for for Data AnalysisObjectives Variable Indicators Data Collection Registration

(c) Ministry of Education * No. of illiterate persons Worksheet 11 1 Technical Quarterlyand Culture identified: Reports of staff in

(a) Caregivers SENALEP charge(b) Parents of children

enrolled in day-carecenters

* No. of illiterate personswho participate inliteracy SENALEPprogram:(a) Caregivers0) Parents of children

enrolled in day-carecenters

(d) Food Donors * No. of rations Agreement Regional Quarterlyprogrammed, by forms Technicaldonor Team

* No. of rationsreceived, by donor

(e) Financiers * Funds committed, by Financing National Monthlycategory of agreements Teamdisbursement

* Funds disbursed, by Accountingcategory of Systemdisbursement

* Funds expended, bycategory of Accountdisbursement Statements

.__ _ _ _ _ _ _ _ _ _ -_ _ _ _ _ _ _ _ _ _ _ _ _ _ -_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _SIG _

BOLIVIAINTEGRATED CHILD DEVELOPMENT PROJECT

IMPACT EVALUATION SYSTEM

An Analytical Model

Community Proram PrSchoo|Chcaracteri | c Characterisics| l Developmental Outcomes Partciptio

School Outcomnes

Background * articiation in * Women's < -* Community SchoolVariblots (Famiy PIDI _Well-Being Organization |/Charactoristics

A /~~~~~~~~~~~~

r~~~~~~

- 71 -Annex 6

BOLIVIAINTEGRATED CHILD DEVELOPMENT PROJECT

Impact Evaluation SystemAn Analytical Model

VARIABLES

Background Variables Participatn ODayCare Cente Program Characteristics

Income/Employment Yes/No QualityFamily Structure Age of Entrance EfficiencyLanguage Length in ProgramParental EducationWater

Outcome Variables Pre-School- Schooling...

Child Well-Being Yes/No Age at Entrance* Health Type Repetition* Nutrition Dropout' Psycho-Soc Dev. Performance

BehaviorWomen's Well-Being* Personal Health* Labor Force Insertion* Education Level

* Childrearing KnowlegeExpectations

* Self-esteem

Community Organization andAction

- 72 - Annex 7, Table I

BOLIMAINTEGRATED CHILD DEVELOPMENT PROJECT

Detailed Project Cost Summary

Local I Foreign Total % Total

% Foreign Basel-----USS million------ Exchange Costs

A. Sector Policy Developmentand Management Stengthening

1. Sector Policy Development 0.7 0.5 1.2 42.6 0.9

2. Management Strengthening 2.5 0.2 2.7 7.9 2.1

Subtotal 3.2 0.7 3.9 18.5 3.0

B. Service Delivery Support

1. Home Rehabilitation 2.9 0.0 2.9 0.0 2.2

2. Equipment for Centers 18.9 10.6 29.5 36.1 22.4

3. Training 2.1 0.5 2.6 19.8 1.9

4. Food Supplementation 49.1 0.0 49.1 0.0 37.2

5. Stipends to Caregivers 16.5 0.0 16.5 0.0 12.5

6. Health Fund 1.2 0.0 1.2 0.0 0.9

7. Operation Costs of Centers 8.3 0.0 8.3 0.0 6.3

8. Equipment for Project 0.3 0.4 0.7 62.6 0.5Offices

9. Vehicles 0.0 0.9 0.9 100.0 0.7

10. Extend Supervision 2.6 0.0 2.6 0.0 2.0

11. Salaries and Administrative 10.3 1.0 11.3 8.5 8.6Costs

Subtoal 112.2 13.4 125.6 10.7 95.3

C. Monitoring and Evaluation

1. Monitoring 0.1 0.0 0.1 30.0 0.1

2. Evaluation 1.3 0.9 2.2 40.0 1.7

Subtoal 1.4 0.9 2.3 39.6 1.7

Total Basdine Costs 116.4 15.0 131.3 11.4 100.0

1. Physical Contingencies 0.1 0.1 0.2 45.2 0.1

2. Price Contingencies 6.4 1.7 8.1 21.3 6.2

Totol Projec Costs 123.3 16.9 140.2 12.1 106.3

BOLMA

INTEGRATED CHILD DEVELOPMENT PROJECT

F hnncn Plan by YearUSS milon

YearS Governt .. t.DA -% W.F.P, # BenetIParleF % UNICEF % CE % ASD 'IF % Oth % TOWa %

1994 1.40 18 5.30 00 0.96 11 0.27 3 0.46 5 0.00 0 0.58 7 0.00 0 8.90 6 -$

1995 2.29 24 5.14 54 1.00 11 0.43 5 0.32 3 0.27 3 0.00 0 0.00 0 9.51 7

1995 3.20 21 6.94 45 1.51 10 0.83 5 0.30 2 0.31 2 0.00 0 2.18 14 15.27 11

1997 4.11 16 1024 40 2.40 9 1.49 6 0.20 1 0.47 2 0.00 0 6.47 25 25.38 18

1996 5.00 14 11.78 33 3.00 8 2.38 7 0.00 0 0.39 1 0.00 0 12.78 36 35.33 25

1999 5.00 11 11.30 25 300 7 3.36 7 0.00 0 0.42 1 0.00 0 22.73 50 45.81 33

oW- : - -: 2100 -:::- 15-.=. 501036-8: 11.93 9 - 8.76 6 - 1.28 1 1.86 1 :-: 0.58 0 44.16 3 140.20 100

O) 8i&ppot fo pparailn from USAID and Social wemet Fund() Co4lnncn to be confirmed duvig the Ajnma and Ml-Term Revew

I.a'

3.1 74 - Annex 8

Presidencia de la Rep6bIlcaO N AM FA\ Organismo nocional del menor, mujer y fomillo

BOLIVIAINTEGRATED CHTI DEVELOPMENT PROJECT

SUPREME DECREE NO. 23415

JAIME PAZ ZAMORA

CONSTITUTIONAL PRESIDENT OF THE REPUBLIC

CONSIDERING%

That the social politics of the Government of NationalUnity is to prioritize the protection of women in disadvantagecircumstances as well as the infant population, due to the factthat they constitute the group with the largest vulnerabilityin the most impoverished segments of the population.

That the Ten Year Action Plan for Women and Childrenpermit concentrated intersectorial and inter institutionalactions to elevate the impact of investments that favor theobjectives of the development of women and children, for whichthe food donations, the technical assistance and the financialcooperations of the country should be geared towards making upfor the nutritional, health, sanitation, educational andproductive stimulation deficiencies of the population at risk.

That it has been established that the country maintainselevated infant and maternal mortality rates in rural andperiurban areas, due to the nutritional deficiencies,infectious diseases, parasites, anemias, respiratory diseases,and complications during pregnancy, labor and puerperium; whoseservice coverage and low accessibility to these do notguarantee an appropriate health protection.

That the malnutrition of the newborn starts duringpregnancy, a situation that is aggravated with the suppressionof milk consumption after the period of maternal lactation.

The Fund for Social Investment, as a public entity,dependent of the Presidency of the Republic, whose objective isthe financing of projects in the areas of health and education,in favor of the most impoverished sectors of the population,has earmarked resources towards the implementation of anutritional program in accordance with the governmentalpolitics.

That the 'Junta Nacional de Solidaridad y DesarrolloSocial" dependent of the Presidency of the Republic, has beengiven the responsibility, by law, of carrying out the actionsin favor of the children and women, having started up theIntegral Program for Child Development in the periferal urbanareas of the country.

Edif AcxWia N&cdn.3l

Cailla 5960Teldfonos 376862-663ISOC72 * 350123350489 * 350233Fax 366763La Paz. MolaI'

-75 - Ae menor. - - ~~~~~~Annex S

0 N AM FA Presidencia de la RepublicmaONA /M FA Organismo nocional del menor. mujer y familia

IN MINISTERIAL COUNCIL

DECREES:

FIRST ARTICLE.- The "Nacional Complementary NutritionProgram" is established for two hundred and forty fivethousand pregnant and lactating mothers, and four hundredthousand children between the ages of six months and threeyears of age, including pregnant women detected in the"Integrated Program for Child Development", by providingenriched milk and special nourishment that supplement thenutritional deficiency of mothers and children, in order toguarantee their normal development.

SECOND ARTICLE.- The "Integrated Program for ChildDevelopment" is consolidated, guaranteeing covering two hundredthousand children between the ages of six months and six yearsof age, and one hundred thousand women, with the opening andfunctioning of thirteen thousand home day care centers thatattend children and women daily.

FOURTH ARTICLE.- The Minister of Planning andCoordination, will program the destination of resourcesgenerated by the monetization of food, nutritional assistance,technical assistance, financial cooperation, and/or othersources, towards the "National Complementary Nutrition Program"and the "Integrated Program for Child Development" inaccordance with the following schedule:

National IntegratedComplementary Program forNutrition Program Child Development

1995 Administration: Sus. 5,0001000.- Sus. 1,200,000.-1996 Administration: Sus. 8,000,000.- Sus. 3,200,000.-1997 Administration: Sue. 11,000,000.- Sus. 6,700,000.-1998 Administration: Su.s 14,000,000.- Sus. 15,600,000.-1999 Administration: Sus. 17,000,000.- Sus. 23,300,000.-2000 Administration: Sus- 20,000,000.-

FOUJRTH ARTICLE.- The Fund for Social Investment will beresponsable for the financing of the projects initiallycontemplated in the National Complementary Nutrition Programfrom the promulgation of the present Decree, and of thecounterpart for the first 24 months of execution, guaranteeingthe continuity of the Program with the resources established inthe preceeding Article.

FIFTH ARTICLE.- The "Junta Nacional de Solidaridad yDesarrollo Social" should anticipate in its preparations forthe Integrated Program for Child Development the totality ofthe institutional resources from agencies of cooperation, fromNon-Governmental Organizations, private development

Edif. Loteria NaciooalCaslIla 5560Teklfonos 376862-66350072 * 350123

350489 * 350233Fax 366763

La Paz, Sulivia

-76 - Annex 8

Presidencia de la ReuCjblIcaOC N MFA 0rganisno nocionol del menor. mujer y aml4ca

institutions, and *ntities of the comimunity, necessary for theits establishment and functioning.

The Ministers of State in the Ministry of Planning andCoordination, along with those from the Ministry of SocialAsitance and Public Health, as well as the Fund for SocialInvestment, and the "Junta National de Solidaridad y DesarrolloSocial" are to be in charge of the execution and fulfillmentof the present Supreme Decree.

It is given in the Governmental Palace, in the city of LaPaz, on the fifth day of the month of March, of nineteenhundred and ninety three.

FDO. JAIME PAZ ZAMORAFdo. Ronald McLean AbaroaFdo. Carlos A. Saavedra BrunoFdo. Gustavo FernAndez SaavedraFdo. Alberto Saenz KlinskyFdo. Roberto P-ea RodriguezFdo. Samuel Doria Medina AuzaFdo. Pablo Zegarra AranaFdo. Olga Saavedra de QuerejazuFdo. Carlos Aponte PintoFdo. Fernando Campero PrudencioFdo. Eusebio Gironda CabreraFdo. Carlos Dabdoub ArrienFdo. Alvaro Rejas VillarroelFdo. Oswaldo Antezana Vaca DiezFdo. Herbert Muller CostasFdo. Fernando Kieffer GuzmAnFdo. Jos* Luis Lupo Flores

Edif. Louda NacionmA

Crnila 5960

T*donos 376862-66350072 * 350123350489 * 350233fan 36-6763La Pu. lodi

-77 - Annex 9

BOLIVIAINTEGRATED CHILD DEVELOPMENT PROJECT

i ORGANIZATIONAL STRUCTUREPROYECTO INTEGRAL DE DESARROLLO INFANTIL (PIDI)

(CENTRAL OFFICE)

BOARD OFDIRECTORS

PRESIDENTONAMFA I

_~~~~

EXECU IVEDIRECTOR 1ONAMFA I

NTIRNALl ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~I 1MGe

AUDI'TINtlI ONAMPA

I I . . I.. MANAGERC OF MANAGER Of PROCG

I | AOllINISTRATION FOR CHILDREN,

AND FlNANCE WOMEN AND FAMILY

I~~~l I

I~~ I

I ~~ I

I ~~ I

I ~~ I

NATIO NALCOOtt I MAYOR

NMNAEMCENT INTERNAL

|M LTI NGAUDITING --------------------- I

I r YSTIEM

HIALT" ANO ~~~~~~~~~~COMMUIP"TVNUTRtTION l L OU ttRAACH

CtTOGIONAL

CNIt ATOI ---------- @------------------------------------...... ___COODINAO

Annex 9-78 -

BOLIVIAINTEGRATED CHILD DEVELOPMENT PROJECT

ORGAN I ZAT I ONAL STRUCTUREPROYECTO INTEGRAL DE DESARROLLO INFANTIL (PIDI) (

, ; ~~~~(REGIONAL OFFICES)

NATIONALCOORDINATOR

PlD'

REGIONAL

COORPDINATOR

P101

NAA6 EMENTlN NAAT.NON

SYSTEM

|AOMI ISTNA- | HEALTH ANO ONNT | T1ON l0 l NUTRITION l l EDUCATION l lCOMMUNT I TYUNIT NUTRI I EDU ~~~~~~~~~OUTREACH

- 79 - Annex 10

BOLIVIAINTEGRATED CHILD DEVELOPMENT PROJECT

STUDIES TO BE CARRIED OUT BY ONAMFA

Project Component/ Agreed CompletionStudy Date

Sector Policy Development and Management Strengthening

Food Security and Nutrition June 30, 1995

Extension of Child Development June 30, 1996Services to Rural Areas

Analysis of ONAMFA's Institutional June 30, 1996Capacity

Refinement of Child Development June 30, 1996Measures

Design of a Five-Year Information June 30, 1996System Plan

Monitoring and Evaluation

Impact of the Project on Women June 30, 1996(Interim Report)

June 30, 1998(Final Report)

Impact of the Project on Community June 30, 1996Development (Interim Report)

June 30, 1998(Final Report)

Project Cost-Effectiveness June 30, 1998

Project Impact on Schooling and June 30, 1998School Performance

BOLIVIAINTEGRATED CHILD DEVELOFMENT PROJECT

Implementation Schedule

(USS milhon equivalent)

Project Element PreProject Project Years Total1 2 3 4 5 6 Payment Remarks

CreditrlrnngSign/EffecVClse

GoodsVehices 0.52 0.00 0.00 0.40 0.00 0.00 0.92 ICBOffice Technolgy 0.57 0.00 0.00 0.25 0.00 0.00 0.82 ICBFumiture & Equipment 1.32 2.29 3.90 6.41 8.36 10.04 32.32 ICB/LCB/ShoppingFood Commodities 1.10 2.55 4.94 8.85 14.11 19.59 51.44 Not IDA Financed

Rehabiaeion Fund 0.00 0.29 0.43 0.66 0.69 0.61 2.86 Mixed Loan/Grant

00Consuncs .

Studes & Technical Assistance 0.61 0.88 0.83 0.75 0.89 0.60 4.56Extrnal Supervsion 0.11 0.17 0.31 0.52 0.74 0.94 2.79

Sal-rie & Operatng ExpendituresCivi Service Support 0.36 0.37 0.38 0.39 0.40 0.41 2.31Salaries 0.64 0.78 0.98 1.29 1.43 1.46 6.58Adminitratve Costs 0.36 0.47 0.52 0.64 0.69 0.74 3.42Stipnds to the Caregivers 0.37 0.86 1.67 2.99 4.76 6.71 17.36Opatng Costs of Centers 0.19 0.43 0.83 1.49 2.38 3.36 8.68 Beneficiary ContributonsHealfth Fund 0.03 0.06 0.12 0.22 0.35 0.51 1.29Training 0.35 0.36 0.36 0.52 0.53 0.54 2.66

MiscellaneousPPF Relncin 0.75 0.75

Other Prepa_in Finncing 1.44 1.44

TOTAL 8.90 9.51 15.27 25.38 35.33 45.81 140.20

(IDA Financed) (5.30) (5.14) (6.94) (10.24) (11.78) (11.30) (50.70) _

- 81 -

Annex 12, Table 1

BOLIVIAINTEGRATED CHILD DEVELOPMENT PROJECT

Disbursement Forecast

IDA Fiscal Year Disbursement Cumulativeand Semester Semester Cumulative as % Semester

(US$ million) of Total

1994(a)2nd (Jan '94-June '94) 3.02 3.02 5.96 1

19951st (July '94-Dec '94) 2.28 5.30 10.45 22nd (Jan '95-June '95) 2.57 7.87 15.52 3

19961st (July '95-Dec '95) 2.57 10.44 20.59 42nd (Jan '96-June '96) 3.47 13.91 27.44 5

19971st (July '96-Dec '96) 3.47 17.38 34.28 62nd (Jan '97-June '97) 5.12 22.50 44.38 7

19981st (July '97-Dec '97) 5.12 27.62 54.48 82nd (Jan '98-June '98) 5.89 33.51 66.09 9

19991st (July '98-Dec '98) 5.89 39.40 77.71 102nd (Jan '99-June '99) 5.65 45.05 88.86 11

20001st (July '99-Dec '99) 5.65 50.70 100.00 12

Closing Date: December 31, 1993(a) PPF Refinancing included

- 82 - Annex 12, Table 2

BOLIVIAINTEGRATED CIILD DEVELOPMENT PROJECT

Disbursement Allocations

CATEGORY AMOUNT PERCENTAGE

--(US$ equivalent)--

1. Rehabilitation Fund 2.73 100% of eligible expenditures

2. Goods 26.24 100% of foreign expenditures and80% of local expenditures

3. Consultancies

a. Studies, Technical 5.49 100% of eligible expendituresAssistance and Training

b. External Supervision 0.90 100% in 1993-94; 75% in 1995;60% in 1996; and 25% in 1997 -1999.

4. Health Fund and Stipends to 7.63 100% in 1993-94; 85% in 1995;Caregivers 75% in 1996; 60% in 1997; 46%

in 1998; and 17 % in 1999.

5. Civil Service Support 1.05 87% in 1993-94; 72% in 1995;6. Incremental Salaries for 3.65 54% in 1996; 35% in 1997; 21 %

Project Implementation & in 1998; and 7% in 1999 ofAdministrative Cost eligible expenditures for Civil

Service Support, IncrementalSalaries for ProjectImplementation & AdministrativeCost

7. PPF Refinancing 0.75 100% of eligible expenditures

8. Unallocated 2.26

Total 50.70

- 83 -

Annex 13

BOLIVIAINTEGRATED CHILD DEVELOPMENT PROJECT

SUPERVISION SCH ULE AND DIPLEMENTATION INDICATORS

Supervision Schedule

Semi-annual supervision missions are anticipated for this project, andare likely to take place in December and June each year. The first year ofimplementation (CY94) might require an additional mission in September1994. In addition, the first supervision mission (around the expected time ofcredit effectiveness in December/January 1994 will be the Project's Launch(2 weeks), and might also include a disbursements officer. The total annualnumber of staff/consultant weeks required are:

Year l

TIask Manager 12 20Operations 5 7Health/Nutrition Specialist 4 6Early Childhood Education Sp. 4 5Social Marketing Specialist 2 3Financial Management Sp. 1 2Procurement and/or Disbursement Sp. 2 1

Tbtal 30 44

- 84 - Annex 13

Implementation Indicators

End of Calendar Year

Coverage Targets 1994 1995 1996 1997 1998 1999

Number of Day-CareCenters Functioning 703 1,441 2,617 4,489 6,579 8,670

Number of ChildrenEnrolled 10,545 21,615 39,255 67,335 98,685 130,050

(of which childrenunder 2 years of age) (2,109) (4,323) (7,851)(13,467)(19,737) (26,010)

Number of Caregivers 1,687 3,458 6,280 10,774 15,790 20,808

Selection of Children Enrolled in Day-Care Centers

All new children enrolled in day-care centers will be selectedaccording to the following criteria, in order of importance:

(i) Malnourished(ii) Living in single parent households(iii) Parents employed and, thus, child at risk of abandonment(iv) From families with high parity, i.e., with 5 or more children

The percentage of new enrollees meeting each of the above criterionwould be reviewed.

- 85 -Annex L3

Compliance with Key Operational/Technical Norms of the Project

Indicator Target

Percentage of normal or mildly malnourished 100 percent forchildren enrolled in the day-care centers all years of projectwho have received weight & height control visits implementationat the referral health center once per month

Percentage of children who are mildly malnourished 100 percent forand not gaining weight between control visits, all years ofand moderate and severely malnourished children projectwho have received weight & height control visits implementationonce per week at the referral health center

Percentage of malnourished children enrolled in day-care 100 percent forcenters who are under medical treatment who have received all years ofmedical control visits by a doctor at the referral health projectcenter twice per month implementation

Percentage distribution of children enrolled in day- Over time, thecare centers according to the degree of malnutrition proportion of(i.e., mild, moderate and severe) children

malnourished,particularly ofmoderate andsevere degree,would decline

Percentage of children enrolled in the day-care centers 100 percent forfor six months or more who have received their full all years ofimmunization coverage project

implementation

Percentage distribution of children enrolled in day- Over time, thecare centers according to their level on the Child proportion ofDevelopment Scale children at the

lowest levelswoulddecline

Percentage of children enrolled in day-care centers 100 percent forwho, upon reaching 6 years of age, enter primary school all years of

projectimplementation

- 86 - Annex 13

Costs of Day-Care Center Implementation

Average investment cost per day-care center for:

(i) initial opening(ii) replacement of furniture and equipment

Average monthly operational costs per day-care center

Average monthly project cost per beneficiary

- 87 -

Annex 14

BOLIVIAINTEGRATED CHILD DEVELOPMENT PROJECT

Selected Documents and Data Available in the Project File

A. Selected Reports and Studies in the Sector

A. 1. "Early Childhood Care and Education: Evidence of Long-Term Benefits and Implications for Developing Countries",David Weikart, September 1992.

A.2. "Evaluation of the Early Child Development Project inColombia", by Nelson Ortiz, September 1992.

A.3. "Evaluation of the Early Child Development Project inColombia", Robert G. Myers, May 18, 1993.

A.4. "Bolivian Social Strategy", CONAPSO, Ministry of Planningand Coordination, September 1991.

A.5. "Analysis of the Situation of Children and Women in Bolivia",UNICEF, La Paz, Bolivia, 1992.

A.6. "Ten-year Plan of Action for the Bolivian Children",Presidency of the Republic, December 1991.

A.7. "Preliminary National Census 1992", Ministry of Planning andCoordination, Bolivia, July 1992.

A.8. "Maternal and Child Health in Bolivia - Report on the In-depthDemographic and Health Survey in Bolivia, 1989", Institutefor Resource Development/Macro Systems Inc., April 1991.

A.9. "Principles and Guidelines to Strengthen Programmes of EarlyChildhood Development and Learning"; The Eighth Meeting ofthe Consultative Group on Early Childhood Care andDevelopment, Washington DC, the World Bank, March 31 -April 2, 1993; by Robert G. Myers.

A. 10. "Towards a Comprehensive Strategy for the Development ofthe Young Child", UNICEF, March 1993.

- 88 - Annex 14

A. 1. "Estimates of the Urban Poverty in Bolivia", UDAPSO,February 1993.

A. 12. "Early Child Development - Summary Report", UNICEF,Innocenti Global Seminar, Italy, October 1989.

A. 13. "Early Childhood Development Programs in Latin America:Toward Definition of an Investment Strategy", by Robert G.Myers, the World Bank, August 1992.

B. Selected Documents and Reports Relating to the Project

B. 1. "The Integrated Program of Child Development (PIDI)", JuntaNacional de Solidaridad y Desarrollo Social, April 1993.

B.2. "Criteria for the Choice of Cities and Areas in the Cities toOpen the Day-Care Centers in Each Region", Junta Nacionalde Solidaridad y Desarrollo Social, September 1992.

B.3. Supreme Decree No. 09922 Creating the Junta Nacional deSolidaridad y Desarrollo Social; Gaceta Oficial de Bolivia No.1309.

B.4. Law No. 1403, Code of the Minor, December 18, 1992.

B.5. Supreme Decree No. 23469 Complementing the Law No. 1403of December 18, 1992, Code of the Minor.

B.6. Supreme Decree No. 23415 Creating the National Program ofFood Supplementation, March 15, 1993.

B.7. "Evaluation of the PIDI Pilot Project", La Paz, April 15,1993.

B.8. PIDI Administrative Manual, April 1993.

B.9. PIDI Technical Manual and Emergencies Manual, April 1993.

B. 10. PIDI - Information and Evaluation System, April 1993.

- 89 -Annex 14

C. Selected Working Papers

C. 1. "Multisectoral Nutrition Planning: A Synthesis of Experience",F. James Levinson, December 1989.

C.2. "The Integrated Program of Child Development (PIDI): ARationale for Investing and Analysis of the Proposal", RobertG. Myers, October 14, 1992.

C.3. Back-to-Office Report of Ms. Judith L. Evans concerningTraining within the PIDI Project, December 16, 1992.

C.4. Back-to-Office Report of Mr. Jean-Paul Faguet on the CreditComponent and Procurement Procedures for the IntegratedChild Development Project (PIDI), December 16, 1992.

C.5. Back-to-Office Report of Mr. Angel Gonzalez-Malaxechevarriaon the Financial Management Evaluation of the Junta Nacionalde Solidaridad y Desarrollo Social, February 8, 1993.

C.6. Back-to-Office Report of Mr. Robert G. Myers Assessing theOverall Soundness of the Project's Technical Components,Analyzing the Results of the Pilot Phase, Reviewing the ChildAssessment Tools, and Finalizing the Monitoring andEvaluation Component, May 12, 1993.

C.7. "The Integrated Program of Child Development (PIDI) -Monitoring and Evaluation Component", Marcelo MercadoLora, January 1993.

C.8. Back-to-Office Report of Ms. Julie Van Domelen on theInstitutional and Management Structure of the "Junta Nacionalde Solidaridad y Desarrollo Social (JNSDS), January 19, 1993.

C.9. "Addressing Food-Related Issues in the PIDI Project", by F.James Levinson, January 1993.

C. 10. Back-to-Office Report of Julie Van Domelen on InstitutionalDevelopment, April 12, 1993.

MAP SECTION

IBRD 24922

BO L I V IA

INTEGRATED CHILD DEVELOPMENT PROJECT

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