Madagascar: Increasing Food Security and Nutrition Page 1 of 4 THE WORLD BANK GROUP Findings reports on ongoing operational, economic and sector work carried out by the World Bank and its member governments in the Africa Region. It is published periodically by the Africa Technical Department on behalf of the Region. Madagascar : Increasing Food Security and Nutrition Despite high economic potential, poverty has been increasing steadily in Madagascar since the early 1 960s and it is estimated that almost 54% of the population was living below the poverty line in 1993. Rural areas are estimated to account for 92% of the poor. The quality of basic education and health services has declined sharply: Madagascar is one of the few countries in the developing world where the younger generation is likely to have a worse educational attainment than that of its parents. The infant mortality rate is 107 and 75 per 1000 live births respectively in the rural and urban areas Between 45% to 49% of children are malnourished when measured by height for age or weight for age. Housing conditions are poor, with 53% of households living in a single room and poor households crowded in at the rate of 6 persons per room. Over 60% of households obtain their water from easily polluted sources such as lakes, rivers and ponds while 12.5% obtain water from public taps. Only accelerated, employment-generating growth can result in significant and broad-based poverty reduction. The Madagascar Food Security and Nutrition (SECALINE ) Project, operational since mid- 1993, is designed to address poverty, food insecurity and malnutrition in areas with a particularly high incidence of poverty. The objectives of the project are to reduce food insecurity and malnutrition by empowering communities to help themselves. It combines a mixture of three interlinked approaches to achieving these objectives including: * support for income generating activities; * nutrition programs; and * institutional development to increase national awareness and capacity to combat poverty, food http://www.worldbank.org/afr/findings/english/find45.htm 11/2/2001 Madagascar: Increasing Food Security and Nutrition Page 2 of 4 insecurity and malnutrition. Considering that several Bank projects have had a poor execution record in Madagascar, this project had achieved substantial progress at the end of its first full year of operation: During this period, the project's social fund has helped create 213,000 person-days of temporary employment, financed 114 contracts with micro and small enterprises, and supported sustainable income-generating activities by 10 NGOs. Also, during the last three months in 1994, the project's food-for-work component created almost 20,000 person days (62% among women) of employment linked to cleaning up poor neighborhoods. Malnutrition in target communities has fallen from 19% to 12% (a reduction of about 40%). The iodine deficiency disorders component completed its phase of distributing iodized capsules and is now providing equipment and support to the private sector to iodize salt. An Information, Education and Communication (IEC) campaign has been launched to promote improved nutritional habits and the importance of using iodized salt. A National Food Security Strategy is being prepared by bringing together all studies done in various departments and institutions. A draft paper taking stock of all studies so far has been prepared. This project's success can be attributed to: i the involvement of beneficiaries at all stages; , a widely-attended project launch workshop involving people ranging from Cabinet Ministers to poor peasants, which helped to increase borrower ownership; , active collaboration with NGOs; • the power of choice devolving to the communities; * close collaboration with other donors such as Unicef, the International Labour Office (ILO), the World Food Programme (WFP) etc. Income-Generating Activities Income-generating activities are supported in two ways: * a social fund (Fonds dI'ntervention pour le Developpement or FID) which finances community infrastructure, development of micro-enterprises and other sustainable income generating activities; and * a Food for Work Program (food provided by the WFP ) which targets the poorest segments of the population and provides food in return for the maintenance of community infrastructure. FID has also been successful in helping the development of micro-enterprises creating future capacity to execute labor-intensive work. The food-for-work program has managed to reach the poorest women in urban areas. The project's two components are designed to generate income operate in partnership with local communities. FID responds to demands for financing sub-projects made by local communities usually in partnership with NGOs. FID supports the community and NGO in preparing the project proposal, appraises the projects and once funding is approved, helps to execute the project. Where it is necessary to contract out work, FID's implementation department takes charge of bidding and http://www.worldbank.org/afr/findings/english/find45.htm 11/2/2001 Madagascar: Increasing Food Security and Nutrition Page 3 of 4 supervision. The community has to contribute, though the level and type of community contribution is varied. For rural roads, the contribution is low and concerns mostly maintenance, while for irrigation projects, where there is a direct financial benefit, the contributions are higher. In the case of schools, where there are additional recurrent costs generated, such as by an extra classroom, the community has agreed to bear the cost. Examples include a school where the Parent Teacher Association agreed to pay for the extra teacher. Where it results in direct private benefit such as in a project which trains and then equips people to become carpenters, the training may be provided free but the equipment is financed by a reimbursable credit. While FID collects the loan to ensure that the repayment system is working, it is not a bank and the money collected is immediately given back to a community fund for such activities. The Food-for-Work Program (FWP) has been designed to provide support to the poorest in urban areas (the majority are women heads of households) by giving them food rations in return for work performed in cleaning their neighborhoods. One exception to neighborhood work has been the cleaning of the main canal which evacuates much of the water in the Antananarivo urban zone. This program has helped the most vulnerable residents of the Greater Antananarivo area. FWP is about to enter a new phase as it funds a drive to reduce the rat population of these areas to mitigate the endemic bubonic plague in the poorer crowded areas of Madagascar. FWP is also a good illustration of a working partnership between the World Bank and other UN Agencies. WFP provides the food while the ILO helps to manage it. Nutrition Activities The project supports nutrition activities through a community nutrition program and an Iodine Deficiency Disorders (IDD) program. In addition, IEC activities contribute significantly to improving the nutritional status of the population. The Community Nutrition Program (referred to as PCN in French) has been successfully addressing malnutrition in target communities by putting mothers' groups in each community in charge and keeping the focus on community development. On the directly nutritional activities side, PCN supports nutritional status monitoring, nutrition education and provides a snack prepared from local materials at a very cost to malnourished children. The snack is financed by the WFP, but mainly uses locally available and purchased materials. One of the most interesting aspects of the PCN is the close link between IEC, nutrition and community development. IEC messages are developed regionally using results from local KAP (Knowledge, Attitudes, Practices) Surveys and beneficiary assessment surveys. Relevant messages are then developed in accordance with local mores. Madagascar has high levels of goitre and cretinism due to iodine deficiency and the project supports an Iodine Deficiency Disorders (IDD) program. The IDD program has completed its first phase of iodine capsule distribution and has moved to the phase of iodizing salt. The equipment for salt iodization has now arrived and private sector salt producers have organized themselves to use this equipment. This should increase the proportion of iodized salt in Madagascar to close to 80% of the total salt supply. The IDD program is yet another example of inter-agency cooperation with the program being jointly financed and executed with Unicef. Institutional Development http://www.worldbank.org/afr/findings/english/find45.htm 11/2/2001 Madagascar: Increasing Food Security and Nutrition Page 4 of 4 By supporting FID and the NGOs, the project is making major contributions to Madagascar's capacity to develop and execute poverty reduction and development programs. Furthermore, the project supports IEC activities designed to convince the population at large and opinion makers in particular of the importance of poverty reduction, nutrition and food insecurity. The project also supports the development of a national strategy which would eventually be presented to Parliament for adoption. The project's success is doubly important in an environment that has not really been conducive to broad-based employment-generating economic growth on a financially sustainable basis. However, from the beginning, the SECALINE project has had the strong support of beneficiaries and NGOs. It also has considerable backing from the country's political leadership who publicly speak of the project as a Malgache effort and not as a World Bank-financed project. In an effort to help take this success nation-wide, the Bank is assisting the government in developing 2 related projects, Social Fund II and Nutrition II. Again, the emphasis will be on the involvement of all stakeholders from design through implementation, which has been key to the success of this initiative and offers a concrete example to learn from in Sub-Saharan Africa. This article was contributed by Ms. Eileen Murray, Operations Officer. More information is available from her office, Rm. J7-060, World Bank, 1818 H Street NW, Washington D. C. 20433, Tel. no. 202 - 473-5068. http://www.worldbank.org/afr/findings/english/find45.htm 11/2/2001