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India
>> Regional Overview >> India Overview ACTIVITY DATA SHEET
PROGRAM: India
TITLE AND NUMBER: Improved Child Survival and Nutrition in Selected Areas of India, 386-003
STATUS: Continuing
PLANNED FY 2001 OBLIGATION AND FUNDING SOURCE: $337,000 DA; $4,300,000 CSD; $64,460,000 P.L. 480 Title II
PROPOSED FY 2002 OBLIGATION AND FUNDING SOURCE: $337,000 DA; $4,300,000 CSD; $80,020,000 P.L. 480 Title II
INITIAL OBLIGATION: FY 1995 ESTIMATED COMPLETION DATE: FY 2006Summary: This objective responds to the U.S. national interest of poverty reduction and improving health under USAID's Strategic Plan. India ranks 58th on the Human Poverty Index. Over one-third of India's one billion people lacks adequate food. One of every 11 children in India dies before the age of five. More than half of India's young children (73 million) are underweight (more than two and a half times the number of malnourished children in Africa) and chronic maternal malnutrition is high. Poor access to health care, high illiteracy rates and poor nutrition and health practices contribute to the high mortality and malnutrition. Poor women and children, particularly in remote rural and tribal areas, have the greatest mortality risks. The purpose of this objective is to reduce the high levels of child mortality and malnutrition. The major activity that contributes to this objective is the P.L.480 Title II program under which food aid is integrated with Government of India (GOI) and non-governmental resources to improve key child survival interventions such as immunization, breast feeding, and timely complementary feeding. The Title II program is being implemented by two major NGOs-CARE and Catholic Relief Services (CRS)-and reaches 7.5 million poor women and children (at the greatest risk to mortality, morbidity, and malnutrition) in remote rural and tribal villages. CARE's Integrated Nutrition and Health Program (INHP), which works within GOI's Integrated Child Development Services (ICDS), and CRS' Safe Motherhood and Child Surival (SMCS) program, which is implemented through social service societies, directly contribute to the results under this objective. CRS supports some agriculture and basic education activities and programs managed by Mother Teresa's and the Dalai Lama's organizations.
The Program for Advancement of Commercial Technology/Child and Reproductive Health (PACT/CRH), complements the Title II program. It provides support at the national level for child survival technologies aimed at increasing commercial marketing and distribution of quality child survival products and services, such as oral rehydration salts and vaccines.
Key Results: Among the multiple factors influencing child survival and nutrition, three key results were identified by USAID as critical to achieve this objective: (1) increased use of key child survival interventions; (2) improved maternal and child nutrition; and (3) improved targeting of at-risk populations.
Performance and Prospects: This objective has two components: the P.L. 480 Title II program and maternal and child survival interventions.
The FY 2001 funding level for the P.L. 480 Title II program is $64,460,000. This activity reached 98% of the planned target population with 193,553 metric tons (MT) of Title II commodities supplied in 102,355 villages across the nation. Progress in integrating nutrition and health continues. Strategies were refined during FY 2000 per the recommendations of a mid-term review (FY 1999). Under CARE's INHP, a unified capacity building strategy was implemented (rather than the previous four models of varying intensity and interventions). This unified strategy, with three priority interventions (targeted supplemental feeding of pregnant/nursing mothers and children under two; childhood and maternal immunizations; and antenatal care) is expected to improve impact and better diffuse best practices. Initially there could be some result dilution due to the rapid expansion of the strategy. A new management information system that integrates commodity and health information systems has been developed, tested, and implemented program wide. Given the size and scale of INHP, progress in both these areas is commendable.
Several INFP innovations were successfully tested. Replication of these models is expected to enhance health and survival of children and women. In Bihar, CARE facilitated the development and implementation of a low-cost group health insurance scheme for about 1,100 tribal families. By paying as little as $1.50 per year, a family of five can access curative and preventive health care, including antenatal care and maternal care from identified health facilities. In the states of Andhra Pradesh, Madhya Pradesh, and Bihar, CARE has developed program models where women's groups supply locally processed food for ICDS supplementary feeding. These models promote community ownership, improved livelihood, and food security, while demonstrating possible mechanisms for cost-sharing between the government and communities. Creative pilot activities to fill some of the gaps in government service provision include "Health Information Booths" in MP and an "Adolescent Health Brigade" in Rajasthan. Women's groups and trained adolescent girls act as change agents and actively disseminate information on maternal and child health.
CARE and CRS continue to expand and strengthen partnerships with government, NGOs, and community-based organizations to improve implementation, networking, and sustainability. CARE's financial partnerships with NGOs have increased from 54 in FY 1999 to 84 in FY 2000. Strategic alliances with United Nations Children's Fund (UNICEF), the National Institute of Nutrition, and the National Institute of Public Cooperation and Child Development (ICDS training and research institution) facilitate information sharing. CRS works with 60 counterparts (48 of these work in the health sector) and 3,500 operating partners (619 of these work in the health sector).
FY 2001 obligations of $337,000 in DA and $4,300,000 in CSD are planned to enhance the quality, coverage and number of maternal and child survival interventions such as immunization and antenatal care. USAID has initiated discussions with the government of UP and UNICEF on a vitamin A initiative to improve coverage of vitamin A supplementation in UP. The USAID-World Bank Deworming and Enhanced Vitamin A trial (DEVTA), which covers one million children in UP, will be completed in 2003. DEVTA will validate the impact of concurrent vitamin A supplementation and deworming on mortality and growth of children. Through PACT/CRH, ICICI Limited, a leading Indian bank, supported the promotion campaign to position oral-rehydration solution (ORS) as the scientific, doctor-recommended, first-line product for all cases of childhood diarrhea. To increase access, three Indian commercial firms are engaged in making the World Health Organization-composition ORS widely available in retail outlets in select states. To complement this effort, the Indian Academy of Pediatrics is encouraging doctors (via seminars) to actively endorse and recommend this product.
In FY 2000, USAID responded rapidly to the Orissa cyclones in October 1999, drought in Rajasthan and Gujarat, and floods in several states. The Ambassador donated a total of $100,000 to the Prime Minister's National Relief Fund, USAID approved distribution of Title II commodities valued at over $8 million. Approximately $5 million in grants was given to private voluntary agencies to provide relief and for activities to enhance disaster preparedness of communities. Relief supplies valued at $381,340 were donated to the Indian Red Cross Society. In the wake of the recent severe earthquake in Gujarat that killed over 20,000 people, affected at least 22 million people, and rendered at least 665,000 people homeless, Title II commodities valued at $820,000 were provided for the earthquake victims.
The $337,000 in DA funding will be used to fund a preliminary analysis of food security in India. The analysis will inform USAID about food security-related issues such as collaborative research on new agricultural technologies, hybrids and genetically modified foods, and the transfer of research to commercial uses, as well as look at USAID's comparative advantage in working with food security issues and the feasibility of USAID interventions in this area.
Possible Adjustments to Plans: During FY 2001, USAID will review this activity and prepare a new strategy in FY 2002.
Other Donor Programs: Other donors working in the nutrition and health sector include UNICEF, the World Bank, Sweden, and the World Food Program. The GOI funds all ICDS services, program personnel, and infrastructure for the CARE program, as well as in-country transportation and storage costs for all P.L.480 Title II commodities.
Principal Contractors, Grantees, or Agencies: USAID implements the P.L.480 Title II India program through two U.S. NGOs, namely CARE and CRS. The PACT/CRH is implemented through ICICI Limited, with U.S. technical assistance from Program for Appropriate Technology in Health (PATH), NICHD and ICMR.
FY 2002 Performance Table
India: 386-003
Performance Measures:
Indicator FY97 (Actual) FY98 (Actual) FY99 (Actual) FY00 (Actual) FY00 (Plan) FY01 (Plan) FY02 (Plan) Indicator 1: Number of counterpart personnel and community members given training in nutrition and health topics NA NA NA 22546 NA 87980 NA Indicator 2: Percentage of children under two (6-23 months old) in program catchment area, enrolled for Take Home Ration (THR) NA NA NA 43 NA 60 NA Indicator 3: Percentage of children under two (6-23 months old) in program catchment areas, enrolled in the supplemental food program. NA NA 42 NA NA 50 NA Indicator 4: Average number of Anganwadi Centers conducting at least one monthly Nutrition and Health Day with Take Home Ration and immunization/ante-natal check up NA NA NA 19298 NA 32787 NA Indicator 5: Percentage of pregnant women, in program catchment area, delivered in the past year, who received 90-100 iron-folic acid tablets. NA NA 27 NA NA 35 NA Indicator 6: Percentage of children, 12-23 months old, in program catchment area, fully immunized by age one. NA NA 32 NA NA 34 NA Indicator Information:
Indicator Level (S) or (IR) Unit of Measure Source Indicator Description Indicator 1: IR Number of counterpart personnel and community members CARE's Management Information System (MIS) Number of counterpart personnel and community members trained in nutition and health topics Indicator 2: IR Percentage of children 6-23 months old CARE's Management Information System (MIS) Percentage of children under two years (children 6-23 months old) in program catchment area, enrolled for Take Home Ration Indicator 3: IR Percentage of children under two (6-23 months old) CARE's Results Reports (results from baseline, midterm and final evaluation surveys) Percentage of children under two years (children 6-23 months old) in CARE High Impact and Capacity Building program areas, enrolled in the supplemental food program. Indicator 4: IR Number of Anganwadi Centers CARE's Management Information System (MIS) Average number of Anganwadi Centers, in program catchment area, conducting at least one monthly Nutrition and Health Day with Take Home Ration and immunization/ante-natal check up. Indicator 5: IR Percentage of pregnant women Care's Results Reports (results from baseline, midterm and final evaluation surveys) Percentage of pregnant women in CARE High Impact and Capacity Building program areas who received 90-100 IFA tablets. Indicator 6: IR Percentage of children, 12-23 months old. CARE's Results Reports (results from baseline, midterm and final evaluation surveys) Percentage of children 12-23 months old in CARE High Impact and Capacity Building program areas who are fully immunized by age one, per GOI's National Immunization Schedule. U.S. Financing
(In thousands of dollars)
Obligations Expenditures Unliquidated Through September 30, 1999 2,650 DA 852 DA 1,798 DA 3,925 CSD 0 CSD 3,925 CSD 0 ESF 0 ESF 0 ESF 0 SEED 0 SEED 0 SEED 0 FSA 0 FSA 0 FSA 0 DFA 0 DFA 0 DFA Fiscal Year 2000 0 DA 300 DA 3,000 CSD 2,225 CSD 0 ESF 0 ESF 0 SEED 0 SEED 0 FSA 0 FSA 0 DFA 0 DFA Through September 30, 2000 2,650 DA 1,152 DA 1,498 DA 6,925 CSD 2,225 CSD 4,700 CSD 0 ESF 0 ESF 0 ESF 0 SEED 0 SEED 0 SEED 0 FSA 0 FSA 0 FSA 0 DFA 0 DFA 0 DFA Prior Year Unobligated Funds 0 DA 0 CSD 0 ESF 0 SEED 0 FSA 0 DFA Planned Fiscal Year 2001 NOA 337 DA 4,300 CSD 0 ESF 0 SEED 0 FSA 0 DFA Total Planned Fiscal Year 2001 337 DA 4,300 CSD 0 ESF 0 SEED 0 FSA 0 DFA Future Obligations Est. Total Cost Proposed Fiscal Year 2002 NOA 337 DA 0 DA 3,324 DA 4,300 CSD 7,275 CSD 22,800 CSD 0 ESF 0 ESF 0 ESF 0 SEED 0 SEED 0 SEED 0 FSA 0 FSA 0 FSA 0 DFA 0 DFA 0 DFA
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Last Updated on: May 29, 2002 |
