not for public use - world bank...sapro setor de alimentos proteicos (section on protein foods of...

DOCUMENT OF INTERNATIONAL BANK FOR RECONSTRUCTION AND DEVELOPMENTINTERNATIONAL DEVELOPMENT ASSOCIATION

Not For Public Use FILE COpy

Report No-693a-BR

PRELIMINARY REPORT

ON A

PROPOSED NUTRITION PROJECT IN BRAZIL

May 23, 1975

Population and NutritionProjects Department

This report was prepared for official use only by the Bank Group. It may not be published, quotedor cited without Bank Group authorization. The Bank Group does not accept responsibility for theaccuracy or completeness of the report.

Pub

lic D

iscl

osur

e A

utho

rized

Pub

lic D

iscl

osur

e A

utho

rized

Pub

lic D

iscl

osur

e A

utho

rized

Pub

lic D

iscl

osur

e A

utho

rized

Pub

lic D

iscl

osur

e A

utho

rized

Pub

lic D

iscl

osur

e A

utho

rized

Pub

lic D

iscl

osur

e A

utho

rized

Pub

lic D

iscl

osur

e A

utho

rized

CUP .NY g&IVdlENTS

US-1.00 Cr$7.975Cr$1.00 US$0.13

WEIGHTS AND MEASURES

1 Kilogram (kg.) 2.20 pounds1 Hectare (ha.) = 2.47 acres

ABBREVIATIONS AND ACRONYMS

ABIL Associaqb Brasileira das Ind4strias de Alimentagio(Brazilian Association of Food Industries)

ANCARSE Associac,ao Nacional de Credito e Assistencia Rural-Sergipe(National Association for Rural Credit and Assistance of Sergipe)

BDE Banco Nacional de Desenvolvimento Econ6mico(National Economic Development Banh:)

CEAPES Centro de Educacao e Alimentaggo de Pre-Escolar(Center for Education and Feeding of Pre-School Children)

CNA Comissao Nacional de Alimentacao(National Food Commission)

CNAE Canpanha Nacional de AliAentagao Escolar(National School Food Campaign)

CPMI Coordinaqco de Protegao Materno-Infantil(Maternal-Child Protection Program)

ENERAPA Empresa Brasileira de Pesquisa Agropecuaria(Brazilian Enterprise for Agricultural Research)

ERKATER Enpresa Brasileira de Assistencia Tecnica e Estengao Rural(Brazilian Enterprise for rechnical Assistance and Rural Extension)

FAO Food and Agriculture Organization

FINEP Financiadora de Estudos e Projetos(Agency for Funding Studies and Projects)

IBGE Instituto Brasileiro de Geographia e Estattstica(Brazilian Institute for Geography and Statistics)

INAN Instituto Nacional de Alimentagao e Nutrigao(National Food and Nutrition Institute)

IPEA Instituto de Planejamento Economico e Social(Institute of Economic and Social Planning)

ITAL Instituto de Tecnologia de Alimentos(Institute of Food Technology)

LBA Legiao Brasileira de Assistencia(Brazilian Legion of Assistance)

PRONAN Programma Nacional de Alimentagqo e Nutrigao(National Food and Nutrition Program)

PAHO Pan American Health Organization

SAPRO Setor de Alimentos Proteicos(Section on Protein Foods of ABIA)

SESP Fundagao Servigos de Saude Publica(Public Health Services Foundation)

SUDIEN Superintendencia do Desenvolvimento do Nordeste(Superintendency for Northeast Development)

SUPLAN &Sbsecretaria de Planejamento e Orgamento - Ministerio de Agricultura(Subsecretariat of Planning and Budgeting - Ministry of Agriculture)

UNICEF United Nations Children's Fund

USAID United States Agency for International Development

PRELIMINARY REPORT ON A PROPOSED NUTRITION PROJECT IN BRAZIL

TABLE OF CONTENTS

Page No.

SUMMARY ............................. ................ i-iii

I. INTRODUCTION ........................................ 1

II. BACKGROUND ON BRAZILIAN NUTRITION ................. .. 1

A. Nutritional Needs .. ..........................B. Causes of Malnutrition .. ....................... 3C. Actions to Counter Malnutrition ............... . 5

III. THE PROJECT ........................ 8

A. Project Description ..... ................... 8 B. Detailed Features .............................. 9

IV. IMPLEMENTATION AND ORGANIZATION ................. .... 17

V. COSTS, FINANCING, PROCUREMENT AND DISBURSEMENTS ..... 19

VI. PROJECT JUSTIFICATION ...... ......................... 23

VII. RECOMMENDATIONS ....................... .. 25

ANNEXES

1. Nutrition Intervention Through the Rural ExtensionAgency

2. Organizational Charts:

Chart 1 - Health and Nutrition Organization RelationshipsChart 2 - Contractual Agreements between Participating

Entities

3. Estimated total Project Cost by Type of Expenditure

This report is based on the findings of an appraisal mission which visitedBrazil in November 1974. The mission consisted of: Mr. A. Berg, PNP (Chief),Mr. S. Venkitaramanan, PNP (Deputy Chief), Mr. G. Kaddar (LAC), Mr. S.Reutlinger (DED), Dr. J. Wray (Medical Specialist, Consultant), Mr. E.Thomson (Agriculture and Nutrition Administration Specialist, Consultant),and Ms. E. Johnson-Sirleaf (LAC, Loan Officer). A post-appraisal missionconsisting of Messrs. Berg, Venkitaramanan and Thomson completed a visit toBrazil in February 1975.


SUMMARY

i. Malnutrition in Brazil is widespread and is especially serious inthe Northeast where the infant mortality rate -- largely nutrition-related --is among the highest in Latin America. The Government recognizes the gravityof this problem and has taken certain direct actions to alleviate it. It alsointends to develop a comprehensive national nutrition plan and to providesubstantial resources for an integrated national nutrition program. As inmost countries, however, the basic prerequisites for planning an effective,comprehensive national program do not now exist. The Government of Brazillacks sufficient knowledge of the nature, extent, and causes of malnutrition,the trained manpower and the institutions capable of implementing large-scaleprograms, and knowledge concerning the relative effectiveness of alternateforms of delivering nutrition services. The latter applies especially inlow-income communities to the nutritionally vulnerable pre-school aged childrenand, relatedly, to pregnant and lactating women, who constitute the targetgroup for this project. In addition, appropriate low-cost processed nutritiousfoods are not currently produced in Brazil to meet the needs of the populationincluding the target group through either institutional or commercial channels.

ii. Accordingly, the primary purpose of the proposed project is to pro-vide Brazil with the basic information, institutional and manpower capabilities,and adequate quantities of certain high-priority inexpensive food productsso that within 4 years it will be able to mount an effective national nutritionprogram. Toward this end, the proposed project would consist of:

(a) the development of an information base generated by:

(i) a nutrition and food consumption survey and theestablishment of a monitoring system to provideperiodic surveillance of nutrition conditions,

(ii) the assessment of the nutritional implications ofagricultural policies;

(b) a testing of the relative effectiveness of alternative deliverysystems to improve the nutritional status of the target groupthrough:

(i) the rural extension service,

(ii) the school feeding infrastructure,

(iii) urban and rural health delivery systems,

(iv) the commercial market;

- ii -

(c) development and commercialization of nutritious foods for useby the target group through:

(i) a research and development program for low-cost processedfoods,

(ii) engineering and marketing feasibility studies for indus-trial-scale production of such foods and investmentcapital necessary to commence production on a largescale,

(iii) a program of fortifying food staples; and

(d) training and technical assistance.

iii. As a result of the project, the Government of Brazil would: (a) knowthe magnitude and implications of the nutrition problem and the relationshipof nutrition status to agricultural policies; (b) have a cadre of trainedofficials and strengthened institutions equipped to plan for and implementa national program; (c) know the relative effectiveness of several deliverysystems and have the practical experience provided by the testing of suchsystems; and (d) have available, for institutional and commercial markets,locally-produced low-cost nutritious products and fortified food staples.During the last year of the project, a national nutrition plan would bedeveloped, based on the above.

iv. In the process of carrying out the tests for the long-range purposesstated, approximately 57,000 children and women would benefit directly fromvarious forms of nutritional assistance. An additional 12 million peoplewould benefit from the fortification program proposed in the project.

v. The total cost of the proposed 4-year project would be US$61.8million. The Bank loan would cover 32%, or US$20 million, approximatelyequal to the estimated foreign exchange component. The balance would beprovided by the Government.

vi. For the proposed project. the Bank loan would help finance theconstruction and equipping of pilot food processing plants and laboratories;the import of vitamins and minerals and equipment for fortification research,development and, testing; the purchase of vehicles; technical assistancethrough consultants and fellowships; operating costs for tests and surveysincluding the cost of data processing, additive staff salaries, and foodutilized in the tests; credit to food processing companies; credit to smalllandholders participating in the rural extension test; evaluation of theproject components; and training of staff in the National Food and NutritionInstitute (INAN) and other entities associated with the proposed project.

vii. In addition to providing the foundation for the development of anefficient, comprehensive nutrition program, direct nutritional benefits wouldaccrue to many during the project period as noted in paragraph iv above. The

- iii -

long-term benefits of the project, which would be realized after the imple-mentation of an efficient, comprehensive nutrition program, would be a gener-ally improved health status for the population as a whole and increased pro-ductivity by persons benefitting from the program.

viii. Subject to the assurances described in Section VII, the proposedproject is suitable for Bank financing.


I. INTRODUCTION

1.01 At the conclusion of the Board discussion of the nutrition policypaper held November 27, 1973, the President announced that in keeping withthe President's Memorandum on Board Procedures (R72-45) 1/, the ExecutiveDirectors should have an opportunity to discuss initial nutrition projectsafter appraisal but before negotiations. Accordingly, this paper bringstogether, in summary form, the background and content of a proposed nutritionproject loan requested by the Government of Brazil.

1.02 The Executive Directors noted during the Board discussion thatmany Bank member countries were beginning to recognize the importance of themalnutrition problem and its implications to national development, and thatcertain countries were attempting to develop national nutrition policiesand programs. Brazil is one such country. In November 1972, the Governmentestablished the National Food and Nutrition Institute (INAN), with theintent of providing a coordinating body at the national level with responsi-bility for formulating and overseeing a comprehensive national nutritionprogram. INAN was one of the first such national bodies organized to pro-vide a focus for nutrition activities.

1.03 In response to requests from the Government for assistance with thedevelopment of nutrition programs, a reconnaissance mission from the Bankvisited Brazil in February 1973. Subsequent Bank missions assisted INAN andother public agencies with project preparation. However, growing difficultieswithin INAN, which led in May 1974 to the removal of the institution's leader-ship and nearly all of its staff, seriously interrupted the pace of prepara-tion and appraisal. A new President of INAN, who took office in September1974, resumed the preparation work and an appraisal mission visited Brazilin November 1974. Although the mission found certain components ready forappraisal at that time, gaps in information and differences in approachexisted in respect to some of the components. A post-appraisal missionvisited Brazil in February 1975 and brought to a final stage the process ofappraising the project.

II. BACKGROUND ON BRAZILIAN NUTRITION

A. Nutritional Needs

2.01 Data on nutritional status, food consumption patterns and consumerbudget expenditures in Brazil are meagre, geographically spotty, of uneven

1/ R72-45 provides that the Executive Directors shall have a chance forspecial preliminary review of projects with "unique or unusual features."

- 2 -

quality and usually dated. Nonetheless, from the existing data and observationalreporting, certain broad conclusions can be made about malnutrition in Brazil --enough to provide general direction until the surveys to be sponsored by theproposed project can provide more precise data.

2.02 Although the daily per capita availability of food in Brazil from1960 to 1968 was estimated at 2,900 calories and 63 grams of protein (comparedto recommended daily allowances of 2,700 calories and 56 grams of protein foran adult male), all indications are that more than half the population havecaloric and protein deficiencies. The Getulio Vargas Foundation reportedthat in 1961-62, 61% of the urban and 63% of the rural population in theNortheast were deficient in calories and protein and that a significantportion of the population (from 25% to 47%) in other areas of Brazil alsoconsumed less than the minimum requirements. A 1971 study by the Bank ofNortheast reported that the average daily intake of the urban population inthe Northeast was 1,857 calories, 69% of the recommended allowance. Otherstudies indicate seriously low intake levels among landless laborers, e.g.,families of sugar plantation workers.

2.03 Malnutrition affects especially pre-school age children, reducingoptimum physical and mental development and resistance to infectious diseases,and contributes to high infant mortality, which in Brazil is about 75 per1,000 and in the Northeast officially reported at 137 per 1,000. This com-pares to 20 per 1,000 in North America. A study undertaken by the PanAmerican Health Organization (PAHO) in 1973 reported that nutritional defi--ciency and immaturity (i.e., less than 2,500 grams of weight at birth, aproblem usually related to the malnutrition of the mothers) were underlyingor important associated causes of 60% of the infant mortality in Recife and20-40% in other Brazilian areas studied, compared to 10% in North America.The Recife rate was the highest of the areas studied in the Western Hemisphere.Of the survivors, eight spot surveys in the Northeast show that from 51% to85% of the children studied are suffering from malnutrition, with more thanone-fifth falling below 70% of the normal body weight for their age. Although,like infant mortality, malnutrition among the survivors is most serious in theNortheast, it is also prevalent in other parts of the country, especially theSouthwest. In a study just completed in Sao Paulo, for example, 30% of all thechildren showed anthropometric signs of malnutrition; 48% of the childrenfrom, families with per capita incomes of under US$300 per year had such signs.Of a randpm sample of children under two years of age admitted to Sao Paulohospitals, 73% were below normal for height and weight; 45% were below 70%of the norm. Even though no special studies have been undertaken in Brazil,it is reasonable to assume from studies elsewhere that the combined highdegree of second-and third-degree malnutrition 1/ in the early childhood

1! Second-degree malnutrition refers to body weight 60-75% of the estab-lished norm; third-degree malnutrition includes any child below 60%weight of the norm.

- 3 -

years is one of the causes of poor performance later in school and high ratesof school absenteeism and dropout in Brazil. 1/

2.04 Iron deficiency anemia and vitamin A deficiency, as evaluated bylow blood values, are found in approximately 20-30% of the children in mostof the places where observations have been made. Iron deficiency anemia (af-fecting all ages in Brazil, as was reported in a 1965 survey) is responsible forlethargy and fatigue, experienced especially during physical exertion, and ahigh susceptibility to infection. Pregnant women are especially vulnerableto anemia. A higher incidence of maternal deaths, stillbirths and prematurebirths has been observed among anemic women. Vitamin A deficiency affectsgrowth, the severity of other nutritional diseases and vision. Vitamin Adeficiency is the major cause of blindness in low-income countries.

2.05 One would expect these deficiencies to exacerbate the protein-caloriemalnutrition, although most of the studies were not planned to analyze thiscombination of deficiencies in the same individual. Endemic goiter, resultingfrom iodine deficiency, has also been reported as a severe health problemin parts of the country, although no data are available from the past decade.There also are indications that fluoride, riboflavin and vitamin C deficienciesmay be significant.

B. Causes of Malnutrition

2.06 As in most countries, Brazilian agricultural policies in the pasthave seldom consciously taken into account the nutritional needs of specificage and income segments of the population. Brazilian agriculture has grown atan average of 6.5% over the last five crop years, with much of the increaseattributed to the Government's drive to increase export crops. In someinstances the emphasis on production of certain export crops has had theeffect of displacing basic food crops for domestic consumption and such sub-stitution may not have had, at least in the short term, a positive impact onthe nutritional status of the poor. Beans, which are a major protein sourcefor low-income families, dropped in per capita annual availability from 62.5pounds in 1971 to 47.1 pounds in 1974. Bean prices during this periodincreased from US$.25 to US$.70 per pound.

2.07 Government agricultural services have concentrated attention onlarge mechanized farms, emphasizing export crops. Small farmers in theNortheast, for example, generally have had limited, if any, access to agri-cultural credit and rural extension, although basic food crops constitute themain production of these farms. Similarly, funds for agricultural productionresearch have not been deployed in a manner to increase crop production bysmall farm owners, sharecroppers and tenant farmers. The lack of on-farm

1/ UNESCO data show that for every 1,000 Brazilian children entering school,644 drop out before completing the fourth grade and of the remainingstudents, 200 repeat at least one grade. In the Northeast this situationis worse, with only 19% of beginning students completing the fourth grade.

-4-

storage facilities and access to larger storage facilities has had the effectof forcing the rural poor to sell products at low prices during harvest seasonand to buy them back later at higher prices for family consumption. Moreover,basic social and institutional patterns including concentration of landownership, a sharecropping system, marketing deficiencies and an inadequatesocial infrastructure, serve as underlying constraints to improvement in thenutritional condition.

2.08 In urban areas, problems of inadequate food intake are exacerbatedby infections derived from unsanitary conditions and inadequate personalhygiene. In the low-income Encruzilhada section of Recife, where sanitaryconditions are highly inadequate, infant mortality (90 per 1,000 live births)and the death rate of children under 5 years of age (29 per 1,000 population)are the highest reported for an urban area in the Western Hemisphere.

2.09 Breastfeeding is declining in Brazil, as in many countries in theworld. A common urban practice in Northeast Brazil is for mothers to weantheir children at five or six weeks and substitute manioc gruel (which con-tains almost no protein) for breast milk. Mothers are reluctant to feedchildren fruits or vegetables; meat and eggs are considered noxious. Heavilypromoted commercial milk-based baby formulas are often used, but because ofincome limitations, the product is frequently over-diluted, and served un-hygienically. Infant diarrhea often results, leading to malabsorption, mal-nutrition and increased severity of otherwise minor childhood infections--all factors contributing to the high infant mortality rate. In Recife, 73%of the children who died during their first year had been breast fed lessthan one month. At the age of about one year, children are fed the adultdiet without any added precaution such as pureeing the foods. Among thepoor, there apparently is little understanding about the types of foods andthe amounts to be fed or basic practices of hygiene in child feeding.

2.10 Although Brazil has a large and sophisticated food industry, onlymodest attention to date has been directed to developing and marketing low-cost nutritious products for the poor, in part because profitability fromproducing such foods was unclear. Similarly, the several food technologyinstitutes in Brazil have not given priority attention to the needs of low-income consumers. The cost of manufactured baby foods ranges from US$1.34to US$3.33 equivalent per kilo--beyond the reach of the poor. A few productsemploying new technologies and non-conventional sources of protein thatwould lower the cost have been and are being developed in Brazil, but noneas yet are produced on a large scale.

2.11 Grain products, such as wheat flour and corn meal, lose some oftheir important nutrients during processing. Whereas fortification of theprocessed grain with vitamins and minerals is now standard practice in manyindustrialized countries, in Brazil it is not. Brazil has a program tofortify salt with iodine, but the performance is not fully effective. TheHealth Ministry reports that approximately 50% of the salt used for humanconsumption is fortified.

-5-

C. Actions to Counter Malnutrition

Government Agencies

2.12 Past sporadic attempts have been made to counteract malnutritionamong young children in Brazil, but these generally have been isolated, short-term efforts. Brazilian nutrition experts report that the nutritional impactof these activities has been limited. They ascribe the unsatisfactory resultsto the lack of (a) a nutrition policy based on precise knowledge of the quali-tative and quantitative aspects of malnutrition, (b) clear identification ofthe causes of malnutrition toward which intervening measures can be directed,(c) large-scale intervention programs, (d) coordination among existing prog-rams, (e) continuity, and (f) Government commitment to spend the substantialfunds a national nutrition program re.quires.

2.13 As early as 1945, an interministerial committee known as theNational Food Commission (CNA) was established in Brazil to serve as a focalpoint for nutrition. The CNA conducted several nutritional surveys andstudies. To the extent nutrition activities aimed at young children tookplace in Brazil during the period of the CNA's existence (1945-1971), theywere mostly of a small pilot nature, lacking a policy context. Severalseparate nutrition programs were established, but mostly were aimed at targetgroups other than those addressed by this proposed project. The Ministryof Education, for example, in the early 1960s developed the National SchoolFood Campaign (CNAE) which now provides food to 12 million students through100,000 schools. For this program, much of the food (worth approximatelyUS$273 million) was donated under the U.S. PL-480 program. These donationsare being concluded at the end of FY 75 and the Government has taken stepsto continue the program through commercial purchases. Pre-school aged childrenare not reached by this program. The Health Ministry has had since 1940 someform of its current Maternal Child Protection Program (CPMI), which attemptsto include basic nutrition services, as part of a general maternal-child healthprogram. CPMI, however, concentrates on curative rather than preventativehealth and has had a history of financial and administrative difficulties.

2.14 The Public Health Services Foundation (SESP), a semi-autonomousFederal agency which comes under the Health Ministry, has 126 medical unitslocated mostly in small cities in the Northeast which distribute some foods;until recently these also were mostly foreign donations. The rural extensionagency (EMBRATER), attached to the Ministry of Agriculture, also includesa social extension wing of approximately 800 extensionists who provide basichealth and nutrition education services, primarily to the less-privilegedportions of the rural population. In the past year, a relationship has beenestablished between the work and aims of the social extensionists and theagricultural extensionists of the same organization. Several other philan-thropic organizations are involved in nutrition programs in Brazil, buttheir contributions are modest due to limitations of funds and staff. Thestrongest such entity is the Brazilian Legion of Assistance (LBA), whichtraditionally is headed by the wife of the President of the Republic. This

- 6 -

agency concentrates on medical services to mothers and children during thefirst months of life. With the exception of EMBRATER, none of the programsof the above agencies have been evaluated in terms of their nutritionalimpact.

Nutrition Research and Training Institutions

2.15 Universities and schools in several states offer nutrition trainingand/or research programs which in some cases also have test projects servingadjacent communities. A field project in the satellite city of Sobradinho,for example, gives the nutrition program at the University of Brasilia afocus for research in nutritional rehabilitation, nutrition education andprotein-calorie relationships. The Institute of Nutrition in Recife (asso-ciated with the Federal University of Pernambuco) is involved in training andresearch, including the testing of nutritional rehabilitation centers inadjacent sugar cane growing areas. The Institute recently established adivision of food technology with assistance from the Government of Switzerlandand the Food and Agriculture Organization (FAO).

2.16 The School of Hygiene and Public Health in Sao Paulo offers aregular course in nutrition and also a two-month nutrition course forphysicians from other Latin American countries, with the assistance of PAHO.The staff of the School of Medicine in Ribeirao Preto has conducted a varietyof biochemical and food technology research programs. The largest of severalfood technology institutes in Brazil is ITAL, the Food Technology Institutein Campinas, which-has not, until recently, given major attention to thenutrition problem. Budget expenditure and food consumption surveys have beenconducted by the Getulio Vargas Foundation and the Brazilian Institute ofGeography and Statistics (IBGE).

2.17 The above activities have not been pursued with a national nutritionpolicy focus or in a coordinated fashion, similar to the situation in manycountries. From the industrial sector, the Brazilian Association of FoodIndustries (ABIA), in 1968 established a Section on Protein Foods (SAPRO),designed primarily to coordinate efforts and promote the production of low-cost nutritious foods by food companies. Although SAPRO provides to theGovernment a focal point for communication with industry, little of the earlypromise has materialized.

International 4nd Foreign Agencies

2.18 For more than a decade international agencies have provided servicesto one or another of the Brazilian entities involved in nutrition. The con-tribution of the UN agencies is largely limited by budgetary constraintsand the size and nature of the programs may vary significantly from year toyear. The World Food Program provided approximately 4% of the foods used inthe National School Food Campaign. The Pan American Health Organization/World Health Organization provides training, technical assistance and somefunding for research. The United Nations Development Programme currently

sponsors eight agricultural projects that indirectly relate to nutrition, andFAO provides technical experts in a variety of food and agriculture-relatedfields. The United Nations Children's Fund has sponsored nutrition educationactivities, training for several Brazilian agencies, and evaluation of theirprograms.

2.19 The U.S. Agency for International Development (USAID) has thelargest bilateral nutrition program, with major emphasis until recently onsupplying commodities to institutional feeding programs. USAID also has beenactive in training and technical assistance, especially as it relates to thedevelopment of new foods. Special emphasis has been given to fortificationof manioc flour with soy and the local development of fish protein concentrates.The Ford Foundation also finances a nutrition training program. These externalinputs have been useful but not utilized to their full effectiveness due tothe lack of a strong centralized agency.

Establishment of INANI

2.20 Increased Government concern about the malnutrition problem, andawareness by certain top officials of the inadequacies and lack of focus andcoordination of existing programs, led to the establishment in November 1972of the National Food and Nutrition Institute (INAN). INAN is an autonomousfederal agency (autarquia), under the Ministry of Health, with responsibili-ties for assisting the Government in formulating national nutrition policiesand preparing, supervising and coordinating a national nutrition program.Its official mandate is the National Food and Nutrition Program (PRONAN),which was promulgated in March 1973. Based on this order, INAN's activitieswere to be directed to a target group consisting of children from low-incomefamilies (pre-school and primary-school age), and pregnant and lactating women.PRONAN states that program execution will be undertaken by established agencieswith INAN responsible for "planning, guidance, coordination, supervision andevaluation." INAN's budget for the first year was to be US$100 million equiv-alent, and US$150 million equivalent for the second year.

2.21 INAN's first president, however, developed and attempted to imple-ment a broad-based, family-wide feeding program, accompanied by an extensivepromotion of INAN. Rather than coordinating other agencies, INAN's opera-tional efforts had the effect of creating conflict and of exacerbating analready difficult situation. Additionally, allegations of financial impro-priety were raised against INAN's leadership and formal hearings led to thedismissal of INAN's president and three top aides.

2.22 In early 1974, the new Government reappraised the direction ofINAN's development and in May issued a new decree restating the originalobjectives and providing tighter control by the Ministry of Health. A newpresident was appointed in August 1974.

-8-

2.23 Today, INAN, which had grown to a staff of 450 in its first year,is virtually a shell. Only three or four professionals remain. INAN's newpresident recognizes that current regulations limiting compensation restrictfreedom in hiring persons of high competence in the public health and nutri-tion fields. Top officials of the Ministry of Health and the AdministrativeReform Commission have studied the problem and will recommend a change inINAN's constitution to permit greater flexibility, particularly in regard tosalaries. In the interim, a contractual arrangement (convenio), entered intowith the Institute of Economic and Social Planning (IPEA), has recently pro-vided INAN with funds to contract higher salaried personnel for its immediatetasks, including the preparation of a plan of operation.

III. THE PROJECT

A. Project Description

3.01 The proposed project would provide the Government with the basicinformation, institutional and manpower capabilities, and adequate quantitiesof certain high-priority inexpensive food products so that within 4 years itwould be able to mount an effective program aimed principally at counteringmalnutrition among pre-school age children and pregnant and lactating women.The proposed project would consist of:

(a) the development of an information base comprised of:

(i) a nutrition and food consumption survey and the establishmentof a monitoring system to provide periodic surveillance ofnutrition conditions,

(ii) assessment of the nutritional implications of agriculturalpolicies;

(b) the testing of the relative effectiveness of alternative deliverysystems to improve the nutritional status of the target groupthrough:

(i) the rural extension service,

(ii) the school feeding infrastructure,

(iii) urban and rural health delivery systems,

(iv) the commercial market;

(c) the development and commercialization of nutritious foods foruse by the target groups through:

(i) a research and development program for low-cost processedfoods,

(ii) engineering and marketing feasibility studies forindustrial-scale production of such foods and investmentcapital necessary to commence production on a large scale,

(iii) a program of fortifying food staples; and

(d) training and technical assistance.

By the end of the project period, the Government would have formulated, inconsultation with the Bank, a national nutrition program, detailing compo-nents and estimated costs.

B. Detailed Features

Nutrition Survey and Monitoring System

3.02 The proposed project includes a nutrition survey of a nation-widesample of 14,000 families, to provide the Government with basic data necessaryfor planning nutrition policies and intervention programs. The survey wouldinclude information on intra-family food distribution, weaning practices,attitudes toward foods, history of family illnesses and deaths, history ofpregnancies, anthropometric measurements of height, weight and arm circum-ference, and iron and vitamin A levels. The survey would be managed on behalfof INAN by IBGE, an experienced official survey organization. At present,IBGE is conducting a general family budget and food consumption survey, cover-ing 55,000 families. The 14,000 families to be surveyed in the proposedproject would comprise a sub-sample of the current survey. (For the clinicalmeasurements, a smaller sub-sample would be selected.) INAN would enter intoan agreement with IBGE under which staff employed in the IBGE's ongoing surveywould, upon its completion, be trained to conduct the nutrition survey. Con-sultants would be hired for technical advisory assignments. Design of thesurvey would be discussed during negotiations and finalized within threemonths of loan signing.

3.03 The project would establish a new monitoring unit in the IBGE, con-sisting of four professionals and support staff. This unit would undertakea continuing and detailed surveillance of nutrition status, using the resultsof the food consumption and nutrition surveys, as well as other surveys beingconducted in Brazil (including the World Bank/SUDENE rural development surveyin the Northeast). The unit also would liaise with SUPLAN (see para. 3.04)concerning agricultural data. In addition, the monitoring unit would be in

- 10 -

charge of regular biennial follow-ups of the food consumption and nutritionsurveys; the first is to be undertaken in 1978 through a partial sampling ofthe families covered by the original surveys. The second set of data shouldbe ready for compilation and analysis in 1979.

Nutrition Policy Research and Planning Studies Related to Agriculture

3.04 The proposed project would include: (a) establishment of a nutritionplanning unit in the Subsecretariat of Planning of the Ministry of Agriculture(SUPLAN); and (b) a research program, concerned with the nutritional implica-tions of agricultural policies, to be carried out by universities and otherresearch groups. The aim of the nutrition planning unit in SUPLAN is toprovide the Ministry of Agriculture with information on the nutritionalconsequences of its policies and programs so that this information can betaken into account in future policy decisions. (INAN would enter into anagreement with SUPLAN to ensure that the studies and data generated are per-tinent to and available for the formulation and implementation of nationalnutrition programs.) The functions of the unit would be: (a) to project foodsupplies for different socio-economic groups, and review and analyze thenutritional implications of alternative food/agricultural production strate-gies for these groups; and (b) to coordinate the research program so that itwould provide data and information for the above analysis. 1/ Directions andselection of specific studies for the research program 2/ would be made bya committee to be established under the chairmanship of the Subsecretary ofPlanning in the Ministry of Agriculture, with representatives from INAN, TheBrazilian Enterprige for Agricultural Research (EMBRAPA) and IPEA. Agreementwould be sought during negotiations on prior Bank approval of studies whichwould exceed US$50,000 equivalent in cost. The nutrition planning unit inSUPLAN would serve as secretariat to the committee. The project componentincludes provision for short-term and long-term consultants, workshops andseminars, research costs and costs of incremental staff.

Tests of Alternative Nutrition Delivery Systems

3.05 The proposed project would include a series of tests designed togenerate for future planning purposes knowledge concerning the most effectivemeans of reaching target groups with appropriate food, nutrition education andother nutrition services, and under what circumstances such delivery systemswould be.effective. INAN, assisted by a committee of technical experts, wouldcoordinate the design and evaluation of the tests so that a basis of common

7! The surveys being carried out by IBGE would also provide informationneeded for this analysis.

2/ The studies would include topics such as: (a) the effect of agricul-tural price policies on the level of production of basic food cropscompared to otlher agricultural commodities; (b) the nutritional impli-cations of the deployment of the agriculture production research budget;and (c) the nutritional consequences of shifting from sharecroppingtenancy arrangements to agricultural production employing wage laborers.

- 11 -

measurement is established. The common measurement bases for evaluation ofthe several delivery system tests would be discussed during negotiations andfinalized within three months of loan signing. In addition to providinginformation, the tests of alternative delivery systems would help thoseagencies which would have responsibilities in the subsequent national nutri-tion program to gain operational experience in servicing the target groups.

Test of Nutrition Interventionthrough the Rural Extension Agency

3.06 The potential effectiveness of EMBRATER would be tested as a vehi-cle for improving nutrition of target groups. The test would involve fam-ilies of 3,000 low-income farmers, with holdings generally below 50 ha., intwelve counties in the Northeastern State of Sergipe. The participantswould be divided into three groups; one group (A) being exposed to agriculturalextension alone; another group (B) to social extension alone; and a thirdgroup (C) to both agricultural and social extension. The objective of agri-cultural extension would be to increase output through better farm planning,the application of improved agricultural practices, access to the necessaryagricultural inputs and credit. Social extension would primarily concentrateon education concerning the proper nutritional use of existing family re-sources (e.g., extension of the breast-feeding period, improved sanitationand improved intra-family food distribution) and, for group (C), also on theuse of increased production and increased income (made possible by the agri-cultural advances) in nutritionally beneficial ways. In groups (B) and (C),a total of 30 health miniposts would be opened to provide basic health andnutrition services. The working hypothesis that would be tested in the studyis that there would be greater nutritional improvement from the synergisticeffect of the combined extension activities than from agricultural or socialextension alone or in a control group of similar families who have had noexposure to either form of extension. Information generated from the testwould be used by EMBRATER and other relevant agencies in planning the deploymentof resources for future rural development projects.

3.07 The test would be supported by the provision of supplemental agri-cultural credit, estimated at US$1.5 million, 1/ to be given by the Bank ofBrazil to participating farmers. EMBRATER and the National Association forRural Credit and Assistance of Sergipe (ANCARSE), its affiliate in Sergipe,would entgr into an agreement with the Bank of Brazil, to ensure that thedemands for credit from farmers participating in this program would be meton terms and conditions generally applicable to small farmers in the Northeast.These terms are highly subsidized -- with interest rates of 0-7% without mone-tary correction. (In this case the subsidized terms are considered acceptable,since the recipients are low-income farmers and the credit would be closelysupervised to prevent misuse of resources.) Operationally, the componentwould involve the employment and training of 50 additional agriculturalextensionists, 50 additional social extensionists and 30 additional health

1/ ANCARSE believes a larger amount would be required, and this will bestudied as part of further preparation by expert consultants to thatagency.

- 12 -

orienters. A special project unit within ANCARSE will manage the componentand carry out an initial socio-economic and agricultural survey of theparticipating farmers. The evaluation will be designed and carried out bythe Institute of Nutrition at Recife and the Rural University of Vicosa. Theproject would provide for technical assistance by consultants to ANCARSE.

3.08 The component would consist of two stages. In stage one, ANCARSEwould draw up a detailed plan of project operations, including the methodologyfor evaluation. The preparation stage of the plan of operations is expectedto be completed within six months of the signing of the Loan Agreement. Sub-ject to approval of this plan by the Bank, the project would be implementedas stage two. Annex 1 contains additional details on the proposed projectcomponent. 1/

Test of Nutrition Interventionthrough the School Feeding System

3.09 The proposed project would include a test to determine the nutri-tional impact and efficiency of feeding pre-schoolers by taking advantage ofthe existing transport, storage and other facilities of ongoing school lunchprograms. Two methods of feeding would be tested among children of low-income families in both urban and rural sections of the State of Sao Paulo.The normal channels of the State Department of Education would operate theprogram. The School of Public Health in Sao Paulo would be in charge of thetest design and evaluation.

3.10 The component involves: the establishment and evaluation of 48kindergarten-type centers known as CEAPES (Centers for Education and Feedingof Pre-School Children) in school feeding locations. Approximately 4,800pre-schoolers from the age of 12 months to 5 years would be brought by mothersto the school lunch program centers and fed. Nutrition education would beprovided to the mothers. This test would build on a closely controlled small-er experiment of the same type currently underway. The project would testwhether the concept can be expanded successfully under normal administrativeconditions, especially in poor areas in the interior of the State. Evaluationof nutritional impact would include a control group outside the CEAPES.A second approach would be the testing of "take home" foods as a method ofdelivering needed nutrients to pre-school children, a system under which olderbrothers or sisters take food home to younger siblings. This sub-componentwould test the effectiveness of the "take home" method: (a) with periodic

1/ Because of the complex nature of this c.mponent, greater detail is pro-vided in this preliminary presentation than for other components.

- 13 -

home visits over three years by trained home visitors who would provide nutri-tion education to the mothers; (b) with periodic visits for one year; and(c) without such visits. A total of approximately 4,700 children andmothers would benefit. Evaluation also would include a control group, notreceiving services.

3.11 Costs of the component include the operational costs for CEAPESand the take-home tests, including food, transportation and supervision,and the researchers' salaries and other costs related to the evaluation of thenutritional impact on the children. Included in the evaluation would be adetermination of the effect of the nutritional difference on the educational,health and sociological profiles of the pre-schoolers.

Tests of Nutritional Intervention throughthe Health and Commercial Delivery Systems

3.12 The proposed project would test the efficiency of health and, re-latedly, commercial delivery systems as vehicles for nutrition intervention,the managerial capability of the health system to carry out such programs,and the community's response to the program in the Northeastern State ofPernambuco. In an ongoing maternal and child health program in the low-incomeEncruzilhada area of Recife, the project would test the cost and effectivenessof additive nutrition services to existing health units. More specifically,the project provides for distribution of supplementary foods to approximately24,000 children under 6 years of age and to pregnant and lactating women con-sidered as being at high nutritional risk, and nutrition education to women,including motivation for extending the period of breastfeeding to at leastthree months. Two food delivery systems would be tested: distribution throughthe health system, and distribution through the normal commercial food chan-nels. In the case of the latter, the health staff would provide to targetgroups coupons that would serve as a consumer subsidy. A project group workingin the State University of Pernambuco would design and evaluate the proposedtest, which would also include a control group not receiving the nutritionservices.

3.13 The proposed project also provides for studying the nutritionaleffectiveness and extending the outreach into rural areas of typical maternaland child health programs currently operated by SESP in small cities in thesugar plantation areas of Zona da Mata in Southern Pernambuco. The projectwould finance and evaluate the impact of feeding and of nutrition education(including efforts to extend breast-feeding to six months) to 6,000 benefici-aries in existing SES? centers. In addition, the project would finance thehiring and training of a newly established group of health/nutrition extension-ists who would travel through the Zona da Mata to provide nutrition educationand food supplements, and to identify and forward to 12 SESP centers fortreatment serious cases of malnutrition. An estimated 9,000 rural mothersand children would benefit (and be compared to a control group without services).The research design and evaluation of the Zona da Mata tests would also beunder the direction of the State University of Pernambuco.

- 14 -

3.14 Although the maternal child health program of the Ministry of Healthis not included for financing under the proposed project (because it is alreadyin progress), the testing of the effectiveness of official CPMI centers asvehicles for delivering nutrition services would be coordinated by INAN andthe results measured against those of the other tests discussed in this paper.

Development of Low-Cost Nutritious Foods

3.15 The proposed project would make possible the development, testingand industrial-scale production of low-cost nutritious foods for use ininstitutional feeding programs and the commercial market. To this end, theproposed project would finance at ITAL the construction of a pilot plantincluding blending and auxiliary equipment for producing blended foods, apilot scale extrusion cooker, and packing and packaging equipment. Theproject would also finance a storage testing facility, housing for experimentallaboratory animals, and a cereals testing laboratory. The equipment describedhere would be required for any basic research and development program in "newfoods". The project also would support a group of twelve experienced techni-cians (of whom seven are additional to the existing staff) to plan, manageand carry out the development of 10-15 new low-cost nutritious products,interim technical assistance in the form of two foreign technicians for periodsup to one year and twelve short-term foreign consultants, and training for twoBrazilian technicians abroad. A Food Advisory Board would be established underthe chairmanship of the President of INAN and include nutrition specialistsand representatives of industry, ITAL, agencies responsible for food deliveryprograms, e.g., CNAE and CPMI, and financing agencies such as the Agency forFunding Studies and Projects concerned with Economic Development (FINEP) andthe National Economic Development Bank (BNDE). The Board would advise ITALon the types and specifications of foods to be developed and monitor thedevelopment work.

3.16 Feasibility Studies: Once products have been developed (by ITAL orindustry), detailed engineering and commercial marketing studies would befunded by the proposed project through FINEP. This organization, which reportsto the Planning Secretariat, intends to help make possible 10 detailed engineer-ing studies (costing approximately US$75,000 equivalent each) and 8 commercialmarket tests of products (costing approximately US$200-250,000 equivalent each),determined in conjunction with the Food Advisory Board. 1/ Funding would beprovided to selected companies by FINEP as either grants or loans. When FINEPinvolvement is necessary to stimulate private industrial interest, studieswould be financed fully by FINEP. In a case where private interest has beenestablished, FINEP would finance a study to determine the feasibility of theventure, and the company would pay retroactively for the study if it enters

1/ The number of activities estimated for FINEP and BNDE assumes (based onBank discussions with those institutions and the food industry) that inaddition to the products emerging from the project-financed researchwork at ITAL, other product project proposals - some already at anadvanced stage -- will be presented for financing.

- 15 -

into production of the product. In such instances, payment would be througha five-year loan, with a two-year grace period, at 6-8% interest with monetarycorrection. Standard procedures accepted by the Planning Secretariat havebeen established for requesting, funding, and contracting FINEP studies, andthese procedures would be followed in the case of this proposed project.

3.17 Loans to the Food Industry: As part of this project, industrial-scale production of low-cost nutritious foods would be aided by loans fromBNDE. The loans would be significant because profitability of such foodshas not been proven and production at prices the target groups can affordinvolves considerable risk and may not otherwise occur without subsidiesto private food companies. Selection of the organizations to receive BNDEloans for this purpose would be based on (a) criteria to be agreed upon withthe Bank during negotiations and (b) with the endorsement of the products bythe Food Advisory Board. Loans under the program can cover up to 80% parti-cipation in a project, can be for up to 15 years (with an 18-month graceperiod) and would carry a 3-6% interest rate with monetary correction. Loansare expected to range from US$1 million equivalent (for extruder cooker plantsto produce blended cereal food products) to US$2.5 million equivalent (forsubstitute milk products). An estimated 10 BNDE projects amounting to US$16million equivalent would be undertaken, with an estimated 70% financed byBNDE. Except for the special criteria and the screening through the FoodAdvisory Board, loan applications, decisions and disbursements under thisprogram would be handled according to standard BNDE procedures.

3.18 FINEP and BNDE assistance for development of low-cost foods wouldstart in the first year of the project, when it would be devoted to foodsalready being developed by industry and ITAL. (One example is VITAL, a soy-based milk substitute, which is in the final stage of testing.) The immediatemarket for these products will be the existing institutional feeding agencies,which are now planning substantial commercial imports to replace the phase-outof PL-480, and the normal commercial market. The institutional demand isexpected to grow somewhat with the needs caused by the implementation of theproject and then expand rapidly once the national program is established. Thiscomponent is designed to help provide Brazil with the capacity to meet theincreased demand for low-cost processed foods and the demand for related loanfunds, which is expected to increase dramatically once large institutional andcommercial markets are demonstrated to exist.

Food Fortification

3.19 Several specific nutrition problems could be attacked directly ifselected foods could be fortified with the nutrients now lacking in the dietsof low-income persons. The proposed project would include a component designedto test and develop the capacity for fortification of food staples to meetspecific nutrient deficiencies, as would be reflected in the results of thenutrition survey. Technology exists, and in many countries is used, to fortifywheat and corn flours with beneficial levels of micronutrients without altering

- 16 -

the taste, color, texture or other properties of the flours in any way. For-tification of sugar with vitamin A is now required by law in two other LatinAmerican countries. The technology for the fortification of salt with ironis far advanced elsewhere but will require local development work beforeproceeding on a large scale. The proposed project would provide for:

(a) vitamins and minerals in the form of a premix and the equipmentneeded to add the premix to wheat flour in 13 mills servingstates in the Northeast (fortification will start in the thirdproject year; 600,000 tons of flour per year will be fortified,benefitting approximately 8 million people in the Northeast);

(b) the two largest corn dry milling plants in Brazil to be suppliedwith equipment as well as the vitamin-mineral premix for thefortification of corn flour which would start in the third yearof the project (the estimated 59,400 tons of corn flour to befortified is expected to reach about 1 million persons, largelyin the rural East and South);

(c) the equipment and vitamin A supply required to fortify 50,000tons of sugar in 2 mills in the Northeast (approximately 1million people would benefit); and

(d) the equipment and iron (ferrous sulphate anhydrous and the useof phosphoric acid as a stabilizer) required to fortify 40,000tons of salt (implementation, which would reach 10 millionpeople in the Northeast, would be contingent on successfullaboratory and clinical testing of iron-fortified salt underBrazilian conditions).

The inclusion of (c) and (d) assume the nutrition surveys would verify pre-liminary conclusions of widespread iron deficiency anemia and vitamin Adeficiency (see para. 2.04).

3.20 This portion of the project would be administered by INAN, but thetesting, installation of equipment, training of staff for the food processingmills and evaluation of the nutritional impact would be organized by ITAL.As these steps, which are prerequisites to a fortification program, are ex-pected to take up to two years, large-scale fortification of staples will nottake place until the third year. All costs for the period of the proposedcomponent would be included in the project. It is the Government's intentionto carry forth and expanid the fortification activities (and, where appropriate,require fortification by law) once the testE are successfully completed. Becauseadditional costs are involved in fortification, food processing companies arereluctant to fortify foods voluntarily. Accordingly, during the project period,premixed fortificants would be made available on a grant basis. By the end ofthe project period INAN would have (a) developed specific financing proposalsfor securing participation of food processing companies. e.g., either throughgovernment subsidy, through requiring processors to assume the extra cost

- 17 -

(generally less than 1% of the product cost), or through permitting companiesto pass the cost on to the consumer, and (b) made arrangements for introducingand implementing legislation requiring fortification of appropriate food staplesin appropriate areas.

Training and Technical Assistance

3.21 Training under the proposed project would provide multi-disciplinaryshort-term nutrition planning instruction averaging three months for approxi-mately 200 persons at three major centers in Brazil -- the universities ofBrasilia, Sao Paulo and Pernambuco -- supplemented, as appropriate, by graduate-level instruction abroad for approximately 5 persons. Participants would beselected from INAN and other relevant federal and state agencies such as theMinistries of Health, Agriculture and Education. The program, which coversfour years, would be administered by INAN and would be coordinated by INANwith other training programs supported by UNICEF, the Ford Foundation andUSAID.

3.22 Technical assistance that would be provided by the proposed projectwould meet the short- and medium-term manpower requirements of INAN. Includedwould be a total of 15 short-term consultants with an average of four months'service and three long-term consultants with an average of one year of service.Job descriptions have been discussed and details regarding the criteria forrecruitment of participants in both activities are being prepared by INAN onthe basis of broad guidelines agreed upon with Bank staff.

IV. IM2LEMENTATION AND ORGANIZATION

Implementation

4.01 INAN would be in charge of organizing the project and assuringcoordination among the various agencies that would implement individual por-tions of the project. The Government has agreed to strengthen INAN so thatit can attract qualified staff and fulfill its role effectively. Within INANa special project unit would be created to administer the project. This unitwould be under the leadership of a project coordinator whose qualificationwould be acceptable to the Bank. In addition to the coordinator, the projectunit would include a finance officer, a planning officer, an agriculturaleconomist, a sociologist, a nutritionist and supporting staff. At the con-clusion of the project period, the functions and staff of the project unitwould be merged with the appropriate departments of INAN. Creation of aneffective organizational structure for INAN and the project unit, includingthe appointment of a project coordinator, would be a pre-condition of loannegotiations.

Organizational Relationships

4.02 One possible way of organizing the project would have been to createwithin INAN the capability of carrying out all aspects of the project, e.g., the

- 18 -

testing of delivery systems, conducting of surveys, provision of credit, etc.The attractiveness of the simplicity of this approach is outweighed by:(a) the costs of duplicating facilities and staff; (b) the time required forcreating the operational capability, and (c) jurisdictional disputes withexisting agencies, as was demonstrated in INAN's initial efforts in 1972-73to become an operational agency. A better alternative approach is todraw upon manpower, facilities and expertise of existing agencies now engagedin nutrition-related activities. The consequences of such an approach --which is being proposed here -- is that 12 agencies would be included inproject implementation. This, by definition, presents a major task of coor-dination. However, by strengthening INAN's staff capability to meet theseneeds and by defining clearly the contractual arrangements between INAN andthe other agencies, the problems can be successfully managed. INAN,as reorganized, therefore would act as coordinating agency for the otherentities related to the project. The responsibility for implementation ofthe various components rests with organizations enumerated below:

Implementing Ministry inComponent Agency Charge/State

1. Nutrition Survey IBGE Planning Secretariat

2. Agriculture- SUPIAN Ministry of AgricultureRelated Studies (Ministry of

Agriculture)

3. Test of Nutrition Inter- EMBRATER and Ministry of Agriculturevention through the Rural ANCARSE State of Sergipe (Agri-Extension Agency Bank of Brazil culture)

4. Nutrition Intervention 1. State University Ministry of Healththrough Health and Commer- of Pernambuco State of Pernambucocial Systems 2. SESP (Health)

5. Nutrition Intervention School of Public State of Sao Paulofor Pre-Schoolers through Health (Education)the School Lunch Program (Sao Paulo)

6. Development and Production of ITAL State of Sao PauloLow-Cost Nutritious Foods (Agriculture)

FINEP Planning SecretariatBNDE

7. Fortification of Foods INAN Ministry of HealthITAL State of Sao Paulo

(Agriculture)

S. Training INAN Ministry of HealthTechnical Assistance

- 19 -

The organizational relationships of the participating agencies are noted inChart 1 in Annex 2.

Contractual Arrangements withother Implementing Agencies

4.03 Within three months of loan signing, INAN would enter into appro-priate contractual agreements with IBGE, EMBRATER, SUPLAN, ITAL, SESP, BNDEand FINEP and the State Governments of Sao Paulo, Sergipe and Pernambuco. Anappropriate contractual agreement also would have been reached betweenEMBRATER and Bank of Brazil. (See Chart 2, Annex 2.) Evidence of satisfac-tory agreements would be a condition of disbursement of the proceeds of theloan allocated to the components involving each of these entities.

V. COSTS, FINANCING, PROCUREMENT AND DISBURSEMENTS

Costs

5.01 Total project cost, including contingencies, is estimated at US$61.8million equivalent. Cost estimates by expenditure categories and relativepercentages are given in Annex 3.

5.02 The cost estimates are up-dated to the level of November 1974 andassume a price escalation of 12% per annum for 1975, and 10% for 1976, and8% for 1977-79 with respect to non-construction categories. The constructioncost estimates include a price escalation of 16% for 1975, 14% per annum for1976 and 12% for 1977-79. The costs of food, vitamins, minerals, and operatingvehicles were estimated by the governmental agencies and reviewed by theappraisal mission.

Project Financing

5.03 The total cost of the project would be financed by an IBRD loan ofUS$20 million (32%) and a contribution of US$41.8 million equivalent (68%)by the Government of Brazil 1/ (see Tables 1 and 2 attached.) The Bank loanwould be approximately equal to the foreign exchange component of the project.

1/ This includes an estimated US$4.8 million from borrowers receiving BNDEloans.

- 20 -

Brazil

Table 1. Estimated Prolect Cost by Component

Cr $000 /1 US $000 Equivalent

a ofProject Components Local Foreign Total Local Foreign Total Total

A. Nutrition Planning and Proaraning1. Nutrition Survey 21,255.8 139.6 21,395.4 2,665.3 17.5 2,682.8 42. Food and Nlutrition Policy Research 36,797.4 980.9 37,778.3 4,614.1 123.0 4,737.1 8

B. Testing Alternative Nutrition Delivery Systems1. Agricultural Extension Services 51,721.1 1,717.0 53,438.1 6,485.4 215.3 6,700.7 112. Health and Commercial Delivery Systems 20,468.6 15,721.9 36,190.5 2,566.6 1,971.4 4,538.0 83. School Feeding Programs 23,931.4 1,540.8 25,472.2 3,000.8 193.2 3,194.0 5

C. Development & Commercialization of Nutritious Foods1. Research and Development Program in ITAL 35,476.0 10,436.1 45,912.1 4,448.4 1,308.6 5,757.0 92. Commercialization of Foods 111,650.0 31,900.0 143,550.0 14,000.0 4,000.0 18,000.0 293. Food Fortification Program 3,526.5 81,909.6 85,436.1 442.2 10,270.8 10,713.0 17

D. Training and Technical Assistance1. Training Programs 27,841.5 4,919.8 32,761.3 3,491.1 616.9 4,108.0 72. Technical Assistance 1.279.2 9.790.1 11.069.3 160.4 1.227.6 1.388.0 2

TOTAL ESTIMATED PROJECT COST 159 055.8 493,003.3 41,874. 3 9. 61.818.6 100

I/ As of May 1975, US $1.00 - Cr $7.975.

- 21 -

Brazil

Table 2. Financing of Project

Source (US $000 Equivalent)

Total IBRD Loan Government ContributionProject Components Project Cost Amount % Amount 2

A. Nutrition Planning and Programming1. Nutrition Survey 2,682.8 500.8 18.7 2,182.0 81.32. Food and Nutrition Policy Research 4,737.1 884.3 18.7 3,852.8 81.3

B. Testing Alternative NutritionDelivery Systems

1. Agricultural Extension Service 6,700.7 1,014.0 15.1 5,686.7 84.92. Health & Commercial Delivery Systems 4,538.0 847.1 18.7 3,690.9 81.33. School Feeding Programs 3,194.0 596.3 18.7 2,597.7 81.3

C. Development & Commercialization ofNutritious Foods

1. Research & Development Program in ITAL 5,757.0 1,074.8 18.7 4,682.2 81.32. Commercialization of Foods/I 18,000.0 4,000.0 22.2 14,000.0 77.83. Food Fortification Program 10,713.0 10,056.6 93.9 656.4 6.1

D. Training and Technical Assistance1. Training Programs 4,108.0 766.9 18.7 3,341.1 81.32. Technical Assistance 1.38B.0 259.2 18.7 1.128.8 81.3

TOTAL ESTIMATED PROJECT COST 61,818.6 20.000.0 32.3 41,818.6 67.7

1/ This represents the total cost of commercialization. It includes FINEP's financing of studies (US $2 million),loans by BNDE estimated at US $11.2 million and contributions by companies borrowing from BNDE (US $4.8 million).

- 22 -

Disbursements

5.04 The loan would meet 32% of the total project costs. Disbursementwould be made on the following basis:

(a) 100% of the CIF cost of imported vitamins and minerals;

(b) 30% of expenditures incurred on loans and financialassistance by BNDE and FINEP for commercial productionof foods; and

(c) 19% of all other expenditures of the project.

INAN will set up a revolving fund to facilitate the flow of resources to thevarious agencies implementing the project. Rules of operation of the revolvingfund will be formulated in consultation with the Bank.

5.05 Suitable audit arrangements would be agreed upon during negotiations.Undisbursed funds would be available for reallocation to other components oractivities related to the project, contingent on Bank approval.

Procurement

5.06 All supply contracts for furniture, equipment, vitamins and minerals(excluding small value contracts below US$50,000 equivalent) would be awardedin accordance with the Bank's guidelines for international competitive bidding.Local manufacturers of furniture, equipment, vitamins and minerals would beallowed a preference margin of 15% or the existing rate of import duty, which-ever is lower. To the extent practical, items would be grouped to form size-able bid packages and to permit bulk procurement. Numerous small contractsaggregating an estimated US$500,000 equivalent for items which cannot bepurchased in bulk will be purchased through contracts awarded on the basisof competitive bidding advertised locally and in accordance with local pro-cedures satisfactory to the Bank.

5.07 The procurement of food, costing US$2.7 million (or 4.4% of theproject) does not lend itself to bulk purchases. Various types of food wouldbe purchased at various places for use in individual programs at differenttimes over the four-year project period. Because Brazilian Government agenciesare experienced in food purchasing for institutional and other uses, the Bankwould rely on their established procurement procedures which are satisfactory.

5.08 Construction to be executed under the proposed project would costan estimated US$550,000 including contingencies. The well-developed natureof the Brazilian building industry makes it unlikely that foreign buildingcontractors would be attracted. Therefore, the contracts would be awardedon the basis of competitive bidding advertised locally and in accordance withlocal procedures satisfactory to the Bank.

- 23 -

5.09 About 70 vehicles of four-wheel drive and small motor car types,estimated to cost about US$400,000, are to be purchased over the first twoyears. Suitable vehicles are available from major international firms withmanufacturing facilities in Brazil or other international manufacturersrepresented by local agents and prices are competitive. It is essential thatlocal service and spare parts facilities be readily available. Procurementof the vehicles would therefore be made on the basis of competitive bidding,advertised locally and in accordance with Government procedures satisfactoryto the Bank.

5.10 Procurement with respect to financing by local loans and assistanceby the Bank of Brazil, FINEP and BNDE will follow normal commercial channels.

VI. PROJECT JUSTIFICATION

6.01 The proposed project is suitable for a Bank loan of US$20 million fora term of 25 years including a five-year grace period, providing an understand-ing is reached regarding conditions listed in Section VII.

6.02 There are two basic justifications for Brazil investing to improvethe nutritional standards of its population. First, malnutrition is one of themain determinants of health, and health is by now regarded as an importantobjective on its own -- distinct from the general goal of improving economicwelfare. The second reason for singling out health and nutrition is theirimpact on human capital formation with its implications for future earningsof individuals and the rate of growth in the gross national product. 1/

6.03 The Government has been concerned with the problem of malnutritionin Brazil, but attempts to mitigate it have been frustrated largely by in-adequate data and a lack of proven delivery systems to permit the designand implementation of a sound, comprehensive nutrition program. Since 1972,Bank staff have encouraged the efforts of the Brazilian Government to preparefor a full-scale national attack on malnutrition. Although initial effortsto organize INAN as a coordinating institution experienced difficulties, theGovernment is now committed to proceed with the reorganization of INAN, andhas reaffirmed its commitment to a major investment to alleviate malnutrition.

6.04 The principal benefit of this project to Brazil is that it should,within four years, provide the basis for the design of a practical, action-oriented program to combat malnutrition. In addition to financial support,Bank participation would bring a disciplined approach to the coordination,execution and evaluation of the project, which will be much needed if theproblems confronting the implementation of a nutrition program are to besurmounted. An added benefit of the project would be that the Bank -- by

1/ See Nutrition Policy Paper, November 27, 1973 (pp. 3-6).

- 24 -

participating in a project with so wide a range of activities and in acountry as diverse as Brazil -- would gain useful experience for its acti-vities elsewhere in the world.

6.05 The longer-range benefits of the project, which would flow from anefficient, comprehensive nutrition program, would be a significant improve-ment in the health status of the population and higher productivity amongpersons in the lower income groups of the country which would have a favorableimpact on economic growth.

6.06 The above benefits are not suited to the calculation of a conven-tional rate of economic return. However, it is clear that the benefits thatwould accrue from an efficient, comprehensive national nutrition program --towards which this project is a necessary first step -- would be of signifi-cant value to the development of Brazil, a country in which perhaps half ofthe population suffers from some form of nutritional deficiency.

6.07 Although the basic objective of the project is to provide theknowledge, conditions, and products necessary for a subsequent nationalnutrition program, several side benefits would accrue. Among them:

(a) approximately 57,000 children and pregnant and lactating womenwould benefit directly from food supplementation and othernutrition services;

(b) approximately 12 million people would receive vitamins andminerals, now deficient in Brazilian diets, through thefortification of food staples;

(c) an organizational infrastructure would be established toprovide extension and credit to bring nutrition improve-ment to the lowest income strata of small farmers inSergipe in Northeast Brazil; and

(d) the development of agricultural policies would formallyincorporate consideration of the nutritional implicationsof those policies.

6.08 The nutrition policy guidelines presented to the Board November 17,1973, noted that "Given the inadequate planning and frequent absence of harddata, one strategy would be for the Bank to concentrate efforts over the nexttwo to three years on long-range sector analyses and on helping low-incomecountries to develop a nutrition planning capability. Another would be tomove firmly ahead with project activity, in the absence of the desired detailedunderstanding of the problem and the relative attractions of alternate inter-vention actions. (Even if efforts turned out later not to be the most cost/effective, they nonetheless may be worth doing because of the existing levelsof malnutrition.)" The intermediate approach proposed -- and the one incor-porated in this project -- is the financing of certain evident operationalcomponents, while at the same time financing data gathering and a longer-termanalysis for more sophisticated subsequent projects.

- 25 -

6.09 The proposed Brazil project, moreover, is in keeping with the policyguidelines' projection that initial nutrition projects in most countries wouldcommonly have three general categories of components:

"(a) Activities which are ready for large-scale implementationand which would be expected to rate high on a priority listemerging from long-term study.

(b) Pilot field tests designed to generate necessary cost!effectiveness information about activities which arenot ready for national implementation without a betterunderstanding of results and costs.

(c) Data gathering, including consumer expenditure surveys,food consumption surveys, r%utritional status surveys,and studies on nutritional implications of food and agri-cultural policies. Such data collection is designed toprovide the basis for developing a national food andnutrition policy and for future programs and projects.

In the process of all of the above, efforts would bemade to develop or strengthen the institutional infra-structure required for a national nutrition program."

This, in essence, is the composition of the proposed Brazil nutrition project.

VII. RECOMMENDATIONS

7.01 During negotiations, agreement would be sought with the Governmenton the following principal points:

(a) The preparation, in consultation with the Bank, of anational nutrition plan by the end of the projectperiod (para. 4.01);

(b) The design of the nutrition survey (IBGE) to be finalizedwithin three months of loan signing (para. 3.02);

(c) Prior Bank approval for studies under the SUPLAN componentcosting more than US$50,000 equivalent (para. 3.04);

(d) The common measurement bases, designed by INAN for theevaluation of the several delivery system tests, to befinalized within three months of loan signing (para.3.05);

(e) The criteria for the selection of projects to receiveBNDE loans (para. 3.17);

- 26 -

(f) The ascertainment of appropriate contractual agreementsto be reached between INAN and IBGE, EMBRATER, SUPLAN,ITAL, SESP, BNDE, FINEP and the State Governments ofSao Paulo, Sergipe and Pernambuco, and between EMBRATERand the Bank of Brazil within three months of loan signingas conditions of disbursement of respective portions ofthe proceeds of the loan (para. 4.03);

(g) The setting up of a revolving fund in INAN with appropriateoperating procedures (para. 5.04); and

(h) The provision of suitable audit arrangements (para. 5.05).

7.02 As a pre-condition of loan negotiations the following would becompleted:

(a) The establishment of an effective INAN organizational structure,including an appropriate project unit, on terms and conditionsacceptable to the Bank (para. 4.01); and

(b) The designation of a suitably qualified project unitcoordinator acceptable to the Bank (para. 4.01).

Annex 1Page 1

Nutrition Intervention Through the Rural Extension Agency

Introduction

1. An unusual component of the proposed project is an experimentalscheme for increasing the output of nutritionally desirable foods by low-incomefarmers and in the process improving the nutritional levels of their families.This component of the project would be implemented in the Northeastern Stateof Sergipe by the state branch (ANCARSE) of the rural extension agency(EMBRATER).

2. Nutrition interventions have been traditionally identified withprograms of food supplementation. This has led to the sometimes justifiedcriticism that feeding programs do not have an impact on behavior patternsand, even if they do, the impact cannot be sustained inasmuch as supplementaryfood from external sources may not continue to be available. Other effortsfor improving nutrition have concentrated on food production programs. Doubts,however, have been expressed whether increased food production, of itself, issufficient to meet nutritional needs, especially of certain low-income segmentsof the society. Similarly, efforts at improving food consumption throughnutrition education programs alone appear to have had limited impact.

ObJectives

3. The proposed project seeks to integrate nutrition education effortsand agricultural production efforts via extension and evaluate their effective-ness -- both in conjunction and separately -- in upgrading the nutritionalstatus of a low-income population, in particular the project target groupmembers of small-farm families. The source of nutritional improvement isexpected to be: (a) increased consumption of on-farm production of corn andbeans and (b) the use of increased purchasing power (arising from increasedagricultural production of cotton, corn, beans and other crops) in nutrition-ally beneficial ways. It is expected that with the modest range of proposedinputs (such as improved farming practices and availability of appropriateseed varieties), an assumed increase of about 30% per hectare productionwould be realized. In the areas of Sergipe where the project component wouldbe carried out, existing agricultural technology packages appear satisfactoryas a starting point for the proposed activities. Both the extension andcooperative structures are sufficiently organized and motivated to help smallfarmers, given the assistance to be provided under the project.

4. A total of 3,000 small farmers with individual holdings of generallyup to about 50 ha. would be identified in twelve municipalities.

Annex 1Page 2

5. The twelve municipalities will be divided into three equal groups:

Group Group GroupA B C

Type of Agricultural Social (nutrition Agricultural andextension extension work education and social extension

health) extension workwork

Staffing 25 additional 25 additional 25 additional social

agricultural social extensionists and 25extensionists extensionists additional agricultural

extensionists

Health Miniposts 30 miniposts with 30 health aides

Funding

6. It has been assumed that the participating farmers will require an

annual amount of up to US$1,000 1/ of agricultural credit. This credit wouldbe provided by the Bank of Brazil to farmers in groups (A) and (C) on termsand conditions generally prevailing for agricultural credit in the Northeast.

7. The total cost of the component is tentatively estimated at US$4million equivalent, excluding credit. Credit is provisionally estimated at

US$1.5 million equivalent.

Phase of Implementation

8. It is proposed that the component be implemented in two stages:

(a) the preparation stage, and

(b) implementation, contingent upon the Bank's approval ofa plan of operations, which would be drawn up during

the preparation stage.

1/ ANCARSE has proposed US$2,000 equivalent, the appropriateness of which

will be studied as part of additional preparation by expert consultantsto that agency. The total credit now listed at US$1.5 million wouldincrease correspondingly.

Annex 1Page 3

Preparation Stage 1/

9. The preparation stage would involve:

(a) selection of suitable municipalities;

(b) a survey of the socio-economic status of low-incomefarmers with generally less than 50 ha.;

(c) identification of 3,000 farmers with holdings generallyless than 50 ha.;

(d) drawing up an appropriate plan of operations for agriculturaland social extensions in the selected municipalities, andfinalization of the methodology of evaluation;

(e) recruitment and training of the agricultural and socialextensionists and health orienters needed in the secondstage; and

(f) a baseline survey of the nutritional status of selected farmers'families.

Plan of Operation

10. Under the guidance of EMBRATER, ANCARSE would draw up the plan ofoperations within an initial period of six months. In this work it would beprovided technical assistance by the Rural University of Vicosa, as wellas by suitable consultants selected by EMBRATER, and approved by the Bank.The plan of operations and methodology of evaluation would be approved bythe Bank before EMBRATER and ANCARSE proceed further with the implementa-tion of the components.

11. The plan of operations would include, among other things, detailsregarding the availability of the recommended foods at reasonable prices,in particular the availability of suitable nutritious foods, agriculturalsupplies and marketing facilities.

Evaluation

12. For purposes of control, a group of municipalities outside the pro-ject area with similar agro-economic and social characteristics would beidentified. Baseline surveys of the nutritional status of the vulnerabletarget groups among the small farm families in municipality groups (A), (B)

1/ Details of the preparation stage have been discussed with ANCARSE,which has requested consultant assistance.

Annex 1Page 4

and (C), as well as a similar sample in the control group, would be under-taken within the preparatory stage. By the end of the project, there would beanother evaluation of the nutritional status of the vulnerable target groups.The determination of nutritional status would be made through anthropometricmeasurements -- weight, height and arm circumference tests, simple enough tobe handled by the social extensionists of the project, with some training.

13. The tests would attempt to discriminate between the improvements inthe nutritional status of groups (A), (B), and (C) and to identify the factorsresponsible. The hypothesis being tested is that there is a positive andsynergistic relationship between agricultural and social extension effortson the one hand, and nutritional improvements on the other. This means thatgroup (C) should show significantly larger improvements in nutritional statusas compared to groups (A) and (B), as well as the control group. An evaluationof the agricultural production impact, which takes into consideration bothfarm and institutional performance of the project, 0.11 be undertaken simultan-eously with the test of improvement of the nutritional status. The datacollection would be so organized that the improvements in nutritional statusand production of different groups of farms can be readily analyzed.

Operational Implications of the EMBRATER Component

14. Manpower Needs: The component proposes the recruitment and trainingof 50 agricultural extensionists, 50 social extensionists, and 30 health aides.The first two categories will be available largely from the Rural Universityof Vicosa, as well as from the Institute of Nutrition at Recife and others.Health aides are expected to have had a minimum of 4 years of schooling. Theirfurther training would be provided by the State Health Department as well asby SESP.

15. Organization: The component would be administered by:

(a) a national coordinator with supporting staff in EMBRATER;

(b) a state coordinator heading a special unit; and

(c) 3 regional coordinators.

16. Flow; of Funds: INAN would provide the full cost of the projectdirectly to ANCARSE, simultaneously informing EMBRATER. INANT would operatethrough the creation of a revolving fund for A*JCARSE. The fund would main-tain a sufficient supply of capital to meet requirements for three months.Each month kNCARSE will provide INAN with the necessary statements of expend-iture and claim reimbursement.

Annex 1Page 5

17. Coordination with Other Agencies: INAN, EMBRATER and ANCARSE wouldensure that in both the preparation and implementation of the project allconcerned agencies, including the Bank of Brazil, EMBRAPA, the Rural Univer-sity of Vicosa, the Institute of Nutrition at Recife, and the State Govern-ment, are associated. There would be a committee for coordination in theState under the chairmanship of the Secretary of Agriculture and includingthe State Secretary of Planning and representatives of the various relevantagencies. The ANCARSE project unit coordinator would serve as secretary ofthe coordination committee.

18. Procurement of Equipment and Supplies: The proposed project involvesthe procurement of vehicles, furniture, office equipment, and vitamins andminerals for the health miniposts. Procurement would be arranged by the spe-cial unit in charge of project implementation within ANCARSE in accordancewith the rules accepted for the project as a whole. Concerned experts of theState Government would be associated with the evaluation of procurement oftenders for vitamins, minerals and equipment for the health miniposts.

19. Monitoring and Evaluation: The special project unit in ANCARSE,under the supervision of the Rural University of Vicosa, would monitor projectdevelopment and progress. Evaluation of improvement in nutritional statuswould be designed by the Institute of Nutrition at Recife in consultation withIBGE, which is to undertake the national nutrition survey, and by the RuralUniversity of Vicosa. The Institute of Nutrition at Recife would have aspecial staff to handle this aspect of the project. The methodology of eval-uation would be drawn up by the Institute and approved by a committee of ex-perts including representatives of IBGE, SESP and the Rural University ofVicosa. Results of evaluation would be placed before the committee for recom-mendations.

20. Evaluation of the agricultural impact would be undertaken in termsof production inputs including credit and family net income. It would bedesigned to take into account the performance of the extension and creditagencies. The cost and efficiency of these operations would be evaluated aspart of the test.

O,T'll(:F tThiE

PRE2IDO;T

IfINISTRY OF MINISTRY OF STY OF |ISTRY OPLANNING L FINANCE EATH AGRCLT REAG

t3UPLA1j

; H 3 A | | \ CSTITE OF I!A STATE OF I|SERGIPE PACO SAO PAULOt~~~~~~~~~~~~~~~~~~~~~rt

STATE| ANCAR~SE |UNIVERSITY

iCOF PERNAMJCO

EENCRUZILHA,DAiGROUP

STATE SECRETARYOF EDUCATION

SCHOOL OFPUBLIC HEA1,Th

Annex 2Chart 2

Brazil

_Mntractual Agreements Between Participating Entities(Numbers refer to appropriate paragraphs in the text)

a~~~~~~~~~O

,1~~~~~~~~~~~~~~~~~~z

'.3~~~~~~~~~9

0

0~~~~~~~

i '.3^Jns UoztsXnN |g -

g < I-E V>

<1~~ '0is3l

Annex 3

Brazil

Estimated Total Project Cost by Type of Expenditure

Cr $000 /1 US $000 Equivalent % of

Local Foreign Total Local Foreign Total Total

1. Civil Works1.1 Construction 3,576.0 397.2 3,973.2 448.4 49.8 498.2 0.81.2 Furniture & Equipment 2.992.5 1.303.9 4.196.4 362.7 163.5 526.2 0.9

Subtotal - 1 6,468.5 1,701.1 8,169.6 811.1 213.3 i 1.7

2. Non-Construction2.1 Vehicles 2,410.9 602.9 3,013.8 302.i 75.6 377.9 0.62.2 Special Equipment 2,901.4 1,113.3 4,014.7 363.8 139.6 503.4 0.82.3 Food for Distribution Tests 9,412.9 12,153.1 21,566.0 1,180.3 1,523.9 2,704.2 4.42.4 Vitamins and Minerals - 53,604.8 53,604.8 - 6,721.6 6,721.6 10.92.5 Technical Assistance

2.51 Advisors/Consultants 5,927.0 12,911.5 lS,838.5 743.2 1,619.0 2,362.2 3.82.52 Fellowships 6,268.3 4,107.1 10,375.4 786.0 515.0 1,301.0 2.12.53 Contracts with Universities

and other groups 2480.2 - 24180.2 3.032.0 - 3.032.0 4.9Subtotal - 2.5 36.375.5 17,018.6 53,394.1 4,561.2 2,134.0 6.695.2 10.8

2.6 Salary Support for Incr. Staff 59,159.3 - 59,159.3 7,418.1 - 7,418.1 12.02.7 Other Operating Costs (Incr.)

2.71 Per diem and Travel Allowance 9,227.9 - 9,227.9 1,157.1 - 1,157.1 1.92.72 Vehicle Maintenance 6,667.9 - 6,667.9 836.1 - 836.1 1.32.73 Data Processing & Printing 3,706.8 - 3,706.8 464.8 - 464.8 0.82.74 Seminars, Workshops, Sp.Studies 7, 777. 2 - 7,777.2 975.2 - 975.2 1.62.75 Other (Office Supplies & M'tnce,

Publicity Materials) 6.969.3 _- 6.969.3 873.9 - 873.9 1.4Subtotal - 2.7 34349.1 - 3449.11 - 4,3071 7.0

Subtotal - 2 144,609.1 84,492.7 229.101.8 18.132.8 10,594.7 28,727.5 46.5

3. Local Loans and Assistance3.1 Bank of Brazil/2 11,962.5 - 11,962.5 1,500.0 - 1,500.0 2.43.2 FINEP 15,950.0 - 15,950.0 2,000.0 - 2,000.0 3.23.3 BNDE/3 95,700.0 31.900.0 127,600.0 12,000.0 4,000.0 16,000.0 25.9

Subtotal - 3 123.612.5 31,900.0 155,512.5 15;500.0 4,000.0 19,500.0 31.5

Base Cost Estimate 274,690.1 118,093.8 392,783.9 34,443.9 14,808.0 49,251.9 79.7

4. Contingencies4.1 Physical (67) 15,106.2 8,62.0 23,727.2 1,894.2 1,081.0 2,975.2 4.84.2 Price (18%) 44.151.2 32.341.0 76.492.2 5P536.2 4,U55.3 9,591.5 15.5

Subtotal - 4 59.257.4 40.962. 100.219.4 7.430.4 5.136.3 12.566.7 20.3

TOTAL ESTIMATED PROJECT COST 333.947,5 1 49.03.61.81896 100.0

/1 As of May 1975./2 See footnote 1/ page 11./3 This amount represents the total cost of the project, 70% of which is expected to be lent by BNDE.

not for public use - world bank...sapro setor de alimentos proteicos (section on protein foods of...

Documents