Strengthening Social Protection System in Sindh
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Pakistan: Strengthening Social Protection Delivery System in Sindh (P178532)

  1. Introduction
The “Strengthening Social Protection Delivery System in Sindh” (SSPDS) is a project financed through an IDA credit of US$ 200 million, with counterpart financing of US$ 30 million (in-kind/cash) by Government of Sindh (GoS).  The project supports inclusive growth by reducing inequities for vulnerable groups through development of a sound social protection delivery system and expanding Mother and Child Support Program (MCSP), while promoting resilience and adaptation to shocks, including ones induced by climate change. The project supports operationalization of the Sindh Social Protection Authority (S-SPA), development of the Sindh Social Protection Delivery System and promotes higher utilization of maternal and newborn child health services to safeguard human capital during the first 1,000 days of life. SSPDS will be implemented over a five-year period (2023-2027).

The project development objective is to “Strengthen social protection service delivery system and enhance accessibility and utilization of Mother and Child Health Services in selected districts in Sindh. Result Framework of the project is attached as Annex-1.

SSPDS supports the following components.

Component 1: Strengthen Sindh Social Protection Service Delivery Systems

This component supports the modernization of systems and processes to fully operationalize the newly established S-SPA and improve its institutional capacity by strengthening the administrative, operational, policy, and planning functions and capabilities, including the development of energy efficient/climate-smart information technology (IT) systems and capacity building through the provision of technical assistance for: (i) enhancing the logistics and administration, procurement, financial management (FM), human resources (HR), legal, auditing, M&E, and grievances redressal capacities; and (ii) upgrading and/or customizing the IT systems for managing welfare services, programs, and grievances redressal.

Component 2: Mother and Child Support Programme (MCSP)

This component focuses on birth and first 1,000 days where risks and needs are high but programmatic responses are weak. The main objective of this component is to create demand for MNCH and nutrition services and promote behavioral change to increase uptake of the MNCH services focusing on the first 1,000 days of life through the provision of CCTs in selected districts. This component will build on the MCSP pilot and introduce implementation improvements for enhanced efficacy, based on the administrative assessment of the pilot.

 Institutional and Implementation Arrangements for SSPDS

 Sindh Social Protection Authority (SSPA)

SSPDS will be implemented by the Sindh Social Protection Authority (SSPA) as the lead implementing agency, in close collaboration with the healthcare system of the Government of Sindh. SSPA will also liaise with BISP, NADRA, and, where possible, existing government institutional structures will be used for implementation. As the sole implementing agency, Chief Executive Officer S-SPA will be the ex-officio Project Director for SSPDS, assisted by a Senior Project Manager responsible for day-to-day operations and implementation of activities assigned to the project.

  1. Geographical Scope of the Project

This five-year (2022-2027) project will be implemented in 15 districts in the Sindh province and will be scaled up gradually. The district-wise project roll-out schedule would be finalized based on geographical clustering and other technical, logistical, and administrative criteria.

4.    Target Group

An “eligible beneficiary” for SSPDS is defined as follows:

“All pregnant women and mothers of children aged under 2 years, who are residents of the target districts and hold a valid CNIC (i.e., 18 years or older).”

Table 1 summarizes the eligibility criteria to enroll in the CCT program.

Table 1: Enrolment Eligibility Criteria

 

Criteria Evidence required
Must be pregnant (any stage of pregnancy) or lactating with a child below 2 years of age Screened for pregnancy at the Health Facility
Beneficiary must be resident of area selected for the program roll out Residential address as mentioned in the CNIC

The total number of beneficiaries from the MCSP component is estimated to be 1,300,000 pregnant and lactating women over five years.

  1. Conditionalities and Benefits

The MCSP will provide cash transfers to Pregnant and Lactating Women (PLW), incentivizing them to fulfill conditionalities that include regular health checkups of pregnant and/or lactating women, institutional delivery, and birth registration; child growth promotion; and immunization of children under two years of age. In addition, mothers will be encouraged to participate in counseling and awareness sessions on birth spacing, hygiene, feeding and caring practices; children’s cognitive development; as well as food security and healthy food options for nutrition.

Each MCSP beneficiary is expected to attend the nearest public health facility as per prescribed in project operation manual as MCSP payments are linked to the beneficiary adhering to the scheduled visits. MCSP will offer a maximum of PKR 30,000 to approximately 1.3 million women (about 325,000 women every year) from pregnancy detection until the child turns two years old, subject to compliance with co-responsibilities/conditionalities. These include regular health checkups of PLWs; institutional delivery and birth registration; child growth promotion; and immunization of children under two years of age. In addition, mothers will participate in counseling and awareness sessions on birth spacing, hygiene, feeding and caring practices, children’s cognitive development, as well as food security and healthy food options for nutrition.

The payment service provider recruited will deliver regular CCT payments to beneficiaries. The payment service provider will operate at close distance from beneficiaries to minimize private costs to receiving cash benefits with an acceptable transaction cost, in accordance with international and national current practices. Payments are expected to happen on fixed intervals, and at least one payment is expected to happen every quarter.

All eligible beneficiaries registered until program’s Year 4 will be supported with CCT. No new registration will be done during 5th year of the project. Previously registered clients in 15 districts will continue with the 1,000 days cycle with CCT package.

 

[1] Please note, this is an indicative beneficiary list, which can be adjusted during implementation based on progress and Project evolution.

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