Marshall Islands - RMI Multisectoral Early Childhood Development Project : Environmental Assessment : Environmental and Social Management Framework

The development objective of RMI Multisectoral Early Childhood Development Project for Marshall Islands is to improve coverage of multisectoral early childhood development services in the RMI’s territory. Some of the negative impacts include: (i) pregnant women, particularly in the OI may forego care because they are not comfortable receiving care from a male provider, thus failing to benefit from the revised Reproductive, maternal, newborn and child health and nutrition (RMNCH-N) package; (ii) excessive demands on time availability of limited numbers of health workers; iii) vulnerable children not being able to access benefits due to the time pressures of poorer mothers or primary caregivers who may not have spare time; (iv) adverse health outcomes for children if cash transfer is spent for other family’s needs and expenditures unrelated to nutrition, and health; (v) poor distribution outcomes owing to financial institution limitations to disburse cash transfers, or in case of use of vouchers, no institution available to serve as arm of government to act as intermediary; (vi) inefficiencies caused by low morale of and overburdened government personnel designated to undertake project activities; and (vii) inefficiencies caused by uncoordinated efforts of offices and ministries involved. Some of the mitigation measures include: (i) encourage qualified females to apply as health assistants by improving the compensation, and benefits package through Memoranda of Understanding (MOUs) between Ministry of Health and Human Services (MOHHS) and mayors’ offices; (ii) provide surge support through project to relieve burden on existing health workers until more are recruited; (iii) ensure adequate early childhood education is available to meet anticipated demand; (iv) implement effective Social and Behavior Change Communication (SBCC) as part of social preparation to explain that only the selected needy and cash-strapped will be given the assistance that would help improve specifically maternal and child health; (v) strengthen Ministry of Culture and Internal Affairs (MOCIA) capacity to manage, and implement cash transfer component through training, and mentoring; (vi) explore the possibility of providing allowances to designated personnel as incentive; and (vii) employ strengthening activities for inter agency coordination such as regular periodic meetings on project implementation progress.