CONFIDENTIAL - Not for Circulation
MALDIVES : Integrated Human Development Project
Beneficiary Impact Assessment with Gender Dimension
November 08, 2003 Authors: Dr. Ahmed Shareef and Team
College for Higher Education, Male, Maldives
We thank the World Bank staff, especially Mr. Qaiser M. Khan (Project Team Leader), Mr. Harsha Atrupane and their team for their kind and unwavering support to successfully implement this study.
Our thanks are due to Mr. Hamdhoon Hameed, the Minister of Planning and National Development, Dr. Mahmood Shougy, the Minister of Education, Dr. Hussain Rasheed, Director and Ajwad Ali, Assistant Director of Ministry of Human Resources and Labor, Maimoona Aboobakur, Program Manager and Hussain Shaheed Civil Engineer of Ministry of Health and Ms. Maana Raafiu, Director of Ministry of Women's Affairs, Mr. Mohamed Farooq, Assistant Director General of Ministry of Atolls Administration for providing information, guidance and sectoral perspectives into this project. Mr. Rilwan Shareef, Executive Director and Ms. Fathmath Nuzuha, Assistant Undersecretary of Ministry of Finance and Ms. Aishath Shahuda, Assistant Director, Economic Statistics Section of Ministry of Planning and National Development, for supporting us by reviewing and commenting on our study tools and by assisting us in determining the study sample.
We thank Ms. S. Meenakshy, Social Development Consultant, World Bank for providing us the technical assistance to undertake the study and to develop the report.
We owe special thanks to all those participants in our semi-structured interviews, focus group discussions and community meetings as well as respondents to the household questionnaires who so graciously gave their time and co-operation to provide the information that we require for this project. To all who supported and assisted us, we are filled with gratitude. Thank you.
1. The Maldives Beneficiary Impact Assessment study (henceforth referred to as BIA) supports the Integrated Human Development Project (IHDP). The IHDP, implemented by the Ministry of Human Resources and Labor, Maldives, aims to improve social service provisions and economic opportunities on some focus islands in an ecologically viable concentrated section of select atolls in the North and South Central Regions. These focus islands (FI) will become centers offering people an alternative to Male, the capital region.
2. The BIA primarily involves an analysis that is selective and strategic focusing mainly on operationally relevant issues relating to the project that would create intended and unintended consequences on the well being of different categories of social groups.
3. Within the context of the Maldives IHDP, the BIA aims to identify priorities and choices of both male and female stakeholders and social issues, if any, that may arise out of the project objectives, namely: (a) improving education services; (b) improving health services; (c) supporting economic growth through market based employment generating initiatives, and (d) capacity building for coordinating and managing community services. The BIA was implemented in focus and primary islands in two atolls within the North and South Central regions of Maldives.
4. For the purpose of this BIA, focus islands, primary islands, households, multi-purpose boarding houses, social capital, and Non Governmental Organizations (NGOs) are defined as below.
Focus Islands: (FIs) are islands in an atoll with land mass for potential development, large population size with availability of medical services (clinics and hospitals), education services (school grade from 1 to 10, skill training facilities and IT), basic services (water and electricity), transport services (sea transport) and employment opportunities
Primary Islands (PIs): are smaller islands within the catchments area serviced by the focus islands.
Households are units where members eat food cooked from the same hearth and are /or financially supported by the head of the particular unit and /or contributing to the unit on a regular basis not only when visiting. However, 'regular basis' does not include any form of gifts from relatives or family on a special occasion.
Multi-Purpose Boarding Houses: are housing units, which would be located in focus islands and will be used as boarding houses for students coming from primary islands during school terms. During school holidays these housing units could be used for undertaking training and workshops in different sectors ( such as education, health etc).
Social Capital refers to the institutions, relationships, and norms that shape the quality and quantity of a society's social interactions.. Social capital is not just the sum of the institutions, which underpin a society - it is the glue that holds them together (World Bank).
NGOs: are registered non-governmental organizations that work for the development of the island/atoll/ region/nation working on areas such as health and /or education, and/or employment.
5. The BIA included a series of both qualitative and quantitative techniques. Within the quantitative techniques, it undertook 1, 013 household interviews and within the qualitative techniques, it carried out a total of 32 focus group discussions, 27 community meetings, and 58 semi-structured interviews with community members. Additionally, semi-structured interviews were also undertaken with representatives from the Ministry of Women's Affairs and Line Ministries (Human Resources and Labor, Atoll Administration, Health and Education) and representatives from government and non-government organizations relating to various sectors located in specific islands covered under BIA (see Annex 4 for details)..
6. Questionnaires, checklists, categories of stakeholders and sample sites for BIA were determined in collaboration with the Statistics Division of Ministry of Planning, Ministry of Finance, the international World Bank Consultant and in discussion with select set of stakeholders (see Annex 4 for details). Selection of sample regions took into account variables such as: regions proposed for project; and availability of atolls with FIs and PIs in the catchments areas serviced by these FIs. The two atolls were then selected based on availability of FIs with potential for development with small satellite islands (primary islands) within the catchments area. Within the selected atolls, two FIs were selected, which had similar characteristics such as: (i)almost the same size of population; (ii) large land mass; (iii) secondary education facilities; (iv) hospitals; (v) employment opportunities; and (vi) communication services. From the total number of PIs in the catchment area of each FI, a cluster sample of PI was selected based on three criteria: (i) population size; (ii) dependency on the FI ; and (iii) distance from FI. Within the selected FIs and PIs, blocks of houses were randomly selected for household interviews and a purposive sample of population for focus group discussions, semi-structured interviews and community meetings.
7. The following is the list of islands covered by BIA in the two regions. Specifically:
In the North Central Region, Eydhafushi, from Baa atoll was selected as the FI, and Kudarikilu, Kamadhoo, Kihaadhoo and Dhonfanu as the PIs; and
In the South Central Region, Gan, from Laamu atoll, was selected as the FI, and Kunahandhoo, Gaadhoo, Hithadhoo and Maamendhoo as the PIs..
Overall Characteristics of the Sample Sites
8. As mentioned in the earlier section of the report, the regions and islands were selected in consultation with the Maldives Ministry of Planning and the Ministry of Finance. Both Laamu and Baa atolls have FIs with potential for development with small satellite islands (primary islands) within the catchments area. Both FIs, Eydhafushi and Gan, with almost the same size of population, have large land mass, secondary education facilities, hospitals, employment opportunities and communication services. Key details of the two atolls are provided below.
9. Approximately 63% of the households in the Baa FI are headed by people between the age of 31-50 years, while within the remaining three categories of islands studied, 51% of the household heads fell within the age group of 31—50 years. And, around 80% of the total heads of households have the basic literacy level or just primary education (Refer Table #1 in Annex 1). The total household expenditure of FIs of the two atolls range from 1500- 3000 Rufiya, while in PIs it range from 500-1000 Rufiya ( Refer Table #2 in Annex 1). Out of the total household expenditure, the largest proportion was set aside for food in Baa FI, while in Baa PI and in FI and PI of Laamu atoll, the largest proportion was allocated for education. In both atolls, the average number of people per household ranged from 8- 6 members per household, with a higher head count in FI households than the PI households. Out of the total number of people in each household in FIs and PIs of both atolls, an average of five people in the age group of 18-60 was seen to be dependent on the household earning member(s), where 22% of the total female headed households and 37% of the total male headed households had only one earning member.
10. The FI in the Baa atoll has a harbor, while the Laamu atoll FI does not have a harbor as yet. People have to come to Funadhoo harbor in Laamu atoll and travel by land to the facilities in Gan. The PIs are relatively close to the FIs ( in the range of 6-10 miles) and the PI population depend on the FIs for the major three services, namely: secondary education, hospital and employment. Thus the PI populations, which are serviced by these FIs, are aware of the various developmental activities within the specific FIs.
11. This section provides a cursory insight into the major findings of the BIA. The information under this section is detailed with operational implications in the section called 'Summary of BIA Findings and Operational Implications'.
Education: All PIs have schools up to grade seven. Secondary education (grade 8 and above) is available only in the FIs. All schools in PIs are community owned and community funded, while schools in the FI are owned and funded by both the government and community. There is a major gap in the level of knowledge content among the teachers in both atolls. 93% of the total number of teachers covered under the study, indicate urgent need for training and upgrading in terms of their knowledge content in order to be able to effectively instruct in English-medium Maldivian schools.
Student Boarding: Over 90% of the total students studying in grade 8 and above live in host houses in FIs, away from their homes in PIs. All categories of stakeholders gladly welcome the proposed concept of multi-purpose boarding houses in FIs. The average cost paid by each student boarder in Laamu atoll ranges from 125 rufiya - 500 rufiya per student, while in the Baa atoll, it ranges from 200 rupiya - 400 rufiya per boarder. Over 80% of the total population educated in PIs expressed their willingness to pay an average cost of 400 rufiya per student for safe, clean and study-conducive boarding houses.
Health: There is no gender and age disparity in availing treatment for both common illnesses and emergency health conditions within households. Among the PI populations, the type of illness determined the choice of the category of health facility and personnel. In the case of health emergencies, unavailability of affordable and timely transport (speed boats, land ambulance services) was identified as the biggest constraint to move patients to the hospitals.
Supplementary Feeding: There is no common knowledge of any past experience in supplementary feeding programs among the communities in both North and South Central Regions. Within the preferred list of programs, the first priority was given to supplementary nutrition packages for pregnant women, followed by supplementary vitamin pills for pregnant women and then for school going children.
Level of Dependency on Earning HH Members: An average of five people in the age group of 18-60 per household was seen to be dependent on the household earning member(s), where 22% of the total female headed households and 37% of the total male headed households had only one earning member. Out of the total dependents per household, an average of three were noted to be females.
Access and Availability of Employment: Weak access to and low availability of employment opportunities are two major constraints leading to current low level of employment within the two regions. Lack of necessary qualifications and access to information on job opportunities create a negative impact on the already weak employment situation within both regions. The proposed development of micro-enterprises and establishment of job search centers are gladly welcomed by all categories of stakeholders.
Age and Gender Disparity in Employment: There is a defined disparity in both age and gender in employment. Seventy five percent of the total workforce fall in the age group between 18-40, and out of the total employed, only 30% are female. The foremost reason for this is the fact that 'resorts and government' are the main employers and they prefer to employ younger populations who meet their qualification requirements. And, the need to live away from the primary residence exacerbates the already existing constraint with regards to employment among the females due to existing cultural patterns.
Requirements and Willingness to Move to FIs: Quality education, health services and employment opportunities are identified as the three major requirements by priority to enable population to move to any given FI. Willingness to move out of their PIs to FIs could be interpreted as a phenomena of the region as only a lower volume of population from PIs in Laamu atoll are willing to move, while a higher volume of people from PIs in Baa atoll were willing to move, if the FIs met their requirements
Service Delivery: Water and electricity services are managed by both government and/or communities in both atolls. Maintenance of the services is the major constraint among the community service providers due to their low level of technical expertise. Effectiveness of community service providers is also largely dependent on the 'community spirit' of the population within the particular island.
Development Committees: Among, the Atoll Development Committees (ADCs), Island Development Committees, Women's Committees, and NGOs, ADCs have been identified as major role players in determining the overall welfare of specific islands. Within this context, the common concern among the PIs visited was that ADCs showed lower concern about the welfare of the PIs. Decisions in the ADCs were often made among the members from the FIs and atoll offices without involving any representatives from PIs, often resulting in the diversion of the majority of available funds to FIs. The proposal to set up Atoll Level Consultative Groups were gladly welcomed by populations from both regions and they provided suggestions to consider while setting up these Consultative Groups.
Summary of BIA Findings and its Operational Implications
12. This section provides details on the major findings of the BIA followed by the operational implications of these findings. For ease in reading, the findings are clustered under each sector.
Type and Level of Schooling in PIs and FIs
13. Within the study sample of both atolls, it was noted that 40% of the teachers are expatriates, 26% are untrained, and 27% are Dhivehi-medium trained teachers. Since, in general, the medium of instruction in schools currently is in English, the Dhivehi-medium trained teachers have to be re-trained in English-medium. Further, many of the Dhivehi-medium trained teachers have entered teacher education at a lower level of general education (grade 5 or 7), and therefore, their knowledge content has also to be upgraded. In essence, 93% of the teachers need to trained or upgraded in terms of their knowledge content (Refer Table #9 in Annex1). Only 7% of a total of 218 teachers in this study sample are sufficiently trained to instruct in English-medium Maldivian schools.
14. The populations in both atolls had very little knowledge / experience with distance learning facilities. The only distance-learning program that these populations were familiar with was the non-formal English language courses through radios. However, when the study team explained about the concept of teaching formal school curriculum through distance learning, it was repeatedly suggested by the participants that such mechanisms could assist in improving the quality of school education, but, only if combined with the regular school system (suggestions included having teachers in classrooms and including distance learning as a component of the overall school system). They were unable to think in lines of anything that was not tangible and repeatedly explained the need for teachers in classrooms to ensure effectiveness. Community meeting in the Laamu atoll, Quote: 'we are not sure how it could be effective in teaching the children in the absence of real live teachers in class rooms to guide them'. It is thus, interesting to note that the opinions of PI and FI communities with regards to distance learning are similar.
15. PIs: All PIs have schools up to grade seven. Secondary education (grade 8 and above) is available only in FIs (Ministry of Education, Maldives). All schools in PIs are community owned and community funded. On the quality of education, over 60% of the total number of schools in PIs do not offer quality teaching due to reasons already stated above. This finding indicates that within the Maldivian context, lower level of educational services are associated with small populations rather than poverty.
16. Further, the current quality of education provided in the PIs up to the grade seven does not often match the quality in the FIs, making the students less competent than the other youths entering higher school grades in FIs. These youths, who have completed grade seven in PIs, do not have any means of further education, nor are they old enough to do any productive work. Community member focus group discussions in Laamu PI, Quote' Poor students in PIs seem to be in a socio-economic vacuum without access to education beyond grade seven, no jobs and no means of getting one either'. Student focus group discussions in one of the Baa PIs, Quote: 'My friends and I are repeating grade seven in our island because our parents cannot afford to send us to FI for higher studies, while we like to continue being in school'.
17. Discussions with the PI population also confirmed that the question relating to the level of Information Technology (IT) among the PIs communities was not pertinent as the PIs visited did not have access to IT facilities and those populations from PIs, who had IT skills were not residing in the PIs. However, from the interview with households in Kihaadhoo (PI) in the Baa atoll, it was noted that there was one computer in the whole island and it was located in the school.
18. FIs: The schools in two FIs studied were community owned and community funded, except two government schools namely AEC in the PI - Eydhafushi in Baa atoll and Qatar Amir School in FI - Gan in Laamu atoll. The Atoll Education Center (AEC) in Eydhafushi has the largest number of students, including students from outside the FI island (40% of the total) (Refer to Table #3 in the Annex1). With regards to Qatar Amir School in Gan, only 22% of the total number of students are from other islands, though there is a boarding facility in Funadhoo for outside students. Discussions with various stakeholders repeatedly brought out that the reason for the low percentage of outside students in Qatar Amir School was that the school is still in its formative years. Community member focus group discussions in PI , Quote 'Increased government school service means more and better job opportunities in the FIs in addition to quality education for our children'. Further, the discussions and interviews also confirmed that graduated youth have no opportunities for training beyond grade 10 or 12 even in the FIs, except in the capital city of Male, where the residential rents are prohibitively high and common people are unable to afford it unless they have family or friends in city, forcing them to make do with what is available in their regional atolls.
19. Information technology (IT) skills are slowly but steadily becoming a common feature among the youth. The government schools promote IT through their computer laboratories requiring the students to work on documents electronically. Specifically, the schools visited in Eydhafushi FI in Baa atoll had computer laboratories, while the schools visited in Gan FI in Laamu atoll had no such facility. Further the 'cyber cafes' in FIs of both atolls encouraged especially the youth, to acquire computer skills. However, the discussions confirmed that IT skills are still underdeveloped among the majority of Maldivian populations. Lastly, in both atolls, there is a disparity relating to age and gender in the current level of IT skills and the patterns of using IT.
20. The above findings suggest:
· Undertaking a nationwide capacity assessment of teachers and initiating training or upgrading of the teachers in terms of knowledge content;
· Supporting long-term training of teachers to enable them to obtain a qualification certificate;
· Expanding government owned and managed schools in the FIs to ensure efficient and quality secondary education to a larger number of students, especially from the PIs within the catchments area
· Establishing initiatives to make distance and open learning packages available to students even in the curriculum subjects. Australian models like the 'School of Indigenous and Distance Education' which uses different modes including satellite and radio could be adapted to the Maldivian context in both FIs and PIs. However, this would require training teachers as a pre-requisite in both FIs and PIs.
· Encouraging all secondary schools in FIs to provide opportunities for IT-skill development by establishing computer laboratories. Further IT skills training could be linked with enterprise development, which is detailed under the section on employment.
Residential Arrangements for FI Students:
21. Over 90% of the total students studying in grade 8 and above live in host houses in FIs, away from their homes in the PIs. Clean and safe boarding houses in FIs, with an environment conducive to learning, was the number one priority of all stakeholders. Out of the total households studied in the PIs of both atolls, 52.8% reported that 51.6% of the total household expenditure was on education. Among the total households in the PIs who had students living in host houses/ boarding houses in the FIs, nearly 90% of their total expenditure on education was to avail residential arrangements for their children in the FIs. Nearly 26% of the total number of children within the households covered in the FIs are boarders from PIs. The average cost paid by each student boarder in Laamu atoll ranges from 125 Rufiya - 500 Rufiya per student, while in Baa atoll it ranges from 200 Rufiya - 400 Rufiya per boarder (Refer Table # 4 in the Annex 1). In addition to the cash payments, the families of the students also sent in kind gifts to the host families. The low cost for boarding in Laamu atoll reflects the cost per student in the boarding house in Funadhoo, which is Rufia125 per student per month.
22. Focus group discussions with students and community members from PIs brought out experiences where students have shifted over three times to secure a safe, clean and learning-conducive host house in FIs. Girls are often preferred boarders in FI host households as they can offer more domestic services than male student boarders. It is also found that female students get a better chance of staying in friends' houses free of charge by simply providing services to the host families (semi-structured interviews and discussions). A women only focus group in the PI in Baa atoll reported that about 50 children from their island are in the FIs. For each child the families are paying an average of 300 Rufiya, plus gifts to keep their child in the FI. The parents also travel frequently to FIs to visit their children living in host houses. The particular PI is about half an hour to one hour by boat to the FI, and a single boat trip costs about 300-400 rufiya. The mothers in the group reported, Quote: 'we are very concerned about our young children 'suffering' on another island with 'strangers' in host houses, where they are not getting the required attention and/ or services of being a guest in the host houses'. They went on to suggest that, a boarding house in the FI with an affordable ferry service at least bi-weekly between the FIs and the PI would assist them greatly. According to the community members, the ferry would not only benefit the students by improving their interaction with their biological family members, but, it will also build and strengthen the social networks among the populations in the PIs and FIs.
23. Over 80% of the total population studied from PIs expressed their willingness to pay an average cost of 400 Rufiya per student and the remaining population were willing to pay an average cost ranging from Rufiya 500-1000 per student, for availing safe, clean and learning-conducive residential arrangements in FIs.
24. All categories of stakeholders confirmed that students from grade 8 and above would benefit most from multi-purpose boarding houses, while the population from Laamu PI said that it would also help the students from grades 1-7 as the quality of education in FIs are better than the current services offered in Laamu PIs. Thus it could be concluded that, the populations gladly support the concept of multi-purpose boarding houses, which cater to the residential needs of students from PIs and training needs of staff from various sectors (such as education, health, IT, etc) during school vacations.
25. However, there was a distinct contrast in the opinion of people from the two atolls, with respect to using student boarding houses as paid accommodations for families of health care seekers coming to FIs from nearby islands. It was interesting to note that, unlike Baa atoll FI population, the Laamu FI community did not agree to use student boarding houses as paid accommodations for families of health care seekers coming to FIs from nearby islands .
26. The findings suggest establishing multi-purpose boarding houses in FIs, built by the government and managed by community members from PIs, to provide safe, clean and learning-conducive residences for the students who are away from their primary homes in the PIs. Within this context, the cost of availing the facilities of multipurpose boarding houses should not exceed 400 rufiya per student implying that the facilities should consider safety, cleanliness and environment conducive to learning as priority, and not luxury. These boarding houses would also provide a venue for workshops and training for staff from various sectors of the specific atolls.
27. Household (HH) interviews and discussions with various categories of stakeholders in PIs and FIs confirm that there is no gender and age disparity in availing treatment for both common illnesses and emergency health conditions within the households.
Table C: The People Avail Treatment in the Households
Who Avails Treatment
Total number of respondents
28. The decision to avail treatment was purely based on the type of illness. The glaring difference in the type of health service facilities in PIs and FIs is that all FIs have doctors and hospitals, while PIs have only health workers and with optional health post facilities. It is interesting to add that there are instances where health workers operated from island offices in PIs, as there were no health posts in these islands .The following paragraphs detail issues relating to treatment of both common illness and emergency health conditions.
Disparity In and Types of Health Facilities to Avail Treatment for Common Illness:
29. Among the PI populations, the type of illness determined the choice of the type of health facility and personnel for the respondents to avail treatment. (See Table #5 in the Annex 1) Community member focus group discussions in PIs of Laamu atoll Quote:' if the illness is normal like fever, diarrhea and cold, we normally go to the health worker as he/she is available and easily accessible within the island itself. It is very expensive to travel to FIs and we have to wait in long queues to see the doctor. Furthermore, many times we come to the FIs in private boats that belong to our friends, thus forcing us to adhere to our friends' schedules. So we prefer to make do with the available help in our resident islands for these common illnesses.' Both discussions and interviews confirmed that there is no tradition of general medical check-ups within both FIs and PIs.
30. The other major factor that determined the choice of the type of health facility and personnel among the PI populations was 'easy access'. Easy access refers to timely and affordable transport services.
31. Population from the FIs always went to the hospital in their island for all types of illness, except when referred to by the FI hospital to go to a hospital in the capital city of Male. Population from FIs never referred to using any health facility other than hospitals or any type of health worker other than the medical doctors in any discussion or interview.
32. The above finding suggests that:
· Provide higher level training to health workers/ personnel on the PIs in order to effectively provide tele-medicine services. With the tele-medicine services, the health worker who is qualified enough could explain the medical condition and be capable to act upon any instruction provided.
· Complement tele-medicine services with health promotion campaigns. Health promotion campaigns are identified as a cost-effective and rapid means to improve health by bringing about changes in the household behavior (see paragraph #39 for details).
Types of Facilities to Avail Treatment for Emergency Health Conditions
33. This section mainly attempts to identify facilities considered priority during emergency health situations. Transport was the highest priority requirement (89 % in Baa and 79% in Laamu atoll) identified for all populations studied. This was followed by emergency monitory assistance on a pay-back basis, and affordable public accommodations in FIs while availing treatment for family members. Community member focus group discussions in PI, Baa atoll. Quote: 'traveling is difficult and expensive'.
Table D: Emergency Health Services Required in the Resident Island
Emergency transport services (e.g. sea plane)
Emergency monetary assistance on a pay-back basis
Availability of accommodation for rent in the islands where services are available
34. People from PIs are forced to hire transport at any cost during emergencies. Some participants from the PIs have cited that there are instances when they have hired transport for emergency requirements even on a daily basis, once in two days or bi-weekly. However, they repeatedly confirmed that it is frequent to hire such transport services at least once a month in many families.
35. In the event of a family member requiring to see the hospital doctors, the PI populations reported to join the monthly trips (organized by the government) from PIs to FIs (capital island) because it is free or use the 'dhoni' (ferry). An average 'dhoni' (ferry) trip costs from Rufia 300/- upwards from a PI to the nearest FI. On many occasions, while using the 'dhoni', PI populations are forced to return from FIs, without treatment because the 'dhoni' schedule did not provide a large time frame between the trips and / or because they were unable to meet the doctor due to long queues and /or other treatment related delays. Further, a girls-only focus group in the FI highlighted the fact that most 'dhonis' are fishing vessels and they had to go fishing everyday, reducing their availability for other needs. This was further confirmed during semi-structured and structured interviews in PIs.
36. Group discussions in PIs (both 18-35 and 36 to 59 age group) strongly voiced the opinion that PIs would benefit more from the services in FIs, if an affordable and regular water transport system is established - a speed launch be kept in the hospital and a 'dhoni' in each PI. They also added that it is not important to consider the weather as a variable to undertake water transport as bad weather is not so frequent in the islands the team visited. This opinion was supported in the individual semi-structured interviews.
37. The above findings suggest that transport for emergency health situations be part of the proposed initiatives within the health sector. Specifically, it would include, speed boats, 'dhonis' for water transport and ambulances for road transport in both PIs and FIs. Ambulances would ensure safe transport of the patient from the residence to the boat and from the boat to the hospital. Ambulance and 'dhoni' services operated privately could be linked with proposed alternate income generation programs for the communities under the project (see page#19 for more details).
Age , Gender and/or Region as the Determinant of the Timing and Composition of Daily Meals
38. Age and/or gender did not determine the number of meals taken by various members of the households. It is a phenomena which relates to the region (interview and discussion with community members). Both FIs and PIs in the North Central region report that in general five meals are typical to a household, while in the South Central region, 3-4 meals are typical to a household. Meals in both regions mainly included sea produce, while in the PIs there were instances where vegetables and fruits were included in their daily consumption (especially in the Laamu PIs). However, the concept of balanced diet is yet to be known among the populations.
39. The above findings suggest that nutritional campaigns could be a recommended strategy to promote cost-effective and rapid means to improve the nutritional status and the general health of any given household. This recommendation is based on the universal assumption that nutrition and general health outcomes are complex and are contingent on many household factors, among which traditional practices rank high. World Development Report (WDR) indicates outreach programs are extremely effective in influencing household behavior regarding balanced diet and proper treatment for common illnesses, resulting in improved general health and diminished malnutrition within households. Successful examples of outreach programs are numerous, of which two are: (i) nutrition campaign in Indonesia leading to an improved nutritional status in 40% of the nation's children; (ii) Oral re-hydration therapy (ORT) promotion program in Egypt leading to 68% increase in use of ORT in one year and a 30% decline in infant mortality in less than one year (Source Nicaragua Poverty Assessment 2000; WDR 1993 and Information, Education and Communication: Guidelines for Health, Nutrition and Family Planning Program).
Supplementary Feeding Programs
40. There was limited knowledge of any past experience in supplementary feeding programs among the communities in both the North and South Central regions. However, the populations from both FIs and PIs showed key interest in initiating such programs. In an attempt to prioritize various programs, it was noted that in both FIs and PIs of the two regions, the first priority was given to supplementary nutrition packages for pregnant women, followed by supplementary vitamin pills for pregnant women and then for school going children (Refer Table # 6 in Annex 1).
41. The above finding suggests further investigation of experiences on supplementary feeding programs in other parts of the country and to propose a strategy to pursue it within the country's social policy and expenditures.
Age and Gender Disparity in Employment
42. The two regions indicate age and gender disparity in employment. With regards to age, the two regions reflect a very young workforce. Over 75% of the total workforce is noted to fall with the age group 18-30 years, when the average age of male household heads is 31 -50 years, and the average age of female household heads is below 40 years of age. The major reason contributing to the disparity in age is that among the variety of jobs available in FIs and PIs, 'resorts and government' are identified as the two primary employers (Refer Table # 7 in the Annex 1), and they prefer to employ younger populations because they meet their qualification requirements (see below Tables E and F).
43. Further, with regards to gender, only 30% of the total employed are women. (Refer below Table G), strongly indicating a gender disparity within these two employment opportunities. This is mainly because the female youths (especially unmarried girls/women) are often not permitted by their family elders to take on employment that require them to stay away from their primary residences, except in cases where extended family, friends and /or other social network connections are present in those islands that offer employment Thus, the low employment rates among the female youths could lead to stagnation of the current level of household welfare. The correlation between low levels of employment among the female youth and household welfare is based on the universal assumption that educated and employed mothers contribute greatly towards household welfare rather than uneducated and unemployed mothers. Discussions with all stakeholders confirm that the rate of employment would increase, if more jobs were made available in their resident islands.
Table E: Ten types of Jobs with Highest Employment Rates
Type of Job
Number of people employed
government job/ civil service/servant
Carpentry/masonry (carpenter; mason; carpenter/mason)
self employed/ private
% out of a total of 548
60 & abv
44. The above findings clearly suggest:
· Alternate employment opportunities to suit the current needs and skill levels of various age groups of both male and female populations (such as employment in agriculture, marine produce etc) could be an approach to address this issue within the current socio-economic context (more details on alternate employment in page# 19).
Availability and Access to Employment
45. Out of the total population studied, only 27. 42 % of the population were noted to be employed. 'No jobs' was the common complaint from all discussions and interviews conducted in both regions, though the communities confirmed that FIs provide more job opportunities than the PIs. Some of the major reasons contributing towards increased job opportunities in the FIs were identified as: (i) availability of communication services; (ii) (ii) presence of atoll offices; (iii) variety of businesses; and (iv) presence of National Security Service. This finding tends to lean towards the assumption that lower levels of employment opportunities are associated with small populations within the Maldivian context, rather than with variables such as poverty, social context, geographical isolation (as the land mass of FIs and PIs are equally isolated from each other, with few exceptions).
46. The household interviews confirm the results from discussions with stakeholders that there is a high level of dependency on the earning members within each household. For instance, considering both FIs and PIs in the two atolls, an average of five dependents in the age group of 18-60 years have been identified within each household. And, out of the five dependents, an average of three, were females within each household. This shows negative implications on the household welfare, especially when 22% of the total female headed households and 37% of the total male headed households studied had only one earning member within its respective household, thus making the issue of dependency even more critical.
47. Among the various reasons, three most repeated were the non-availability of jobs within the islands, followed by the 'non-availability of desired types of jobs' and the lack of necessary qualifications for the jobs which are available. These reasons were especially pertinent to PIs in both Baa and Laamu atolls (Refer Table# 8 the Annex 1).
48. There was no experience or general knowledge with regards to micro-enterprises in both atolls. However, when the study team explained about micro-enterprises to the communities, and then enquired about their preferences with regards to the type of micro-enterprises, there was a clearly defined regional difference in their choices. The population from Laamu atoll preferred enterprises relating to agriculture and fisheries, while population from Baa atoll preferred enterprises relating to non-farm activities.
49. The discussions and interviews repeatedly indicated that access to information on job opportunities was as important to the populations of the two atolls, as the availability of employment. Both these factors pose major constraints within the Maldivian context. Radio was the current primary source of information on employment in both FIs and PIs, followed by friends and newspapers. The discussions and interviews with participants confirmed the need for access to information on employment opportunities especially to provide a forum for selection of jobs among the populations. To date, the Maldives Ministry of Human Resources and Labor is the only organization that maintains an electronic site on availability of employment opportunities. The proposed idea of job centers was greatly welcomed by over 90% of the interviewed populations and this was further supported in group discussions/meetings
Table H: Opinions on Level of Usage of Proposed Job Centers in FI s
50. The above findings on unavailability of jobs suggest the following:
· Support the proposed creation of micro-enterprises to enable increased employment levels among the populations. The proposed idea should be undertaken in the light of creating enterprises that suit the current socio-economic situations. Two types of enterprises could be considered, one which could employ the populations immediately rather than requiring them to undergo training for long periods of time (such as 6 months to one year). This is mandatory in order to provide the necessary 'pull' into employment, especially among the current household heads who reside in agricultural islands and have technical expertise in handling agricultural and marine produce jobs. The initiative should be complimented by required infrastructure such as storage facilities for agricultural and marine produce, as all stakeholders repeatedly brought out the issue of agricultural and marine produce wastage due to lack of storage facilities in the production islands. However, individual / community contributions such as cash, and /or venue, and or labor towards these enterprises should be made mandatory to ensure ownership and sustainability.
· Initiate younger graduates (18- 25years of age) into the enterprises through a series of free training programs. The training will make them technically competent to undertake enterprises, which could compete in the global market rather than only within Maldives. However individual / community contributions such as cash, and /or venue, and or labor towards these enterprises should be made mandatory to ensure ownership and sustainability. The location of these enterprises need not be restricted to PIs, as the discussions clearly confirmed the willingness of large sections of populations to move out of PIs, if job opportunities are available (this was especially pertinent to PI population from Baa atoll).
· Establish job search centers in FIs that would ensure a successful strategy to inform populations on the various types of available jobs. These job search centers could also put up a separate department called ' enterprise development' to provide information on successful experience in developing various types of micro-enterprises) around the world.
Future Focus Islands
51. The current list of focus islands (FI) are proposed to become centers offering people an alternative to Male, the capital region ( please refer Project Concept Note for details)
Services Proposed by PIs as Mandatory in FIs
52. Schools with qualified teachers was the first priority need in FIs, for both Laamu and Baa atolls, followed by health services. With regards to third priority, Baa PIs chose housing, and Laamu PIs chose employment. Discussions were undertaken to further understand the basis for this difference. The discussions confirmed that the dearth for housing in Eydhafushi was the major reason that contributed to people's request for housing in the Baa atoll. Furthermore, the population who moved to FIs from PIs in Baa atoll in search of employment aggravated the already existing housing scarcity in Baa FI, unlike in Laamu atoll, where majority of PI population stayed back in their resident islands as their main occupation was in agriculture. However, stakeholders repeated that although employment was listed as the third priority in the household interviews in Laamu atoll and fourth in Baa atoll, employment is still a 'major priority' especially among the PI populations of both atolls
Table I: Services Necessary to be Found in a Focus Island
Other: transport services
53. The findings strongly suggest urgency in improving the access to and availability of education and health services in the focus islands. The strategy with regards to improving employment opportunities, refer to earlier section on 'employment'.
Current Frequency and Reasons of Movement Between PIs and FIs Versus Willingness to Move from PIs to FIs
54 The current level of frequency and reasons for movement from PIs to FIs in both regions were noted to be similar, though the issue of moving permanently from PIs to FIs showed a clear difference between the Laamu and Baa atolls. Both populations confirmed that they traveled to FIs mainly for educational requirements for their children or for themselves, and/or for employment reasons, and/or to access health facilities, strongly suggesting that the age group of the people who traveled out of PIs to FIs were largely the younger population. With regards to gender disparity, it was noted that the number of women who traveled to FIs was lower than the men as women normally traveled to FIs only for health and social reasons (which is not as frequent/regular as for education /employment ).
55. It was also noted that a large proportion of the total household expenditure within the PIs and FIs was spent on telephone services, to contact family and friends in other islands. The population who had relocated to FIs for employment reasons continued to send cash gifts at least on a monthly basis to their biological families residing in their primary islands. Lastly, in the case of persons who have moved to FIs to set up families through marriage, mentioned that they traveled to and fro from PIs to FIs for social reasons within their respective families, and went on to repeatedly bring up the issue of unavailability of timely and affordable transportation which posed as the major constraint. It was thus concluded by the participants that people would more frequently travel to FIs and travel out of PIs for both social and economic reasons, if timely and affordable transport was available to them. A community member from a PI in the Baa atoll Quote 'we try to reduce unnecessary travel because the transport is expensive and we are forced to limit our travel requirements for those issues for which we cannot do without. In this way we often miss out especially on many social events in FIs and are also forced to limit the interactions with populations from'.
56 84% of the total population studied in PIs of Baa atoll confirmed that they would gladly move or move with limited reservation to FI , if their priority needs were met. However, in the Laamu atoll only 45% of the total population indicated that they would move to FI gladly or with limited reservation. (see below Table J) because, according to them the soil in the PIs in the Laamu atoll was extremely good for agriculture, though they currently faced some constraints due to limited infrastructure. Laamu atoll populations confirmed that they still would like to continue staying in PIs and improve their agricultural initiatives with some form of technical assistance, rather than move to FIs. Quote 'I started a papaya farm here and now I make over Rufiya 15,000 from every crop harvest. I would like to stay and tend to my papaya cultivation which I have grown with much care'(semi interview with a female community member in Laamu atoll PI).
Table J : Opinions on Relocating to FI Permanently
Would you move to FI
57. These findings suggest that the establishment of multi-purpose boarding houses in FIs will contribute towards changing the attitude among the younger generation who live in FIs for continued period of time as it would gives them ample opportunities to realize the advantages of residing in FI and to also establish various levels of social networks with the FI populations. Further, the increased availability of employment opportunities in FIs will provide the additional 'pull' to the populations from the PIs into the FIs. The long-term interaction with the FI populations appears to be the major option to bring about the attitudinal change within the populations of PIs.
Impact on Social Capital Due to Relocation to FIs
58. Nearly three percent of the total households studied in FIs of both atolls reported that one of the household heads had shifted from a nearby PI to the FI. Over 60% of these household heads had come to the FI to set up families through marriage, and the remaining 40% had shifted for employment reasons. The populations who had shifted from PIs, and the original residents of the FIs confirmed that they had a positive impact on their social capital networks due to the move to FIs. They made new friends (100%), established relations with families through marriage (60%) and had become members in various social groups (17%). No one talked about negative impacts on their social capital due to their relocation to FIs. This question was asked only to the FI populations.
59. The finding suggests creating opportunities for interaction of the populations between PIs and FIs through increased employment opportunities in FIs, setting up of multi-purpose boarding houses and establishing timely and affordable transportation within various islands in the atolls.
Capacity in Service Delivery
60. In both atolls, water and electricity services are managed by government and/or communities. In the Laamu atoll, communities managed both services in FIs and PIs, while in the Baa atoll, government managed services in FIs and communities managed services in the PIs. Within this context, the term 'community' refers to island development committees, cooperatives and associations. Laamu atoll, in general, provides a good practice example of community involvement in delivery of services in the PIs. For instance, there are examples of efficient and effective electricity service delivery by communities using generators with loans provided by the government. The common constraint identified by the participants in service delivery mechanisms was the low level of the technical know-how among the community based service providers. Many community service providers indicated that they had no formal training before undertaking the job. There were instances where the community service providers in PIs had to bring technical experts from Male to address the mechanical problems in their respective islands. The other major finding was that the capacity and effectiveness in community-based service delivery mechanisms depend largely on the 'community spirit' of the population within the islands.
61. With regards to Atoll Development Committees, the participants from PIs repeatedly brought out the issue that these committees were not concerned about the welfare of the PIs, and often the members from the FIs and atoll offices took decisions without involving any representatives from PIs, resulting in the diversion of the majority of available funds to FIs. Further, it was also noticed that few participants from PIs were not even aware of such committees. In general, however, participants felt that if managed well, these committees could make a defined impact on the welfare of both PIs and FIs, and the proposed idea of setting up atoll-level consultative groups were welcomed in all discussions
62. The Island Development Committees (IDCs) were present in all islands, and there was a distinct difference in the level of their effectiveness from island to island. This reflected the effectiveness of these committees largely depended on the 'community spirit'. IDCs were noted to be primarily engaged in development activities, and supported communities in various tasks. Community members were fully aware of IDCs. However, the discussion did not attempt to capture more on the specific activities of IDCs within each island, given the understanding that a proposed Atoll Consultative Group would be established to better link government with communities and to oversee the community needs and priorities.
63. Women's Committees (WCs) were present in all islands, except in one PI in Baa atoll. They were active in both development (specially in the area of health) and employment generation programs. For example, the WC in one of the PIs in Laamu atoll grew a large field of papayas and chilies using funds collected from community members and from the local island agencies. The funds received from the produce were used for community development activities, such as augmenting the number of teachers available to the community. WCs are well accepted and regarded by community members of both atolls.
64. With regards to NGOs in particular, majority of the organizations were noted to be dormant and with limited activities, thus the study team was not able to gauge their level of acceptance within the communities within the limited timeframe. The NGOs who were functional were mainly involved in some form of social activity, of which fund raising for particular community causes through entertainment was one of their major activities. However, it was observed that only approximately 2% of the total population studied had heard about the NGO activities and discussions with the communities or interview results do not indicate any negative remarks with regards to the presence of NGOs in their communities nor of their activities.
65. The above finding suggests a strategy, which incorporates components of community suggestions. The strategy urges a three-step approach:
· undertake an in-depth assessment of ADCs, IDCs, WCs and select NGOs in order to determine: (i) the available type and level of capacity of each group; (ii) their current role and interest in community welfare, and (iii) a participatory development plan for service delivery in each island;
· carry out necessary capacity building programs to strengthen relevant stakeholders to effectively participate in the development plan for service delivery in each island; and
set up Atoll Level Consultative Groups by supporting them with policy guidelines and by developing a well defined organizational structure for these groups with participation from government, Bank and the respective communities. The atoll level consultative group should ensure: (i) gender sensitivity; (ii) representation from categories of population, including youth, adults and senior citizens; and (iv) transparency in all its decisions and activities to the whole community. The atoll level consultative group, in the opinion of the study participants, can oversee the activities of the various groups in each island and provide a forum for discussing their constraints, achievements and sharing of good practice examples. Additionally, they could also help by transmitting community priorities to higher government authorities to scale them up within public sector interventions, and provide a channel for macro-level social and policy environments to positively impact the service delivery within each atoll.
66. The study findings strongly urge implementation of the first and second step of the strategy before launching the atoll level consultative groups.
NOTE: The BIA fieldwork was implemented in a period of 35 days (July 24 - September 01, 2003). We recognize the gaps in the above section on 'service delivery'. This is due to the limited discussions with relevant stakeholders on this topic as it was required to complete the BIA within the proposed timeframe in order to maintain the project schedule. It was thus necessary to conduct BIA during the monsoon months, which posed great difficulties to access various committee members.
Qualitative Monitoring and Evaluation Strategy
67. Given the output based nature of the overall monitoring and evaluation strategy of the project, the BIA suggests a participatory approach with qualitative indicators to promote accountability of service providers, thus complimenting the overall strategy. The approach promotes a working partnership between the government and community institutions (proposed 'atoll level consultative groups') in undertaking the monitoring and evaluation efforts. The study recommends implementation of 'gendered score cards'.
68. 'Gendered score cards' are instruments to exact public accountability by soliciting user perceptions on the quality, efficiency, and adequacy of the various public services that are funded by tax payers. They add value by identifying and developing a database on the impact of proposed activities on both genders. Within this context, 'public services' would include education, multi-purpose boarding houses, health and employment within each atoll. Score cards bring forth information on user(s) access, usage and quality/reliability of these services, which are some of the key components of measuring an output in a qualitative manner. The insights derived from these cards are useful in understanding the degree to which the services are reaching the target groups, the extent of leakages and also factors that contribute to such misdirection of resources and services. They help identify physical availability, quality and cost factors that constrain the access to, and the use of services by the poor, and the possible means to rectify the situation. Report cards on Bangalore's public services and Filipino citizen report cards on pro-poor services provide two good practice examples.
69. Information for scorecards will be gathered through household interviews with sample populations within each atoll, implemented by a team with representation from relevant stakeholders. The interviews would be carried out every year on a random sample of households within randomly selected FIs and PIs of specific atolls. The interview checklist will include few indicators on each service delivery against which individual ratings will be made.
70. The responsible agency and the methodology for implementing the score cards is recommended to be further discussed, detailed and finalized in collaboration within the monitoring and evaluation (M&E) strategy of the whole program. The information from the scorecards will feed into the overall M&E of the project.
71. The M&E will be carried out on three parameters within the four public service variables: (i) education; (ii) multi-purpose boarding houses, (iii) health, and (iv) employment. The ratings will be generated addressing both male and female beneficiaries. The ratings will include the following: (i) not satisfactory; (ii) satisfactory; (iii) fully satisfied.
72. Specifically, the parameters and variables are given below.
Access ' access to primary and secondary education in all FIs' as the indicator
Usage ' eligible respondents sending children to primary and secondary school in FIs' as the indicator
Quality/reliability ' full satisfaction with the performance of teachers in the primary and secondary schools' as the indicator
Muti-Purpose Boarding Houses
Access ' access to multi-purpose boarding houses in all FIs' as the indicator
Usage ' eligible respondents sending children to boarding houses in FIs.' as the indicator
Quality /reliability 'level of satisfaction with the type of management and environment within the boarding houses' as the indicator
Access ' access to desired types of health facilities including pharmacy in FIs and PIs' as the indicator
Usage ' eligible respondents using the desired types of health facilities in FIs and PIs' as the indicator
Quality /reliability ' level of satisfaction with type of health staff and services in FIs and PIs' as the indicator
Access ' access to employment in the desired location' as the indicator
Usage ' eligible population fully employed' as the indicator
Quality/reliability 'level of satisfaction with the type and location of available employment opportunities' as the indicator
 Total number of households covering both atolls is 1,730 out of which 1,443 are occupied , with a total population of 10,023
 Please note that Gan was in the top list of focus islands provided by Ministry of Planning and was recommended as a sample FI for study by all stakeholders
 island in Laamu atoll, close by to Gaan and connected by bridge to Gan.
 Bangalore is in Southern part of India
© Dhivehi Observer 2004