EL SALVADOR

	FY 1998 Actuals	FY 1999 Estimate	FY 2000 Request
Development Assistance	$23,152,000	$20,050,000	$23,300,000
Child Survival & Disease Fund	$10,881,000	$11,616,000	$10,645,000
Economic Support Funds	$1,000,000	$2,000,000	$5,000,000
P.L. 480 Title II	$1,623,000	$2,259,000 *	---
* includes emergency food aid in response to Hurricane Mitch

Introduction

Recent history has demonstrated the impact that political and economic instability in El Salvador have on its neighbors, including the United States. El Salvador alone has sent more illegal immigrants to the United States than all of Europe, Asia and Africa--a phenomenon that would likely be repeated if political and economic instability returned. USAID support for economic growth with greater equity is designed to prevent that eventuality by giving Salvadorans a stake in a peaceful and prosperous future. Equally important is the country's role in facilitating regional cooperation in the fight against international crime, the expansion of economic opportunities for U.S. companies, regional integration, and environmental protection.

The Development Challenge

While El Salvador continues to progress toward sustainable development and democracy, its graduation from U.S. assistance is not imminent. The need for continuing efforts to consolidate democracy and alleviate poverty are more evident during this election year. While electoral experience suggests that the forthcoming March 1999 presidential elections, and the March 2000 municipal and legislative elections will be free, fair and transparent, low voter turnout indicates that other factors still discourage great voter participation. Moreover, the high rate of violent crime continues to be a major concern, reflecting weaknesses in the rule of law.

Many faces of rural poverty still grip the nation. Nationally, 35 infants die for every 1,000 live births, a rate three times that of Costa Rica. The literacy rate is the fourth lowest in the hemisphere; fewer than 50% of Salvadorans graduate from sixth grade. The second-highest population density in the hemisphere exacerbates already severe environmental degradation. Virtually all natural surface water is contaminated with sewage, agricultural runoff, industrial waste and sediment -- with consequent impacts on human health and environmental stability. A rural population growth rate of 3.0% (2.1% nationally) and lack of economic opportunity in rural areas are major forces behind the high rural-urban migration rate, and contribute to the high annual exodus to the United States of 20,000-25,000 legal and illegal immigrants. A 1997 study found that 26% of Salvadoran adolescents, the highest percentage in Latin America, had parents who lived in other countries.

In late 1998, flooding and landslides in El Salvador caused by Tropical Storm Mitch resulted in 374 persons dead or missing, and 55,864 displaced. Twelve of the country's fourteen departments suffered significant damage, but the hardest hit areas are in low-lying coastal zones. Roughly 163,000 acres were flooded and three major bridges crossing the Lempa River were swept away, restricting access to the eastern part of the country. The GOES estimates the total damage at $282 million.

This was the worst natural disaster in El Salvador since the 1986 earthquake, which killed 1,000. The greater loss of life and property from the earthquake was due to its direct impact on heavily congested urban areas of San Salvador. The flooding, by contrast, was felt most in rural areas, including some of the poorest in the country. These were also areas where people affected by the war had been recently resettled, ex-combatants had been given land, and many land-reform cooperatives are located.

While El Salvador was spared the widespread destruction wrought upon Honduras and Nicaragua, the storm exposed the fragility of El Salvador's environment and highlighted the devastating impact of natural disasters on the rural poor. USAID responded with $123,451 in emergency relief supplies and a $1 million grant to CARE International to restore potable water services. By January 30, 1999, CARE had cleaned or reparied 2,800 wells and rehabilitated 3,200 latrines.

In FY 1998, USAID continued to implement its six-year rural poverty alleviation strategy by pursuing four inter-dependent strategic objectives in economic growth, democracy, health and water. Achievements to date have been impressive. Several of these, captured by the 1998 Demographic and Health Survey, show that infant and child mortality rates and malarial cases have dropped dramatically over the past 20 years -- largely a result of USAID's leadership as the largest donor in the health sector. Numerous other survey data illustrate the gains achieved. For example, between 1998 and 1998, 99,000 more people have potable water and 82,000 more have sanitary latrines; acute respiratory infections decreased from 59.4% to 33.4%; the total fertility rate dropped from 3.83 to 3.54 children per woman, and bouts of diarrhea nationwide decreased by more than four percent. USAID's emphasis on decentralizing the health sector is also showing results: the Ministry of Health has agreed to hire 240 additional rural health promoters as well as contract non-governmental organizations (NGOs) to provide basic health services in rural areas, thereby expanding coverage from 67% to 87% of rural communities over the next three years.

The USAID focus on decentralization has helped El Salvador in several other sectors. With the utilities and telecommunications industries now privatized, they are poised to expand services into rural areas. The municipalities received six percent of the national budget this year and programmed much of it into needed infrastructure improvements, that were identified and prioritized by local citizens. Finally, with a successful decentralized model for basic education in place, USAID is now turning its attention to early childhood and family education.

In 1998, El Salvador's external debt was one of the lowest in Central America, both in absolute terms ($2.556 billion) and as a percent of gross domestic product (21%). Multilateral creditors hold 73% of the debt. Debt to the U.S. government was $337 million after the United States, in 1993, forgave $471 million under the Enterprise for the Americas Initiative and rescheduled another $155 million.

Other Donors

The United States continues to be the largest bilateral donor in El Salvador, followed by Japan, Germany, Spain, the Netherlands and Sweden. The Inter-American Development Bank (IDB) remains the largest multilateral donor, and is focused on social sector reforms, local development, the environment, promoting private investment and improving public sector efficiency. Other multilateral donors include the World Bank, the European Union and the United Nations Development Program.

FY 2000 Program

In FY 2000, USAID will continue to pursue its six-year rural poverty reduction strategy begun in FY 1997. It will expand access and opportunities for poor, rural families to participate in and benefit from El Salvador's growing economy. One activity will work with cooperatives and other rural organizations to promote the cultivation and marketing of organic crops. USAID will complete ongoing efforts to assist communities that received land under the Peace Accords to parcel the land and secure individual titles for their members. Another activity will support policy reforms to privatize, decentralize and develop policy options to combat rural poverty. Others will expand access by the poor to credit through microfinance lending and provide targeted training opportunities that support the overall strategy. Finally, building on past successes in the education sector, USAID will work with local NGOs and government institutions to increase the awareness of child-raising practices and improve the skills of those who care for young children.

USAID will deepen democracy in El Salvador by helping Salvadorans to develop more inclusive and effective democratic processes. A new activity will increase citizen awareness and participation in democratic processes. USAID will continue to strengthen key institutions such as the Human Rights Ombusdman's Office and the prosecutors' and public defenders' offices, which began to implement the new criminal codes in 1998. Other ongoing activities will upgrade the administrative capacities of municipal governments and strengthen citizen involvement in local and national government.

USAID will help Salvadorans expand the coverage of health services in rural areas, especially for women and children, and to enhance the sustainability of those services. USAID will continue to support the Government of El Salvador and NGO health providers to provide basic preventive health care services to reduce child and maternal mortality in rural areas. These approaches will be complemented by policy reform to encourage greater attention to the needs of rural areas and to implement more cost-effective approaches to delivering health care.

USAID will work with the Government of El Salvador and private institutions to increase access to clean water by rural residents. USAID will support efforts primarily at the municipal and community levels to strengthen municipal management of watersheds, increase citizen involvement in addressing water problems and protect water sources. These actions will be complemented by targeted support for policy reforms at the national level to support decentralization of local water resource management, improve waste-water management, and establish and enforce water quality standards. In addition, community-based water distribution systems will be installed or rehabilitated, and complemented by health education, to reduce water-borne illnesses.

Additionally, to address the damage wrought by Tropical Storm Mitch, with additional funding, USAID proposes to begin in FY 1999 a reconstruction program that will rehabilitate key productive infrastructure, including many tertiary rural roads necessary for moving produce to market, and to target food and agricultural assistance to the most affected communities. USAID will also continue to focus priority attention on restoring potable water and sanitation services, and to mitigating flood-related diseases. To provide basic public services, it is necessary to rehabilitate public infrastructure, especially clinics and schools. The public's heightened awareness of the devastating impact of natural disasters provides an important opportunity to redouble efforts to strengthen El Salvador's disaster prevention preparedness through education, flood control measures, improved watershed management and improved capacity to assess damage. All of these activities complement or intensify USAID's ongoing efforts in these areas.

EL SALVADOR

FY 2000 PROGRAM SUMMARY *
($000s)

USAID Mission Director: Kenneth C. Ellis

USAID Strategic and Special Objectives	Economic Growth	Population & Health	Environment	Democracy	Human Capacity Developmnt	Humanitarian Assistance	TOTALS
S.O. 1 Expanded Access and Economic Opportunity - DA - CSD - ESF	8,500 --- 3,000	--- --- ---	1,600 --- ---	--- --- ---	--- 3,500 ---	--- --- ---	10,100 3,500 3,000
S.O. 2 More Inclusive and Effective Democratic Processes - DA - ESF	--- ---	--- ---	--- ---	4,800 2,000	--- ---	--- ---	4,800 2,000
S.O. 3 Sustainable Improvements in Health of Women and Children Achieved - DA - CSD	--- ---	4,000 7,145	--- ---	--- ---	--- ---	--- ---	4,000 7,145
S.O. 4 Increased Access by Rural Households to Clean Water - DA	----	---	4,400	---	---	---	4,400
Totals - DA - CSD - ESF	8,500 --- 3,000	4,000 7,145 ---	6,000 --- ---	4,800 --- 2,000	--- 3,500 ---	--- --- ---	23,300 10,645 5,000
* R4 FY 2000 Request

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ACTIVITY DATA SHEET

PROGRAM: El Salvador
TITLE AND NUMBER: Expanded Access and Economic Opportunity for El Salvador's Rural Poor Families, 519-SO01
STATUS: Continuing
PROPOSED OBLIGATION AND FUNDING SOURCES: FY 2000: $10,100,000 DA; $3,500,000 CS; $3,000,000 ESF
INITIAL OBLIGATION: FY 1997 ESTIMATED COMPLETION DATE: FY 2002

Summary: The long years of conflict and economic stagnation that El Salvador experienced in the 1970s and 1980s severely deteriorated living standards for the country's urban and rural poor. In contrast, the peace process and ambitious economic and social sector reforms consolidated during the 1990s have raised incomes, reduced unemployment, and expanded access to higher quality primary education. Since the chief beneficiaries of economic growth and social spending in El Salvador have been the urban poor, USAID now directs its programs to expand access to financial services, markets, education and infrastructure for rural households so that they may better participate in and benefit from the strengthened Salvadoran economy.

USAID policy dialogue emphasizes that the Government of El Salvador (GOES) must do more to distribute the benefits of economic growth to the rural poor, especially through infrastructure investment and greater availability of social services in rural areas. Hence, USAID's other activities complement these policy reform objectives by giving rural poor households better access to credit, technology, education and training, to help raise their incomes. USAID seeks to strengthen service providers that work with the rural poor, with the objective of expanding household income opportunities and making service provision sustainable. For example, USAID works with NGOs and credit cooperatives to increase access by the rural poor to credit and secure savings, and to technology and marketing services. USAID is also collaborating with the Salvadoran Institute for Protection of Minors in a new initiative to expand access to early childhood education in rural areas, and is providing small grants to rural communities for vital infrastructure such as roads, bridges, schools and health clinics.

Key Results: USAID is working to achieve five key intermediate results, essential to expand opportunity and access for rural poor families. These results are based on increasing access to (1) education and training; (2) secure land titles; (3) marketing, technology, and financial services for rural producers; 4) infrastructure; and (5) a supportive policy environment.

Performance and Prospects: Performance over the past year has reached expectations, despite several implementation delays that affected the start-up of new activities. New activities in early childhood education, microfinance and agriculture are expected to demonstrate initial results by late 1999.

In the policy arena, USAID has contributed to several significant reform processes. On the rural infrastructure side, USAID has stimulated a productive debate on municipal finance, and is assisting pilot municipalities in designing tax reforms that will help raise more funding for local infrastructure. USAID works with the government to implement its subsidy program to guarantee rural access to power and telephones in the newly privatized market. USAID has also contributed to a process of local NGOs and credit cooperatives participating in the development of new banking laws; one result is that the National Assembly is now considering legislation that would provide microfinance NGOs a means to be recognized by the formal banking sector.

Policy reforms facilitate the USAID activities that work directly with rural producers. USAID-supported microfinance institutions have opened access to credit for approximately 33,300 borrowers, from predominantly rural and poor households. Since 1997, USAID partners have provided marketing and technology services to 50,471 producers. A total of 548 properties transferred to Peace Accords beneficiaries have been subdivided into 11,614 secure individual titles. Now in its final year, USAID's groundbreaking primary education activity has provided textbooks, improved curriculum and better trained teachers for all Salvadoran schoolchildren; in rural areas, testing shows improved educational attainment has resulted from USAID investments. During FY 1999, USAID will award grants to an estimated 35 rural poor communities to implement infrastructure activities that they designed themselves.

Possible Adjustment to Plans: No changes to the current strategy are being considered. However, USAID is considering to significantly expand its support for infrastructure activities to help El Salvador recover from the damage caused by Tropical Storm Mitch. This would include increased funding for community-initiated activities in the hardest hit areas, and for rehabilitating rural market roads and drainage canals. These activities will be complemented by additional assistance to poor farmers whose crops were destroyed by the floods, and by funding for school textbooks and supplies damaged or destroyed in the flooding. USAID is also considering working with NGOs to introduce housing designs that are more appropriate for the country's flood-prone regions.

Other Donor Programs: Active international financial institution programs of the InterAmerican Development Bank and the World Bank provide significant resources to El Salvador in education, infrastructure, land registry, microfinance and economic policy. Many bilateral donors are also present. USAID assistance is directed to (1) providing seed financing in innovative areas where other donors are not yet present, but which have great potential (e.g., early childhood, formalization of microfinance NGOs); and (2) helping to leverage the efforts of players outside the central government to participate more fully in rural development, in particular local government and sustainable local NGOs. USAID coordinates with the aforementioned donors to support the GOES in setting a policy framework that is conducive to reducing rural poverty.

Principal Contractors, Grantees or Agencies: Current grantees and contractors include the U.S. firms Chemonics, Harvard Institute for International Development, Development Alternatives Inc., Development Associates, and DevTech Systems Inc.; GOES agencies such as the Ministries of Education and Agriculture; and an array of local and U.S.-based NGOs, including CARE, Catholic Relief Services, the Cooperative League of the USA, the World Council of Credit Unions, the Foundation of Entrepreneurs for Educational Development and the Ungo Foundation.

Selected Performance Measures:

	Baseline	Target (2000)	Target (2002)
Rural population with children aged 7-10 attending school	79.4% (1995)	85.5%	88.1%
No. of male/female customers receiving services (i.e.manage- ment, agricultural technical assistance, bulk input supply, processing or produce marketing)	28,594 m (1996) 7,856 f (1996)	55,000 m 7,500 f	70,000 m 10,000 f
GOES investment budget allocated to the poorest departments	2.8% (1995)	4.9%	6.0%

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ACTIVITY DATA SHEET

PROGRAM: El Salvador
TITLE AND NUMBER: More Inclusive and Effective Democratic Processes, 519-S002
STATUS: Continuing
PROPOSED OBLIGATION AND FUNDING SOURCES: FY 2000:$4,800,000 DA; $2,000,000 ESF
INITIAL OBLIGATION: FY 1997 ESTIMATED COMPLETION DATE: FY 2002

Summary: By the beginning of the strategy period in 1997, most of the structural and organizational changes to key democratic institutions mandated by the Peace Accords had been effected -- the Office of the Human Rights Ombudsman and a new national civilian police force were established, and reforms to the appointment process and terms of office for Supreme Court magistrates had significantly depoliticized the judicial branch and strengthened its independence. These structural changes alone, however, merely set the stage for the much more profound transformation of El Salvador's legal and political system, which will take at least the next decade to achieve. USAID is supporting Salvadoran efforts to strengthen democratic processes, increase citizen participation and improve the quality of governance. USAID is directing its efforts toward ensuring that all Salvadorans, especially women and minors, have access to effective legal and judicial protection.

Key Results: USAID considers four key intermediate results as necessary for achieving this objective: (1) in the area of legal protection, significant improvements in the level of citizen confidence in the judicial system, resulting from an improved legal framework and reduced average processing time for criminal cases; (2) in 18 selected municipalities, establishment of broadly representative local development committees, preparation of community development plans, and an increase of at least 50% in local tax revenues invested in public works or other priorities established in the community development plan; (3) establishment of a new civil registry and issuance of new identity/voter registration cards to 3,000,000 adult Salvadorans; and (4) a more vibrant, better informed and active civil society involved in national and local decision-making processes.

Performance and Prospects: Performance has generally kept pace with targets established for USAID's municipal development and citizen participation activities, the establishment of the new civil registry, and judicial training to facilitate implementing reforms to criminal legislation, which entered into force in the spring of 1998.

USAID catalyzed support for the drafting and passage of important criminal justice system reforms. To facilitate implementation of the new criminal procedures and sentencing codes (which took effect in April 1998) and to expand citizen access to them, USAID helped purchase equipment to establish public defender and prosecutor offices in each of the country's 14 departments. USAID also delivered specialized training for judges, prosecutors and public defenders in formulating oral trial court arguments, interviewing witnesses and in following trial court procedures. During 1997, 4,500 community, municipal and non-governmental organization (NGO) leaders participated in new criminal legislation training. USAID expects that data on 1998 performance, not yet available, will show continued improvements over 1997, when more than 19,000 backlogged cases were brought to closure and the Public Defender's Office provided 8,000 individuals with free legal counsel.

During 1998, USAID continued to strengthen democratic local governance. It made grants to nine Salvadoran NGOs to help form local committees to develop and implement local development plans in concert with the elected municipal authorities. In all of the 18 municipalities where USAID provides technical assistance for municipal services administration, mayors held at least one public forum to present and discuss the 1998 budget, and are consulting on priorities more regularly with their constituents. In 14 of the 18 municipalities, mayors have also hired internal auditors and are undertaking other efforts to improve the local government's accountability for public resources.

Upon appointment of a new National Registrar in late 1997, USAID and the United Nations Development Program (UNDP) agreed to co-finance the technical design studies required prior to purchasing equipment and launching the new civil registry system. In July 1998, the technical study was completed and approved by the National Registrar. Technical specifications are being developed to purchase the equipment required to implement the new identification system. USAID will help finance an intensive effort to collect and record electronically all valid birth certificates--a first step in a three-year effort to issue the estimated 3,000,000 new identity/voter registration cards.

Civil society cannot function effectively without access to information, the participation of a broad range of citizens, and the opportunity to participate in the policy-making process. Recognizing this, making the legislative process accessible to its constituents is an important element of USAID's program. During 1998, USAID assisted the legislature to develop a modernization plan -- one element of which is the creation of departmental offices to facilitate public access to the legislature. The first of these offices, located in Chalatenango Department, was opened in January 1999. USAID is also providing technical assistance to establish the equivalent of a congressional budget office. On the citizen "demand" side, USAID initiated an advocacy training program for local NGOs and has trained public and private sector leaders in anti-corruption strategies. An anti-corruption working group has been formed and will receive USAID support for its advocacy and public awareness activities.

Possible Adjustments to Plans: No adjustments are planned.

Other Donor Programs: The IDB and Spain continue to contribute significantly to judicial reform, with a World Bank program under design. The IDB, the German aid agency GTZ, and the UNDP all have active local development programs. The United States and Japan continue to identify and fund projects designed to strengthen civil society under the Common Agenda.

Principal Contractors, Grantees or Agencies: Current grantees and contractors include Chemonics, DPK Consulting, Research Triangle, World Learning Inc., DevTech Systems Inc., National Center for State Courts, and local NGOs. The International Foundation for Electoral Systems was the principal contractor for the technical design studies for the civil registry.

Selected Performance Measures:

	Baseline (1996)	Target (2000)	Target (year)
Average criminal case processing time, in months	16	12	3 (2002)
Local development/municipal service delivery plans, in number of municipalities	0	25 (1999)*	25 (1999)*
Increase in locally-generated tax revenues	0%	50% (1999)* in 18 munic.	50% (1999)* in 18 munic.
New identity/voter registration cards issued	0	3 million	3 million (2002)
* the activity for which this data is being collected ends in 1999

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ACTIVITY DATA SHEET

PROGRAM: El Salvador
TITLE AND NUMBER: Sustainable Improvements in Health of Women and Children, 519-SOO3
STATUS: Continuing
PROPOSED OBLIGATION AND FUNDING SOURCES: FY 2000: $7,145,000 CS; $4,000,000 DA
INITIAL OBLIGATION: FY 1997 ESTIMATED COMPLETION DATE: FY 2002

Summary: USAID is helping to improve the health of women of reproductive age and children under age five through increasing the use and sustainability of appropriate health practices and services. USAID's support for health and population activities in El Salvador spans several decades and is associated with a steady improvement in health and population indicators. Now, USAID is expanding geographically the coverage of health services, especially for women and children, and seeking mechanisms to enhance their long-term viability while reducing the dependency on donor funding.

Key Results: Three key intermediate results contribute to achieving this objective:

• Child Survival: USAID programs reduce mortality and morbidity in children under the age of five through support to the Ministry of Health (MOH) and to NGOs to provide primary health services such as vaccinations, growth monitoring, and the prevention and treatment of preventable diseases.
• Reproductive Health: USAID programs reduce reproductive health problems through improved safe motherhood and birth outcomes. Families receive assistance to have fewer unplanned and mis-timed pregnancies. Assistance to prevent sexually transmitted infections and HIV/AIDS is provided.
• Policy: To improve health for women and children, USAID works with the government and other donors to enhance the policy environment to support long-term changes. The policy component supports decentralization and increasing community participation in health services policies and practices at the local level. These achievements are quantified in more detail under the Selected Performance Measures, below.

Performance and Prospects: USAID has financed major health and demographic surveys every five years in El Salvador since the late 1970s. The 1993 and 1998 surveys showed marked improvement in the health status of Salvadorans: infant mortality dropped from 41 to 35 per 1,000 live births. For child mortality, they showed a decrease from 12 to eight per 1,000 live births. Contraceptive prevalence increased from 53% to 59.8%. Acute respiratory infections decreased from 59.4% to 33.4%. The total fertility rate dropped from 3.83 to 3.54 children per woman. Prenatal visits increased from 68.7% in 1993 to 76.0% in 1998, with a higher number of women seeking prenatal care in their first pregnancy quarter (from 45.7% in 1993 to 75.2% in 1998). Rural inhabitants have more access to potable water and latrines: due to USAID support, 99,000 more people have potable water and 82,000 more people have sanitary latrines. Diarrhea incidence nationally decreased from 24.4% in 1993 to 20.2% in 1998. As the health sector's leading donor for over 20 years and virtually its only donor during El Salvador's 12 years of civil conflict, USAID can take the credit for much of these improvements.

USAID plays an important leading role in coordinating, developing and implementing activities to support the health reform process. USAID will continue to provide financial and technical assistance to develop new health legislation that ensures equitable service provision, especially for the rural poor, and assist the MOH to develop a more effective and affordable health care delivery system.

An assessment of the MOH National Tuberculosis Program, conducted in close coordination with the Pan American Health Organization (PAHO), resulted in a $2 million, three-year infectious disease program to reinforce and improve TB control, to be implemented through a cooperative agreement with the PAHO. It is expected to begin early in 1999. PAHO will coordinate activity implementation with close USAID monitoring. USAID supports the MOH in implementing, developing and strengthening programs to prevent the spread of sexually-transmitted infections and HIV/AIDS. USAID is also coordinating with the Regional Central American HIV/AIDS Project to develop El Salvador's National Strategic Plan for HIV/AIDS.

To ensure the coverage of child survival and reproductive health services in those areas previously assisted by USAID-funded NGOs, the MOH has agreed to recruit 240 new health promoters and contract with five local NGOs to continue providing and expanding service delivery to the rural population. The number of MOH health promoters will increase from 1,471 to 1,711, and the five NGOs will be providing services to approximately 113,000 people in 318 communities. Under this new strategy, the MOH coverage will increase from 67% to 87% of the rural communities in El Salvador.

Possible Adjustments to Plans: No adjustments to the current strategy are planned. To assist with reconstruction following Tropical Storm Mitch, USAID is considering a significant increase in funding for construction and rehabilitation of water and sanitation services.

Other Donor Programs: Three other major donors besides USAID work in the health policy and reform area: PAHO, the IDB and the German aid agency (GTZ). PAHO and GTZ concentrate mostly on supporting the MOH decentralization process in limited geographic regions. PAHO also supports the MOH's implementation of the Integrated Management of Childhood Diseases initiative and other aspects of child health and emerging diseases. A $21 million, 25-year IDB loan, which was expected to be approved by the GOES in 1998, is still pending ratification by the National Assembly. The European Union is developing complementary activities to improve access to potable water and sanitation services for rural people. The Government of Japan is also implementing activities to address water quality and distribution, and sanitation. UNICEF supplies essential medicines and is the lead donor on food fortification and micronutrient issues, and is developing activities to improve access to water and sanitation at the national and departmental levels. In the area of reproductive health, the United Nations Fund for Population Activities has been working with the MOH to develop a national reproductive health plan. UNICEF programs continue to target adolescents with information including HIV prevention and, together with PAHO, educating Salvadorans on domestic violence and women's role in society. The European Union and GTZ also support reproductive health programs in El Salvador.

Principal Contractors, Grantees or Agencies: Current grantees, contractors and/or technical assistance recipients include the MOH, the Legislative Assembly, CARE International, the Salvadoran Demographic Association, and other local NGOs. Other entities supporting the activities under this Objective include the National Administration for Aqueducts and Sewage and the Rotary Club International.

Selected Performance Measures:

	Baseline (1993)	Target (2000)*	Target (2002)**
Maternal mortality ratio (per 100,000 live births)	158	120	90
Infant mortality rate (per 1,000 live births)	41	30	19
Child mortality rate (per 1,000 children under 5)	12	9	6
Total fertility rate (children per woman)	3.85	3.5	3.1
*data are collected every five years in the regular health and demographic survey, hence data in this column reflect the targets for 2000, which are the same as for 1998 and 1999
**although the activity will be completed in 2002, the data will be collected in the year 2003 health and demographic survey

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ACTIVITY DATA SHEET

PROGRAM: El Salvador
TITLE AND NUMBER: Increased Access by Rural Households to Clean Water, 519-S004
STATUS: Continuing
PROPOSED OBLIGATION AND FUNDING SOURCES: FY 2000: $4,400,000 DA
INITIAL OBLIGATION: FY 1998 ESTIMATED COMPLETION DATE: FY 2002

Summary: Increased Access by Rural Households to Clean Water focuses activities of the entire Mission program upon three critical watersheds that transcend the boundaries of 16 municipalities. In these municipalities, the availability of clean water to rural households is critical and has potential to be replicated throughout the country. While the strategy is national in scope, its primary focus is on devolving national authority to the municipal level, and working at the community level through diverse activities that cut across the Mission portfolio. To make a meaningful and lasting impact on water resources in rural El Salvador, communities must organize to demand clean water, the water provided must be of acceptable quality, sufficient water must be available to fulfill residents' needs, water delivery systems must be operational and efficient, and municipalities must be able to manage and regulate water use effectively.

Key Results: USAID is working to achieve four key intermediate results to increase access by rural households to clean water: (1) improved quality of water sources: increase the area where sound agricultural practices are used to reduce soil erosion and runoff into the rivers and water sources; (2) improved performance of water distribution systems: of the 91 existing water systems, only eight work properly, this should increase to 82 by the end of FY 2002; (3) more effective citizen actions to address water issues: increase the changes resulting from citizen's actions from 43 to 300; and (4) improved municipal management of water resources: at least 36 local ordinances passed and municipalities invest at least 25% of their resources in water related projects.

Performance and Prospects: Since the revised strategy was approved in October 1997, USAID signed the agreement with the Government of El Salvador in September 1998 and is proceeding with contracting for its implementation.

In November, Tropical Storm Mitch hit the selected areas and gave watershed protection and water purification program greater visibility by showing people throughout the country the tangible need for caring for watersheds and assuring sustainable supplies of clean water. The environmental education component assisted the affected areas immediately, providing chlorine and safe water. These efforts were augmented by strong collaboration with and counterpart funding by the Ministry of Environment. In environmental policy, the Legislative Assembly passed the landmark framework environmental law, that took effect on May 4, 1998. The Ministry then drafted detailed regulations for the law, and is consulting with appropriate interest groups on them. In one department, two local non-governmental organizations completely took over the demonstration farmer promoter program's continuation and extended it to more small-scale farmers. The Enterprise for the Americas Initiative in El Salvador received 64 proposals for new projects in environmental protection and child survival. It has already granted over $12 million for 260 similar projects nationwide since 1994.

Possible Adjustments to Plans: USAID's assistance to post-Tropical Storm Mitch reconstruction will not require significant changes to the current strategy since this activity's geographic focus coincides with the areas hardest hit by the flooding. Nonetheless, USAID does envision increased assistance for disaster mitigation in these areas, primarily through reforestation and watershed management. USAID is also considering additional assistance to construct wastewater treatment systems (oxidation lagoons, for example) to reduce the amount of wastewater being dumped into the rivers that flow through the flood-prone coastal area.

Other Donor Programs: The IDB is the largest multilateral donor in the water sector. In 1998 it approved a $55 million, 20-year repayment period loan for an activity to modernize the water sector and rehabilitate water systems for San Salvador, in small, decentralized municipalities (under 5,000 inhabitants), and in small communities in rural areas. The European Union, Sweden, Germany, Japan and Spain all implement activities through the Government of El Salvador or NGOs to install, rehabilitate and construct water supply and sewage systems in rural areas and ex-conflictive zones. The Food and Agriculture Organization of the United Nations and Pan American Health Organization/World Health Organization also support interventions to increase access to water supply and sanitation services as well as to strengthen water resource management in rural areas. A UNICEF environmental education program features water and sanitation as one of its themes.

Principal Contractors, Grantees or Agencies: The current contractor is the Academy for Educational Development. USAID also works through local NGOs and consultants.

Selected Performance Measures:

	Baseline	Target (2000)	Target (2002)
Rural households in target areas with water that meets quality and time standards, by gender of head of household	30% m (1997) 26% f (1997)	46% m 45% f	65% m 65% f
Rural households nationally with water that meets quality and time standards, by gender of head of household	41% m (1997) 38% f (1997)	48% m 47% f	57% m 57% f
Increased use of improved agricultural and conservation practices, in number of hectares a. soil conservation b. organic cropping c. integrated pest management	a. 3,804 (1998) b.   815 (1998) c.   811 (1998)	a. 4,250 b. 1,000 c. 1,000	a. 4,800 b. 1,200 c. 1,200

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