Policy reforms should not be too numerous and should be well integrated into an overall project. Highest priority should be given to policy reforms (and covenants) that are necessary for project implementation or sustainability. A stakeholder analysis should be conducted for all proposed policy reforms, and a strategy developed for moving systematically to the desired policy reform reflected in the project's design and monitoring framework. Means of compensating the losers should be identified (e.g., by including project investments in institutions adversely affected by policy reforms). Progress toward achievement of policy reforms needs to be monitored carefully. The need to strictly adhere to the guidelines for the design and monitoring framework to ensure the participatory formulation of achievable objectives backed by relevant activities is a major lesson from this project.
Second Health Sector Development Project