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Lesson
Need to better identify barriers to access and use of primary health care services by the intended beneficiaries. HSDP addressed supply-side issues, but demand for services needs to be increased and oriented through better information and communication, and social marketing addressed to the beneficiaries. The health sector needs to mobilize other sectors to achieve health for all. Some barriers cannot be reduced by the health sector alone.

Project Number: 41376-022
Project Name: Lao People’s Democratic Republic: Health Sector Development Program
Report Date:
Lesson
No new lessons

Project Number: 42503-013, 42503-023
Project Name: Economic Recovery Support Program—Subprograms 1 and 2
Report Date:
Lesson
The design monitoring framework would have better tracked improvements in the quality of LSE in the target regions if it had measured the impact of the inputs, rather than only the inputs. For example, instead of counting the number of ethnic minority upper secondary education (USE) graduates who received a scholarship, the indicator could have measured the number who received scholarships and who returned to their own communities to work, which was the project's original intention.

Project Number: 36008-013
Project Name: Lower Secondary Education for the Most Disadvantaged Regions Project
Report Date:
Lesson
The coverage for the health equity fund (HEF) scheme supported by the program increased from three pilot provinces to cover all eight target provinces. This resulted in a higher number of eligible beneficiaries and health service utilization by the poor. Despite this, a large percentage of the eligible beneficiaries were not accessing the free HEF-funded services.

Project Number: 41376-022
Project Name: Health Sector Development Program
Report Date:
Lesson
Relevant project design. The project's target identification methodology was relevant and sophisticated. Prior to this project, ADB support to disadvantaged provinces covered all parts of 22 provinces (determined by the government), which was nearly a third of the country. In contrast, the targeted support of the project resulted in focused investment on the poorest groups.

Project Number: 36008-013
Project Name: Lower Secondary Education for the Most Disadvantaged Regions Project
Report Date:
Lesson
The program tested a new fund flow mechanism for the health sector. Based on the successful trial the government has increased funding for health at the provincial level, resulting in expanded health services coverage, particularly for maternal, newborn, and child health care (MNCH) services and the provision of free health care for the poor.

Project Number: 41376-022
Project Name: Health Sector Development Program
Report Date:
Lesson
Internal LSE subsector cooperation and coordination. Some project activities required close cooperation among stakeholders. For example, campaigns promoting the importance of LSE among disadvantaged communities in remote areas, where young children contribute to the family income through employment, required committed engagement by Ministry of Education and Training (MOET), Department of Education and Training (DOET), Bureau of Education and Training (BOET), teachers, and others, to ensure that LSE awareness campaigns reached their target audience.

Project Number: 36008-013
Project Name: Lower Secondary Education for the Most Disadvantaged Regions Project
Report Date:
Lesson
Capacity building for sustainability of project outcome and outputs. Project design strengthened the planning and management capacity of education planners and managers. This investment for the future is necessary to ensure sustainability of the project outcome and outputs over the longer term. In addition, one sub-output of the project introduced the concept of continuing professional development, to provide opportunities and support for teachers to systematically improve their knowledge and skills throughout their teaching careers.

Project Number: 36008-013
Project Name: Lower Secondary Education for the Most Disadvantaged Regions Project
Report Date:
Lesson
Output and outcome performance monitoring was generally limited to the baseline, midterm and end of program survey. Key core performance data should be collected, analyzed and reported on a quarterly basis, in alignment with standard government indicators. This provides provinces and the national level with an up-to-date status of program performance and comparative data across provinces. These data should inform the annual planning process and identify where additional support is needed.

Project Number: 41376-022
Project Name: Health Sector Development Program
Report Date:
Lesson
Participatory approach to project design and implementation. Extensive consultation with and participation by key stakeholders from project formulation through implementation resulted in higher ownership of the project among stakeholders. It also led to realistic and implementable project design, and allowed for an effective response to challenges encountered by the LSE subsector. It also promoted good coordination and communication, which was necessary for a timely resolution of issues.

Project Number: 36008-013
Project Name: Lower Secondary Education for the Most Disadvantaged Regions Project
Report Date:
Lesson
Funding is necessary, but is not sufficient for building capacity in the provinces and districts as they move to decentralized governance. Strengthening regulatory arrangements and institutional capacity is dependent on good management and financial procedures. A number of the provinces have increased management and technical competency and can play a valuable role through mentoring and/or twinning programs to help expand successful initiatives to others provinces.

Project Number: 41376-022
Project Name: Health Sector Development Program
Report Date:
Lesson
Consider engaging the ministry staff in project administration, instead of establishing a parallel PIU. This can be supported, but not led, by an external consulting service. While this may have challenges due to staff capacity, it is ideal from the standpoint of ownership and may perhaps discourage the high staff turnover experienced in the past. Staff accountability can be strengthened through closer monitoring of its performance and the provision of staff development inputs based on needs.

Project Number: 41119-012
Project Name: Third Health Sector Development Project
Report Date:
Lesson
There should be continuing advocacy and social marketing of the reform ideals, given frequent changes in leadership. Hence, it is important to keep the rhetoric up and alive to create and maintain the groundswell of support from everyone.

Project Number: 41119-012
Project Name: Third Health Sector Development Project
Report Date:
Lesson
The project’s quality-at-entry can often be assessed through the project DMF. A good project DMF should be self-explanatory and formulated as a real and understandable tool for project implementation and project monitoring by the executing agency, particularly by the PMU staff.

Project Number: 34348-013
Project Name: Preventive Health System Support Project
Report Date:
Lesson
The importance of a strong and well-functioning PMU, with a full-time and qualified project coordinator, is paramount.

Project Number: 34348-013
Project Name: Preventive Health System Support Project
Report Date: