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Lesson
The central project management unit and provincial project management units have monitored financial flows and activity progress as part of routine quarterly reporting. Limited attention was paid to project outcomes in the project framework; outcomes were not changed during the project. Similarly, measurement of the outcomes of the training programs appears to have been limited. Given ADB's results-based approach to Project Management, both the Ministry of Health and ADB should have given a greater focus to monitoring and evaluation.

Project Number: 37115-013
Project Name: Health Care in the Central Highlands Project
Report Date:
Lesson
Investment in civil works and equipment has recurrent budget implications. Monitoring of whether provinces are allocating greater resources to recurrent budgets is difficult as financial tracking is complicated in a devolved financial management system. User fees may help support the ongoing expenditure support for buildings and equipment in the curative sector, but the preventive system has limited capacity to mobilize resources outside of the state budget.

Project Number: 37115-013
Project Name: Health Care in the Central Highlands Project
Report Date:
Lesson
Substantial evidence demonstrates that community-driven development (CDD) approaches are more effective than other approaches to basic infrastructure development. Evidence also indicates that CDD is likely to offer better cost recovery and maintenance of completed infrastructure facilities and services because of the strong sense of ownership of the community members. In addition, CDD leads to better accountability. Transparency in decision making and procurement and increased use of audits have demonstrably reduced corruption and leakage of public funds.

Project Number: 40247-013
Project Name: Rural Infrastructure Support to the PNPM Mandiri Project
Report Date:
Lesson
Community facilitators must be qualified and committed, and enough time must be set aside for community empowerment activities, to ensure that community members are sufficiently involved in prioritizing their needs, developing investment proposals, and making decisions. [Main text, para. 65(ii)]

Project Number: 40247-013
Project Name: Rural Infrastructure Support to the PNPM Mandiri Project
Report Date:
Lesson
Involving the beneficiaries at all stages of planning and implementation of upgrading activities and promoting inclusive community empowerment are critical in ensuring pro-poor investments and sustainability.

Project Number: 40247-013
Project Name: Rural Infrastructure Support to the PNPM Mandiri Project
Report Date:
Lesson
Even if a project is aligned with regional strategies, designs need to incorporate sufficient national consultation and consider country absorptive and technical capacity and commitment.

Project Number: 38599-022
Project Name: HIV/AIDS Prevention and Capacity Development in the Pacific
Report Date:
Lesson
Establishing a project steering committee is challenging where separate development partner committees already exist to oversee arrangements for Pacific countries.

Project Number: 38599-022
Project Name: HIV/AIDS Prevention and Capacity Development in the Pacific
Report Date:
Lesson
Targeting. The project improved services for the poor and had a substantial focus on maternal care but provided less targeted support for ethnic minorities. Several of the interventions for ethnic minorities didn't materialize. The project evaluation study showed that the poor in general and ethnic minorities in particular benefited from the government support for commune health stations (CHSs) and health insurance, while ADB funding provided more general public support. More could have been achieved with better targeting for minorities, assuming MOH concurrence.

Project Number: 30285-013
Project Name: Rural Health Project
Report Date:
Lesson
The sequence of reforms in the policy matrix was such that all substantial results could be achieved only after the completion of second tranche actions. In addition, liberal assessment of compliance allowed the release of the first tranche without achieving much toward sustainable outputs. More result-oriented sequencing of policy actions for the first tranche could have achieved some sustainable improvements in social service delivery.

Project Number: 37218-013
Project Name: Balochistan Devolved Social Services Program
Report Date:
Lesson
Piloting reforms. While government ownership of project formulation was strong, proposed pilots were too ambitious given MOH constraints and the lack of detailed plans or technical support. On the other hand, the project flexibly responded to several policy changes and national developments by adjusting its scope, which counterparts appreciated. Demand-led programming improved project impact.

Project Number: 30285-013
Project Name: Rural Health Project
Report Date:
Lesson
Given provincial and district capacity limitations, a Program focusing on a single sector would have had a better chance of success. Sustained support in one sector can be less demanding for both the government and ADB. Multi-sector policy reform interventions involving governance reform are difficult to manage, and a new system of local political governance imposed by the federal government added further complications.

Project Number: 37218-013
Project Name: Balochistan Devolved Social Services Program
Report Date:
Lesson
Priorities for health sector development. One issue with health projects in Viet Nam is that the Ministry of Health (MOH) and the provinces typically give priority to upgrading facilities and staff. Provinces may be less focused on sector reforms and improving outcomes, perhaps as this is not seen as a role of projects, and the results are less understood and tangible. Provinces need to focus more on improving the quality of services and maintaining assets.

Project Number: 30285-013
Project Name: Rural Health Project
Report Date:
Lesson
Capacity in the executing and implementing agencies was expected to be built through the accompanying TA loan. Program outputs like developing sector strategies, implementing expenditure tracking and service delivery surveys, training communities to manage and monitor social service delivery, and other outputs critical to achieving Program outcome depended on effective technical assistance (TA) loan administration. However, executing agency capacity to administer the TA loan was inadequate.

Project Number: 37218-013
Project Name: Balochistan Devolved Social Services Program
Report Date:
Lesson
No new lessons

Project Number: 42477-013
Project Name: Emergency Assistance for Post-Conflict Recovery
Report Date:
Lesson
An executing agency's ability to implement project activities within set timeframes is diluted where there is limited PMU capacity, a lack of experience with ADB procedures, and inadequate executive oversight.

Project Number: 38599-022
Project Name: HIV/AIDS Prevention and Capacity Development in the Pacific
Report Date: