The working relationship between MOH (Ministry of Health) and the project team was to be assisted by working groups whereby MOH staff would work in tandem with project staff and consultants. This arrangement was meant to co-opt MOH in project implementation. Often however, the ministry officials' understanding of their role was limited to reviewing and commenting on project outputs, and that project staff and consultants would be responsible for project outputs. This view is shared widely across all government institutions, not just MOH. The working relationship between MOH and a project team could be improved with clearer cooperation arrangements and agreed schedules. An expanded management board version, where project-related stakeholders are invited to the formal management board meeting as observers with the right to vote, could be an option to be explored in the future. In the longer term, ADB should consider not to establish a parallel PIU (project implementation unit) and instead engage ministry staff in project administration. Although this approach could possibly result in slower project implementation because of staff overload and unfamiliarity with ADB regulations and procedures, overall government ownership and commitment could increase significantly.
Third Health Sector Development Project