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Lesson
Need for strong emphasis on establishing adequate O&M mechanisms to ensure sustainability of the built infrastructure. Lastly, more guidance is required from district administrations, consultants, and community facilitators to ensure that communities understand the importance of systematic maintenance.

Project Number: 38385-013
Project Name: Rural Infrastructure Support to the PNPM Mandiri Project II
Report Date:
Lesson
A project that requires behavioral change within communities needs a long-term agenda. Measuring the impact of such a project will take time. A project may be deemed successful on the basis of short-term outcomes, but it may not endure, particularly if there were deficiencies during project implementation. Thus, setting impact performance indicators to be achieved by 2012 (the year of project closing) might have been too short-term.

Project Number: 38117-013
Project Name: Nutrition Improvement through Community Empowerment Project
Report Date:
Lesson
The adequacy and appropriateness of project design have to be tailored to the project’s ultimate objectives and complexities. The PCR provided weak justification of the relevance of the extension and the insufficiency of indicators.

Project Number: 39662-012, 39662-022
Project Name: Prevention and Control of Avian Influenza in Asia and the Pacific
Report Date:
Lesson
More needs to be done to enhance capacity at the local governments to sustain community involvement.

Project Number: 34152-013
Project Name: Community Water Services and Health Project
Report Date:
Lesson
Project scope and coverage should be feasible. To increase impact, project resources should not be spread over a large geographic area. A large number of intended outputs most likely will slow down project implementation. Investment priorities based on health needs and poverty incidence may contribute to increased effectiveness.

Project Number: 34149-013
Project Name: Second Decentralized Health Services
Report Date:
Lesson
The project yielded the following insights for similar, future community-driven development projects: (i) Inclusive involvement of community members in decision making and implementation of infrastructure projects is needed to ensure ownership and transparency. (ii) Community facilitators and consultants must be well selected so that only qualified and committed personnel are deployed to support communities in the empowerment process and on technical matters.

Project Number: 38385-013
Project Name: Rural Infrastructure Support to the PNPM Mandiri Project II
Report Date:
Lesson
Capacity development requires continuous investment. Human resource development is key to providing improved health services. A large number of health staff, including medical doctors and midwives, received scholarships to build capacity in obstetrics and neonatal care. However, local governments' fiscal capacity to finance capacity development was limited or nonexistent. Significant investments, both in terms of capacity building and health infrastructure, will be required to meet the maternal mortality MDG target by 2015.

Project Number: 34149-013
Project Name: Second Decentralized Health Services
Report Date:
Lesson
The growing evidence that community-driven development approaches deliver investments that greatly impact beneficiaries in a cost-effective manner is presumably applicable to situations where it is feasible and economical for beneficiaries to observe project activities.

Project Number: 40247-013
Project Name: Rural Infrastructure Support to the PNPM Mandiri Project
Report Date:
Lesson
ADB's high-level steering committee demonstrated ADB's institutional support, which enhanced coordination between development partners. The committee, comprising the heads of all regional departments and the Strategy and Policy Department and chaired by the director general of RSDD, provided prompt policy guidance and expedited decisions and actions. It also ensured that the needs of the countries were ascertained and that they had adequate access to project resources.

Project Number: 39662-012
Project Name: Prevention and Control of Avian Influenza in Asia and the Pacific
Report Date:
Lesson
ADB was able to use its convening power effectively because it had the necessary in-house technical expertise. Public health experts on ADB's staff with knowledge of emerging infectious diseases were involved in designing and implementing the project. This in-house expertise made the dialogue with the technical and regional agencies to strengthen regional collaboration within and across the animal health and human health sectors possible.

Project Number: 39662-012
Project Name: Prevention and Control of Avian Influenza in Asia and the Pacific
Report Date:
Lesson
Each new outbreak of disease confronts projects such as this one, as well as the implementing partners and global community, with a fresh challenge, because its early spread outpaces the gathering of scientific evidence needed to formulate containment policies. Each successive outbreak is followed by an initial opaque period characterized by a frustrating lack of scientific evidence on which to base policies and technical guidance.

Project Number: 39662-012
Project Name: Prevention and Control of Avian Influenza in Asia and the Pacific
Report Date:
Lesson
The rapid launch and accelerated implementation of the project made necessary by the threat that avian influenza would become a pandemic made it difficult to define verifiable indicators for a number of the outputs under the regional capacity building and regional coordination components. A mid-term review of the project would have facilitated a review and updating of the design and monitoring framework.

Project Number: 39662-012
Project Name: Prevention and Control of Avian Influenza in Asia and the Pacific
Report Date:
Lesson
The project supported the One Health concept, which emphasizes the links between animal health and human health and emerging animal and human diseases. One Health provided a platform for unprecedented integration of animal, human and ecosystem health issues to fight the threat of avian influenza. The systematic collaboration of technical agencies across disciplines, such as FAO (veterinarians) and WHO (medical doctors) and civil society organizations (community health workers) supported by the project has promoted this concept since the beginning of the project.

Project Number: 39662-012
Project Name: Prevention and Control of Avian Influenza in Asia and the Pacific
Report Date:
Lesson
Results from successful pilot initiatives should be disseminated in time and used in scaling up such initiatives to maximize the impact. The health insurance scheme piloted in the Jembrana district of Bali has been recognized as one of the successful initiatives and is now being rolled out across the entire province. A number of lessons have emerged for ADB and the World Bank from piloting of this reform.

Project Number: 34007-012, 34007-014
Project Name: Decentralized Health Services Project
Report Date:
Lesson
ADB has helped improve infrastructure and promote reforms in a comprehensive manner. This was seen as a key positive feature of the project. Informants thought that by combining better planning and infrastructure and higher quality human resources, access to health services and their quality had improved. Many felt that without a comprehensive approach this might not have happened.

Project Number: 34007-012, 34007-019
Project Name: Decentralized Health Services Project
Report Date: