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CSV
Lesson
The scope and implementation coverage of projects should be manageable. For significant impact, project investment should not be spread too thinly nor be so ambitious in scope as to hamper implementation. The project interventions, while generating some positive outcomes locally, did not show much impact at the provincial level because they were too small to produce a broader impact. Concentrating investment in a few provinces would have been more effective. Strategic investment choices based on poverty and health needs should have been made when deciding geographical coverage.

Project Number: 34007-012, 34007-015
Project Name: Decentralized Health Services Project
Report Date:
Lesson
A good M&E system can help develop a better understanding of what works and what does not. While the potential benefits of a comprehensive approach were noted during the evaluation team’s field visits, there is limited effort to quantify these benefits systematically. A survey of stakeholders was conducted at project exit and documented in a benefit-monitoring report. A range of customer satisfaction questions were posed and scored in the survey.

Project Number: 34007-012, 34007-020
Project Name: Decentralized Health Services Project
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:
Lesson
Proper problem analysis is needed based on risk and mitigation analysis before rolling out a program under decentralization. Problem analysis was undertaken to some degree during project preparations. Risks were outlined in the project framework (under Assumptions and Risks) but little detail was given in the main text of the report and recommendation of the President, or in the project design.

Project Number: 34007-012, 34007-013
Project Name: Decentralized Health Services Project
Report Date:
Lesson
A comprehensive approach is needed for a well-functioning health system. Well-functioning provincial and district systems have proven to contribute to overall coordination and control of local health service delivery. During evaluation, health facility staff frequently cited the development of human resource capacity through longer-term fellowships as a key benefit of the project. Many of the project-supported fellows are now in key positions within the district and provincial health services. Many fellows thought that their careers would not have progressed so well without the project.

Project Number: 34007-012, 34007-018
Project Name: Decentralized Health Services Project
Report Date:
Lesson
If this project is to be replicated elsewhere, (i) group mobilization, (ii) social preparation by facilitators who come from within the communities, and (iii) downloading of funds that fosters full accountability by all recipients are key ingredients that must be included in its design and format.

Project Number: 34112-013
Project Name: Poor Farmers’ Income Improvement through Innovation Project
Report Date:
Lesson
Greater synergy is required between family planning and health-care services. Inclusion of family planning advocacy in future programs could help reduce maternal mortality, as high fertility and maternal mortality are correlated. During key informant interviews, many expressed an opinion that more support for family planning is needed. It will require a coordinated and balanced joint approach from MOH and BKKBN, supported by appropriate resources.

Project Number: 34007-012, 34007-017
Project Name: Decentralized Health Services Project
Report Date:
Lesson
Proper evaluation of capacity development would help assess the utility of current investment and justify further investment in human resource development. A large number of staff in health service delivery received training or fellowships under the project. However, there has not been any attempt to document actual benefits stemming from this investment. A proper analysis will help the central, provincial, and district governments to determine skills gaps that can be targeted over the next couple of decades.

Project Number: 34007-012, 34007-022
Project Name: Decentralized Health Services Project
Report Date:
Lesson
A project performance monitoring system (PPMS) was not required, since an existing system was already in place at Directorate General of Highways. However, ADB did require the conduct of surveys and collection of data for specific performance indicators identified at appraisal, which should have been finalized during the early stage of project implementation.

Project Number: 34159-013
Project Name: Road Rehabilitation-2 Project
Report Date:
Lesson
The procurement process for consultancy services and civil works was too long in spite of approval by ADB to advance corresponding action. ADB and the executing agency should have agreed on the length of the procurement process, which was already set in the ADB procurement guidelines. The delay in core team consultant procurement led to national consultants being tapped to proceed with the project and avoid delays.

Project Number: 34159-013
Project Name: Road Rehabilitation-2 Project
Report Date:
Lesson
More in-depth involvement by the borrower, executing agency, and implementing agencies in the preparation of the project design is important. The cancellation during the implementation of two subcomponents, which were essential to project sustainability, seemed too late since resources have already been committed. Agreeing to the changes should have triggered the revision of the design and monitoring framework.

Project Number: 34159-013
Project Name: Road Rehabilitation-2 Project
Report Date:
Lesson
Gender mainstreaming, particularly in the implementation of livelihood projects, is an effective strategy for empowering women.

Project Number: 32176-013
Project Name: Coral Reef Rehabilitation and Management Project Phase II
Report Date:
Lesson
Obtaining the full support and cooperation of the regional legislators and local officials is necessary to fast-track the legislative approval process and budget support.

Project Number: 32176-013
Project Name: Coral Reef Rehabilitation and Management Project Phase II
Report Date:
Lesson
Empowered communities with a high level of awareness are effective in reducing destructive fishing practices.

Project Number: 32176-013
Project Name: Coral Reef Rehabilitation and Management Project Phase II
Report Date:
CSV