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Lesson
More intensive support from ADB gender specialists throughout the project period is vital to ensuring the effective implementation of gender action plans (GAPs).

Project Number: 42179-013
Project Name: Greater Mekong Subregion Capacity Building for HIV/AIDS Prevention Project
Report Date:
Lesson
Successful innovations require careful consideration of the project context.

Project Number: 42179-013
Project Name: Greater Mekong Subregion Capacity Building for HIV/AIDS Prevention Project
Report Date:
Lesson
An SDP approach increases the transaction costs compared with a programmatic approach. It is, however, a useful transition in supporting the development of a sector, and in establishing collaboration between MOF and line ministries (such as MOH or others). A CDTA grant or loan attached to an SDP or a program increases the chances of successful development of the sector.

Project Number: 41376-022
Project Name: Lao People’s Democratic Republic: Health Sector Development Program
Report Date:
Lesson
The successful implementation of HSDP is the result of ADB’s long-term commitment to the health sector in the Lao PDR. Long-term commitment and policy dialogue built on trust and confidence between ADB and MOH, and the government, in general. The SDP modality was proposed by ADB in 2007 for the Health System Development Project but MOH was not yet confident enough about the support of MOF. Policy dialogue continued and in 2009, MOH and MOF were ready for an SDP approach.

Project Number: 41376-022
Project Name: Lao People’s Democratic Republic: Health Sector Development Program
Report Date:
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
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
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
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
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
The RCU could have been embedded within an established organization (e.g., an intergovernmental agency or nongovernment organization) or existing program with similar objectives to the CDC1. By hiring a consultant and housing the RCU independently, institutional capacity for coordinating CDC was not developed within these agencies, risking loss of momentum after project closure.

Project Number: 36672-012, 37604-022, 38017-012
Project Name: Greater Mekong Subregion Regional Communicable Diseases Control Project
Report Date:
Lesson
Regional cooperation for CDC is a long-term prospect. As a first generation GMS project supported by ADB, the CDC1 project left behind a legacy of regional political commitment, trust, and familiarity among counterpart colleagues in Cambodia, the Lao People’s Democratic Republic, and Viet Nam countries, and knowledge products generated from Regional Coordination Unit (CDC1 and CDC2) -supported studies.

Project Number: 36672-012, 37604-022, 38017-012
Project Name: Greater Mekong Subregion Regional Communicable Diseases Control Project
Report Date:
Lesson
All three countries reported difficulty keeping up with the frequent changes in ADB’s procurement and audit requirements. This was compounded by the executing agencies’ difficulty in retaining qualified national staff for financial management, lack of in-service training from ADB, and limited support from ADB resident missions since the project was managed out of Manila.

Project Number: 36672-012, 37604-022, 38017-012
Project Name: Greater Mekong Subregion Regional Communicable Diseases Control Project
Report Date:
Lesson
Continuity of ADB project staff was an important element of the successful implementation of this complex three-country project. The same team of senior staff continued to guide the GMS CDC1 project though all stages from the concept paper, formulation, implementation, and writing of the PCR.

Project Number: 36672-012, 37604-022, 38017-012
Project Name: Greater Mekong Subregion Regional Communicable Diseases Control 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
No additional lesson.

Project Number: 32313-012
Project Name: Lao People’s Democratic Republic: Health System Development Project
Report Date: