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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
The considerable delays in implementation were due to complicated procurement regulations of both ADB and the government. These delays and price inflation resulted in the quality of civil works being compromised in some locations and some facilities deviating from the design. Delays in equipment procurement led to the purchase of inappropriate and out-dated equipment. Limited district administrative capacity resulted in delays in imprest accounts being replenished, which constrained progress.

Project Number: 37115-013
Project Name: Health Care in the Central Highlands Project
Report Date:
Lesson
The Joint Annual Health Review, 2010 notes that a shortage of human resources continues in several fields, including preventive medicine, public health, pediatrics, infectious diseases, mental illness, forensics, pathology, tuberculosis and leprosy, food safety and hygiene inspection, medical technology, engineers specialized in medical equipment, health statistics, and hospital management. The provincial health departments identified postgraduate training in health specializations as a major project benefit, leading to more available district staff and specializations.

Project Number: 37115-013
Project Name: Health Care in the Central Highlands Project
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
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
There were no apparent incentives for project management to properly assess project impacts, so the collection and use of baseline data and strengthening of overall monitoring of beneficiaries need a stronger institutional push.

Project Number: 31361-013
Project Name: Rural Enterprise Finance Project
Report Date:
Lesson
No new lessons

Project Number: 35343-013
Project Name: Support the Implementation of the Public Administration Reform Master Program, Phase 1
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
Monitoring and evaluation. Data were regularly collected, and efforts were made not to create a separate monitoring system but use existing information. However, project monitoring was incomplete and insufficiently used as a management tool to achieve results. Substantive project evaluation was very useful.

Project Number: 30285-013
Project Name: Rural Health Project
Report Date:
Lesson
Lengthy administrative processes. Implementation delays were largely caused by lengthy procurement and financial control procedures at all levels. While the project management unit (PMU) and provincial project management unit (PPMU) capacity was also an issue, the government's administrative procedures were time consuming. ADB administration was considered relatively efficient.

Project Number: 30285-013
Project Name: Rural Health Project
Report Date:
Lesson
Not limited to the case of Viet Nam, the impact on gross domestic product (GDP) growth rates of the fiscal stimulus package shows the importance of a multidimensional strategy that allowed responding to the variety of challenges posed by the severe global financial crisis of the last few years. In Viet Nam, the strategy included tax cuts, large infrastructure spending, interest rate subsidies, and social welfare programs.

Project Number: 43315-013
Project Name: Countercyclical Support
Report Date:
Lesson
Water supply and sanitation coverage indicators need to be simplified. Monitoring coverage ratios requires the monitoring of two independent parameters: physical outputs and population growth. Sometimes this is complicated by a change in delineating the service area of the utilities. Nominal targets are therefore easier to monitor than ratios and are equally functional for assessing achievements.

Project Number: 28315-013
Project Name: Third Provincial Towns Water Supply and Sanitation Project
Report Date:
Lesson
The introduction and enforcement of local regulations on sanitation and environment protection was not supported by the project nor included as a covenant. Although the introduction was still achievable, enforcement would need support from the project.

Project Number: 28315-013
Project Name: Third Provincial Towns Water Supply and Sanitation Project
Report Date:
Lesson
Despite a shortened loan processing period, by the time the loan was eventually disbursed, most of the elements of the stimulus package were expiring. To the extent that loan processing could be further simplified and accelerated in the future, the potential impact of the CSF might be assisted.

Project Number: 43315-013
Project Name: Countercyclical Support
Report Date: