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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
Project design should be thorough, realistic in cost and time estimation, and in the delivery of target outputs.

Project Number: 35377-013, 35377-023
Project Name: Regional Road Development Project
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
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
ADB’s having frequent review missions at the initial stage, active participation in technical discussions, and prompt action on project requests, were critical factors in ensuring that the project remained responsive to recurrent and emerging needs and that implementation was on track with the project timelines.

Project Number: 33036-013
Project Name: Health Sector Reform Project
Report Date:
Lesson
Installation of project management at a very high level with the President’s office as executing agency and the deputy prime minister as project coordinator facilitated the success of the project. With such high level management support, the adoption of key policy recommendations and implementation of essential reform packages had a much better chance of being acted upon more quickly than if it were anchored on a weak ministry that still needed reform and strengthening.

Project Number: 33036-013
Project Name: Health Sector Reform Project
Report Date:
Lesson
Construction of sewerage and wastewater treatment plants (WWTP) was substantially delayed due to delays in land acquisition, preparation of a detailed design, and a change of site location. In order to avoid any unnecessary delay in the implementation of the project, sufficient attention should be paid to land acquisition in project preparation, and the land should be made available for the project prior to mobilization of the design consultant.

Project Number: 32239-013
Project Name: Urban and Environmental Improvement Project
Report Date:
Lesson
For effective gender mainstreaming and achievements, gender action plans should be prepared and agreed on by all agencies involved in project implementation. Sufficient financial and technical resources should be allocated for implementation of the gender action plan.

Project Number: 32239-013
Project Name: Urban and Environmental Improvement Project
Report Date:
Lesson
The project should focus on a small number of physically integrated components to simplify project administration and optimize intersector linkages.

Project Number: 32239-013
Project Name: Urban and Environmental Improvement Project
Report Date:
Lesson
A complex financing plan causes difficulties in consolidation of expenditures and slow submission of withdrawal applications.

Project Number: 32239-013
Project Name: Urban and Environmental Improvement Project
Report Date:
Lesson
Along with consultations related to subproject design and scope, consultation with project towns on cost recovery, tariffs, and user charges is crucial for sustainability.

Project Number: 32239-013
Project Name: Urban and Environmental Improvement Project
Report Date: