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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
To minimize large variations in partner agreement nongovernment organization performance (PANGO), it is necessary to (i) evaluate, contract, and mobilize PANGOs within a specific time frame to avoid delays; (ii) critically evaluate budget proposals to ensure they are sufficient to deliver primary health care services; and (iii) set realistic selection criteria for evaluating the experience of PANGOs and their capacity to deliver services.

Project Number: 36296-013
Project Name: Second Urban Primary Health Care Project
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
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
Design flaws resulted from the rehabilitation of existing facilities. Budget constraints may have led to the use of substandard materials. Some equipment was purchased that did not meet technical specifications. Further improvements can be made by improving specifications, adequately budgeting for works and equipment, and ensuring proper commissioning.

Project Number: 33278-013
Project Name: Health Sector Development Program
Report Date:
Lesson
A high on-lending rate prevented the targeted provinces from participating. At appraisal, careful consideration needs to be given to the project's financial feasibility. Limited project funds could finance only about 30% of required investments in targeted health facilities. Although additional funding was mobilized to complete upgrading of these facilities, more detailed advanced planning could mitigate financing risks.

Project Number: 33278-013
Project Name: Health Sector Development Program
Report Date:
Lesson
Health Sector Development Program supported the entire Health Sector Reform Agenda, with six reform areas, a large number of stakeholders, multiple levels, and intervening policy alterations, making it a complex undertaking. However, the government reported that ADB's support for the entire reform program helped advance reforms. Nevertheless, careful consideration should be given to the scope of program support.

Project Number: 33278-013
Project Name: Health Sector Development Program
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
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: