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Lesson
Consider engaging the ministry staff in project administration, instead of establishing a parallel PIU. This can be supported, but not led, by an external consulting service. While this may have challenges due to staff capacity, it is ideal from the standpoint of ownership and may perhaps discourage the high staff turnover experienced in the past. Staff accountability can be strengthened through closer monitoring of its performance and the provision of staff development inputs based on needs.

Project Number: 41119-012
Project Name: Third Health Sector Development Project
Report Date:
Lesson
There should be continuing advocacy and social marketing of the reform ideals, given frequent changes in leadership. Hence, it is important to keep the rhetoric up and alive to create and maintain the groundswell of support from everyone.

Project Number: 41119-012
Project Name: Third Health Sector Development Project
Report Date:
Lesson
No new lessons

Project Number: 34149-013
Project Name: Second Decentralized Health Services Project
Report Date:
Lesson
During program appraisal, enough time should be given to assess the policies involved, to engage with the political leadership in creating ownership, and to reach a consensus on the suitable reforms, including an action plan. The government’s capacity to implement the program successfully should have been thoroughly assessed, at least at the time of Subprogram 2.

Project Number: 41641-013, 41641-023
Project Name: Punjab Millennium Development Goals Program
Report Date:
Lesson
The provisions of funds under a program loan will generally only have an immediate impact on the overall level of economic activity if a pipeline of projects is in place when the funding becomes available. This was not the case when the ERSP (economic recovery support program) subprogram 1 loan was disbursed, but the delay in capital project construction to ensure more sustainable and beneficial projects were implemented was desirable.

Project Number: 42503-013
Project Name: Economic Recovery Support Program - Subprograms 1 and 2
Report Date:
Lesson
No new lessons

Project Number: 33278-013
Project Name: Health Sector Development Program
Report Date:
Lesson
No new lessons

Project Number: 36296-013
Project Name: Second Urban Primary Health Care Project
Report Date:
Lesson
The working relationship between MOH (Ministry of Health) and the project team was to be assisted by working groups whereby MOH staff would work in tandem with project staff and consultants. This arrangement was meant to co-opt MOH in project implementation. Often however, the ministry officials' understanding of their role was limited to reviewing and commenting on project outputs, and that project staff and consultants would be responsible for project outputs. This view is shared widely across all government institutions, not just MOH.

Project Number: 41119-012
Project Name: Third Health Sector Development Project
Report Date:
Lesson
Very high turnover of MOH (Ministry of Health) staff slowed policy reforms that required legislative approval and government commitment. Although government changes cannot be predicted, a longer-term assessment of overall political stability would be valuable, so as to prioritize project policy goals that are necessary for project implementation and sustainability. A key lesson is that reform ambitions need to match the actual capacity of government agencies and factor in turnovers.

Project Number: 41119-012
Project Name: Third Health Sector Development Project
Report Date:
Lesson
A project that requires behavioral change within communities needs a long-term agenda. Measuring the impact of such a project will take time. A project may be deemed successful on the basis of short-term outcomes, but it may not endure, particularly if there were deficiencies during project implementation. Thus, setting impact performance indicators to be achieved by 2012 (the year of project closing) might have been too short-term.

Project Number: 38117-013
Project Name: Nutrition Improvement through Community Empowerment Project
Report Date:
Lesson
Given the weak capacity of the executing agency, a large, well-conceived, and properly structured TA (technical assistance) project should have been piggybacked on the program to address the obstacles presented by inherent system inefficiencies and limited capacit

Project Number: 41641-013
Project Name: Punjab Millennium Development Goals Program - Subprograms 1 and 2
Report Date:
Lesson
A well-thought-out conceptual design is a key to the success of any program. In the case of the PMDGP (Punjab Millennium Development Goals Program), the design set a commendable goal in the intended outcome, but it seems to have overestimated the capacity of the GOP (Government of Punjab) to help achieve it. It also relied too heavily on the establishment of the MSDSs (minimum service delivery standards) as a strategy for attaining MDGs (Millennium Development Goal) 4 and 5.

Project Number: 41641-013
Project Name: Punjab Millennium Development Goals Program - Subprograms 1 and 2
Report Date:
Lesson
One of the PMDGP's (Punjab Millennium Development Goals Program) principal lessons is that interventions in countries with difficult socioeconomic conditions and generally weak implementation capacity require more comprehensive due diligence during design. When large complex programs are prepared in this context, ADB needs to carry out detailed, rigorous, and objective analysis of the potential implementation risks, especially those related to the executing agency. Once that is done, all necessary mitigation measures must be built into the design.

Project Number: 41641-013
Project Name: Punjab Millennium Development Goals Program - Subprograms 1 and 2
Report Date: