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Lesson
Demand-driven approach to improve the local health situation. The project highlighted the importance of evidence-based and demand-driven project planning and implementation to address local health needs better. The establishment of district team problem-solving empowered staff and encouraged intersectoral coordination.

Project Number: 34007-012
Project Name: Decentralized Health Services I
Report Date:
Lesson
Assess and evaluate human resource development needs. Training needs assessment and post-evaluation of training courses need to be included to assess adequacy, quality and training impact.

Project Number: 34007-012
Project Name: Decentralized Health Services I
Report Date:
Lesson
Capacity building has to be linked to incentive structures. Investment in training has to be linked to incentive schemes (financed by local governments) to ensure staff retention, especially in remote areas. The project showed that several local governments initiated incentive schemes for medical doctors and midwives.

Project Number: 34007-012
Project Name: Decentralized Health Services I
Report Date:
Lesson
Management skills have to be improved. Training largely focused on technical matters rather than improving management skills. In strengthening decentralization of health services there is a need to focus on health management training and monitoring and evaluation of health staff.

Project Number: 34007-012
Project Name: Decentralized Health Services I
Report Date:
Lesson
Mobilize local leaders. Local leaders and or champions need to be identified to initiate local health care reform initiatives and the financial sustainability of activities. The project demonstrated that local regulations to support health sector reform and ensure sustainability are possible through large-scale socialization and advocacy.

Project Number: 34007-012
Project Name: Decentralized Health Services I
Report Date:
Lesson
Strengthen management capacity for decentralized health services. While central and local staff were empowered and received diverse technical training, overall more attention needs to be given to the management of health services in the decentralized environment.

Project Number: 34007-012
Project Name: Decentralized Health Services I
Report Date: