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Lesson
Implementation of government’s priorities. Involving the provincial and district levels and strengthening their capacity to identify and address the local needs reflected the government’s Sam Sang initiative, giving provinces and the districts more responsibilities and authorities. The reforms offered an opportunity to effectively apply the new policy, resulting in a strong government support for HSGP. ADB’s capacity-building activities at the provincial level in previous health projects provided useful experience to better target technical support at all levels.

Project Number: 47137-003, 47137-006
Project Name: Health Sector Governance Program (Subprograms 1 and 2)
Report Date:
Lesson
Understanding and addressing the needs of all those involved in the sector. The health system requires two types of personnel: (i) health services providers; and (ii) administrative personnel responsible for planning, budgeting, resource allocation, and monitoring. Both need to be involved.

Project Number: 47137-003, 47137-006
Project Name: Health Sector Governance Program (Subprograms 1 and 2)
Report Date:
Lesson
The implementation arrangements ensured that the provincial health offices, as implementing agencies, were stakeholders of the reforms. Rather than simply following instructions from the center, the provinces were involved in the program, better understood the reform objectives, and supported the implementation of the HSRS.

Project Number: 47137-003, 47137-006
Project Name: Health Sector Governance Program (Subprograms 1 and 2)
Report Date:
Lesson
Intersector coordination. ADB involvement in the financial sector facilitated dialogue with and support from the MOF and ensured better harmonization of the financial systems from different sectors. This support from one key sector, for instance, reinforced effectiveness of the reforms and is likely to enhance the sustainability of the program.

Project Number: 47137-003, 47137-006
Project Name: Health Sector Governance Program (Subprograms 1 and 2)
Report Date:
Lesson
Better data and information. A better use of more accurate data for planning and budgeting by newly trained personnel at the central, provincial, and district levels could have significantly improved allocative efficiency in the health sector, enabling better targeted policies and activities in operational and development plans.

Project Number: 47137-003, 47137-006
Project Name: Health Sector Governance Program (Subprograms 1 and 2)
Report Date:
Lesson
Supplementing programmatic assistance with sufficient, targeted technical assistance (TA) is effective in achieving reforms

Project Number: 47137-003, 47137-006
Project Name: Health Sector Governance Program (Subprograms 1 and 2)
Report Date:
Lesson
A multiple tranche arrangement ensures satisfactory progression of reforms and strengthens government accountability for the reforms.

Project Number: 47137-003, 47137-006
Project Name: Health Sector Governance Program (Subprograms 1 and 2)
Report Date:
Lesson
Participatory development and full alignment of reform programs with country strategies and plans foster strong ownership and commitment from the government.

Project Number: 47137-003, 47137-006
Project Name: Health Sector Governance Program (Subprograms 1 and 2)
Report Date:
Lesson
A needs assessment should be conducted to ensure that project components are realistically achievable given the proposed time frame and other project resources.

Project Number: 36509-013
Project Name: Woman and Child Health Development Project
Report Date:
Lesson
The project illustrates the importance of (i) strong commitment by the government, (ii) close collaboration among development partners, and (iii) prompt response to changing client needs during implementation. The leadership provided by MOH and the project coordinator was a key to the project's achievements. The project was not a stand-alone WCH project, but a part of broader health sector reforms.

Project Number: 36509-013
Project Name: Woman and Child Health Development Project
Report Date:
Lesson
The project was somewhat overambitious in setting the timelines for achieving the reforms. The government was fully committed to the reforms, but progress depended on the progress of other projects. In this project, two loan covenants were partly complied with at the project completion due their complexity. If reforms are significant, it is useful to consider a phased approach, so that interim achievements can be captured within the project timeframe.

Project Number: 36509-013
Project Name: Woman and Child Health Development Project
Report Date:
Lesson
The need to take immediate action to scale down project costs, and/or cancel part of the corresponding loan, when it becomes apparent that the government is unable or unwilling to put up the necessary counterpart funds. While it is important to correctly and objectively assess implementation constraints and implementation capacity, countries with serious development needs and weak institutional capacity should be assisted with building up this capacity as part of project design.

Project Number: 30210-013
Project Name: Reproductive Health Project [Loan 1900(SF)-PAK]
Report Date:
Lesson
The need for more frequent review missions, probably with an appropriate consultant/advisor on board, in the early years of implementation and for as long as project implementation is deemed off track; and

Project Number: 30210-013
Project Name: Reproductive Health Project [Loan 1900(SF)-PAK]
Report Date:
Lesson
The need for start-up TA to set the stage for effective project implementation as part of the loan covenant, establish the PCUs and/or PIUs, and ensure that a realistic implementation arrangement is put in place, even if it means revising the project implementation design, drafting a management operation manual, assisting in the opening of imprest accounts, training project staff on ADB procurement and disbursement procedures and reporting requirements, and initiating the preparation of procurement and disbursement documents;

Project Number: 30210-013
Project Name: Reproductive Health Project [Loan 1900(SF)-PAK]
Report Date: