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Lesson
Although the Federated States of Micronesia (FSM) government and ADB flexibly responded to the changes required as a result of second Compact, few activities were implemented during the first 5 years after the project was approved. To respond to such changes, long-term technical assistance on the ground and closer communication between local stakeholders and ADB is critical, through consultations and review missions.

Project Number: 33312-013
Project Name: Basic Social Services Project
Report Date:
Lesson
To improve ownership, state governments should be closely involved in project monitoring and evaluation.

Project Number: 33312-013
Project Name: Basic Social Services Project
Report Date:
Lesson
Providing long-term technical assistance at the state level would be more appropriate to support long-term development, including human resource development and monitoring and quality control systems. Institutional capacity developments require gradual changes and long-term support at the local level would be more efficient.

Project Number: 33312-013
Project Name: Basic Social Services Project
Report Date:
Lesson
Lessons from the irregularities with civil works in Zavhan aimag are the need to (i) provide external monitoring of civil works in addition to regular monitoring by Ministry of Health (MOH) and various statutory inspection bodies (ADB has organized external monitoring for subsequent projects in the health sector), and (ii) strengthen the bid evaluation capacity of MOH (the weak capacity of some of the firms involved in irregularities could have been detected at an early stage).

Project Number: 31242-013
Project Name: Second Health Sector Development Project
Report Date:
Lesson
Given that the idea of community-based preschools was innovative for the country, sufficient time should be given for a legal and regulatory framework to be established to adequately serve preschool educational services at the community level.

Project Number: 32143-013
Project Name: Community-Based Early Childhood Development Project
Report Date:
Lesson
Policy reforms should not be too numerous and should be well integrated into an overall project. Highest priority should be given to policy reforms (and covenants) that are necessary for project implementation or sustainability. A stakeholder analysis should be conducted for all proposed policy reforms, and a strategy developed for moving systematically to the desired policy reform reflected in the project's design and monitoring framework.

Project Number: 31242-013
Project Name: Second Health Sector Development Project
Report Date:
Lesson
Implementing a project in a new field, especially in a dynamically changing transition economy, requires flexibility on the part of both the government and ADB. Willingness to adjust the project's design to a new environment or new findings and acceptance of extra time required for the adjustments is essential. To be successful, the project must also be transparent to receive support from local governments and communities.

Project Number: 32143-013
Project Name: Community-Based Early Childhood Development Project
Report Date:
Lesson
As the project proved, communities are powerful agents for designing and implementing projects that they themselves benefit from. Those community developed projects are likely to be sustainable.

Project Number: 32143-013
Project Name: Community-Based Early Childhood Development Project
Report Date:
Lesson
A multisector project requires a strong executing agency that can coordinate multiple implementing agencies. Major reforms also require strong leadership from the executing agency. The Administration of the President of the Kyrgyz Republic as the executing agency contributed enormously to the project's success despite the major regime change in the middle of project implementation.

Project Number: 32143-013
Project Name: Community-Based Early Childhood Development Project
Report Date:
Lesson
The relationship between Ministry of Health (MOH) and the project implementation unit needed to be discussed from the beginning of the project. This would have avoided the PIU isolating itself from MOH's decision-making process, as happened too often during the first 2 years of implementation. Decision-making procedures need to be clarified to involve MOH departments and higher authorities in decisions affecting bidding processes, consultant selection and outputs, policy matters, and resource allocation in the health sector.

Project Number: 31242-013
Project Name: Second Health Sector Development Project
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:
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
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
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
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: