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Lesson
Establishing a comprehensive coordination unit for rural health transformation is a gargantuan and complex task requiring dedicated programming and targeted resources. A feature of the intended design, where the project support unit would be integrated into the Department of Health (DOH) to establish a comprehensive coordination unit for rural health transformation, was not realized. The ambition was relevant, and the government’s capability to manage projects to improve primary health care and coordinate partner programs should be strengthened.

Project Number: 41509-013
Project Name: Rural Primary Health Services Delivery Project
Report Date:
Lesson
Coordination across several government agencies require strong leadership and persistence; given the regular transfer of government officials to other positions and ministries, it is important to set up a scheme for maintaining institutional memory within the executing and implementing agencies throughout program implementation.

Project Number: 55041-001, 55041-003
Project Name: Strengthening Social Resilience Program (Subprograms 1 and 2)
Report Date:
Lesson
Focusing on existing social protection programs and systems and making in-depth policy discussions on reforming them contribute to avoiding the creation of ad hoc programs and arrangements or introducing reforms without having in place a solid institutional setup for its implementation. Alignment with the relevant national strategies ensures the government's strong ownership of prior actions and outcomes. Consideration of these two key lessons will strengthen the design and implementation of future similar programs.

Project Number: 55041-001, 55041-003
Project Name: Strengthening Social Resilience Program (Subprograms 1 and 2)
Report Date:
Lesson
High turnover of staff in project implementing and other relevant agencies affects institutional memory. It requires additional time and effort to introduce to new staff while ensuring close involvement and ownership in project implementation.

Project Number: 45009-002
Project Name: Fifth Health Sector Development Project
Report Date:
Lesson
High staff turnover worsens capacity constraints. In this project, it aggravated lack of capacity to undertake procurement using ADB's Procurement Guidelines and the increased risk of misconduct and delays during implementation. Additional procurement capacity building for executing agency staff during implementation is therefore necessary even if procurement capacity risk is considered minimal at project appraisal.

Project Number: 48226-003
Project Name: Fifth Health Sector Development Project
Report Date:
Lesson
Proper handover of project responsibilities and documents will prevent staff turnover from negatively impacting project implementation and documentation. Staff turnover at the executing and implementing agencies caused implementation delays and loss of institutional memory. The executing agency was not able to prepare the project completion report because staff could not recall or find information related to the original project. The unintended consequences would have been prevented by proper handover of documents and responsibilities.

Project Number: 42322-012
Project Name: Food and Nutrition Social Welfare Program and Project
Report Date:
Lesson
At the methodology level, actions that demonstrate the achievement of program policy matrix milestones should indicate what was achieved, rather than the process of their accomplishment. Cabinet approval is an inadequate indicator to demonstrate the successful implementation of policy reform in Tonga.

Project Number: 52030-001
Project Name: Strengthening Macroeconomic Resilience Program
Report Date:
Lesson
Building systems and organizational capacity is critical to the success of social assistance programs. Moving beyond a pilot to a national CCTprogram requires establishing project management structures, robust systems for information management, accountability mechanisms, and significant human resources. Despite impressive growth, the Philippines' CCT program faced challenges as it expanded nationally.

Project Number: 43407-013
Project Name: Social Protection Support Project
Report Date:
Lesson
To support an effective and sustainable exit strategy for beneficiaries, CCTs must strengthen the productive capacity of poor households. With the Philippines CCT law’s 7-year ceiling on duration of family participation,it will be important to communicate clearly with beneficiaries on their co-responsibilities and establish referral pathways.

Project Number: 43407-013
Project Name: Social Protection Support Project
Report Date:
Lesson
Allocating dedicated technical assistance resources to support government compliance with ADB requirements, notably those related to Monitoring and evaluation and Gender, is important.

Project Number: 54174-001
Project Name: COVID-19 Rapid Response Program
Report Date:
Lesson
ADB's long standing engagement in the country, especially in the health and public finance sectors and in fiscal and macroeconomic policy developed its readiness to respond effectively and quickly. The One ADB approach and the application of the streamlined business processes under the CPRO policy also worked well for Mongolia, as it clearly demonstrated that cutting several bureaucratic layers in the approval process does not necessarily compromise the quality of the end product.

Project Number: 54174-001
Project Name: COVID-19 Rapid Response Program
Report Date:
Lesson
The CPRO experience highlighted three main lessons. First, it confirmed Mongolia's solid precrisis record in structural reforms and macroeconomics, which put the country in a strong position to effectively respond to the multifarious impact of the pandemic. Second, the fast approval of the CPRO policy and lending modality enabled ADB to provide critical emergency support to eligible client countries in times of exceptional need, clearly showcasing the importance of institutional

Project Number: 54174-001
Project Name: COVID-19 Rapid Response Program
Report Date:
Lesson
The One ADB review mechanism that supported program and/or project processing under the COVID-19 Pandemic Response Option (CPRO) was effective in facilitating quick access by DMCs to emergency support from ADB. The CPRO policy and guidelines were still being developed while the program was under preparation, and managing changing internal guidance and expectations added significant pressure. Neverthelesss, program preparation efficiency gains from the One ADB review mechanism were widely experienced.

Project Number: 54309-001
Project Name: Health Expenditure and Livelihoods Support Program
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
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: