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Lesson
Multisector collaboration is most beneficial for HIV/AIDS prevention.

Project Number: 39033-022
Project Name: HIV/AIDS Prevention and Control in Rural Development Enclaves
Report Date:
Lesson
Context−specific behavior change programs are crucial to HIV/AIDS prevention.

Project Number: 39033-022
Project Name: HIV/AIDS Prevention and Control in Rural Development Enclaves
Report Date:
Lesson
The private sector can be a viable partner in health services delivery.

Project Number: 39033-022
Project Name: HIV/AIDS Prevention and Control in Rural Development Enclaves
Report Date:
Lesson
An SDP approach increases the transaction costs compared with a programmatic approach. It is, however, a useful transition in supporting the development of a sector, and in establishing collaboration between MOF and line ministries (such as MOH or others). A CDTA grant or loan attached to an SDP or a program increases the chances of successful development of the sector.

Project Number: 41376-022
Project Name: Lao People’s Democratic Republic: Health Sector Development Program
Report Date:
Lesson
The successful implementation of HSDP is the result of ADB’s long-term commitment to the health sector in the Lao PDR. Long-term commitment and policy dialogue built on trust and confidence between ADB and MOH, and the government, in general. The SDP modality was proposed by ADB in 2007 for the Health System Development Project but MOH was not yet confident enough about the support of MOF. Policy dialogue continued and in 2009, MOH and MOF were ready for an SDP approach.

Project Number: 41376-022
Project Name: Lao People’s Democratic Republic: Health Sector Development Program
Report Date:
Lesson
Need to better identify barriers to access and use of primary health care services by the intended beneficiaries. HSDP addressed supply-side issues, but demand for services needs to be increased and oriented through better information and communication, and social marketing addressed to the beneficiaries. The health sector needs to mobilize other sectors to achieve health for all. Some barriers cannot be reduced by the health sector alone.

Project Number: 41376-022
Project Name: Lao People’s Democratic Republic: Health Sector Development Program
Report Date:
Lesson
Project design should be thorough, realistic in cost and time estimation, and in the delivery of target outputs.

Project Number: 35377-013, 35377-023
Project Name: Regional Road Development Project
Report Date:
Lesson
Output and outcome performance monitoring was generally limited to the baseline, midterm and end of program survey. Key core performance data should be collected, analyzed and reported on a quarterly basis, in alignment with standard government indicators. This provides provinces and the national level with an up-to-date status of program performance and comparative data across provinces. These data should inform the annual planning process and identify where additional support is needed.

Project Number: 41376-022
Project Name: Health Sector Development Program
Report Date:
Lesson
Funding is necessary, but is not sufficient for building capacity in the provinces and districts as they move to decentralized governance. Strengthening regulatory arrangements and institutional capacity is dependent on good management and financial procedures. A number of the provinces have increased management and technical competency and can play a valuable role through mentoring and/or twinning programs to help expand successful initiatives to others provinces.

Project Number: 41376-022
Project Name: Health Sector Development Program
Report Date:
Lesson
The coverage for the health equity fund (HEF) scheme supported by the program increased from three pilot provinces to cover all eight target provinces. This resulted in a higher number of eligible beneficiaries and health service utilization by the poor. Despite this, a large percentage of the eligible beneficiaries were not accessing the free HEF-funded services.

Project Number: 41376-022
Project Name: Health Sector Development Program
Report Date:
Lesson
The program tested a new fund flow mechanism for the health sector. Based on the successful trial the government has increased funding for health at the provincial level, resulting in expanded health services coverage, particularly for maternal, newborn, and child health care (MNCH) services and the provision of free health care for the poor.

Project Number: 41376-022
Project Name: Health Sector Development Program
Report Date:
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
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
No new lessons

Project Number: 33278-013
Project Name: Health Sector Development Program
Report Date: