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Lesson
Advance procurement actions and decisiveness on the end of the Ceylon Electricity Board and ADB could have prevented procurement delays. The project completion report noted that the project was extended by 24 months to accommodate delays in procurement. [Main text, paras. 20, 71]

Project Number: 30207-013, 30207-023
Project Name: Power Sector Development Program
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
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:
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
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: