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LESSONS:

Greater Mekong Subregion Regional Communicable Diseases Control Project

sector: Health | country: Cambodia Lao, People’s Democratic Republic | region: Regional

1. The project was designed to target vulnerable groups, including the poor, women and children, and ethnic minorities. It mainly targeted poor provinces in border areas, including 7 provinces out of 20 with a predominantly ethnic minority population. The project interventions benefited poor women and children, who are more at risk of communicable diseases. However, based on ADB’s results framework criteria, the project is rated unsatisfactory for gender equity. It only partially complied with gender and ethnic minority covenants. While the executing agencies were responsive to prioritizing the needs of women and ethnic groups, these groups were not specifically targeted in outbreak control. Disaggregated indicators could not be provided. Engagement of consulting services also takes time in government systems, and came too late to help integrate gender and ethnic concerns in project activities. The feasibility of indicators and monitoring targets, and the capacity of the executing agencies should be taken into consideration when preparing the project.

2. The ministries have a strong tradition of top-down training programs to be implemented by the provinces, often in an ad hoc manner. Provincial capacity to plan and coordinate training activities is insufficient. Provinces also lack core capacities in teaching methodology and in monitoring staff performance.

3. Participation in regional dialogues and other knowledge management activities has, through learning and sharing, made national and provincial communicable diseases control leaders more competent, cooperative, and competitive. However, participation in internet-based learning and sharing is still at a nascent stage.

4. Carrying out project administration through existing structures helped speed up project implementation. Delegation of project activities to concerned departments and provinces facilitated implementation. Inclusion of project activities in national and provincial annual operational plans provided better integration of health services and funding.

5. Financial management requires further improvement through training of provincial staff, timely approvals of annual operational plans, and timely liquidation of advances.

Lessons from Project Evaluation

Regional: Greater Mekong Subregion Regional Communicable Diseases Control Project

Consistent support. Continuity of ADB project staff was an important element of the successful implementation of this complex three-country project. The same team of senior staff continued to guide the Greater Mekong Subregion Regional Communicable Diseases Control Project, 2006-2009 project though all stages from the concept paper, formulation, implementation, and writing of the project completion report.

ADB procurement. All three countries reported difficulty keeping up with the frequent changes in ADB’s procurement and audit requirements. This was compounded by the executing agencies’ difficulty in retaining qualified national staff for financial management, lack of in-service training from ADB, and limited support from ADB resident missions since the project was managed out of Manila.

Long-term prospect. Regional cooperation for communicable disease control is a long-term prospect. As a first generation Greater Mekong Subregion (GMS) project supported by ADB, the GMS Regional Communicable Diseases Control (CDC) Project, 2006-2009 project left behind a legacy of regional political commitment, trust, and familiarity among counterpart colleagues in Cambodia, the Lao People’s Democratic Republic, and Viet Nam countries, and knowledge products generated from Regional Coordination Unit-supported studies.

Alternative Regional Coordination Unit designs. The Regional Coordination Unit could have been embedded within an established organization (e.g., an intergovernmental agency or nongovernment organization) or existing program with similar objectives to the GMS Regional CDC Project, 2006-2009. By hiring a consultant and housing the Regional Coordination Unit independently, institutional capacity for coordinating CDC was not developed within these agencies, risking loss of momentum after project closure.

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