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LESSONS:

Health Sector Development Program

sector: Health | country: Papua New Guinea | region: Pacific Islands

Alternate staffing arrangements should be introduced in project implementing units (PIUs), in cases when the project manager or project coordinators go on long leave, to ensure smooth project implementation. Alternates should have hands-on experience in administering projects, specifically those funded by ADB.

Capacity building through the use of consultants varied largely depending on the area. The major problem was the availability of local counterparts and the continuity of their presence during the job. Too often they were transferred to other sectors after being trained. While this modality was very effective with the health health management information system (HMIS), due to the stability and leadership within themonitoring and research branch, the transfer of the senior finance officer trained in the Health Sector Development Program (HSDP) secretariat to another sector puts at risk the capacity built in this area by the attached technical assistance.

The choice of a quick-disbursing approach, with release of two large tranches was not adequate for the kind of reforms and support envisaged in the Health Sector Development Program (HSDP). This approach resulted in major difficulties between the Department of Treasury (DOT) and the National Department of Health (NDOH), with the latter not releasing funds as scheduled. The approach also did not allow ADB’s close monitoring of the progress made during the program’s entire life, as any leverage disappeared after the release of the second tranche.

The Health Sector Development Program (HSDP) established early on a policy of producing and disseminating information on as broad a basis as possible. The attention given to transparency and resolving issues raised through the monitoring process also served to underscore the importance of the monitoring and information process. The useful application of information in the management process is acquired through practice. Only when managers have acquired this skill is the costly exercise of producing information justified.

The reform process underway in the National Department of Health (NDOH), with the assistance of an international accounting firm, also needs to be sustained. The progress to date is substantial, but a change in public service culture will require continued assistance and the progressive and active involvement of the relevant government support agencies, including the Auditor General’s Office, Department of Finance, Department of Intergovernment Relations, Department of Personnel Management, and others. A public service culture change cannot occur in a sustainable manner in one government department alone.

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