Preventive Health System Support Project: Completion Report
sector: Health | country: Viet Nam, Socialist Republic of
Consideration of local government fiscal capacity. The project originally required participating provinces to provide funds to upgrade the PPMCs (provincial preventive medicine centers), including their laboratories. While local government commitment to preventive health care is significant in Viet Nam, the fiscal situation of some provinces does not allow investments of the scale that was needed. ADB needs to carefully consider the local costs of such infrastructure projects and the fiscal ability of local governments to meet them before committing to an investment.
Phased approach. Implementing the project across almost four dozen provinces and such a wide geographical area led to challenges both in providing laboratory equipment in a timely manner and in ensuring that training was provided in the use of this equipment. A phased approach prioritizing provinces with stronger technical capacities would ensure a closer link between the provision of equipment and training thus increase efficiency.
Need for market-based remuneration. The government’s cost norm is too low and not competitive. Because of this, recruiting experienced senior national consultants (with the exception of retired government employees) remains a challenge. Training allowances are also too low. This also applies to its training allowances, which discourages participation by staff who must travel from where they live and work to take part. Future projects should include a clause that allows remuneration for consultants and allowances for staff training to be market-based.
The PCR (project completion report) identified the following three lessons: (i) ADB has to take into consideration the local governments’ fiscal capacity to upgrade PPMCs (provincial preventive medicine centers), (ii) adopt a phased approach for projects with such large project coverage, and (iii) use market-based rates for consultants’ remuneration and realistic training allowance. This validation agrees with these lessons.
This validation would like to add the following lessons. First, the importance of a strong and well-functioning PMU (project management unit), with a full-time and qualified project coordinator, is paramount. Second, the project’s quality-at-entry can often be assessed through the project DMF (design and monitoring framework). A good project DMF should be self-explanatory and formulated as a real and understandable tool for project implementation and project monitoring by the executing agency, particularly by the PMU staff.