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LESSONS:

Rural Health Project

sector: Health | country: Viet Nam, Socialist Republic of

Priorities for health sector development. One issue with health projects in Viet Nam is that the Ministry of Health (MOH) and the provinces typically give priority to upgrading facilities and staff. Provinces may be less focused on sector reforms and improving outcomes, perhaps as this is not seen as a role of projects, and the results are less understood and tangible. Provinces need to focus more on improving the quality of services and maintaining assets.

Piloting reforms. While government ownership of project formulation was strong, proposed pilots were too ambitious given MOH constraints and the lack of detailed plans or technical support. On the other hand, the project flexibly responded to several policy changes and national developments by adjusting its scope, which counterparts appreciated. Demand-led programming improved project impact.

Targeting. The project improved services for the poor and had a substantial focus on maternal care but provided less targeted support for ethnic minorities. Several of the interventions for ethnic minorities didn’t materialize. The project evaluation study showed that the poor in general and ethnic minorities in particular benefited from the government support for commune health stations (CHSs) and health insurance, while ADB funding provided more general public support. More could have been achieved with better targeting for minorities, assuming MOH concurrence.

Lengthy administrative processes. Implementation delays were largely caused by lengthy procurement and financial control procedures at all levels. While the project management unit (PMU) and provincial project management unit (PPMU) capacity was also an issue, the government’s administrative procedures were time consuming. ADB administration was considered relatively efficient.

Monitoring and evaluation. Data were regularly collected, and efforts were made not to create a separate monitoring system but use existing information. However, project monitoring was incomplete and insufficiently used as a management tool to achieve results. Substantive project evaluation was very useful.

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