Project Performance Assessment Report for the Indonesia Provincial Health I and II Projects, and the Health Work Force and Services Project / Provincial Health III Project
This Project Performance Assessment Report (PPAR) reviews the performance of three health projects in Indonesia, the (i) Provincial Health I (effective from August 2000 through December 2007); (ii) Provincial Health II (from April 2002 through July 2009); and (iii) Health Work Force and Services... Full Description »
This Project Performance Assessment Report (PPAR) reviews the performance of three health projects in Indonesia, the (i) Provincial Health I (effective from August 2000 through December 2007); (ii) Provincial Health II (from April 2002 through July 2009); and (iii) Health Work Force and Services Project (Provincial Health III) (from December 2003 through December 2008). The projects shared two development objectives, (i) to pilot effective health sector decentralization in selected provinces; and (ii) to support the Ministry of Health (MOH) in its new oversight role within the decentralized health system. The Health Work Force and Services Project (Provincial Health III) had a third, additional objective, to support effective health workforce policy and management. Decentralization was seen as an opportunity to revitalize a public health system that was facing coverage, quality, and equity challenges, as well as declining demand for public health services.
The outcome of each of the three projects is rated unsatisfactory. Key lessons include, (i) planning for and managing risks when undertaking extensive policy reforms is essential for achieving success, especially in a rapidly changing environment; (ii) a strong monitoring and evaluation (M&E) framework is a prerequisite when undertaking potential high-risk/high-potential operations and that it incorporates appropriate technical as well as political economy indicators;, and includes a schedule for rigorous assessment of progress and results; (iii) goals and project organization need to be well understood and supported by the client—at national and sub-national levels—for achieving effective M&E and learning. This also requires collaborative project development and continuous socialization of the project among participants to ensure client ownership; (iv) sufficiently existing technical capabilities to take on new roles are also a prerequisite for success. The design and timing of inputs—the roadmap for implementation—must be calibrated to ensure clients' absorptive capacity exists; (v) institutional flexibility and adaptability of processes, checks and balances is critical, particularly when piloting new methods; (vi) project sequencing is critical given the context and complex reforms to be undertaking, for example, to allow for sufficient opportunities for transmittal of learning from one project to another.
Content Type : Reports , Doc Sub Category : Project Performance Assessment Report , Country : Indonesia
November 13, 2013