Ratings for the Health System Improvement Project for Uzbekistan were as follows: outcome and Bank performance was satisfactory, and monitoring and evaluation (M and E) quality was substantial. Some lessons learned included: strong government ownership is critical, particularly with reform-oriented projects. Continuous and long-term involvement of the World Bank in the specific sector of a country is very important for the success of the operation in that sector. Close coordination and collaboration with World Health Organization (WHO) in supporting implementation aspects of the project helped keep key activities on track. Failure to implement a successful pilot of case-based financing in hospitals show that such complex reforms require thorough preparation and fulfillment of all preconditions. In the absence of clinical protocols and the lack of continuous training of the health staff, patients were at risk of being under- or over-referred to higher levels of care in treating their condition. Providing continuous guidance and actively engaging in the overall sector policy dialogue was crucial in ensuring consistency of the messages being delivered to the government. Supporting government’s policy, along with comprehensive and careful project design greatly facilitates project implementation. The design, mechanism, and rules of International Development Association (IDA) financing cycles should be revisited for possible improvements.
Details
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Document Date
2020/08/31
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Document Type
Implementation Completion and Results Report
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Report Number
ICR4995
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Volume No
1
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Total Volume(s)
1
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Country
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Region
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Disclosure Date
2020/09/03
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Disclosure Status
Disclosed
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Doc Name
Uzbekistan - Health System Improvement Project
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Keywords
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Citation
Uzbekistan - Health System Improvement Project (English). Washington, D.C. : World Bank Group. http://documents.worldbank.org/curated/en/207551599142919624/Uzbekistan-Health-System-Improvement-Project