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Chad - Health Sector Support Project (English)

The Health Sector Support Project of Chad had the following ratings: outcomes were unsatisfactory, risk to development outcome was substantial, Bank performance was moderately satisfactory, and borrower performance was moderately unsatisfactory. The lessons learned included: 1) The support of the central ministries is essential for an operation with the ambition of addressing the most pressing issues in a sector; 2) Supervision of a broad-based sector operation should include a review of budget implementation for the sector and agreement on an updated Medium-Term Expenditure Framework (MTEF) on an annual basis. This was not done for the project under review; 3) Heroic efforts to get things done at the micro level do not bring about expected results if the macroeconomic and governance environment becomes increasingly hostile. At the mid-term review, which took place a month after the portfolio review, the Bank team should have come to the conclusion that continued support to the sector was difficult to justify under the unchanging country circumstances; and 4) In such a challenging and difficult country environment fraught with governance-related issues, the design of projects should be simple and well-targeted.

Details

  • Document Date

    2007/06/28

  • Document Type

    Implementation Completion and Results Report

  • Report Number

    ICR451

  • Volume No

    1

  • Total Volume(s)

    1

  • Country

    Chad,

  • Region

    Africa,

  • Disclosure Date

    2007/07/30

  • Disclosure Status

    Disclosed

  • Doc Name

    Chad - Health Sector Support Project

  • Keywords

    access to basic health service;French Agency for Development;average for sub-saharan africa;Demographic and Health Survey;project monitoring and evaluation;decentralization of health service;millennium development goal;access to health service;Environmental and Social Safeguard;human resource development;cost recovery mechanism;basic social service;distribution of medicine;allocation of resource;oil revenue management;condition of effectiveness;provision of equipment;quality health care;health districts;quality of health;negative environmental impact;Compulsory Health Finance;annual budget preparation;Public Finance Management;Human Immunodeficiency Virus;financial management procedure;primary health care;budget for health;lack of resource;Public Expenditure Management;regional training center;peripheral health facilities;local health officials;rehabilitation of buildings;Civil Service Employment;reproductive health care;maternal mortality rate;weak financial management;national health policies;change in exchange rate;quality at entry;national health system;sense of ownership;quality of data;public health specialists;human resource strategy;cost recovery measure;Exchange Rates;construction and rehabilitation;poverty reduction policy;Civil Service Reform;lack of incentive;cost recovery policy;secondary school teacher;availability of finance;readiness for implementation;institutional capacity building;outputs by components;suspension of disbursement;health facility;project intervention;civil works;Essential Drugs;vaccination coverage;credit effectiveness;counterpart funding;community participation;medical supply;contractual approach;petroleum revenue;intended beneficiary;portfolio review;utilization rate;improved delivery;national procurement;health area;difficult environment;external partner;continuing training;security situation;pharmaceutical policy;health communication;governance environment;results framework;entire portfolio;donor community;political interference;budget allocation;quality service;Health Workers;live birth;adequate supply;pregnant woman;corrective action;local stakeholder;widespread poverty;aid control;management personnel;blood safety;social analysis;health reform;risk analysis;public resource;increased revenue;procurement staff;rural district;Child Health;hospital waste;std treatment;outcome indicator;effectiveness condition;decentralization process;procurement process;procurement reform;severe shortage;medical personnel;political affiliation;improved public;government commitment;Civil War;local personnel;geographical area;procurement delay;health strategy;draft form;personnel training;satisfactory progress;macroeconomic adjustment;security concern;common problems;procurement practice;hospital autonomy;fiscal discipline;external assistance;working condition;military expenditure;darfur conflict;health needs;project financing;institutional change;annual variations;hospital level;health outcome;high spending;sector budget;vaccination rate;rebel attack;fiscal deficit;financial problem;government budget;real gdp;limited resources;remote area;Budget Management;intermediate outcome;budgetary process;baseline data;medical aspects;medium-term expenditure;poverty alleviation;national strategy;decentralization framework;management capacity;Macroeconomic Management;community level;effective supervision;credit negotiation;gender aspect;national school;Basic Drugs;total credit;extreme poverty;health committee;project finance;reproductive age;expenditure tracking;pharmaceutical sector;rural area;partnership arrangement;basic skill;high volatility;political pressure;site visits;process use;national norm;qualified personnel;project indicator;international consultant;donor coordination;budget execution;foreign assistance;aid agency;procurement administration;procurement procedure;transition arrangement;project sustainability;external financing;health expenditure;government data;

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Citation

Chad - Health Sector Support Project (English). Washington, D.C. : World Bank Group. http://documents.worldbank.org/curated/en/446291468236103615/Chad-Health-Sector-Support-Project