in the number of people living in poverty and a reversal of social development progress achieved over the preceding two decades. The Government’s limited budget constrained the delivery of essential and basic services, preventing people—especially the poor and vulnerable groups—from accessing quality health care and educating their children.
The health and nutrition sector development program aimed to secure for the poor access to essential health, nutrition, and family planning services; maintain the nutritional status of vulnerable groups; and reduce the incidence and impacts of communicable diseases associated with poverty and malnutrition. It supported fundamental reforms through the development of pro-poor health policies, structures, and systems. The project was designed to improve and maintain the health and nutrition of the population and secure continued access to essential health, nutrition, and family planning services. The program helped the government institute policy reforms. The project produced most of the expected outputs. Project interventions largely reached the intended beneficiaries. These included (i) health card distribution to the poor; (ii) revitalization of community-based health posts that provide prevention and promotive health, nutrition, and family planning services, and community volunteers; and (iii) provision of maternal care, family planning, and immunization services. However, complementary and supplementary feeding for infants, children, and pregnant women with high caloric deficiency, as well as assistance for schoolchildren, reached fewer than expected. Key health indicators suggest that the general health and nutrition status of the population, including family planning practice, improved. Maternal deaths were contained by promoting prenatal care, increasing the number of deliveries attended by professionals, and enhancing the referral system for high-risk cases. The health of infants and children was improved by intensifying outreach by paraprofessionals and ensuring support for immunization programs. A pro-poor-based planning and resource allocation system was established. Furthermore, mechanisms were put in place to minimize misuse of resources and to resolve complaints.
The purpose of the sector development program for social protection was to reduce impoverishment while introducing sector reforms to strengthen social services delivery in anticipation of decentralization. The program loan provided support to government policies aimed at maintaining access of the poor to social services; maintaining the quality of services; continuing decentralization of social services management; and strengthening the efficiency, transparency, and accountability of management of funds in schools and health centers. The project loan aimed to maintain school enrollment and educational quality at precrisis levels through the provision of scholarships and school grants; protect the health and nutritional status of the poor, especially infants, mothers, and children; and provide scholarships and supplementary feeding to street children. Overall, the program succeeded in achieving its objectives. Achievements in education surpassed expected outputs. The nutrition component, due to its complexity, was less successful. Enrollment ratios were either maintained or rose. The block grants to primary schools prevented them from refusing children who could not pay. Life expectancy rose and infant mortality declined during the period of loan activity. The program was highly relevant in mitigating the impact of the crisis on the most vulnerable members of Indonesian society in terms of their access to basic social services in education, health, family planning, and nutrition. The education components generated additional funding from the World Bank and the Government, which enhanced the success of the program. The policy actions supported numerous novel interventions, including (i) allocating central government funding to local government based on the poverty index, (ii) decentralizing decision making, (iii) providing block grants to education and health service providers, (iv) making direct transfers to final beneficiaries through the post office to increase efficiency and reduce leakage, and (v) establishing independent monitoring of effectiveness of the program and accuracy of funds transfer. Although the central monitoring unit demonstrated the value of independent monitoring, this component was not sustainable after donor funding ceased.
a Available: www.adb.org/documents/ppers/ino/32516-ino-pper.pdf and www.adb.org/documents/ppers/ino/32255-ino-pper.pdf
Box 6: Pakistan Livestock Development Projecta
Unsuccessful
Millions of rural poor in Pakistan depend on livestock for their livelihood. The project sought to address problems related to weak extension services, animal health and breeding, and limited feed sources during the summer. It aimed to establish a policy and institutional framework to encourage private investment in livestock, increase production and by-product utilization, and increase rural employment and incomes. Components were (i) strengthening the Federal Livestock Division and provincial livestock departments, (ii) stablishing extension services, (iii) breed improvement, (iv) improving animal health services, (v) slaughterhouse improvement, and (vi) capacity building through local and overseas training and consultancies.
Considerable resistance was encountered in reorienting the traditional extension services to a more bottom-up, production-based system. Rivalry among provincial agencies had a negative impact on project coordination. While the appointment and training of extension staff were partly effective, benefits were limited. Breeding activities were partly successful. A major accomplishment was the privatization of veterinary services, but slaughterhouse initiatives were a failure. The training component was extensive and successful, but consultants’ inputs were often poorly coordinated. At the time of evaluation, the only project-supported initiatives still operating were those that involved the private sector or where beneficiaries were charged for services. Economic reevaluation resulted in an almost negative economic internal rate of return, an unsatisfactory project outcome. Extension activities were unsustainable.
a Available: www.adb.org/documents/ppars/pak/ppar-pak-21131.pdf
Project performance varied more significantly by sector than by country category. The likelihood of project success by sector is depicted in Table 2. The findings indicate that both OCR- and ADF-funded projects generally perform similarly in the same sectors, with certain important exceptions. The ratings of ADF-funded projects eventually converged with those of OCR-funded projects across sectors from 1970 to 1997.
Table 2: Project Performance by Sector and Source of Financing (% of Projects Rated as Successful)
ADF = Asian Development Fund, DFI = development finance institution, OCR = ordinary capital resources.
Source: OED.
ADB’s experience has been best in the transport/communications and energy sectors, with project success rates reaching 87% for both in the 1990s; the success rates are high for both ADF- and OCR-funded projects. In the transport sector, road projects have dominated the portfolio for both sources of funding. Project success has also been high for port, airport, and telecommunication projects, again regardless of the source of funding. The performance of the relatively small railway portfolio has been considerably weaker than that of the other transport modes. The characteristics of successful road projects are listed in the box.
Evaluations of ADB’s energy portfolio have found generally good project outcomes regardless of funding source. Power projects dominate the portfolio. Difficulties are sometimes experienced in complying with financial covenants and with ADB’s environmental and resettlement safeguard policies, particularly for hydropower projects. Nongovernment organizations (NGOs) and civil society organizations have raised concerns about the latter. Successful power projects exhibit the characteristics listed in the box.
The
