Tanzania - The Health and Nutrition Project
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World Bank, Washington, DC
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The objectives of the Health and
Nutrition Project were to raise the quality, coverage, and
effectiveness of family planning, nutrition, and basic
health services through the provision of support to critical
and strategic elements of the Health, Nutrition and
Population (HNP) sector. This was the first International
Development Association (IDA)-financed health project in
Tanzania. The project suffered from poor quality at entry,
with ambitious objectives, complex design, and
implementation arrangements, and ill-considered covenants
and cross-conditionality's between different
implementing agencies. Combined with the government's
weak ownership at the outset and poor project management,
project performance during the first three years was very
poor. A mid-term review in 1994, and subsequent project
restructuring in 1996, resulted in clearer project
direction, more feasible work plans and more streamlined
implementation. By the end of the project, the government
assumed full ownership, and planned activities were
completed with project objectives largely achieved.
Moreover, the project initiated some of the key reform
agenda, paving the way for a multi- donor supported health
sector reform program which the follow-on IDA credit is
supporting. This note summarizes the impact on the ground
and lessons learned.
Palabras clave
PROJECT MANAGEMENT, GOVERNMENT OWNERSHIP, PROJECT RESTRUCTURING, DONOR COORDINATION, DRUG POLICY, ACCESS TO HEALTH CARE, ALLOCATION OF RESOURCES, COMMUNITY PARTICIPATION, COUNTERPART FUNDS, PROCUREMENT, DATA GATHERING, BASIC HEALTH SERVICES, COMMUNICATION CAMPAIGN, COMMUNITIES, COMMUNITY HEALTH, DISTRICTS, FAMILY PLANNING, HEALTH FACILITIES, HEALTH FINANCING, HEALTH INFRASTRUCTURE, HEALTH INITIATIVES, HEALTH PLANS, HEALTH SECTOR, HEALTH SECTOR REFORM, HEALTH SERVICES, HOSPITALS, MINISTRY OF HEALTH, NUTRITION, NUTRITIONAL STATUS, PRIMARY HEALTH CARE, PRIMARY HEALTH FACILITIES, PROVISION OF SUPPORT, SUSTAINABLE FINANCING, TECHNICAL CAPACITY, USER FEES, VULNERABILITY PROJECT MANAGEMENT, GOVERNMENT OWNERSHIP, PROJECT RESTRUCTURING, DONOR COORDINATION, DRUG POLICY, ACCESS TO HEALTH CARE, ALLOCATION OF RESOURCES, COMMUNITY PARTICIPATION, COUNTERPART FUNDS, PROCUREMENT, DATA GATHERING