Reason for Selection
The first and second Health Sector Reform Projects supported a Government-generated health care reform strategy, with the Bank taking the lead in an active and cohesive donor environment that included USAID, WHO, DfID, and others. The projects supported the establishment of a nationwide Mandatory Health Insurance Fund (MHIF) and output-oriented provider reimbursement mechanisms that helped overcome many inefficiencies in the health sector. The two projects also supported creation of Family Group Practices that provide primary health care through family practice physicians, and greater autonomy of hospitals over their budgets. By the end of the period, more than 85% of the population was covered by the MHIF and more than 98% had access to primary health care. The Bank was instrumental, through policy dialogue and complementary programmatic lending, in keeping health sector reform squarely on the political agenda in the face of opposition at many key decision points. It played an important role in developing institutional capacity at the Ministry of Health through project activities and technical assistance over the life of the two projects. The Bank's consistent and effective supervision across the spectrum of health sector reform, public sector management, and fiduciary management directly contributed to such learning. The Bank was also effective in its role as lead agency among donors active in the health sector. Sector-wide monitoring and evaluation was strong.