Implementation Completion Report - First Health Project
Summary — This report assesses the implementation and outcomes of the HT-First Health Project in Haiti, funded by the World Bank. The project aimed to improve health outcomes and strengthen the Ministry of Health, but faced significant challenges due to political instability and weak governance.
Key Findings
- The project failed to achieve most of its major objectives, particularly in institutional development and reducing maternal and child mortality.
- The project had some important successes in provision of essential drugs and in certain elements of Epidemic Prevention and Control, particularly TB control.
- Public-private partnerships can help to mitigate institutional constraints, as demonstrated by the TB program.
- Supply-driven public sector projects cannot overcome systemic constraints.
- Governance of acceptable quality and basic implementation capacity are essential for the success of a Bank operation.
Full Description
The HT-First Health Project in Haiti, supported by the World Bank, aimed to reduce central administration expenditures of the Ministry of Health, improve the ratio of salaries to operating expenditures, enhance patient contribution collection, strengthen key management and technical functions, reduce maternal and child mortality rates, and counter the effects of AIDS and tuberculosis. However, the project faced numerous revisions due to political instability, a coup d'etat, and an international embargo. These revisions shifted the emphasis away from large-scale institutional change towards strengthening specific, high-impact elements of public health and basic health service delivery, particularly in maternal and child health, TB, and HIV/AIDS.