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PROJECT PERFORMANCE EVALUATION REPORT IN THE ... ... Performance Evaluation Report Operations Evaluation Department Project Number: PPE: PHI 27010 Loan Number: 1331-PHI(SF) July 2007

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  • ASIAN DEVELOPMENT BANK Operations Evaluation Department


    IN THE


    In this electronic file, the report is followed by Management’s response.

  • Performance Evaluation Report

    Operations Evaluation Department

    Project Number: PPE: PHI 27010 Loan Number: 1331-PHI(SF) July 2007

    Philippines: Women’s Health and Safe Motherhood



    Currency Unit – Peso (P)

    At Appraisal

    (12 Oct 1994) At Program Completion

    (1 Sep 2003) At Operations Evaluation

    (30 Jun 2007) P1.00 = $0.04 $0.0182 $0.0216 $1.00 = P25.57 P55.045 P46.195

    ABBREVIATIONS ADB – Asian Development Bank AusAID – Australian Agency for International Development DOH – Department of Health GNP – gross national product IEC – information, education, and communication KfW – Kreditanstalt für Wiederaufbau LGU – local government unit MCP – maternity care package MDG – millennium development goal ODA – official development assistance OED – Operations Evaluation Department OEM – operations evaluation mission PCR – project completion report PhilHealth – Philippines Health Insurance Corporation PMO – project management office RRP – report and recommendation of the President WHSMP – Women’s Health and Safe Motherhood Project UNICEF – United Nations Children’s Fund WHO – World Health Organization


    barangay smallest local-government unit in the Philippines hilot traditional birth attendant kuliglig tractor converted to passenger vehicle


    In this report, "$" refers to US dollars

  • Overall Assessment Methodology

    Weight (%) Definition

    Rating Description

    Rating Value Criterion

    1. Relevance 20 Relevance is the consistency of a project’s impact and outcome with the government’s development strategy, the Asian Development Bank’s lending strategy for the country, and the Asian Development Bank’s strategic objectives at the time of approval and evaluation and the adequacy of the design.

    Highly relevant Relevant Partly relevant Irrelevant

    3 2 1 0

    2. Effectiveness 30 Effectiveness describes the extent to which the outcome, as specified in the design and monitoring framework, either as agreed at approval or as subsequently modified, has been achieved.

    Highly effective Effective Less effective Ineffective

    3 2 1 0

    3. Efficiency 30 Efficiency describes, ex post, how economically resources have been converted to results, using the economic internal rate of return, or cost-effectiveness, of the investment or other indicators as a measure and resilience to risk of the net benefit flows over time.

    Highly efficient Efficient Less efficient Inefficient

    3 2 1 0

    4. Sustainability 20 Sustainability considers the likelihood that human, institutional, financial, and other resources are sufficient to maintain the outcome over its economic life.

    Most likely Likely Less likely Unlikely

    3 2 1 0

    Overall Assessment (weighted average of above criteria)

    Highly successful: Overall weighted average is greater than 2.7. Successful: Overall weighted average is greater than 1.6 and less than 2.7. Partly successful: Overall weighted average is greater than 0.8 and less than 1.6. Unsuccessful: Overall weighted average is greater than 0.8.

    Source: ADB. 2006. Guidelines for Preparing Performance Evaluation Reports for Public Sector Operations. Manila. Available:

    Director General B. Murray, Operations Evaluation Department (OED) Director R. K. Leonard, Operations Evaluation Division 1, OED Team Leader S. Shrestha, Evaluation Specialist, Operations Evaluation Division

    1, OED Team Members C. Infantado, Portfolio Evaluation Officer, Operations Evaluation

    Division 1, OED O. A. Badiola, Senior Operations Evaluation Assistant, Operations

    Evaluation Division 1, OED

    Operations Evaluation Department, PE-704


    Basic Data iii

    Executive Summary v

    Map ix

    I. Introduction 1 A. Evaluation Purpose and Process 1 B. Project Objectives and Expected Results 2

    II. Design and Implementation 3 A. Formulation 3 B. Rationale 4 C. Cost, Financing, and Executing Arrangements 4 D. Procurement, Construction, and Scheduling 5 E. Design Changes 5 F. Outputs 6 G. Consultants 10 H. Loan Covenants 11 I. Policy Framework 11

    III. Performance Assessment 11 A. Overall Assessment 11 B. Relevance 12 C. Effectiveness 14 D. Efficiency 16 E. Sustainability 18

    IV. Other Assessments 20 A. Impact on Achievement of the Millennium Development Goals 20 B. Impact on Other Maternal Health Targets 22 C. Impact on Gender and Ethnicity 23 D. Institutional Impact 24 E. Environmental Impact 24 F. Asian Development Bank Performance 25 G. Executing Agency Performance 25

    V. Issues, Lessons, and Follow-Up Actions 26 A. Issues 26 B. Lessons 27 C. Follow-Up Actions 29

    The guidelines formally adopted by the Operations Evaluation Department (OED) on avoiding conflict of interest in its independent evaluation were observed in the preparation of this report. Marilyn Noval-Gorra was a public health specialist consultant. To the knowledge of the management of OED, there were no conflicts of interest of the persons preparing, reviewing, or approving this report.

  • ii Appendixes 1. Findings of the Beneficiary Household Survey and Focus-Group Discussions 31 2. Maternal Health Care Policies and Systems in the Philippines 41 3. Appraisal Estimate and Actual Cost Breakdown by Project Component 49 4. Ratings Matrix for Core Evaluation Criteria 50 5. Assessment of the Project outcomes and Impacts based on Published Official

    Data 52

    Attachment: Management Response


    Loan 1331-PHI(SF): Women’s Health and Safe Motherhood Project

    Project Preparation TA No. TA Name Type Person-

    Months Amount

    ($) Approval Date

    1926 Women’s Health and Safe Motherhood

    PPTA 10 100,000 16 August 1993

    Key Project Data ($ million)

    As per ADB Loan Documents


    Total Project Cost 67.5 33.4 ADB Loan Amount/Utilization 54.0 29.0 ADB Loan Amount/Cancellation 19.7 Key Dates Expected Actual Fact-Finding 7–23 February 1994 Appraisal 6-24 June 1994 Loan Negotiations 10–11 October 1994 Board Approval 10 November 1994 Loan Signing 20 January 1995 Loan Effectiveness 20 April 1995 19 May 1995 Project Completion December 2000 June 2002 Loan Closing 30 June 2001 16 October 2002 Months (effectiveness to completion) 68 79 Borrower Republic of the Philippines Executing Agency Department of Health Mission Data Type of Mission No. of Missions No. of Person-Days Fact-Finding 1 85 Appraisal 1 19 Project Administration Inception 1 12 Review 10 148 Midterm Review 1 41 Special Loan Administration 3 45 Disbursement 1 2 Project Completion 1 82 Operations Evaluation 1 55


    This project performance evaluation report presents the findings of the evaluation of the

    Women’s Health and Safe Motherhood Project funded by the Asian Development Bank (ADB). This was ADB’s first health-sector project in the Philippines. It was also the first ADB-supported project designed exclusively for improving women’s reproductive health and well-being. The Project commenced in May 1995 and was completed in June 2002.

    The rationale for the Project was that the Philippines had one of the highest maternal mortality ratios in Southeast Asia. Women’s health in the Philippines had not been improving at the same rate as in other countries in the region. Nationally the maternal mortality ratio in 1990 was 209 per 100,000 live births, compared to the rate in neighboring countries such as Thailand at 140 per 100,000, Viet Nam at 140 per 100,000, and Malaysia at 59 per 100,000. The fertility rate of 3.1 births per woman was also one of the highest in the region. The Government gave high priority to improving women’s health and developed a national program to achieve this. The Project provided support for implementing this government initiative. ADB had also accorded high priority to improving women’s health in the Philippines.

    ADB was one of five international partners involved in designing and financing the initiative. The ADB-supported component had three objectives: (i) to improve maternal care support; (ii) to develop and utilize integrated information, education, and communication (IEC) strategies; and (iii) to support the Project Management Office (PMO). The maternal care support focused on strengthening the referral systems and promoting the national Safe Motherhood Program. The IEC component sought to develop and utilize an integrated communication strategy to make women more aware of their health needs and encourage them to seek health information and services during and after pregnancy. The PMO was responsible for coordinating, planning, and implementing the Project activities, and for providing technical assistance, training, information, logistical, and

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