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# Methods of Carrvine Out Project Desi,en and Implementation. and Sector Work

26. Experience has shown that the involvement of regional experts, practitioners and beneficiaries in needs assessment and in project design and implementation contributes to a significantly improved product, which is more responsive to needs and priorities and more appropriate to the political, cultural, traditional, logistical and economic context of the country in question. In addition, the success and sustainability of initiatives emanating from such a prceess are much more likely, with the commitment and sense of ownership such a strategy stimulates, which are otherwise difficult, if not impossible to elicit. Notwithstanding the often strongly country-specific nature of wonsumer preferences (and hence of appropriate programmatic and institutional solutions to PHN problems), the employment of experts coming from the same region but not the same country, can be extremely useful. Not only might they supplement a possible short supply of local expertise and/or strong community institutions, they also permit an exchange of regional expertise and experience, which has great potential for resolving country-specific issues which may be comrnmon to a region and for stimulating a regional dialogue from which all participants could benefit. The Africa region, in particular, should be cited for having fruitfully employed this strategy in the course of its work. AFTPN's success in establishing and effectively utilizing a Population Advisory Committee comprised of African experts is noteworthy, and has resulted in a commitment and partnership between the Bank and key Africans in the promotion and expansion of population activities in Africa. The initiative of AFTPN and PHRHN to elicit the input of African health experts in the African Health Policy Study, through a series of regional workshops, also deserves mention. The Lesotho Population, Health and Nutrition II Project is innovative in its successful efforts to involve service providers in the project design; and the efforts to .1rengthen community participation in the design and management of PHN interventions in Benin, Guinea, Cameroon and Togo are noteworthy and provide useful examples upon which other such efforts could be built.

27. Given tight schedules and constrained budgets, it is understandable that, while appreciating the benefits of such a strategy, staff might be inclined to avoid this approach, the costs and risks of which are perceived to be hign. Wider employment of this strategy in PHN is recommended by such means as: the producticn of case studies and/or guidelines to facilitate its implementation; creation of rosters of developing country PHN experts; a change in incentive structures to reward this approach, such as the acknowledgement and reward of such efforts through the PPR process; the creation of special funds from the Bank's administrative budget to cover the costs of very well designed and defined, short- or medium-term internships for Third World experts who never have worked with the Bank, to name a few.

# Cofinancin, and Aid Coordination

28. In an effort to ensure full implementation of human resources deveiopment policies, sttdtegies and programs, Ba1ik staff are making greater efforts to attract, consolidate and rationalize the flow of external resources into the PHN sectors, in direct support of program implementation to maximize cost-effectiveness of such investments as well as to mobilize more resources for the sectors. Some efforts to this effect have resulted in formal, and sometimes expansive, cofinancing arrangements for projects/programs initiated by the Bank (e.g. Bangladesh Population I, 11 and III Projects), while others culminated in much less formal and looser (no guarantee) agreements with donors for parallel or complementary financing of strategies or programs. As discussed in paras. 6 and 9, the Bank has had some success in attracting the support of aid donors for the PHN sectors. This demonstrated potential for raising cofinancing should be exploited, given the great need for increased financial resources for PHN sectors, as weil as the equally important need to ensure a rational allocation of resources flowing into the