Economics & Development

Ratings of Health Service and Capacity Strengthening Project for Guinea were as follows: outcome was highly satisfactory, Bank performance was satisfactory, and monitoring and evaluation quality was substantial. Some of the lessons learned include: Narrowing the catchment area can ensure achievement of the Project Development Objective (PDO) in low-capacity settings; Focusing on essential health system building blocks, with a combination of supply-side and demand-side interventions, in fragile contexts allows the health system to function; Having a well-staffed, stable, and decentralized Project Coordination Unit (PCU) can ensure the overall progress of a project; Involving local authorities, such as governors and prefects, increases accountability for Human Resource for Health (HRHs), Community Health Workers (CHWs), and relays, and promotes Reproductive, Maternal, Neonatal, and Child Health (RMNCH) service utilization; Ensuring financial autonomy of health facilities in fragile contexts is essential for the continuity of care; Results-Based Financing (RBF) is a powerful tool for ensuring health facility autonomy and improving service quality; and the implementation of a free care program for indigents in a fragile context is challenging and requires adequate preparation and prerequisites.