The objectives of the Health and Nutrition Project were to raise the quality, coverage, and effectiveness of family planning, nutrition, and basic health services through the provision of support to critical and strategic elements of the Health, Nutrition and Population (HNP) sector. This was the first International Development Association (IDA)-financed health project in Tanzania. The project suffered from poor quality at entry, with ambitious objectives, complex design, and implementation arrangements, and ill-considered covenants and cross-conditionality's between different implementing agencies. Combined with the government's weak ownership at the outset and poor project management, project performance during the first three years was very poor. A mid-term review in 1994, and subsequent project restructuring in 1996, resulted in clearer project direction, more feasible work plans and more streamlined implementation. By the end of the project, the government assumed full ownership, and planned activities were completed with project objectives largely achieved. Moreover, the project initiated some of the key reform agenda, paving the way for a multi- donor supported health sector reform program which the follow-on IDA credit is supporting. This note summarizes the impact on the ground and lessons learned.
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