The German Federal Ministry for Economic Development asked a team of consultants comprising of a public health and an economic specialist to evaluate four ongoing projects of the German Agency for Technical Cooperation (GTZ). After a detailed analysis of the four projects, a proposal for the optimisation of their combined effects were developed. Because of coordination problems between the donor organisations, potential measures were outlined to improve collaboration and to gain additional synergetic potential. The regional demand for training services, health information systems, and a shift from urban to rural family health programmes were portrayed and proposals were drafted to improve future interventions in these key areas of the health sector.
The aim of the consultancy services was: - To assess the actual and present state of implementation as well as performance of the projects - To determine possible means of achieving synergetic effects - To recommend appropriate strategic and operational changes within and between projects. Proposals were developed to change the organization and contents of the four projects to optimise their contribution to the development of the health sector, and to strengthen the medium and long term planning as well as the project management and monitoring and evaluation activities. The importance for further transfer of external know-how for establishing a national health insurance system was emphasised. Due to the spatial distribution of the family health program which was mainly located in the urban and suburban areas, it was suggested to include rural areas as well. After evaluating national priorities and already existing programs, it was suggested to intensify efforts in Mindanao. In order to properly evaluate potential synergetic effects resulting from the program, all four projects were to be present in the same geographical area. To gain further insight as to how far certain constraints could influence the success of the project, it was important to introduce combined project efforts in different environments.