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Documented examples

Each record describes something a country built that the indicators do not capture. The source provides the published number; the mechanism is our interpretation.

Scores describe outcomes. These records describe how a country acted, what it needed and what happened. 863 of 863 records include a mechanism. They do not affect scores.

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3 of 863 deliveries

Coordination

1 delivery linked to Public-private collaboration.

Lesothosince 2011dismantledbears on Public-private collaboration

Queen 'Mamohato Memorial Hospital PPP, and its termination

Lesotho's Ministry of Health replaced its national referral hospital through an 18-year partnership with the private Tsepong consortium, which opened the hospital and three filter clinics in 2010 and 2011 and handled 24,796 admissions in 2018; the government terminated the contract in 2021, about five years before its end date, and took over management in mid-2021.

24,796 admissions, admissions at the ppp-run national referral hospital, 2018. 5 years, years of the 18-year contract term cut by the 2021 termination, 2021. McGuire et al., Annals of Global Health (2024), study of the Queen 'Mamohato Memorial Hospital integrated network PPP, retrieved 2026-10-17.

The move, and what it needed

The Ministry of Health contracted a private consortium to build and run the national referral hospital and its clinics for a fixed fee against quality standards, then ended the contract in 2021 after a nurse strike and the consortium's dismissal of the strikers broke the relationship.

Preconditions

  • A health budget able to carry a fixed, indexed unitary payment over 18 years
  • A ministry able to monitor performance standards and enforce deductions
  • Wage policy for public health workers that does not undercut the contract's staffing terms

Limits: The source is a peer-reviewed interview study, not a government or World Bank evaluation, and its volume figures come from the hospital itself for one year, 2018. The termination is given only as approximately five years before the contract end, so the second metric is a rounded figure. The record shows one hospital network, the country's single referral facility, so it bears on national delivery only because that facility is the top of the public referral system; it is not a programme of many projects. The source does not give the annual payment to the consortium or its share of the health budget, and that cost is the main reason a reviewer would call the partnership a failure of design before it was a failure of delivery. Admissions after the government takeover are not published at this URL, so the record cannot show whether service fell after the handover.

Adaptability

1 delivery linked to Institutional responsiveness.

Lesothosince 2020delivered and closedbears on Institutional responsiveness

Child Grants Programme drought top-ups, 2020

After Lesotho declared a drought emergency in October 2019, the government and the World Bank restructured the Social Assistance Project in January 2020 to reallocate US$7.4 million, and between February and September 2020 the Ministry of Social Development paid more than 40,000 Child Grants Programme households a LSL 500 monthly top-up for six months and added about 10,000 new households, which it kept on the programme at its own cost.

40,000 households, child grants programme households receiving drought top-ups (more than), 2020-09. 10,000 households, new households added in the horizontal expansion and retained on the budget (around), 2020. World Bank, Implementation Completion and Results Report, Lesotho Social Assistance Project, retrieved 2026-10-02.

The move, and what it needed

The social development ministry used its national household registry (NISSA) and the Child Grants Programme to add a temporary top-up for existing recipients and enrol new poor households in drought districts, financed by restructuring an existing World Bank credit instead of waiting for new money.

Preconditions

  • A household registry covering every rural council before the shock
  • A standing cash transfer with pay points in the affected districts
  • A lender willing to reallocate an existing loan within three months

Where else it has been used: Lesotho used the same route after the 2016 drought (27,000 recipients topped up in 2017, per the same ICR); NGOs also used NISSA to target their own responses.

Limits: The figures are in a PDF (the restructuring in paragraph 39 on PDF page 22; the top-up figures in paragraph 62 on PDF page 31). The World Bank financed the top-ups and rates its own project. The elapsed time is about four months from the October 2019 declaration to the first top-ups in February 2020, which we computed from dates in the report; the report gives no date for the first payment, only the February to September window. The results framework counts 67,000 beneficiaries of emergency top-ups against a target raised to 50,000, a different unit from the 40,000 households in the text, and the extra reach is partly attributed to exchange rate movements during COVID-19. Fewer than 10 percent of payments were digital, so most top-ups went out at cash pay points. The government paid the base benefit and absorbed the 10,000 new households; the top-ups themselves were donor money.

Building

1 delivery linked to Large project delivery.

Lesothosince 2011still operatingbears on Large project delivery

Metolong Dam and Water Supply Programme

Lesotho's Metolong Authority built the Metolong Dam and raw water pump station near Maseru, starting impoundment on 15 February 2014 against a contract date of 31 October 2012 and delivering 93 megalitres a day on 8 October 2014 against a contract date of 1 July 2013, with every component of the programme overrunning its cost.

15.2 months, delay in reaching water delivery of 93 ml/day (contract date 1 july 2013, achieved 8 october 2014), 2014-10-08. 15.5 months, delay in starting impoundment (contract date 31 october 2012, achieved 15 february 2014), 2014-02-15. World Bank, Implementation Completion and Results Report, Lesotho Water Sector Improvement APL Phase II: Metolong Dam and Water Supply (P108143), 2019, retrieved 2026-10-02.

The move, and what it needed

Lesotho created a dedicated authority to deliver a dam, treatment works and bulk pipelines for the lowlands with many co-financiers, and delivered water about 15 months behind contract after price escalation and procurement delays.

Preconditions

  • A ring-fenced delivery authority for one programme
  • Several co-financiers able to cover cost gaps
  • Experience from the Lesotho Highlands Water Project to draw on

Limits: The contract and revised dates are in Table 9.1 (Annex 9, page 53 of 59) of the World Bank's completion report, which rated the outcome Moderately Satisfactory; both delays in months (15.2 and 15.5) are computed here from the dates in that table. The report states that all components overran their cost, attributing it partly to construction-price inflation from South Africa's 2010 World Cup works (para. 72), but gives no programme-wide baseline and outturn cost, and the World Bank financed only part of a programme co-financed by the Kuwait Fund, Arab and other lenders, the EIB and the government. The project closing date was extended three times for a cumulative 42 months, to 31 December 2018. Impoundment coincided with the 2015 to 2016 drought. Plain-text file of a PDF.