A lot of the tiles help finish cities/roads that you might not have been able to fit in the original. The added risk/reward of cathedrals and taverns, don't really add much to the game for me. Personally I'd take out the cathedrals and ignore the taverns (scoring wise).
I like this better than the original expansion - the addition of the goods tiles makes for a nice challenge for bonus points at the end, and the pigs are cool. This expansion essentially makes the River redundant.
The North African map/expansion really only works well with East/WestFront, but the Spanish Civil War is a brilliant little gem of a game - it has all the complexity and flavour of the xFront system, but a small compact game that typically plays in an hour.
As others have noted, the MedFront part doesn't really shine on its own. My rating is mostly based on the Spanish Civil War portion.
The SCW game is an 8, the rest of MedFront gets a 6 - Rommel in the Desert is the block game of choice for North Africa.
Added note: While I have upgraded to *Front II across the board, I did buy the components for SCW from Columbia Games as it makes a great small wargame.
My rating for this item reflects not my interest/willingness to play Ogre as much as it reflects the amount of cool information that's in this sourcebook. If you're a big Ogre fan and get to play it a lot, you'd be remiss if you didn't try to find a copy.