The World Bank                                                                                      Implementation Status & Results Report
            Indonesia: Strengthening National Tuberculosis Response Program (P178517)



Indonesia: Strengthening National Tuberculosis Response Program (P178517)


 EAST ASIA AND PACIFIC | Indonesia | Health, Nutrition & Population Global Practice | Requesting Unit: EACIF | Responsible Unit: HEAHN
 IBRD/IDA | Program-for-Results Financing | FY 2023 | Team Leader(s): Pandu Harimurti, Somil Nagpal


 Seq No: 2 | ARCHIVED on 01-Nov-2023 | ISR58413 | Created by: Yulia Nur Izati on 22-Oct-2023 | Modified by: Pandu Harimurti on 30-Oct-2023


 Program Development Objectives

  PDO Table
  Program Development Objective (from Program Appraisal Document)
  To improve coverage, quality and efficiency of tuberculosis services in Indonesia

 Overall Ratings

 Name                                                                           Previous Rating                         Current Rating

 Progress towards achievement of PDO                                            Satisfactory                           Satisfactory
 Overall Implementation Progress (IP)                                           Satisfactory                           Moderately Satisfactory


 Implementation Status and Key Decisions

  The Program's Loan Agreement has been effective since January 19, 2023, and is under implementation for over nine months. This is the second
  ISR for the Program following the first formal implementation support mission in August 3 -11, 2023. Overall, the program implementation is
  progressing well. Technical assistance is being planned to further improve implementation in strengthening performance-based transfers and
  results-based provider payment, and in risk communication to address stigma in TB.



 Data on Financial Performance


 Disbursements (by loan)

 Project        Loan/Credit/TF     Status       Currency         Original    Revised     Cancelled     Disbursed      Undisbursed             % Disbursed


 P178517        IBRD-94640         Effective    USD              300.00       300.00            0.00        75.00           225.00                   25%


 Key Dates (by loan)

 Project         Loan/Credit/TF     Status      Approval Date        Signing Date      Effectiveness Date     Orig. Closing Date     Rev. Closing Date

 P178517         IBRD-94640         Effective   19-Dec-2022          13-Jan-2023       19-Jan-2023            31-Mar-2027            31-Mar-2027


 DLI Disbursement

                                                                                            Achievement      Disbursed amount in      Disbursement % for
 DLI ID       DLI Type       Description                   Coc              DLI Amount
                                                                                            Status           Coc                      DLI

 Loan: IBRD94640-001




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            The World Bank                                                                         Implementation Status & Results Report
            Indonesia: Strengthening National Tuberculosis Response Program (P178517)




                             MOH desgned and
  1.1         Regular                                 USD          25,000,000.00    Not Achieved               0.00
                             implmnted BOK Kinerja-Y1
                             MOH permnce-based BOK
  1.2a        Regular                              USD             10,000,000.00    Not Achieved               0.00
                             paymnts to disrct-
                             MOH adptd transprnt
  1.2b        Regular                                     USD        5,000,000.00   Not Achieved               0.00
                             apprch in implntng B
                             MOH adptd & appvd
  1.2c        Regular                                     USD      10,000,000.00    Not Achieved               0.00
                             verifiction manual for
                             More distrct have improvd
  1.3         Regular                                     USD      40,000,000.00    Not Achieved               0.00
                             basd on TB ind
                             More pub primary healt
  2.1         Regular                                     USD      10,000,000.00    Not Achieved               0.00
                             facilities met se
                             MOH updated comphsve
  2.2         Regular                                     USD        5,000,000.00   Not Achieved               0.00
                             TB protocol
                             MOH devlpd trng
  2.3a        Regular                                     USD        5,000,000.00   Not Achieved               0.00
                             mechanism (incl modules)
                             More prim health care
  2.3b        Regular                                     USD        5,000,000.00   Not Achieved               0.00
                             provdrs registered
                             More prim health care
  2.3c        Regular                                     USD        5,000,000.00   Not Achieved               0.00
                             provdrs registered
                             MOH enctd regu-lab
  3.1         Regular                                     USD        5,000,000.00   Not Achieved               0.00
                             specimen trans, etc.
                             MOH devlpd template
  3.2         Regular                                     USD        5,000,000.00   Not Achieved               0.00
                             agreemnts-specmn tra
                             More distrct signed SA 3rd
  3.3         Regular                                     USD      10,000,000.00    Not Achieved               0.00
                             party
                             More private PHC
  3.4         Regular                                     USD      20,000,000.00    Not Achieved               0.00
                             provders becme reg user
                             MOH devlpd logisticsto
  4.1         Regular                                     USD      10,000,000.00    Not Achieved               0.00
                             access TB prgrm d
                             More prmry PHC prvdrs
  4.2         Regular                                     USD      20,000,000.00    Not Achieved               0.00
                             have access
                             Revised PKBK to link
  5.1a        Regular                                     USD      15,000,000.00    Not Achieved               0.00
                             capitation
                             Piloting non-capitation
  5.1b        Regular                                     USD      15,000,000.00    Not Achieved               0.00
                             pymnt mech
                             MOH reformd InaCBG by
  5.2         Regular                                     USD      10,000,000.00    Not Achieved               0.00
                             amndng regulation
                             MOH simplies interface of
  6.1         Regular                                     USD      10,000,000.00    Not Achieved               0.00
                             TB prgrm info
                             MOH enhanced TB info
  6.2a        Regular                                     USD      10,000,000.00    Not Achieved               0.00
                             system
                             MOH estab integration or
  6.2b        Regular                                     USD      10,000,000.00    Not Achieved               0.00
                             interoperabilit
                             More prvate PHC provdrs
  6.3         Regular                                     USD      20,000,000.00    Not Achieved               0.00
                             use new info sys



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            The World Bank                                                                                       Implementation Status & Results Report
            Indonesia: Strengthening National Tuberculosis Response Program (P178517)




                             MOH implntd national TFB
  7.1         Regular                                     USD           10,000,000.00       Not Achieved                      0.00
                             prevalence
                             MOH published at lest 2
  7.2         Regular                                     USD           10,000,000.00       Not Achieved                      0.00
                             process eval

 Program Action Plan

                                  Implementation of capacity building activities to health facilities and health workers, incl CHW & volunteers, for proper
  Action Description
                                  handling of specimens from TB related services, incl proper usage & disposal of PPE (online and/or offline activities)

  Source                          DLI#                   Responsibility            Timing                   Timing Value                Status

                                                         •         Dit of
  Environmental and Social
                                                         Quality Improvement       Recurrent                Semi-Annually               Not Yet Due
  Systems
                                                         & NTP

  Completion Measurement          Number of training and capacity-building sessions delivered

                                  MoH has carried out training and capacity building for health workers using (a) E-learning platform started in Q1-2
  Comments                        2023 and as of July 2023 has been accessed by 610 health workers. The in-person training recorded in 9 priority
                                  provinces



                                  Conduct need assessment on current practice in the health facilities and laboratories in provisioning adequate
  Action Description              number of PPE for health workers, health facilities and lab staff, and CHW for TB contact tracing, testing and
                                  treatment

  Source                          DLI#                   Responsibility            Timing                   Timing Value                Status

  Environmental and Social                               Dit of Infectious
                                                                                   Recurrent                Yearly                      Not Yet Due
  Systems                                                Disease Prev - NTP

                                  Needs assessments of PPE adequacy in health facilities and laboratories at the central level as reference for
  Completion Measurement
                                  implementers at the subnational level

                                  The PPE assessment for 2023 completed, and for 2024 will be conducted by the end of November 2023 to meet the
  Comments
                                  planning cycle timeline



                                  Periodic screening and testing for healthcare workers, health facility and laboratory staff, and community health
  Action Description
                                  volunteers responsible for direct handling of TB suspects, confirmed cases, and testing specimens.

  Source                          DLI#                   Responsibility            Timing                   Timing Value                Status

  Environmental and Social                               Dit Productive & Old
                                                                                   Recurrent                Yearly                      Not Yet Due
  Systems                                                Age, NTP, DTO

                                  Develop guidelines that prescribe periodic screening & testing for health care workers (HCW) & facility staff; establish
  Completion Measurement          a data segregation record system for periodic screening & testing implementation (Y1); & record the number of HCW
                                  screened (Y2-6)

                                  The technical guidelines on periodic screening and testing is still in the progress for finalization. MoH targets to
  Comments
                                  finalize the guidelines by 2024




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            The World Bank                                                                                       Implementation Status & Results Report
            Indonesia: Strengthening National Tuberculosis Response Program (P178517)



                                  Nominate responsible staff from the MOH whom in coordination with the MOEF to advise health facilities in managing
  Action Description
                                  the expected increase of volume of medical waste TB cases at the health facilities including through:

  Source                          DLI#                   Responsibility            Timing                  Timing Value                  Status

                                                                                                           Within 3 months upon
                                                                                                           Program effectiveness
  Environmental and Social                               Directorate General
                                                                                   Other                   and to be maintained          Completed
  Systems                                                of Health Service
                                                                                                           throughout Program
                                                                                                           implementation

  Completion Measurement          Letters that indicate the nomination of responsible staff (job title or position) from the MOH

  Comments



                                  a.Monitor current capacity/practice in the health facilities and laboratories in Provinces or Districts level to manage
  Action Description              medical waste and the expected volume of waste generated, including waste handling proper handling of sputum
                                  collection activities

  Source                          DLI#                   Responsibility            Timing                  Timing Value                  Status

                                                         Directorate
  Environmental and Social
                                                         Environmental             Recurrent               Yearly                        Not Yet Due
  Systems
                                                         Health of MoH

                                  Routine report on medical waste management of health facilities and laboratories at the central level as reference for
  Completion Measurement          implementers at the subnational level, which informs the need for alternative medical waste management advise (that
                                  is, 4.b)...

                                  MoH has carried out online capacity building session on medical waste management for nation-wide community
  Comments
                                  health centers (Puskesmas) on 11-13 July 2023



                                  A protocol for communication for TB patients included in the TB clinical guidelines
                                  incorporating data protection measures and consent is developed and disseminated to health workers and facilities
  Action Description



  Source                          DLI#                   Responsibility            Timing                  Timing Value                  Status

                                                         Communication
  Environmental and Social
                                                         Bureau of Health          Recurrent               Semi-Annually                 Not Yet Due
  Systems
                                                         Service

  Completion Measurement          Clinical guideline with protocol for communication developed, disseminated and implemented.

  Comments



                                  b.Advising health facilities on the alternatives to manage their wastes (in house and external services), support
  Action Description              approval of agreed options and develop the necessary work instructions for these alternatives. Based on agreed
                                  options for medical waste

  Source                          DLI#                   Responsibility            Timing                  Timing Value                  Status




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            The World Bank                                                                                      Implementation Status & Results Report
            Indonesia: Strengthening National Tuberculosis Response Program (P178517)




                                                         Directorate
  Environmental and Social
                                                         Environmental            Recurrent                Semi-Annually               Not Yet Due
  Systems
                                                         Health of MoH

                                  Administrative records, may include records/log of meetings, discussions, dialogue with MOEF, PHOs, and DHOs;
  Completion Measurement          minutes of the meeting & other documentations; & record of outreach and socialization activities on medical waste
                                  treatment alternatives

                                  MoH continues to provide technical support in addition developing technical guidelines for subnational level and
  Comments
                                  health facilities



                                  c. Providing capacity building for health workers, health facilities and laboratories staff, and community health
  Action Description
                                  volunteers and workers on the proper management of TB response wastes (offline and/or online training

  Source                          DLI#                   Responsibility           Timing                   Timing Value                Status

                                                         Directorate
  Environmental and Social
                                                         Environmental            Recurrent                Yearly                      Not Yet Due
  Systems
                                                         Health of MoH

  Completion Measurement          Number of capacity-building sessions delivered and number of participants in the capacity-building sessions.

                                  MoH has carried out online capacity building session on medical waste management for nation-wide community
  Comments
                                  health centers (Puskesmas) on 11-13 July 2023



                                  Strengthening the existing communication strategy on public health messaging and community outreach on TB
  Action Description              related facts to reduce stigma, in coordination with media and civil society organizations.



  Source                          DLI#                   Responsibility           Timing                   Timing Value                Status

  Environmental and Social                               Directorate of Health
                                                                                  Recurrent                Semi-Annually               Not Yet Due
  Systems                                                Promotion and CE

                                  Implementation of national communication strategy, using various mechanisms and channels.
  Completion Measurement          Include capacity buildings, monitoring and evaluation tools.



                                  Public health messaging and community outreach on TB related facts have been carried out using various media
  Comments                        channels and TB related educational materials are available at MoH webpage. Messaging to address stigma in TB is
                                  yet to be developed



                                  Strengthen the existing system regarding patients’ and health workers’ safety at health facilities, including on aspects
  Action Description              related to sexual exploitation and abuse/sexual harassment, such as safety during consultation and treatment, and
                                  safe workplace

  Source                          DLI#                   Responsibility           Timing                   Timing Value                Status

  Environmental and Social                               Directorate of Health
                                                                                  Recurrent                Semi-Annually               Not Yet Due
  Systems                                                Care Quality




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            The World Bank                                                                                    Implementation Status & Results Report
            Indonesia: Strengthening National Tuberculosis Response Program (P178517)




                                  Materials on patients’ security and safety and safe workplace environment developed and records of dissemination
  Completion Measurement
                                  activities delivered

                                  MOH has produced a circular letter on respectful workplace, and a MoH Instruction No.HK.02.01/Menkes/ 1512/2023
  Comments
                                  regarding prevention and bullying toward medical interns.



                                  Strengthen the existing public FGRM for TB care including complaints about drugs and diagnostic availability, quality
  Action Description
                                  of health service, stigma/discrimination during health service delivery, and so on.

  Source                          DLI#                  Responsibility           Timing                  Timing Value               Status

  Environmental and Social                              Directorate of Health
                                                                                 Recurrent               Semi-Annually              Not Yet Due
  Systems                                               Care Quality

  Completion Measurement          SOP on FGRM for TB care developed, monitored, and disseminated to relevant stakeholders

                                  There are nine TB specific complaints collected from the official MoH FGRM platform during the first Semester of
  Comments
                                  2023, on pediatric drugs and test stock out, TB e-training, treatment protocol



                                  MOH to require UKPBJs and PPK to check the WB debarment site and temp suspension lists and record verification
  Action Description              in the bid evaluation report before awarding the contract to a firm or individual that is under debarment and/or temp
                                  suspension by WB.

  Source                          DLI#                  Responsibility           Timing                  Timing Value               Status

                                                        Bureau of
  Fiduciary Systems                                     Procurement of           Recurrent               Continuous                 Not Yet Due
                                                        goods/service

                                  Guidance provided to UKPBJ/procurement officers/PPK is implemented to ensure that no contract under the Program
  Completion Measurement
                                  is awarded to a firm or individual that is under debarment and/or temporary suspension by the World Bank.

  Comments                        Complied with. MoH has provided the Bank the procurement and contract data related to the Program.



                                  The MOH to provide the World Bank information of procurement profiles and contract information regularly or at least
  Action Description
                                  every 6 months of Program implementation.

  Source                          DLI#                  Responsibility           Timing                  Timing Value               Status

                                                        Bureau of
  Fiduciary Systems                                     Procurement of           Recurrent               Semi-Annually              Not Yet Due
                                                        goods/ services

                                  Procurement activities under the NTP is compiled as well as procurement and contract data are provided to the Bank
  Completion Measurement
                                  according to the agreed timeline

  Comments



                                  MOH to ensure that 100% PPK, PPSPM, and staff positions for the Program (esp in DG Disease Prevention and
  Action Description              Control & DG Pharmacy and Medical Devices) are held by staff who have already completed training on payment
                                  verification for goods from BPPK.



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            The World Bank                                                                                        Implementation Status & Results Report
            Indonesia: Strengthening National Tuberculosis Response Program (P178517)




  Source                           DLI#                   Responsibility            Timing                Timing Value                Status

                                                          Bureau of Finance
  Fiduciary Systems                                       and Assets, and           Recurrent             Semi-Annually               Not Yet Due
                                                          Budget

                                   Report on update training completion status of PPK, PPSPM and staff for the program (especially in DG Disease
  Completion Measurement
                                   Prevention & Control and DG Pharmacy and Medical Devices).

                                   The World Bank has received data on the current status of PPK, PPSPM and staff members of the relevant working
  Comments                         units involved in the TB program who have completed the required training on payment verification for goods from
                                   BPPK (33 percent trained)



                                   MoH IG to conduct internal audit on NTP implementation and its related procurement process financed under the
  Action Description
                                   Program.

  Source                           DLI#                   Responsibility            Timing                Timing Value                Status

                                                          Inspectorate III and
  Fiduciary Systems                                                                 Recurrent             Semi-Annually               Not Yet Due
                                                          Inspectorate for

                                   Report on the internal audit conducted by the MOH IG on the implementation of the NTP activities from all the
  Completion Measurement
                                   relevant working units/satuan kerja within the MOH

  Comments



                                   MOH to inform WB promptly of all credible and material allegations or other indications of fraud and corruption in
  Action Description               connection with the Program that come to its attention, together with the investigative and other actions that it
                                   proposes to take.

  Source                           DLI#                   Responsibility            Timing                Timing Value                Status

                                                          Inspectorate III and
  Fiduciary Systems                                                                 Recurrent             Semi-Annually               Not Yet Due
                                                          Inspectorate for

                                   Semiannual reports provided to the World Bank on allegations of fraud and corruption under the Program received
  Completion Measurement
                                   during such period and any related investigations and actions taken.

  Comments                         MoH has submitted data on F&C allegations, none on TB related activities




  Risks


 Systematic Operations Risk-rating Tool


  Risk Category                                                Rating at Approval               Previous Rating               Current Rating

  Political and Governance                                     Moderate                        Moderate                     Moderate
  Macroeconomic                                                Moderate                        Moderate                     Moderate
  Sector Strategies and Policies                               Moderate                        Moderate                     Moderate



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            The World Bank                                                                                   Implementation Status & Results Report
            Indonesia: Strengthening National Tuberculosis Response Program (P178517)




  Technical Design of Project or Program                    Substantial                    Substantial                 Substantial
  Institutional Capacity for Implementation and
                                                            Substantial                    Substantial                 Substantial
  Sustainability
  Fiduciary                                                 Moderate                       Moderate                    Moderate
  Environment and Social                                    Moderate                       Moderate                    Moderate
  Stakeholders                                              Moderate                       Moderate                    Moderate
  Other                                                     Moderate                       Moderate                    Moderate
  Overall                                                   Moderate                       Moderate                    Moderate




  Results


 PDO Indicators by Objectives / Outcomes


  Improve coverage and quality of the national TB program
    IN01358163
    ►Increased TB treatment coverage rate (%) (Percentage, Custom)

                                      Baseline                    Actual (Previous)            Actual (Current)          End Target

    Value                             55.00                       55.00                        74.00                     70.00

    Date                              31-Dec-2021                 31-Dec-2021                  30-Jun-2022              31-Mar-2027
                                      TB treatment coverage defined in accordance with the WHO definition of number of new and relapse TB
                                      cases that were notified and treated in a given year (numerator), divided by the estimated number of
    Comments                          incident TB cases in the same year (denominator), expressed as a percentage increase from the (agreed)
                                      baseline. The data is updated with the latest available annual data. Disaggregated by gender is available


  Improve quality and efficiency
    IN01358164
    ►Increased TB treatment success rate (%) (Percentage, Custom)

                                      Baseline                    Actual (Previous)            Actual (Current)          End Target

    Value                             74.00                       74.00                        82.00                     85.00

    Date                              31-Dec-2021                 31-Dec-2021                  30-Jun-2023              31-Mar-2027
                                      Treatment success rates for drug sensitive TB are calculated from cohort data (outcomes in registered
                                      patients) as the proportion of new smear-positive TB cases registered under DOTS in a given year
    Comments
                                      (denominator) that successfully completed treatment (numerator), whether with (“cured”) or without
                                      (“treatment completed”) bacteriologic evidence of success. Disaggregated by gender

  Improve coverage, and efficiency
    IN01358165
    ►Increased number of notified TB cases managed at private primary care level (Number, Custom)

                                      Baseline                    Actual (Previous)            Actual (Current)          End Target

    Value                             1,138.00                    1,138.00                     9,298.00                  100,000.00

    Date                              31-Dec-2021                 31-Dec-2021                  30-Dec-2022              31-Mar-2027


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            The World Bank                                                                                     Implementation Status & Results Report
            Indonesia: Strengthening National Tuberculosis Response Program (P178517)



                                       Total number of notified TB cases managed (identified and initiated treatment) at private primary care level
    Comments                           providers; In addition the percentage (with numerator the total number of TB cases notified) will be
                                       monitored as a derived indicator

  Improve coverage, quality, and efficiency
    IN01358191
    ►A functional, integrated information system linked to a citizen mobile health application is in place (Text, Custom)

                                       Baseline                     Actual (Previous)             Actual (Current)          End Target
                                                                                                                            TB information system
                                       TB information system not TB information system           TB information system      integrated or
    Value
                                       integrated                not integrated                  not yet integrated         interoperable and
                                                                                                                            functioning
    Date                               19-Aug-2022                  19-Aug-2022                  11-Aug-2023                31-Mar-2027
                                       The information system for TB case management is interoperable with a citizen mobile health application
                                       and is functioning to inform the NTP. The citizen health application here can be described as an integrated
    Comments
                                       health information platform that serves individuals to access their personal health information and to obtain
                                       information to maintain optimal health.

 Intermediate Results Indicators by Results Areas



  Strengthened Subnational Tuberculosis Response
    IN01358193
    ►Decreased loss to follow up of diagnosed cases to treatment – reduced number of TB cases diagnosed and not put on treatment (Number,
   Custom)

                                       Baseline                     Actual (Previous)             Actual (Current)          End Target

    Value                              30,000.00                    30,000.00                    88,727.00                  22,500.00

    Date                               31-Dec-2021                  31-Dec-2021                  30-Dec-2022                31-Mar-2027

                                    The proportion of diagnosed TB cases who have not started treatment in a given year to the total TB cases
   Comments
                                    diagnosed during the same time period.
   IN01358196
   ►Decreased loss to follow up of diagnosed cases to treatment – reduced share of TB cases diagnosed and not put on treatment
   (Percentage, Custom)

                                       Baseline                     Actual (Previous)             Actual (Current)          End Target

    Value                              7.00                         7.00                         12.00                      5.00

    Date                               31-Dec-2021                  31-Dec-2021                  30-Dec-2022                31-Mar-2027

                                       The proportion of diagnosed TB cases who have not started treatment in a given year to the total TB cases
    Comments
                                       diagnosed during the same time period.


  Strengthened TB care among public and private health providers
    IN01358194
    ►Increased number of private primary care providers that notify TB cases to the NTP (Number, Custom)

                                       Baseline                     Actual (Previous)             Actual (Current)          End Target

    Value                              216.00                       216.00                       1,133.00                   7,500.00

    Date                               31-Dec-2021                  31-Dec-2021                  30-Dec-2022                31-Mar-2027




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            The World Bank                                                                                     Implementation Status & Results Report
            Indonesia: Strengthening National Tuberculosis Response Program (P178517)




   Comments                        Private primary care providers who notify TB cases
   IN01358197
   ►Increased number of private providers that have ever used the relevant TB program information system for TB notification (Number,
   Custom)

                                      Baseline                     Actual (Previous)             Actual (Current)           End Target

    Value                             1,300.00                     1,300.00                      4,327.00                   10,000.00

    Date                              31-Dec-2021                  31-Dec-2021                   30-Dec-2022                31-Mar-2027

                                      Expressed in number of private providers that have ever used (‘ever’ that will be translated as at least 5 -
    Comments
                                      five patients )
    IN01358199
    ►Increase in the number of private primary care providers who received capacity building support on TB management (Number, Custom)

                                      Baseline                     Actual (Previous)             Actual (Current)           End Target

    Value                             0.00                         0.00                          9,000.00                   12,000.00

    Date                              31-Dec-2021                  31-Dec-2021                   30-Jun-2023                31-Mar-2027

                                      Number of private primary care providers received the NTP’s standardized TB case management capacity
    Comments
                                      building
    IN01358201
    ►Increase number of private primary care providers who have access to TB program drugs (Number, Custom)

                                      Baseline                     Actual (Previous)             Actual (Current)           End Target

    Value                             346.00                       346.00                        644.00                     7,500.00

    Date                              31-Dec-2021                  31-Dec-2021                   30-Jun-2023                31-Mar-2027

                                      Expressed in total number of private primary care providers who have signed MOU to access program
    Comments
                                      drugs and have treated patients using TB program drugs


  Enhanced digital systems for TB and evidence-informed policy
   IN01358192
   ►A template for agreements for specimen transport services that can be used between districts and third-party service providers. (Text,
   Custom)

                                      Baseline                     Actual (Previous)             Actual (Current)        End Target
                                      No template or modality      No template or modality       No template or modality Modality/template is in
    Value
                                      exists                       exists                        exists                  regular use

    Date                              31-Dec-2021                  31-Dec-2021                   11-Aug-2023                31-Mar-2027
                                      The development and establishment of agreements and/or regulations including memorandum of
                                      understanding, contracts, and technical guidelines for engaging/contracting a third party or more than one
    Comments                          such party for specimen transport services for public and private health facilities with no in-house WRD
                                      capacity to those with such capacity to be issued at the central level/by MOH as reference for implementers
                                      at the sub national level
    IN01358195
    ►The number of sub-national level units (districts) using the laboratory specimen transport system in the reporting period (Number, Custom)

                                      Baseline                     Actual (Previous)             Actual (Current)           End Target

    Value                             41.00                        41.00                         290.00                     345.00

    Date                              31-Dec-2021                  31-Dec-2021                   11-Aug-2023                31-Mar-2027



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            The World Bank                                                                                    Implementation Status & Results Report
            Indonesia: Strengthening National Tuberculosis Response Program (P178517)



                                      Expressed in total number of sub national administrative level i.e districts (Kabupaten/Kota) that developed
                                      diagnostic linkage and mechanism arrangement of specimen transport or under the signed-contract/MoU
    Comments
                                      between PHO/DHO with courier service for specimen transport services in its area or had it used by private
                                      primary care providers in its catchment area
    IN01358198
    ►The number of laboratory samples transported using the new mechanism (Number, Custom)

                                      Baseline                     Actual (Previous)            Actual (Current)          End Target

    Value                             0.00                         0.00                         560,000.00                1,000,000.00

    Date                              31-Dec-2020                  31-Dec-2020                  30-Jun-2023               31-Mar-2027

    Comments                          Expressed in total number of TB specimen transported using the new transport specimen arrangement
    IN01358200
    ►Functioning interoperable TB information systems that have the ability to produce gender disaggregated data (Text, Custom)

                                      Baseline                     Actual (Previous)            Actual (Current)          End Target
                                      Fragmented TB                Fragmented TB                Fragmented TB
                                      information system and       information system and       information system and    Interoperable TB
    Value
                                      interoperabiity is not       interoperabiity is not       interoperabiity is not    information system
                                      established                  established                  established
    Date                              31-Dec-2021                  31-Dec-2021                  31-Dec-2021               31-Mar-2027
                                      Existing TB reporting systems that includes information system from service delivery points (SITB, WIFI TB,
    Comments                          SITRUST), demand side/community based information system (Empati), and the BPJS-K (pCare) are
                                      interoperable. Text indicator stated annually, and gender disaggregated data will be final year objective
   IN01358202
   ►Specific communication measures that focus on addressing stigma and discrimination towards female TB patients, are devised and
   implemented (Text, Custom)

                                      Baseline                     Actual (Previous)            Actual (Current)        End Target
                                                                                                                        The communication
                                      Communication strategy       Communication strategy       Communication strategy
                                                                                                                        strategy to address
    Value                             to address stigma in TB is   to address stigma in TB      to address stigma in TB
                                                                                                                        stigma is developed
                                      not yet developed            is not yet developed         is not yet developed
                                                                                                                        and implemented
    Date                              31-Dec-2021                  31-Dec-2021                  31-Dec-2021               31-Mar-2027
                                      The communication strategy for the national TB program has included a strategy to address stigma in the
    Comments                          first year of the Program, which particularly focuses on stigma and discrimination faced by female TB
                                      Patients.. The strategy is implemented in the following year throughout the duration of the Program
    IN01358203
    ►Number of presumptive TB cases access laboratory testing (Number, Custom)

                                      Baseline                     Actual (Previous)            Actual (Current)          End Target

    Value                             0.00                         0.00                         560,000.00                1,000,000.00

    Date                              31-Dec-2021                  31-Dec-2021                  30-Jun-2023               31-Mar-2027

                                      Expressed in total number of presumptive TB cases tested with the WRD test at the end of the Program
    Comments
                                      implementation December 2025, monitored annually


 Disbursement Linked Indicators
 DLI_IND_TABLE
    ►DLI 1 An intergovernmental fiscal transfer mechanism being linked with TB key performance indicators (Output, 90,000,000.00, 0%)




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            Indonesia: Strengthening National Tuberculosis Response Program (P178517)



                                                                                                                             From January 1,
                                                                                                                             2025 to December
                                  Baseline                       Actual (Previous)            Actual (Current)               31, 2025
                                                                                                                             The
                                                                                                                             intergovernmental
                                                                 The intergovernmental
                                  The intergovernmental                                       The intergovernmental          fiscal transfer
                                                                 fiscal transfer scheme for
                                  fiscal transfer scheme for                                  fiscal transfer scheme for     scheme for
                                                                 Puskesmas operations is
                                  Puskesmas operations is                                     Puskesmas operations is        Puskesmas
    Value                                                        not yet linked with both
                                  not yet linked with both TB                                 not yet linked with both TB    operations has been
                                                                 TB notification and
                                  notification and success TB                                 notification and success       linked with both TB
                                                                 success TB treatment
                                  treatment rate                                              TB treatment rate              notification and
                                                                 rate
                                                                                                                             success TB
                                                                                                                             treatment rate
    Date                          --                             31-Dec-2021                  29-Sep-2023                    --

    Comments
     IN01358205
     DLI 1.1 MOH has designed and implemented the BOK Kinerja that includes improvements of a focused and balanced set of indicators,
     including TB notification and successful treatment. (Process, 25,000,000.00, 0%)
     Unit of Measure: Text
     Indicator Type:

                                                                                                                             From January 1,
                                                                                                                             2025 to December
                                  Baseline                       Actual (Previous)            Actual (Current)               31, 2025
                                                                                              The TB performance
                                                                 The TB performance           linked transfer final design
                                  The TB performance linked
     Value                                                       linked transfer not yet      is up for discussion with      NA
                                  transfer not yet designed
                                                                 designed                     the responsible unit at the
                                                                                              Ministry of Finance
     Date                         --                             31-Dec-2021                  29-Sep-2023                    --

     Comments

     IN01358206
     DLI 1.2 (a) MOH has made performance-based BOK payments directly to districts, (b) MOH has adopted a transparent approach in
     implementing BOK Kinerja (c) MOH prepared, approved and adopted verification manual (Output, 25,000,000.00, 0%)
     Unit of Measure: Text
     Indicator Type:

                                                                                                                             From January 1,
                                                                                                                             2025 to December
                                  Baseline                       Actual (Previous)            Actual (Current)               31, 2025
     Value                        MOH has not made               MOH has not made             MOH has not                    NA
                                  performance-based BOK          performance-based BOK        implemented
                                  payments directly to           payments directly to         performance-based BOK
                                  districts in accordance with   districts in accordance      payments directly to
                                  the BOK Kinerja designed       with the BOK Kinerja         districts in accordance
                                  under DLR 1.1 and as per       designed under DLR 1.1       with the BOK Kinerja
                                  the associated technical       and as per the               designed under DLR 1.1
                                  guideline; a transparent       associated technical         and as per the associated
                                  approach in implementing       guideline; a transparent     technical guideline; a
                                  the BOK Kinerja by             approach in                  transparent approach in
                                  providing a breakdown of       implementing the BOK         implementing the BOK
                                  the performance linked         Kinerja by providing a       Kinerja by providing a
                                  payments to the relevant       breakdown of the             breakdown of the
                                  districts and Puskesmas is     performance linked           performance linked
                                  not yet done; Verification     payments to the relevant     payments to the relevant


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            Indonesia: Strengthening National Tuberculosis Response Program (P178517)



                                  and counterverification        districts and Puskesmas       districts and Puskesmas is
                                  manual is not yet available    is not yet done;              not yet done; Verification
                                                                 Verification and              and counter verification
                                                                 counterverification           manual is not yet available
                                                                 manual is not yet
                                                                 available
     Date                         --                             31-Dec-2021                   29-Sep-2023                   --

     Comments

     IN01358207
     DLI 1.3 More districts have improved performance (as specified in the Verification Protocol) based on the relevant TB case notification
     and treatment success rate indicators over the baseline year 2022 (Output, 40,000,000.00, 0%)
     Unit of Measure: Percentage
     Indicator Type:

                                                                                                                             From January 1,
                                                                                                                             2025 to December
                                  Baseline                       Actual (Previous)             Actual (Current)              31, 2025

     Value                        0.00                           0.00                          0.00                          68.00

     Date                         --                             31-Dec-2021                   31-Dec-2021                   --

     Comments



    ►DLI 2 Improved supply side readiness (Output, 30,000,000.00, 0%)

                                                                                                                             From January 1,
                                                                                                                             2025 to December
                                  Baseline                       Actual (Previous)             Actual (Current)              31, 2025

    Value                         No                             No                            No                             Yes

    Date                          --                             31-Dec-2021                   31-Dec-2021                   --

    Comments
     IN01358209
     DLI 2.1 More public primary health care facilities have met service readiness criteria as specified in the Verification Protocol for TB
     services. (Output, 10,000,000.00, 0%)
     Unit of Measure: Text
     Indicator Type:

                                                                                                                             From January 1,
                                                                                                                             2025 to December
                                  Baseline                       Actual (Previous)             Actual (Current)              31, 2025
                                                                                                                             10 percentage point
     Value                        80%                            80%                           80%
                                                                                                                             increase

     Date                         --                             31-Dec-2021                   31-Dec-2021                   --

     Comments

     IN01358210
     DLI 2.2 MOH has updated a comprehensive TB service protocol and made appropriate decision support tools available for primary health
     care facilities, laboratories, and hospitals. (Output, 5,000,000.00, 0%)


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            Indonesia: Strengthening National Tuberculosis Response Program (P178517)



     Unit of Measure: Text
     Indicator Type:

                                                                                                                       From January 1,
                                                                                                                       2025 to December
                                  Baseline                     Actual (Previous)          Actual (Current)             31, 2025

     Value                        Not available                Not available              Not available                NA

     Date                         --                           31-Dec-2021                31-Dec-2021                  --

     Comments

     IN01358211
     DLI 2.3 (a) MOH has developed an updated training mechanism; (b) more public primary providers have completed capacity building; (c)
     more private primary providers have completed capacity building (Output, 15,000,000.00, 0%)
     Unit of Measure: Text
     Indicator Type:

                                                                                                                       From January 1,
                                                                                                                       2025 to December
                                  Baseline                     Actual (Previous)          Actual (Current)             31, 2025
                                                                                                                       (b) More public
                                                                                                                       primary health care
                                                                                                                       providers have
                                                                                                                       registered at MOH to
                                                               No public primary health                                complete capacity
                                  No public primary health     care providers have        No public primary health     building program
                                  care providers have          registered at MOH to       care providers have          developed under
                                  registered at MOH to         complete capacity          registered at MOH to         DLR 2.2.
                                  complete capacity building   building program and       complete capacity building   (c) More private
     Value
                                  program and contracted       contracted with JKN to     program and contracted       primary health care
                                  with JKN to complete         complete capacity          with JKN to complete         providers have
                                  capacity building program    building program           capacity building program    registered at MOH
                                  developed under DLR 2.2.     developed under DLR        developed under DLR 2.2.     and contracted with
                                                               2.2.                                                    JKN to complete
                                                                                                                       capacity building
                                                                                                                       program developed
                                                                                                                       under DLR 2.2.


     Date                         --                           31-Dec-2021                31-Dec-2021                  --

     Comments



    ►DLI 3 Strengthened access to diagnostic and regular sample transport mechanisms (Output, 40,000,000.00, 0%)

                                                                                                                       From January 1,
                                                                                                                       2025 to December
                                  Baseline                     Actual (Previous)          Actual (Current)             31, 2025

    Value                         No                           No                         No                           Yes

    Date                          --                           31-Dec-2021                31-Dec-2021                  --

    Comments
     IN01358213



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            Indonesia: Strengthening National Tuberculosis Response Program (P178517)



     DLI 3.1 MOH has enacted a regulation to strengthen laboratory specimen transport practice, including that of private primary health care
     providers (Output, 5,000,000.00, 0%)
     Unit of Measure: Text
     Indicator Type:

                                                                                                                            From January 1,
                                                                                                                            2025 to December
                                  Baseline                       Actual (Previous)           Actual (Current)               31, 2025
                                                                 The review and
                                  The review and                 development of              The review and
                                  development of regulation      regulation needed for       development of regulation
                                  needed for centrally           centrally negotiated lab    needed for centrally
     Value                                                                                                                  NA
                                  negotiated lab specimen        specimen transport          negotiated lab specimen
                                  transport service is not yet   service is not yet          transport service is not yet
                                  conducted and completed        conducted and               conducted and completed
                                                                 completed
     Date                         --                             31-Dec-2021                 31-Dec-2021                    --

     Comments

     IN01358214
     DLI 3.2 MOH has developed a template for agreements for specimen transport services that can be used between districts and third-party
     service providers. (Output, 5,000,000.00, 0%)
     Unit of Measure: Text
     Indicator Type:

                                                                                                                            From January 1,
                                                                                                                            2025 to December
                                  Baseline                       Actual (Previous)           Actual (Current)               31, 2025
                                  Template for agreements        Template for agreements     Template for agreements
     Value                        for specimen transport         for specimen transport      for specimen transport         NA
                                  services is not available      services is not available   services is not available
     Date                         --                             31-Dec-2021                 31-Dec-2021                    --

     Comments

     IN01358215
     DLI 3.3 More districts have signed service agreements with third-party service providers for specimen transport services that serve all
     engaged public and private health care facilities in their area (Output, 10,000,000.00, 0%)
     Unit of Measure: Percentage
     Indicator Type:

                                                                                                                            From January 1,
                                                                                                                            2025 to December
                                  Baseline                       Actual (Previous)           Actual (Current)               31, 2025

     Value                        8.00                           8.00                        8.00                           68.00

     Date                         --                             31-Dec-2021                 31-Dec-2021                    --

     Comments

     IN01358216
     DLI 3.4 More private primary health care providers have become new regular users of the services provided by third-party service
     providers for specimen transport services. (Output, 20,000,000.00, 0%)
     Unit of Measure: Percentage
     Indicator Type:

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            Indonesia: Strengthening National Tuberculosis Response Program (P178517)




                                                                                                                     From January 1,
                                                                                                                     2025 to December
                                  Baseline                       Actual (Previous)       Actual (Current)            31, 2025

     Value                        0.00                           0.00                    0.00                        50.00

     Date                         --                             31-Dec-2021             31-Dec-2021                 --

     Comments



    ►DLI 4 Improved access to TB program drugs among private primary health care providers (Output, 30,000,000.00, 0%)

                                                                                                                     From January 1,
                                                                                                                     2025 to December
                                  Baseline                       Actual (Previous)       Actual (Current)            31, 2025

    Value                         No                             No                      No                           Yes

    Date                          --                             31-Dec-2021             31-Dec-2021                 --

    Comments
     IN01358218
     DLI 4.1 MOH has developed logistics and arrangements to access TB program drugs for private primary health care providers by: a)
     issuing a guideline; and b) issuing a revised agreement template (Output, 10,000,000.00, 0%)
     Unit of Measure: Text
     Indicator Type:

                                                                                                                     From January 1,
                                                                                                                     2025 to December
                                  Baseline                       Actual (Previous)       Actual (Current)            31, 2025
                                                                 Access to TB Program    Access to TB Program
                                  Access to TB Program
     Value                                                       Drugs is not yet        Drugs is not yet            NA
                                  Drugs is not yet established
                                                                 established             established
     Date                         --                             31-Dec-2021             31-Dec-2021                 --

     Comments

     IN01358219
     DLI 4.2 More private primary health care providers have had access to TB program drugs. (Output, 20,000,000.00, 0%)

     Unit of Measure: Percentage
     Indicator Type:

                                                                                                                     From January 1,
                                                                                                                     2025 to December
                                  Baseline                       Actual (Previous)       Actual (Current)            31, 2025

     Value                        3.00                           3.00                    3.00                        50.00

     Date                         --                             31-Dec-2021             31-Dec-2021                 --

     Comments




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            Indonesia: Strengthening National Tuberculosis Response Program (P178517)




    ►DLI 5 Strengthened payment mechanism links to TB notification and treatment (Output, 40,000,000.00, 0%)

                                                                                                                       From January 1,
                                                                                                                       2025 to December
                                  Baseline                    Actual (Previous)           Actual (Current)             31, 2025

    Value                         No                          No                          No                           Yes

    Date                          --                          31-Dec-2021                 31-Dec-2021                  --

    Comments
     IN01358221
     DLI 5.1 MOH has implemented new payment arrangements to increase the rates of TB notifications and treatments by: a) revising the
     PKBK to include TB indicators; b) piloting a non-capitation payment for TB (Output, 30,000,000.00, 0%)
     Unit of Measure: Text
     Indicator Type:

                                                                                                                       From January 1,
                                                                                                                       2025 to December
                                  Baseline                    Actual (Previous)           Actual (Current)             31, 2025
                                  The new payment             The new payment             The new payment
     Value                        arrangement for TB is not   arrangement for TB is not   arrangement for TB is not   NA
                                  yet implemented             yet implemented             yet implemented
     Date                         --                          31-Dec-2021                 31-Dec-2021                  --

     Comments

     IN01358222
     DLI 5.2 MOH has reformed InaCBG by amending the relevant regulation to the effect that a large part of hospital payments will be made
     to hospitals only upon completion of each TB treatment course. (Output, 10,000,000.00, 0%)
     Unit of Measure: Text
     Indicator Type:

                                                                                                                       From January 1,
                                                                                                                       2025 to December
                                  Baseline                    Actual (Previous)           Actual (Current)             31, 2025
                                  The revisions to the        The revisions to the        The revisions to the
     Value                        InaCBG system have not      InaCBG system have not      InaCBG system have not      NA
                                  been carried out            been carried out            been carried out
     Date                         --                          31-Dec-2021                 31-Dec-2021                  --

     Comments



    ►DLI 6 An integrated TB transaction-based information system (Output, 50,000,000.00, 0%)

                                                                                                                       From January 1,
                                                                                                                       2025 to December
                                  Baseline                    Actual (Previous)           Actual (Current)             31, 2025

    Value                         No                          No                          No                           Yes

    Date                          --                          31-Dec-2021                 31-Dec-2021                  --




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            Indonesia: Strengthening National Tuberculosis Response Program (P178517)




    Comments
     IN01358224
     DLI 6.1 MOH has implemented a simplified interface of the TB program information system to notify of TB cases. (Output, 10,000,000.00,
     0%)
     Unit of Measure: Text
     Indicator Type:

                                                                                                                          From January 1,
                                                                                                                          2025 to December
                                  Baseline                     Actual (Previous)             Actual (Current)             31, 2025
                                                               Complex and
                                  Complex and burdensome                                    Complex and burdensome
     Value                                                     burdensome TB reporting                                    NA
                                  TB reporting system                                       TB reporting system
                                                               system
     Date                         --                           31-Dec-2021                  31-Dec-2021                   --

     Comments

     IN01358225
     DLI 6.2 (i) Enhance the existing TB information system to have more automated data entry interfaces for data inputs; and (ii)
     Integration/Interoperability of TB applications/information systems with IHS (Output, 20,000,000.00, 0%)
     Unit of Measure: Text
     Indicator Type:

                                                                                                                          From January 1,
                                                                                                                          2025 to December
                                  Baseline                     Actual (Previous)             Actual (Current)             31, 2025
                                  Fragmented and manual        Fragmented and manual        Fragmented and manual
     Value                        entry-reliance TB            entry-reliance TB            entry-reliance TB             NA
                                  information system           information system           information system
     Date                         --                           31-Dec-2021                  31-Dec-2021                   --

     Comments

     IN01358226
     DLI 6.3 More private primary health care providers have become new users of the TB program information system implemented under
     DLR 6.1 for TB notification. (Output, 20,000,000.00, 0%)
     Unit of Measure: Number
     Indicator Type:

                                                                                                                          From January 1,
                                                                                                                          2025 to December
                                  Baseline                     Actual (Previous)             Actual (Current)             31, 2025

     Value                        0.00                         0.00                          0.00                         60.00

     Date                         --                           31-Dec-2021                  31-Dec-2021                   --

     Comments



    ►DLI 7 Improve use of evidence in decision making (Output, 20,000,000.00, 0%)

                                                                                                                          From January 1,
                                                                                                                          2025 to December
                                  Baseline                     Actual (Previous)             Actual (Current)             31, 2025


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            Indonesia: Strengthening National Tuberculosis Response Program (P178517)




    Value                         No                          No                         No                           Yes

    Date                          --                          31-Dec-2021                31-Dec-2021                  --

    Comments
     IN01358228
     DLI 7.1 MOH has implemented the national TB prevalence survey and used it to estimate local-level TB prevalence. (Output,
     10,000,000.00, 0%)
     Unit of Measure: Text
     Indicator Type:

                                                                                                                      From January 1,
                                                                                                                      2025 to December
                                  Baseline                    Actual (Previous)          Actual (Current)             31, 2025
                                                                                                                     The national TB
                                                                                                                     prevalence survey is
                                  National TB prevalence      National TB prevalence     National TB prevalence
                                                                                                                     implemented and
     Value                        survey is not implemented   survey is not              survey is not implemented
                                                                                                                     used to estimate
                                  yet                         implemented yet            yet
                                                                                                                     local-level TB
                                                                                                                     prevalence
     Date                         --                          31-Dec-2021                31-Dec-2021                  --

     Comments

     IN01358229
     DLI 7.2 MOH has completed and published at least two process evaluations of the newly introduced design features under this Program.
     (Output, 10,000,000.00, 0%)
     Unit of Measure: Number
     Indicator Type:

                                                                                                                      From January 1,
                                                                                                                      2025 to December
                                  Baseline                    Actual (Previous)          Actual (Current)             31, 2025

     Value                        0.00                        0.00                       0.00                         2.00

     Date                         --                          31-Dec-2021                31-Dec-2021                  --

     Comments




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