The World Bank Implementation Status & Results Report India's Enhanced Health Service Delivery Program (P178146) India's Enhanced Health Service Delivery Program (P178146) SOUTH ASIA | India | Health, Nutrition & Population Global Practice | Requesting Unit: SACIN | Responsible Unit: HSAHN IBRD/IDA | Program-for-Results Financing | FY 2022 | Team Leader(s): Sheena Chhabra Seq No: 4 | ARCHIVED on 15-Dec-2023 | ISR59136 | Created by: Deepika Anand on 04-Dec-2023 | Modified by: Deepika Anand on 12-Dec-2023 Program Development Objectives PDO Table Program Development Objective (from Program Appraisal Document) To increase utilization of comprehensive primary health care services, improve quality of care, and strengthen governance of the health sector in India. Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Satisfactory Implementation Status and Key Decisions India’s Enhanced Health Service Delivery Program (EHSDP) was approved by the Board of Directors on June 28, 2022, signed on March 3, 2023 and became effective on April 13, 2023. To date, targets for five PDO indicators have been met or surpassed (except DLI 4) and targets for 11 of 14 intermediate result (IR) indicators for Year 1 have been met or surpassed. The Independent Verification Agency (IVA) is onboarded, and verification protocols and checklists finalized for 4 prior results and four Year 1 results. IVA has submitted the final verification report confirming the achievement of 4 prior results (DLR 4, 6.1, 7.1 and 9.1) and the verification of four Year 1 results is also expected to be completed in December 2023. Close to US$ 54 million is linked to the disbursements against the four prior results and the four Year 1 results.. The immediate priorities are to: (i) Finalize the verification protocols and checklists for verification of DLR#1 and 2 and timebound Year 2 results; (ii) focus Program implementation efforts on the achievement of Year 2 results; and; (iii) support analytical work, knowledge events and partnerships with local institutions at state level. Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P178146 IBRD-94180 Effective USD 500.00 500.00 0.00 1.25 498.75 0.3% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P178146 IBRD-94180 Effective 28-Jun-2022 03-Mar-2023 13-Apr-2023 30-Jun-2027 30-Jun-2027 12/15/2023 Page 1 of 15 The World Bank Implementation Status & Results Report India's Enhanced Health Service Delivery Program (P178146) DLI Disbursement Achievement Disbursed amount in Disbursement % for DLI ID DLI Type Description Coc DLI Amount Status Coc DLI Loan: IBRD94180-001 Increased footfalls at 1 Regular USD 50,000,000.00 Not Achieved 0.00 HWCs Increased population 2 Regular USD 87,000,000.00 Not Achieved 0.00 screened based on e strngtd CPHC data sys fr 3 Regular USD 53,000,000.00 Not Achieved 0.00 impd prfmce trc Increased HWCs with 4 Regular USD 60,000,000.00 Not Achieved 0.00 NQAS certification Dvlpmt & Adptn of state 5 Regular USD 60,000,000.00 Not Achieved 0.00 spcfc HRH stgs f Strghtd ntnl implmn frwk & 6 Regular USD 37,750,000.00 Not Achieved 0.00 lrng plfm Imprvd cmnty ownsh & 7 Regular USD 50,000,000.00 Not Achieved 0.00 mngmt of HWC Inrd state implmtn of Dstrt 8 Regular USD 56,000,000.00 Not Achieved 0.00 prfmc mmsrmn Smplfctn & enhncd trnspcy 9 Regular USD 45,000,000.00 Not Achieved 0.00 of hlth scts p Program Action Plan Action Description Conduct an annual knowledge-exchange event for Medical Service Corporations (MSCs) Source DLI# Responsibility Timing Timing Value Status Fiduciary Systems MoHFW Recurrent Yearly Not Yet Due Completion Measurement Held annual knowledge exchange event among state medical service corporations/entities To be discussed in the next ISM proposed for January 2024. The first annual knowledge exchange event for MSCs is Comments due on or before April 02, 2024. Action Description Timely sharing of Program’s fiduciary reports with the Bank Source DLI# Responsibility Timing Timing Value Status MoHFW supported Fiduciary Systems Recurrent Semi-Annually Not Yet Due by priority states Sharing fiduciary report regarding KPIs and Anti-Corruption Guidelines protocol within two months from last date of Completion Measurement each (six-month) reporting period. The KPI formats were shared with the MoHFW in the last ISM; the status for the same will be discussed in the next Comments ISM proposed for January 2024. MoHFW shared that they had consulted with the Priority states regarding the KPI formats. 12/15/2023 Page 2 of 15 The World Bank Implementation Status & Results Report India's Enhanced Health Service Delivery Program (P178146) Action Description Establish a complaints handling mechanism Source DLI# Responsibility Timing Timing Value Status MoHFW with SHS of Within 6 months of the Fiduciary Systems Other Not Yet Due priority states Effective Date Completion Measurement Sharing details of Complaint Handling Nodal Officer on the website of respective State Health Societies. MoHFW has communicated the applicability of the Bank's ACGs vide OM [File. No. 7(58y202I-NHM-I(Part-l)], advised Comments SHS to establish procurement complaint handling system, display NOs details on SHS website. A semi-annual report is pending from MoHFW. Program expenditure audit reports for Priority States shall be annually disclosed on the National Health Mission Action Description official website. Source DLI# Responsibility Timing Timing Value Status Fiduciary Systems MoHFW Recurrent Yearly Not Yet Due Annual public disclosure of Program expenditure audit reports for states on the National Health Mission official Completion Measurement website. Comments Due on December 31, 2023 Quarterly financial reports, and PFMS shall be used for all transaction processing Action Description Source DLI# Responsibility Timing Timing Value Status MoHFW through Fiduciary Systems SHS of priority Recurrent Semi-Annually In Progress states Completion Measurement Quarterly financial reports submitted by States to MoHFW, and continued use of PFMS for all transaction processing Comments Details to be discussed in the next ISM in January 2024. Internal audit function shall be strengthened through: issuance of standardized TOR by NHM-FMG; carrying out Action Description quarterly concurrent audits at Priority States; and establishment of State Audit Committee at SHS in priority states with clear TORs. Source DLI# Responsibility Timing Timing Value Status MoHFW through Within one year of the Fiduciary Systems SHS of priority Other Not Yet Due effective date states Standardized ToR issued for Concurrent Audit by NHM-FMG Completion Measurement Quarterly concurrent audit confirmation through 6 monthly KPI reporting State Audit Committee meetings confirmation through 6 monthly KPI reporting 12/15/2023 Page 3 of 15 The World Bank Implementation Status & Results Report India's Enhanced Health Service Delivery Program (P178146) Comments Details to be discussed in the next ISM in January 2024. Action Description Designating environmental and social (E&S) specialists for the Program Source DLI# Responsibility Timing Timing Value Status Environmental and Social Within three months of MoHFW Other In Progress Systems the effective date Designation of qualified staff, with defined scope of work (including the preparation of E&S guidance, monitoring the Completion Measurement implementation of E&S actions and reporting protocols). Comments Details expected to be shared in the next ISM scheduled in January 2024 Sharing of guidelines with the states as issued and updated by the MoEF&CC and CPCB on management of all Action Description health care related waste. Source DLI# Responsibility Timing Timing Value Status Environmental and Social MoHFW Recurrent Continuous Not Yet Due Systems Completion Measurement Updated guidelines issued to state-level bio-medical waste management advisory committee Comments Priority States shall conduct periodic occupational health and safety training to all outsourced agencies engaged in Action Description the cleanliness activities for HWCs Source DLI# Responsibility Timing Timing Value Status Environmental and Social Priority states Recurrent Yearly Not Yet Due Systems Completion Measurement Priority States to include action and costing in their annual work plans submitted to MoHFW States will ensure that any outsourced agencies hired to undertake works or services in the health centers will have Comments necessary credentials on environment and occupational health and safety; states will provide refresher trainings if/when needed. Development of an inclusion monitoring template to track roll-out of PM-ABHIM in aspirational districts and integrated Action Description tribal development blocks in Priority States. Source DLI# Responsibility Timing Timing Value Status Environmental and Social Within the first year MoHFW Other Not Yet Due Systems after the Effective Date Submission of a template for Priority States to monitor: (i) fund utilization in integrated tribal development blocks; (ii) Completion Measurement specific KPIs to track tribal health programming, utilization; and (iii) functionality of JAS in aspirational districts. Comments 12/15/2023 Page 4 of 15 The World Bank Implementation Status & Results Report India's Enhanced Health Service Delivery Program (P178146) Action Description Produce a simple monitoring framework for priority states to monitor E&S actions. Source DLI# Responsibility Timing Timing Value Status Environmental and Social MoHFW Recurrent Semi-Annually Not Yet Due Systems Completion Measurement Regular reporting in implementation support missions Comments 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 Technical Design of Project or Program Moderate Moderate Moderate Institutional Capacity for Implementation and Substantial Substantial Substantial Sustainability Fiduciary Substantial Substantial Substantial Environment and Social Moderate Moderate Moderate Stakeholders Moderate Moderate Moderate Other -- -- -- Overall Moderate Moderate Moderate Results PDO Indicators by Objectives / Outcomes Increase Utilization of Comprehensive Primary Healthcare Services IN01377029 ►Increased pregnant women who received 4 or more ANC visits (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target 89 percent is the 84 percent is the average 89 percent is the average average of the 7 states of the 7 states where PW of the 7 states where PW where PW receive 4 or Value receive 4 or more ANC receive 4 or more ANC 90 Percent more ANC checks checks among those checks among those among those registered registered for ANC. registered for ANC. for ANC. 12/15/2023 Page 5 of 15 The World Bank Implementation Status & Results Report India's Enhanced Health Service Delivery Program (P178146) Date 31-Mar-2022 31-Mar-2023 31-Mar-2023 31-Mar-2027 Comments IN01377157 ►Increased infants 9-11 months old who received full immunization as per the schedule (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Urban Male: 810,151 Urban Male: 938,572; Urban Male: 851,477 Urban Male: 938,572; Urban Female: 753,402 Urban Female: 880,913; Urban Female: Urban Female: 880,913; Value Rural Male: 3,492,945 Rural Male: 3,775,706; 791,833 Rural Male: Rural Male: 3,775,706; Rural Female: 3,177,710 Rural Female: 3,671,120 Rural Rural Female: 3,424,411 3,424,411 Female: 3,339,805 Date 31-Mar-2022 31-Mar-2023 31-Mar-2023 31-Mar-2027 Comments IN01377159 ►Increased footfalls at Health and Wellness Centers (CRI) (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target 40 percent for rural; 40 212,006,578 in rural percent for urban; 40 areas; 47,924,765 in Aggregate 9% increase Aggregate 9% increase percent in aggregate Value urban areas; 259,931,343 from baseline from baseline (increase over in aggregate baseline, as percent of baseline) Date 31-Mar-2022 31-Mar-2023 31-Mar-2023 31-Mar-2027 Data on number of footfalls awaited; % increase in rural and urban areas also awaited. Comments IN01377160 Increased footfalls at Health and Wellness Centers by women (Text, Custom Supplement) Baseline Actual (Previous) Actual (Current) End Target 40 percent for women in rural areas; 40 percent for women in 116,397,996 in rural areas; Aggregate 5% increase Aggregate 5% increase urban areas; 40 Value 27,135,351 in urban areas; from baseline from baseline percent for women in 143,533,347 in aggregate aggregate (increase over baseline, as percent of baseline) Improve Quality of Care IN01377030 ►Increased HWCs with NQAS certification (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Prior result:127; HWC- HWC-SC:0; HWC- HWC PHC: 244, HWC HWC PHC: 244, HWC Value SC:961: HWC-PHC: PHC:501; HWC-UPHC:59 UPHC:54, HWC SC:2 UPHC:54, HWC SC:2 774: HWC-UPHC:165 Date 31-Mar-2022 31-Mar-2023 31-Mar-2023 31-Mar-2027 Comments Strengthen governance of the health sector in India IN01377156 12/15/2023 Page 6 of 15 The World Bank Implementation Status & Results Report India's Enhanced Health Service Delivery Program (P178146) ►Improved community ownership and management of HWCs through Jan Arogya Samitis (JAS) (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target 40 percent of HWCs Value None 0.00 0.00 with functional JAS Date 31-Mar-2022 31-Mar-2023 31-Mar-2023 31-Mar-2027 Comments IN01377158 ►Increased state implementation of district performance measurement and rewards framework (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 5.00 Date 31-Mar-2022 31-Mar-2023 31-Mar-2023 31-Mar-2027 Comments Intermediate Results Indicators by Results Areas Strengthened service delivery through redesigned CPHC model IN01377161 ►Functional HWCs providing expanded healthcare service delivery packages of CPHC (including urban HWCs) (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target 47,855 rural HWCs Rural HWC: 52,418; Rural HWC: 52,418; and 1,559 urban Urban HWC: 3035 Urban HWC: 3035 HWCs functional with 37,653 for rural areas; functional with 7 service functional with 7 service Value 9 service delivery 1,831 for urban areas delivery packages as delivery packages as packages as defined defined by CPHC defined by CPHC by CPHC guidelines of guidelines of GoI guidelines of GoI GoI Date 31-Mar-2022 31-Mar-2023 31-Mar-2023 31-Mar-2027 Comments IN01377164 ►Strengthened CPHC data systems for improved performance tracking and performance incentives (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target (i) Generate HWC Health Index and CPHC performance CPHC performance publicly disseminate it monitoring framework monitoring framework (ii) Implement Value TBC developed and shared developed and shared incentives to HWCs with priority States with priority States based on HWC Health Index scores Date 31-Mar-2022 31-Mar-2023 31-Mar-2023 31-Mar-2027 Comments IN01377167 12/15/2023 Page 7 of 15 The World Bank Implementation Status & Results Report India's Enhanced Health Service Delivery Program (P178146) ►Increased population screened based on established national protocol (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target 87 percent for rural; 87 35,072,471 in rural areas; percent for urban; 87 11,750,531 in urban Aggregate 159% Aggregate 159% percent in aggregate Value areas; 46,823,002 in increase from baseline increase from baseline (increase over aggregate. baseline, as percent of baseline) Date 31-Mar-2022 31-Mar-2023 31-Mar-2023 31-Mar-2027 Comments IN01377170 ►Infants 9-11 months who have received the first dose of Pentavalent vaccine (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 88.00 95.50 95.50 88.00 Date 31-Mar-2022 31-Mar-2023 31-Mar-2023 31-Mar-2027 Comments Improved comprehensive quality of care IN01377162 ►Development and adoption of state-specific Human Resources for Health (HRH) strategies for public health facilities (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 5.00 Date 31-Mar-2022 31-Mar-2023 31-Mar-2023 31-Mar-2027 Comments IN01377165 ►A diagnostic analysis for quality of care improvement conducted to develop a template for a comprehensive state-specific Quality of Care Strategy (QOCS) (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 31-Mar-2022 31-Mar-2023 31-Mar-2023 31-Mar-2027 Comments IN01377168 ►Development of state QOCS (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1.00 1.00 1.00 5.00 Date 31-Mar-2022 31-Mar-2023 31-Mar-2023 31-Mar-2027 Comments 12/15/2023 Page 8 of 15 The World Bank Implementation Status & Results Report India's Enhanced Health Service Delivery Program (P178146) IN01377171 ►Conducting a learning exchange event for fostering an enabling environment for comprehensive quality of care improvement (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 5.00 Date 31-Mar-2022 31-Mar-2023 31-Mar-2023 31-Mar-2027 Comments IN01377172 ►Piloting of routine measurement of patient/user experience at primary and secondary facilities (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Routine measurement of patient/user experience at primary Value No No No and secondary facilities piloted in at least 1 district in FOUR priority states: Y Date 31-Mar-2022 31-Mar-2023 31-Mar-2023 31-Mar-2027 Comments Transformed health sector governance, accountability, and institutional and management capacity IN01377163 ►States conducting operational research (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 5.00 Date 31-Mar-2022 31-Mar-2023 31-Mar-2023 31-Mar-2027 Comments IN01377166 ►National knowledge exchange events held (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 4.00 Date 31-Mar-2022 31-Mar-2023 31-Mar-2023 31-Mar-2027 Comments IN01377169 ►Development of Jan Arogya Samitis (JAS) template for annual report and financial audit (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target At least 40 percent of HWCs with functional Value No No No JAS; At least 70 percent of JAS utilizing at least 12/15/2023 Page 9 of 15 The World Bank Implementation Status & Results Report India's Enhanced Health Service Delivery Program (P178146) 50 percent of their annual resources Date 31-Mar-2022 31-Mar-2023 31-Mar-2023 31-Mar-2027 As per the Legal Agreement, development of JAS template is due for year 2. Comments IN01377173 ►Increased state implementation of district performance measurement and rewards framework (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Annual district level Draft for the District level Draft for the District performance-based performance level performance Value No measurement measurement developed measurement implemented by 5 by MoHFW developed by MoHFW Priority States Date 31-Mar-2022 31-Mar-2023 31-Mar-2023 31-Mar-2027 Development of a district level performance measurement system that includes CPHC performance and Comments other relevant indicators. IN01377174 ►Simplification and enhanced transparency of the health sector's public financial management (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Annual reporting of all Draft guidelines on Draft guidelines on approvals and streamlining the PIP streamlining the PIP releases under PM- process planning, process planning, ABHIM by MoHFW Value No appraisal, appraisal, Annual reporting of implementation and implementation and PM-ABHIM monitoring developed by monitoring developed expenditures by 7 MoHFW by MoHFW Priority States Date 31-Mar-2022 31-Mar-2023 31-Mar-2023 31-Mar-2027 Comments Disbursement Linked Indicators DLI_IND_TABLE ►DLI 1 Increased footfalls at Health and Wellness Centers (Outcome, 50.00, 0%) Results to be achieved in FY26/27 Baseline Actual (Previous) Actual (Current) (Year 5) 40 percent increase Aggregate 9% increase Aggregate 9% increase Value 259,931,343 in number of from baseline from baseline footfalls at HWCs Date -- 31-Mar-2023 31-Mar-2023 -- Footfall numbers awaited Comments ►DLI 2 Increased population screened based on established national protocol (Outcome, 87.00, 0%) 12/15/2023 Page 10 of 15 The World Bank Implementation Status & Results Report India's Enhanced Health Service Delivery Program (P178146) Results to be achieved in FY26/27 Baseline Actual (Previous) Actual (Current) (Year 5) 87 percent increase in number of individuals screened Aggregate 159% with community- Aggregate 159% increase Value 46,823,002 increase from the based assessment from the baseline baseline checklist (CBAC) in accordance with established national protocol. Date -- 31-Mar-2023 31-Mar-2023 -- Comments ►DLI 3 Strengthened CPHC data systems for improved performance tracking and performance incentives (Intermediate Outcome, 53.00, 0%) Results to be achieved in FY26/27 Baseline Actual (Previous) Actual (Current) (Year 5) 3.6 HWC health index generated and publicly CPHC performance CPHC performance disseminated by monitoring framework monitoring framework MoHFW; Value - developed and shared developed and shared 3.7 Incentives to with priority States with priority States HWCs based on HWC health index scores implemented Date -- 31-Mar-2023 31-Mar-2023 -- Comments ►DLI 4 Increased HWCs with NQAS certification (Outcome, 60.00, 0%) Results to be achieved in FY26/27 Baseline Actual (Previous) Actual (Current) (Year 5) Value 560.00 860.00 860.00 2,027.00 Date -- 31-Mar-2023 31-Mar-2023 -- Comments ►DLI 5 Development and adoption of state-specific Human Resources for Health (HRH) strategies for public health facilities in Priority States (Intermediate Outcome, 60.00, 0%) Results to be achieved in FY26/27 Baseline Actual (Previous) Actual (Current) (Year 5) 12/15/2023 Page 11 of 15 The World Bank Implementation Status & Results Report India's Enhanced Health Service Delivery Program (P178146) 5.3 HRH strategy for public health facilities, based on Value 0.00 0.00 0.00 the template developed by MoHFW, adopted by 5 Priority States Date -- 31-Mar-2023 31-Mar-2023 -- Comments ►DLI 6 Strengthened national implementation framework and learning platform (Process, 37.75, 0%) Results to be achieved in FY26/27 Baseline Actual (Previous) Actual (Current) (Year 5) 6.6 Operational research on Program's topics initiated in at least 5 Office Memorandum Office Memorandum Priority States and issued by MoHFW and issued by MoHFW and the approved by Value None the Guidelines on Guidelines on knowledge MoHFW knowledge and learning and learning developed by 6.7 At least one developed by MoHFW MoHFW annual knowledge exchange event developed and implemented by MoHFW Date -- 31-Mar-2023 31-Mar-2023 -- Comments IN01377181 DLI 6.1 Office Memorandum issued by MoHFW (Output, 6.00, 0%) Unit of Measure: Text Indicator Type: Results to be achieved in FY26/27 Baseline Actual (Previous) Actual (Current) (Year 5) Office memorandum Office memorandum issued by MoHFW on issued by MoHFW on implementing implementing Value NA arrangements at national arrangements at national - level and Priority States level and Priority States for achievement of for achievement of Program results Program results Date -- 31-Mar-2023 31-Mar-2023 -- Comments IN01377182 DLI 6.2 Guidelines on knowledge and learning developed by MoHFW (Output, 4.25, 0%) Unit of Measure: Text 12/15/2023 Page 12 of 15 The World Bank Implementation Status & Results Report India's Enhanced Health Service Delivery Program (P178146) Indicator Type: Results to be achieved in FY26/27 Baseline Actual (Previous) Actual (Current) (Year 5) Guidelines on knowledge Guidelines on knowledge Value NA and learning developed and learning developed by - by MoHFW MoHFW Date -- 31-Mar-2023 31-Mar-2023 -- Comments IN01377183 DLI 6.3 Operational research on Program's topics initiated in at least 2 Priority States and approved by MoHFW (Output, 7.00, 0%) Unit of Measure: Text Indicator Type: Results to be achieved in FY26/27 Baseline Actual (Previous) Actual (Current) (Year 5) Value NA NA NA - Date -- 31-Mar-2023 31-Mar-2023 -- Comments IN01377184 DLI 6.4 Operational research on Program's topics initiated in at least 3 Priority States and approved by MoHFW (Output, 3.50, 0%) Unit of Measure: Text Indicator Type: Results to be achieved in FY26/27 Baseline Actual (Previous) Actual (Current) (Year 5) Value NA NA NA - Date -- 31-Mar-2023 31-Mar-2023 -- Comments IN01377185 DLI 6.5 Operational research on Program's topics initiated in at least 4 Priority States and approved by MoHFW (Output, 3.00, 0%) Unit of Measure: Text Indicator Type: Results to be achieved in FY26/27 Baseline Actual (Previous) Actual (Current) (Year 5) Value NA NA NA - Date -- 31-Mar-2023 31-Mar-2023 -- 12/15/2023 Page 13 of 15 The World Bank Implementation Status & Results Report India's Enhanced Health Service Delivery Program (P178146) Comments IN01377186 DLI 6.6 Operational research on Program's topics initiated in at least 5 Priority States and approved by MoHFW (Output, 2.00, 0%) Unit of Measure: Text Indicator Type: Results to be achieved in FY26/27 Baseline Actual (Previous) Actual (Current) (Year 5) Operational research on Program's topics (e.g., CPHC, urban Value NA NA NA health, quality, governance) initiated in at least 5 Priority States. Date -- 31-Mar-2023 31-Mar-2023 -- Comments IN01377187 DLI 6.7 At least one annual knowledge exchange event developed and implemented by MoHFW (Output, 12.00, 0%) Unit of Measure: Number Indicator Type: Results to be achieved in FY26/27 Baseline Actual (Previous) Actual (Current) (Year 5) Value 0.00 0.00 0.00 4.00 Date -- 31-Mar-2023 31-Mar-2023 -- Comments ►DLI 7 Improved community ownership and management of HWCs through Jan Arogya Samitis (JAS) (Outcome, 50.00, 0%) Results to be achieved in FY26/27 Baseline Actual (Previous) Actual (Current) (Year 5) 7.8 At least 40 percent of HWCs Template for Jan Arogya Template for Jan Arogya with functional JAS Samitis (JAS) annual Samitis (JAS) annual 7.9 At least 70 Value None report and financial audit report and financial audit percent of JAS developed by MoHFW developed by MoHFW utilizing at least 50 percent of their annual resources Date -- 31-Mar-2023 31-Mar-2023 -- Comments 12/15/2023 Page 14 of 15 The World Bank Implementation Status & Results Report India's Enhanced Health Service Delivery Program (P178146) ►DLI 8 Increased implementation of district performance measurement and rewards framework in Prirority States (Outcome, 56.00, 0%) Results to be achieved in FY26/27 Baseline Actual (Previous) Actual (Current) (Year 5) Value 0.00 0.00 0.00 - Date -- 31-Mar-2023 31-Mar-2023 -- Comments ►DLI 9 Simplification and enhanced transparency of the health sector's public financial management (Intermediate Outcome, 45.00, 0%) Results to be achieved in FY26/27 Baseline Actual (Previous) Actual (Current) (Year 5) Draft guidelines on Draft guidelines on streamlining the PIP streamlining the PIP (Program Implementation (Program Implementation Plan) process planning, Value No Plan) process planning, - appraisal, appraisal, implementation implementation and and monitoring developed monitoring developed by by MoHFW MoHFW Date -- 31-Mar-2023 31-Mar-2023 -- Comments 12/15/2023 Page 15 of 15