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: EAITL (358) | Responsible Unit: HEAH1 (9317) IBRD/IDA | Program-for-Results Financing | FY 2023 | Team Leader(s): Pandu Harimurti, Somil Nagpal Seq No: 4 | Archived on 22-Nov-2024 | ISR02494 | Created by: Pandu Harimurti on 14-Nov-2024 | Modified by: Pandu Harimurti on 19-Nov-2024 1. PROJECT DEVELOPMENT OBJECTIVE 1.1 Development Objective Original Development Objective (Approved as part of Approval package on 19-Dec-2022) To improve coverage, quality and efficiency of tuberculosis services in Indonesia 2. OVERALL RATINGS Name Previous Current Progress towards achievement of PDO Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Satisfactory Overall Risk Rating Moderate Moderate 3. KEY ISSUES & STATUS 3.1 Implementation Status and Key Decisions The Program's Loan Agreement has been effective since January 19, 2023, and is under implementation for over 20 months. The status of the Program builds on the discussions held during the third Joint Implementation Support Mission of September 2 -9, 2024. Overall, the program implementation is progressing well. Technical assistance activities continue to further improve implementation of performance-based transfers and results-based provider payments, aiming to create an enabling environment to foster the involvement of primary public and private providers, and in strengthening risk communication to address stigma in TB. May 31, 2025 Page 1 of 27 The World Bank Implementation Status & Results Report Indonesia: Strengthening National Tuberculosis Response Program (P178517) 4. DATA ON FINANCIAL PERFORMANCE 4.1 Disbursements (by loan) Loan/Credit/TF Status Original Revised Cancelled Disbursed Undisbursed % Disbursed IBRD-94640 Effective 300.00 300.00 0.00 166.82 133.18 55.61% 4.2 Key Dates (by loan) Loan/Credit/TF Status Approval Signing Effectiveness Orig. Closing Rev. Closing IBRD-94640 Effective 19-Dec-2022 13-Jan-2023 19-Jan-2023 31-Mar-2027 31-Mar-2027 4.3 Program Action Plan Implementation of capacity building activities to health facilities and health workers, incl Action Description CHW & volunteers, for proper 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 Quality Environmental and NA Improvement & Recurrent Semi-Annually In Progress Social Systems NTP Completion Number of training and capacity-building sessions delivered Measurement MoH has carried out training and capacity building for health workers with 4 e-learning Comments modules and 18 face-to-face workshops with a total 6,810 health workers. These training throughout 2024 were conducted by accredited health training centers Conduct need assessment on current practice in the health facilities and laboratories in Action Description provisioning adequate 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 May 31, 2025 Page 2 of 27 The World Bank Implementation Status & Results Report Indonesia: Strengthening National Tuberculosis Response Program (P178517) Environmental and Dit of Infectious NA Recurrent Yearly In Progress Social Systems Disease Prev - NTP Completion Needs assessments of PPE adequacy in health facilities and laboratories at the central level Measurement as reference for implementers at the subnational level The PPE assessments for the year 2024 and 2025 have been conductedannually at the end of Comments November in accordance to budget planning cycle. During 2024 stock was less than the estimated needs of which local government to fill the gaps Periodic screening and testing for healthcare workers, health facility and laboratory staff, Action Description and community health volunteers responsible for direct handling of TB suspects, confirmed cases, and testing specimens. Source DLI# Responsibility Timing Timing Value Status Environmental and Dit Productive & NA Recurrent Yearly In Progress Social Systems Old Age, NTP, DTO Develop guidelines that prescribe periodic screening & testing for health care workers Completion (HCW) & facility staff; establish a data segregation record system for periodic screening & Measurement testing implementation (Y1); & record the number of HCW screened (Y2-6) The technical guidelines on periodic screening and testing of health workers and community Comments volunteers was issued in December 2023 and in 2025, TB screening is included in the nationwide annual “Free Health Check” program Nominate responsible staff from the MOH whom in coordination with the MOEF to advise Action Description health facilities in managing 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 Directorate effectiveness and Environmental and NA General of Health Other to be maintained Completed Social Systems Service throughout Program implementation Completion Letters that nominate responsible staff (job title or position) were issued from the MOH. Measurement MoH has appointed a responsible staff with a MoH decree who coordinates with the MOEF Comments to advise health facilities in managing the expected increase of volume of medical waste TB cases at the health facilities May 31, 2025 Page 3 of 27 The World Bank Implementation Status & Results Report Indonesia: Strengthening National Tuberculosis Response Program (P178517) a.Monitor current capacity/practice in the health facilities and laboratories in Provinces or Action Description Districts level to manage 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 NA Environmental Recurrent Yearly In Progress Social Systems Health of MoH Routine report on medical waste management of health facilities and laboratories at the Completion central level as reference for implementers at the subnational level, which informs the need Measurement for alternative medical waste management advise (that is, 4.b). The monitoring of medical waste management carried out in coordination with subnational Comments authorities but only 3,227 out of 10,231 health service facilities (31.5 percent) submitting reports through the waste management information system b.Advising health facilities on the alternatives to manage their wastes (in house and external Action Description services), support 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 Directorate Environmental and NA Environmental Recurrent Semi-Annually In Progress Social Systems Health of MoH Administrative records, may include records/log of meetings, discussions, dialogue with Completion MOEF, PHOs, and DHOs; minutes of the meeting & other documentations; & record of Measurement outreach and socialization activities on medical waste treatment alternatives MoH continues to provide technical support in addition to developing technical guidelines Comments for subnational level and health facilities. It is recommended to have targeted technical support based on the level of readiness of waste management system c. Providing capacity building for health workers, health facilities and laboratories staff, and Action Description community health 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 NA Environmental Recurrent Yearly In Progress Social Systems Health of MoH May 31, 2025 Page 4 of 27 The World Bank Implementation Status & Results Report Indonesia: Strengthening National Tuberculosis Response Program (P178517) Completion Number of capacity-building sessions delivered and number of participants in the capacity- Measurement building sessions. MoH has carried out online capacity building sessions on medical waste management for Comments nation-wide community health centers (Puskesmas) January - December 2024. Strengthening the existing communication strategy on public health messaging and Action Description community outreach on TB related facts to reduce stigma, in coordination with media and civil society organizations. Source DLI# Responsibility Timing Timing Value Status Directorate of Environmental and NA Health Promotion Recurrent Semi-Annually In Progress Social Systems and CE Implementation of national communication strategy, using various mechanisms and Completion channels. Measurement Include capacity buildings, monitoring and evaluation tools. Public health messaging and community outreach on TB related facts have been carried out Comments using various media channels and TB related educational materials are available at MoH webpage. Also, the revised protocol was launched during World TB Day 24. A protocol for communication for TB patients included in the TB clinical guidelines Action Description incorporating data protection measures and consent is developed and disseminated to health workers and facilities Source DLI# Responsibility Timing Timing Value Status Communication Environmental and NA Bureau of Health Recurrent Semi-Annually Completed Social Systems Service Completion Clinical guideline with protocol for communication developed, disseminated and Measurement implemented. The Integrated TB Contact Investigation Guideline and the TPT Technical Guideline that Comments includes data protection and informed consent Data Confidentiality Tagging for access restriction was finalized Sept 2024 and dissemination started October 2024 Strengthen the existing system regarding patients’ and health workers’ safety at health Action Description facilities, including on aspects 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 May 31, 2025 Page 5 of 27 The World Bank Implementation Status & Results Report Indonesia: Strengthening National Tuberculosis Response Program (P178517) Environmental and Directorate of NA Recurrent Semi-Annually In Progress Social Systems Health Care Quality Completion Materials on patients’ security and safety and safe workplace environment developed and Measurement records of dissemination activities delivered MOH has produced a circular letter on respectful workplace. The MoH has issued Instruction Comments (No.HK.02.01/Menkes/1512/2023) regarding prevention and bullying toward medical interns. A working team on SEAH is being developed Strengthen the existing public FGRM for TB care including complaints about drugs and Action Description diagnostic availability, quality of health service, stigma/discrimination during health service delivery, and so on. Source DLI# Responsibility Timing Timing Value Status Environmental and Directorate of NA Recurrent Semi-Annually In Progress Social Systems Health Care Quality Completion SOP on FGRM for TB care developed, monitored, and disseminated to relevant stakeholders Measurement Throughout 2024 and for the first two months in 2025 there are four queries related to TB Comments services, and there were no TB specific complaints MOH to require UKPBJs and PPK to check the WB debarment site and temp suspension lists Action Description and record verification 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 NA Procurement of Recurrent Continuous In Progress goods/service Guidance provided to UKPBJ/procurement officers/PPK is implemented to ensure that no Completion contract under the Program is awarded to a firm or individual that is under debarment Measurement and/or temporary suspension by the World Bank. Complied with. MoH has provided the Bank the procurement and contract data related to Comments the Program. The MOH to provide the World Bank information of procurement profiles and contract Action Description information regularly or at least every 6 months of Program implementation. Source DLI# Responsibility Timing Timing Value Status May 31, 2025 Page 6 of 27 The World Bank Implementation Status & Results Report Indonesia: Strengthening National Tuberculosis Response Program (P178517) Bureau of Fiduciary Systems NA Procurement of Recurrent Semi-Annually In Progress goods/ services Completion Procurement activities under the NTP is compiled as well as procurement and contract data Measurement are provided to the Bank according to the agreed timeline MoH has provided the Bank the procurement and contract data related to the Program, Comments which identifies various procurement categories and methods (mainly following open tender, fast tender, direct procurement, direct contracting and e-purchasing). MOH to ensure that 100% PPK, PPSPM, and staff positions for the Program (esp in DG Action Description Disease Prevention and Control & DG Pharmacy and Medical Devices) are held by staff who have already completed training on payment verification for goods from BPPK. Source DLI# Responsibility Timing Timing Value Status Bureau of Finance Fiduciary Systems NA and Assets, and Recurrent Semi-Annually In Progress Budget PPK, PPSPM and staff members of the relevant working units involved in the TB program Completion completed the required training on payment verification for goods from BPPK was 26 Measurement percent (8 out of 31) As of March 2025 PPK staff of the implementing units involved in the TB program only 23 Comments percent (5 out of 18) of staff completed the required training on payment verification for goods from BPPK. This is due to staff rotation MoH IG to conduct internal audit on NTP implementation and its related procurement Action Description process financed under the Program. Source DLI# Responsibility Timing Timing Value Status Inspectorate III and Fiduciary Systems NA Recurrent Semi-Annually In Progress Inspectorate for Completion Report on the internal audit conducted by the MOH IG on the implementation of the NTP Measurement activities from all the relevant working units/satuan kerja within the MOH The Inspectorate General of MOH has conducted audit by end of 2024 that include TB Comments program performance effectiveness, audit for GeneXpert Rapid Molecular Test Maintenance, audit SITB patient data MOH to inform WB promptly of all credible and material allegations or other indications of Action Description fraud and corruption in connection with the Program that come to its attention, together with the investigative and other actions that it proposes to take. May 31, 2025 Page 7 of 27 The World Bank Implementation Status & Results Report Indonesia: Strengthening National Tuberculosis Response Program (P178517) Source DLI# Responsibility Timing Timing Value Status Inspectorate III and Fiduciary Systems NA Recurrent Semi-Annually In Progress Inspectorate for Completion Semiannual reports provided to the World Bank on allegations of fraud and corruption under Measurement the Program received during such period and any related investigations and actions taken. MoH has submitted data on complaints but not on F&C allegations as, none have been Comments labeled as on TB related activities for the last six months. The report however doesnot use the standard report format 5. KEY DATES Key Events Planned Actual Approval 19-Dec-2022 19-Dec-2022 Effectiveness 19-Jan-2023 19-Jan-2023 Mid-Term Review No. 01 03-Mar-2025 Operation Closing/Cancellation 31-Mar-2027 6. SYSTEMATIC OPERATIONS RISK-RATING TOOL Rating at Approval Last Approved Rating Risk Category Approval Package - ISR Seq. 03 - 19 May Proposed Rating 19 Dec 2022 2024 Political and Governance Moderate Moderate Moderate Macroeconomic Moderate Moderate Moderate Sector Strategies and Policies Moderate Moderate Moderate Technical Design of Project or Program Substantial Substantial Substantial Institutional Capacity for Implementation and Substantial Substantial Substantial Sustainability Fiduciary Moderate Moderate Moderate May 31, 2025 Page 8 of 27 The World Bank Implementation Status & Results Report Indonesia: Strengthening National Tuberculosis Response Program (P178517) Environment and Social Moderate Moderate Moderate Stakeholders Moderate Moderate Moderate Overall Moderate Moderate Moderate May 31, 2025 Page 9 of 27 The World Bank Implementation Status & Results Report Indonesia: Strengthening National Tuberculosis Response Program (P178517) 7. RESULTS 7.1 PDO Indicators by PDO Outcomes Improve coverage and quality of the national TB program Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year 55.00 Dec/2021 77.00 31-Dec-2023 77.40 31-Jul-2024 70.00 Mar/2027 Comments on TB treatment coverage defined in accordance with the WHO definition of number of new Increased TB treatment achieving targets and relapse TB cases that were notified and treated in a given year (numerator), divided by coverage rate (%) the estimated number of incident TB cases in the same year (denominator), expressed as a (Percentage) percentage increase from the (agreed) baseline. The data is updated with the latest available annual data. Improve quality and efficiency Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year 74.00 Dec/2021 86.00 31-Dec-2023 80.00 31-Jul-2024 85.00 Mar/2027 Comments on Treatment success rates for drug sensitive TB are calculated from cohort data (outcomes in Increased TB treatment achieving targets registered patients) as the proportion of new smear-positive TB cases registered under DOTS success rate (%) in a given year (denominator) that successfully completed treatment (numerator), whether (Percentage) with (“cured”) or without (“treatment completed”) bacteriologic evidence of success. Disaggregated by gender Improve coverage, and efficiency Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year 1,138.00 Dec/2021 12,454.00 29-Feb-2024 9,632.00 31-Jul-2024 100,000.00 Mar/2027 May 31, 2025 Page 10 of 27 The World Bank Implementation Status & Results Report Indonesia: Strengthening National Tuberculosis Response Program (P178517) Increased number of notified Comments on Total number of notified TB cases managed (identified and initiated treatment) at private TB cases managed at private achieving targets primary care level providers; In addition the percentage (with numerator the total number primary care level of TB cases notified) will be monitored as a derived indicator (Number) Improve coverage, quality, and efficiency Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year TB information Aug/2022 Integration 29-Feb-2024 Integration 30-Aug-2024 TB information Mar/2027 system not with citizen with citizen system integrated mobile health mobile health integrated or app has been app has been interoperable completed.The completed.The and integration of integration of functioning SITB with the SITB with the SatuSehat SatuSehat Platform is in Platform is in A functional, integrated the Transition the Transition information system linked to Phase, with Phase, with a citizen mobile health linking linking application is in place (Text) between the between the SITB SITB application application and the and the platform’s platform’s dashboard. dashboard. The integration has been piloted in 5 districts May 31, 2025 Page 11 of 27 The World Bank Implementation Status & Results Report Indonesia: Strengthening National Tuberculosis Response Program (P178517) 7.2 Intermediate Results Indicators by Results Areas Strengthened Subnational Tuberculosis Response Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Decreased loss to follow 30,000.00 Dec/2021 106,326.00 31-Dec- 77,910.00 31-Jul- 22,500.00 Mar/2027 up of diagnosed cases to 2023 2024 treatment – reduced Comments on The number of diagnosed TB cases who have not started treatment whose treatment was number of TB cases achieving targets interrupted for 2 consecutive months or more in a given year to the total TB cases diagnosed diagnosed and not put during the same time period. . on treatment (Number) Decreased loss to follow 7.00 Dec/2021 13.00 31-Dec- 16.00 31-Jul- 5.00 Mar/2027 up of diagnosed cases to 2023 2024 treatment – reduced Comments on The proportion of diagnosed TB cases who have not started treatment or whose treatment was share of TB cases achieving targets interrupted for 2 consecutive months or more in a given year to the total TB cases diagnosed diagnosed and not put during the same time period. on treatment (Percentage) Strengthened TB care among public and private health providers Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Increased number of 216.00 Dec/2021 2,272.00 29-Feb- 2,009.00 31-Jul- 7,500.00 Mar/2027 private primary care 2024 2024 providers that notify TB Comments on Private primary care providers who notify TB cases cases to the NTP achieving targets (Number) May 31, 2025 Page 12 of 27 The World Bank Implementation Status & Results Report Indonesia: Strengthening National Tuberculosis Response Program (P178517) Increased number of 1,300.00 Dec/2021 5,717.00 29-Feb- 7,333.00 31-Jul- 10,000.00 Mar/2027 private providers that 2024 2024 have ever used the Comments on Expressed in number of private providers that have ever used (‘ever’ that will be translated as at relevant TB program achieving targets least 5 - five patients ) information system for TB notification (Number) Increase in the number 0.00 Dec/2021 4,653.00 29-Feb- 8,192.00 31-Jul- 12,000.00 Mar/2027 of private primary care 2024 2024 providers who received Comments on Number of private primary care providers received the NTP’s standardized TB case management capacity building achieving targets capacity building. support on TB management (Number) Increase number of 346.00 Dec/2021 1,194.00 29-Feb- 1,264.00 31-Jul- 7,500.00 Mar/2027 private primary care 2024 2024 providers who have Comments on Expressed in total number of private primary care providers who have signed MOU to access access to TB program achieving targets program drugs and have treated patients using TB program drugs drugs (Number) Enhanced digital systems for TB and evidence-informed policy Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year No template or Dec/2021 A national level 29-Feb- A national level 31-Jul- Modality/template Mar/2027 A template for modality exists template document 2024 template document 2024 is in regular use agreements for for for specimen transport contract/arrangement contract/arrangement services that can be for specimen transport for specimen transport used between districts mechanism is provided mechanism is provided and third-party service in the Circular Letter of in the Circular Letter of providers. (Text) DG of Disease DG of Disease May 31, 2025 Page 13 of 27 The World Bank Implementation Status & Results Report Indonesia: Strengthening National Tuberculosis Response Program (P178517) Prevention and Prevention and Control Control HK.02.02/C/4932/2023 HK.02.02/C/4932/2023 regarding Involvement regarding Involvement of All HCFs in the TB of All HCFs in the TB Program and Program and Strengthening the Strengthening the Implementation of the Implementation of the TB Network/Linkage in TB Network/Linkage in Indonesia (2023). Indonesia (2023). The number of sub- 41.00 Dec/2021 290.00 29-Feb- 290.00 31-Jul- 345.00 Mar/2027 national level units 2024 2024 (districts) using the Comments on Expressed in total number of sub national administrative level i.e districts (Kabupaten/Kota) that laboratory specimen achieving targets developed diagnostic linkage and mechanism arrangement of specimen transport or under the transport system in the signed-contract/MoU between PHO/DHO with courier service for specimen tranport services in its reporting period area or had it used by private primary care providers in its catchment area (Number) The number of 0.00 Dec/2020 560,000.00 30-Jun- 560,000.00 31-Jul- 1,000,000.00 Mar/2027 laboratory samples 2023 2024 transported using the Comments on Expressed in total number of TB specimen transported using the new transport specimen new mechanism achieving targets arrangement (Number) Fragmented TB Dec/2021 Fragmented data; 29-Feb- Fragmented data; 31-Jul- Interoperable TB Mar/2027 Functioning information integration is ongoing 2024 integration is ongoing 2024 information interoperable TB system and system information systems interoperabiity that have the ability to is not produce gender established disaggregated data Comments on Existing TB reporting systems that includes information system from service delivery points (SITB, (Text) achieving targets WIFI TB, SITRUST), demand side/community based information system (Empati), and the BPJS-K May 31, 2025 Page 14 of 27 The World Bank Implementation Status & Results Report Indonesia: Strengthening National Tuberculosis Response Program (P178517) (pCare) are interoperable. Text indicator stated annually, and gender disaggregated data will be final year objective Communication Dec/2021 The revision of 29-Feb- The revised version of 31-Jul- The Mar/2027 strategy to communication 2024 the communication 2024 communication Specific communication address stigma strategy is ongoing strategy is being strategy to measures that focus on in TB is not yet finalized address stigma is addressing stigma and developed developed and discrimination towards implemented female TB patients, are Comments on The communication strategy for the national TB program has included a strategy to address stigma devised and achieving targets in the first year of the Program, which particularly focuses on stigma and discrimination faced by implemented (Text) female TB Patients.. The strategy is implemented in the following year throughout the duration of the Program. Number of presumptive 0.00 Dec/2021 3,492,335.00 31-Dec- 2,097,666.00 09-Sep- 1,000,000.00 Mar/2027 TB cases access 2023 2024 laboratory testing Comments on Data will be available on annual basis (Number) achieving targets 7.3 Disbursement Linked Indicators (DLI) Actual (Previous) Actual (Current) PBC Name Baseline Closing Period Value Date Value Date The The The The 1:An intergovernmental fiscal intergovernmental intergovernmental intergovernmental intergovernmental transfer mechanism being 29-Sep- Value fiscal transfer fiscal transfer 29-Sep-2023 fiscal transfer fiscal transfer linked with TB key 2023 scheme for scheme for scheme for scheme for performance indicators (Text) Puskesmas Puskesmas Puskesmas Puskesmas May 31, 2025 Page 15 of 27 The World Bank Implementation Status & Results Report Indonesia: Strengthening National Tuberculosis Response Program (P178517) Achieved operations is not operations is not operations is not yet operations has yet linked with yet linked with linked with both TB been linked with both TB notification both TB notification and TB both TB and success TB notification and TB success treatment notification and treatment rate success treatment rate success TB rate treatment rate Allocated 0.00 0.00 90,000,000.00 Amount DLI allocation 90,000,000.00 TB case 1.1:MOH has designed and TB case notification notification has implemented the BOK has been added as The TB been added as an Kinerja that includes an indicator for BOK performance linked indicator for BOK improvements of a focused Value Kinerja allocation NA transfer not yet Kinerja allocation 09-Sep- and balanced set of 29-Mar-2024 (MOH Decree designed (MOH Decree 2024 indicators, including TB 37/2023), effective 37/2023), effective notification and successful for 2024 allocation for 2024 allocation treatment. (Text) Achieved Allocated 0.00 0.00 0.00 Amount DLI allocation 25,000,000.00 MOH has not made The allocation and The allocation and 1.2:(a) MOH has made performance-based channeling of BOK channeling of BOK performance-based BOK BOK payments Kinerja in Kinerja in payments directly to directly to districts accordance with accordance with the districts, (b) MOH has 09-Sep- Value in accordance with the new Decree 29-Mar-2024 new Decree (MOH NA adopted a transparent 2024 the BOK Kinerja (MOH Decree 37, Decree 37, 2023) approach in implementing designed under 2023) supported supported with the BOK Kinerja (c) MOH DLR 1.1 and as per with the BOK 2024 BOK 2024 technical prepared, approved and the associated technical guideline guideline with the May 31, 2025 Page 16 of 27 The World Bank Implementation Status & Results Report Indonesia: Strengthening National Tuberculosis Response Program (P178517) adopted verification technical guideline; with the breakdown of the manual (Text) a transparent breakdown of the allocation is already Partially achieved approach in allocation is implemented; implementing the already Verification and BOK Kinerja by implemented; counterverification providing a Verification and mechanism is not breakdown of the counterverification yet established prformance linked mechanism is not payments to the yet established relevant districts and Puskesmas is not yet done; Verification and counterverification manual is not yet available Allocated 0.00 0.00 0.00 Amount DLI allocation 25,000,000.00 1.3:More districts have Value 0.00 0.00 0.00 68.00 improved performance (as specified in the Verification Protocol) based on the relevant TB case 29-Mar- Allocated 29-Mar-2024 notification and treatment 0.00 0.00 2024 40,000,000.00 success rate indicators over Amount the baseline year 2022 (Percentage) Not Due May 31, 2025 Page 17 of 27 The World Bank Implementation Status & Results Report Indonesia: Strengthening National Tuberculosis Response Program (P178517) DLI allocation 40,000,000.00 Value No No No Yes 2:Improved supply side 09-Sep- Allocated 29-Mar-2024 readiness (Text) 0.00 0.00 2024 30,000,000.00 Amount DLI allocation 30,000,000.00 2.1:More public primary 10 percentage Value 80% 83% 85% health care facilities have point increase met service readiness 09-Sep- criteria as specified in the 29-Mar-2024 Allocated 2024 Verification Protocol for TB 0.00 0.00 10,000,000.00 services. (Text) Amount Partially achieved DLI allocation 10,000,000.00 The updated The updated approach to approach to involve involve all health 2.2:MOH has updated a all health care care facilities in comprehensive TB service facilities in the TB the TB Program protocol and made Program and to and to strengthen appropriate decision Value Not available strengthen the TB NA the TB network 29-Mar- support tools available for network was issued was issued under 29-Mar-2024 2024 primary health care under the the Directorate facilities, laboratories, and Directorate General General for hospitals. (Text) for Disease Control Disease Control Achieved circular letter circular letter Allocated 0.00 0.00 0.00 Amount DLI allocation 5,000,000.00 May 31, 2025 Page 18 of 27 The World Bank Implementation Status & Results Report Indonesia: Strengthening National Tuberculosis Response Program (P178517) (a) MoH has (a) MoH has developed training developed training mechanisms. The mechanisms. The updated training updated training modules are now modules are now available using (b) More public available using classical, blended primary health classical, blended and e-learning care providers and e-learning under MOH’s have registered at No public primary under MOH’s digital digital learning MOH to complete 2.3:(a) MOH has developed health care learning platform platform capacity building an updated training providers have (Plataran). (b) 14% (Plataran). (b) 14% program mechanism; (b) more registered at MOH of primary health of primary health developed under public primary providers to complete care providers have care providers DLR 2.2.(c) More have completed capacity capacity building completed certified 29-Mar- Value have completed 29-Mar-2024 private primary building; (c) more private program and training. (c) The 2024 certified training. health care primary providers have contracted with credentialing (c) The providers have completed capacity JKN to complete process for the credentialing registered at MOH building (Text) capacity building empanelment into process for the and contracted Achieved program developed the BPJSK Network empanelment into with JKN to under DLR 2.2. has included trained the BPJSK Network complete capacity personnel has included building program component trained personnel developed under although it has small component DLR 2.2. weiht and remains although it has optional so that it is small weiht and not uniformly remains optional adopted by BPJSK so that it is not branch offices uniformly adopted May 31, 2025 Page 19 of 27 The World Bank Implementation Status & Results Report Indonesia: Strengthening National Tuberculosis Response Program (P178517) by BPJSK branch offices Allocated 0.00 0.00 10,000,000.00 Amount DLI allocation 15,000,000.00 3:Strengthened access to Value No No No Yes 29-Mar- diagnostic and regular sample Allocated 29-Mar-2024 0.00 0.00 2024 40,000,000.00 transport mechanisms (Text) Amount DLI allocation 40,000,000.00 A Directorate General for A Directorate Disease Control General for Disease The review and circular letter was Control circular development of 3.1:MOH has enacted a issued on letter was issued on regulation needed regulation to strengthen strengthening the strengthening the for centrally laboratory specimen involvement of involvement of Value negotiated lab NA transport practice, health care health care facilities, 29-Mar- specimen transport 29-Mar-2024 including that of private facilities, public public and private in 2024 service is not yet primary health care and private in the the TB network, conducted and providers (Text) TB network, which which includes completed Achieved includes specimen specimen transport transport mechanism. mechanism. Allocated 0.00 0.00 0.00 Amount DLI allocation 5,000,000.00 3.2:MOH has developed a Template for Template for Template for Value 29-Mar-2024 NA template for agreements agreements for agreements for agreements for May 31, 2025 Page 20 of 27 The World Bank Implementation Status & Results Report Indonesia: Strengthening National Tuberculosis Response Program (P178517) for specimen transport specimen transport specimen specimen transport services that can be used services is not transport services services available. between districts and available available. The The revised third-party service revised template template for providers. (Text) for agreement agreement with a Achieved with a third party third party has been 29-Mar- has been updated updated as 2024 as reference for reference for subnational health subnational health authorities authorities Allocated 0.00 0.00 0.00 Amount DLI allocation 5,000,000.00 3.3:More districts have Value 8.00 48.00 48.00 68.00 signed service agreements with third-party service providers for specimen transport services that 09-Sep- Allocated 29-Mar-2024 serve all engaged public 0.00 0.00 2024 10,000,000.00 and private health care Amount facilities in their area (Percentage) Partially achieved DLI allocation 10,000,000.00 3.4:More private primary Value 0.00 14.00 504.00 50.00 health care providers have 09-Sep- become new regular users Allocated 29-Mar-2024 0.00 0.00 2024 20,000,000.00 of the services provided by Amount third-party service May 31, 2025 Page 21 of 27 The World Bank Implementation Status & Results Report Indonesia: Strengthening National Tuberculosis Response Program (P178517) providers for specimen transport services. (Percentage) Partially achieved DLI allocation 20,000,000.00 4:Improved access to TB Value No No No Yes program drugs among private 29-Mar- Allocated 29-Mar-2024 primary health care providers 0.00 0.00 2024 30,000,000.00 (Text) Amount DLI allocation 30,000,000.00 (a)The DG Circular (a)The DG Circular on the on the involvement involvement of all of all health care health care facilities (public and 4.1:MOH has developed facilities (public private) in TB logistics and arrangements and private) in TB program and the to access TB program drugs program and the strengthening of the for private primary health strengthening of Access to TB TB service network the TB service 29-Mar- care providers by: a) Value Program Drugs is 29-Mar-2024 including access to NA network including 2024 issuing a guideline; and b) not yet established TB program drugs. issuing a revised access to TB (b) The revised agreement template (Text) program drugs. (b) template for access The revised Achieved to TB program drugs template for has been updated a access to TB reference for program drugs has subnational health been updated a authorities reference for May 31, 2025 Page 22 of 27 The World Bank Implementation Status & Results Report Indonesia: Strengthening National Tuberculosis Response Program (P178517) subnational health authorities Allocated 0.00 0.00 0.00 Amount DLI allocation 10,000,000.00 4.2:More private primary Value 3.00 7.00 3.00 50.00 health care providers have 09-Sep- had access to TB program Allocated 29-Mar-2024 0.00 0.00 2024 20,000,000.00 drugs. (Percentage) Amount Partially achieved DLI allocation 20,000,000.00 5:Strengthened payment Value No No No Yes mechanism links to TB 31-Dec- Allocated 31-Dec-2021 notification and treatment 0.00 0.00 2021 40,000,000.00 (Text) Amount DLI allocation 40,000,000.00 (a) The proposed (a) The proposed 5.1:MOH has implemented performance performance new payment indicators list has indicators list has arrangements to increase been finalized, and been finalized, and the rates of TB notifications for TB the for TB the indicator The new payment and treatments by: a) indicator is ‘TB is ‘TB treatment arrangement for TB 09-Sep- Value treatment initiated 29-Mar-2024 initiated at the NA revising the PKBK to is not yet 2024 include TB indicators; b) at the primary primary care implemented piloting a non-capitation care facility’. The facility’. The list of payment for TB (Text) list of proposed proposed performance performance Off-track indicator will be indicator will be discussed with the discussed with the May 31, 2025 Page 23 of 27 The World Bank Implementation Status & Results Report Indonesia: Strengthening National Tuberculosis Response Program (P178517) BPJSK for BPJSK for adoption.(b) The adoption.(b) The Pilot on non Pilot on non capittion payment capittion payment is is ongoing ongoing Allocated 0.00 0.00 0.00 Amount DLI allocation 30,000,000.00 5.2:MOH has reformed The revisions to the The revisions to The revisions to the InaCBG by amending the InaCBG system the InaCBG system Value InaCBG system have NA relevant regulation to the have not been have not been not been carried out effect that a large part of carried out carried out 09-Sep- hospital payments will be 29-Mar-2024 2024 made to hospitals only upon completion of each Allocated 0.00 0.00 0.00 TB treatment course. (Text) Amount Off-track DLI allocation 10,000,000.00 6:An integrated TB transaction- Value No No No Yes 09-Sep- based information system Allocated 29-Mar-2024 0.00 0.00 2024 50,000,000.00 (Text) Amount DLI allocation 50,000,000.00 The number of The number of SITB 6.1:MOH has implemented SITB variables has variables has a simplified interface of the Complex and decreased from 95 decreased from 95 09-Sep- TB program information Value burdensome TB 29-Mar-2024 NA to 46 variables; (a) to 46 variables; (a) 2024 system to notify of TB reporting system Simplification of Simplification of cases. (Text) SITB and SITB and automated May 31, 2025 Page 24 of 27 The World Bank Implementation Status & Results Report Indonesia: Strengthening National Tuberculosis Response Program (P178517) Achieved automated data data entry is entry is enabled enabled with the with the use of NIK use of NIK (Unique (Unique ID ID Number). (b) the Number). (b) the existing TB existing TB applications are not applications are interoperable yet- not interoperable integration process yet- integration is ongoing process is ongoing Allocated 0.00 0.00 0.00 Amount DLI allocation 10,000,000.00 Automation on For healthcare data entry, facilities with 6.2:(i) Enhance the existing including those integrated TB information system to allowed with the information system have more automated data use of unique with SatuSehat, the entry interfaces for data identification Fragmented and manual data entry is inputs; and (ii) number (NIK) in manual entry- significantly reduced 09-Sep- Value SITB. The 31-Dec-2021 NA Integration/Interoperability reliance TB by 50% (shortening 2024 of TB interoperability information system ~4 minutes), as SITB applications/information with the broader data entry will be systems with IHS (Text) health information automatically platform Partially achieved generated by (SatuSehat) and inputting to the BPJSK health SIMPUS/EMR/SIMRS information May 31, 2025 Page 25 of 27 The World Bank Implementation Status & Results Report Indonesia: Strengthening National Tuberculosis Response Program (P178517) system is still ongoing. Allocated 0.00 0.00 0.00 Amount DLI allocation 20,000,000.00 6.3:More private primary Value 0.00 2,319.00 2,319.00 60.00 health care providers have become new users of the TB program information 09-Sep- Allocated 29-Mar-2024 system implemented under 0.00 0.00 2024 20,000,000.00 DLR 6.1 for TB notification. Amount (Number) Not Due DLI allocation 20,000,000.00 Value No No No Yes 7:Improve use of evidence in 09-Sep- Allocated 31-Dec-2021 decision making (Text) 0.00 0.00 2024 20,000,000.00 Amount DLI allocation 20,000,000.00 The national TB prevalence survey 7.1:MOH has implemented National TB The national TB The national TB is implemented the national TB prevalence prevalence survey prevalence survey Value prevalence survey is and used to survey and used it to is not implemented is officially 09-Sep- 29-Mar-2024 officially cancelled. estimate local- estimate local-level TB yet cancelled. 2024 level TB prevalence. (Text) prevalence Off-track Allocated 0.00 0.00 10,000,000.00 Amount DLI allocation 10,000,000.00 May 31, 2025 Page 26 of 27 The World Bank Implementation Status & Results Report Indonesia: Strengthening National Tuberculosis Response Program (P178517) 7.2:MOH has completed Value 0.00 0.00 0.00 2.00 and published at least two process evaluations of the 09-Sep- newly introduced design Allocated 29-Mar-2024 0.00 0.00 2024 10,000,000.00 features under this Amount Program. (Number) Not Due DLI allocation 10,000,000.00 May 31, 2025 Page 27 of 27