Component 1

Overview

This component focuses on reforms in governance and management structures through IPAs between the DoHFW and its subsidiaries at the state and substate levels. An RBF approach is expected to strengthen the management and accountability relationships between the state- and the substate-level implementing units. Fund transfers to institutions and health facilities would be made against the achievement of performance indicators specified in IPAs.

The IPAs aim to foster a spirit of more accountable government, along with results-based monitoring, contributing to improvements in management of the system and delivery of quality health services. At the health facility level, this approach will provide flexible resources, strengthening management autonomy of decentralized structures.

A system of geographic equity adjustments will be put in place to ensure that the most destitute health facility will have relatively the largest performance budget. Measures that will govern these geographic equity adjustments will include travel time to the state capital, human resources density, poverty scores, and immunization coverage.