| DLRs | DLR Description | Achievements and Implementation Plan |
|---|---|---|
| Year – 1 DLR | PHC Facility Readiness Management System, including Standards, based on Norms updated and approved by the Sindh Health Care Commission | Target achieved in 2023-24 Health Facility readiness scorecard has been developed and made part of M&E Checklist. |
| Year-3 DLR | 30% BHUs and RHCs meeting satisfactory scorecard score, of which at least 15% are in lagging areas. 15% points increase in health facility readiness score over FY 2024-25 value in at least 15 districts, including 20% lagging areas | 1. Update the MMU tools to regularly monitor the facility scores. 2. Regularly monitor the health facilities for inputs and services being provided (DoH. PPHI and other PPP managed HFs). 3. Development / updating of App and dashboard for internally assessing the readiness of PHC HFs by (DoH, PPHI and other PPP partners) and using that data for planning and strengthening purposes. 4. Ensuring adequate budget allocations on regular side to fill the readiness gaps by respective management entities to sustainably meet the UHC EPHS-BP. |
| DLRs | DLR Description | Achievements and Implementation Plan |
|---|---|---|
| Year – 1 DLR | Competency-based training system developed for female PHC providers to deliver MNCH, based on approved framework, modules and monitoring tools developed”. | Target Achieved in 2023-24. System is developed and notified by the Health Department. Technical Assistance under IPF component is to be executed for development of a digitalized system. |
| Year-3 DLR | DLR 2.2: 50% of PHC providers -- LHVs, W/MO, nurses, posted at RHCs and BHUs in at least 15 districts-- competent in pre-defined protocols (50% score), of which at least 20% are from lagging districts. | 1. Develop competency assessment monitoring tools. 2. Draft the different options to assess the providers competencies and digitalized systems. 3. Stakeholder engagement to discuss the different options to establish a mechanism to assess the provider competencies. 4. Finalize and notify the mechanism to assess the providers competencies. 5. Develop the plan to conduct the regular assessment. 6. Rollout the plan. 7. Link it with LMS and training plan for refresher courses and grading. 8. Develop LMS / E-training / learning system. |
| DLRs | DLR Description | Achievements and Implementation Plan |
|---|---|---|
| Year – 1 DLR | DLR 3.1 - Referral guidelines developed and relevant indicators included in DHIS2 | Target Achieved in 2023-24. Referral strategy and guidelines developed and notified by Health Department for implementation across the Province. |
| Year-3 DLR | DLR 3.2 - At least 15 districts have functional referral mechanism for women and newborns with (or at risk of) complications during peri-partum period. | 1. Mapping of facilities as per services and strengthening of EmONC services at referral HFs (THQHs and DHQHs) by coordinating the efforts through 1000 Days project and MMU. 2. Establish the linkages with existing ambulance service (existing ones available with DoH, PPHI, other PPPs and SIEHS and 1000 days project). 3. Develop training packages on referral and capacity building of the PHC providers on referral guidelines, protocols and mechanism. 4. Printing and dissemination / displaying of referral guidelines and job aids under IPF component. 5. Develop the monitoring mechanism and dashboard for referrals. 6. Develop the patient feedback system and roll out. 7. Monitor the referrals and share analysis and patient feedback at provincial district level forums. 8. Implementation plan will be developed with DG Health as per endorsed referral guidelines. |
| DLRs | DLR Description | Achievements and Implementation Plan |
|---|---|---|
| Year-2 DLR | At least 85,154 cases notified per annum, of which 4499 are through community case reporting. | Target Achieved in 2024-25. 116,413 cases have been verified by TPV among them 5,755 reported through Community (LHW/CHW). |
| Year-3 DLR | At least 85,154 cases notified per annum, of which 4499 are through community case reporting. | 1. Active engagement of LHWs / CHWs in community to increase case detection and referrals. 2. Enhanced active case finding through community workers of partners like IRD and JSI as well as through mobile screening vans. 3. Training / refresher training of LHWs, doctors, paramedics and other allied staff on updated guidelines. 4. Increased domestic financing on regular side of budget to address the resource gaps. 5. Increased diagnostic capacity of the program by procurement of more Xray and GeneXpert machines. |
| DLRs | DLR Description | Achievements and Implementation Plan |
|---|---|---|
| Year-1 DLR | Annual EPI work plan developed and endorsed | Target Achieved in 2023-24. Costed implementation plan developed and endorsed |
| Year-3 DLR | Baseline Penta-I (85%) PAD Document At least a 3% point increase in provincial coverage for Penta-1; Target 88% Baseline FIC (61%) PAD Document and (b) up to 15% point increase in fully immunized child within lagging areas from baseline Target 76% | 1. Hiring of 500 vaccinators against total shortfall of 1,300 vaccinators as per EPI policy. 2. Training of newly hired 500 vaccinators. 3. Training of 1,068 CMWs hired under SIHPP. 4. Recruitment of 30 District Field Coordinators (DFCs) and additional HR (data analysts, developers, provincial supervisor) 5. Construction of warehouse (supported by UNICEF upto two floors (ground + 1), remaining four floors costing to be done. 6.Solarization of 15 EPI district1 stores. 7. Procurement of shredders for waste disposal. 8. Procurement of motorbikes for vaccinators (500 vaccinators). 9. Provision of mobility support in the form of vehicles and POL for provincial monitors. 10. Quarterly review meetings for 15 districts |
| DLRs | DLR Description | Achievements and Implementation Plan |
|---|---|---|
| Year-2 DLR | 15% of districts have effectively implemented/rolled out DHIS2, 20% of which come from lagging areas | * DHIS-2 reporting forms are finalized and notified. * Printing of DHIS-2 tools are in process through recurrent budget/IPF. * Two Batches of ToT were conducted: * 1st batch-Six (06) districts: Hyderabad, TAY, Umerkot, Tharparkar, SBA, Karachi Malir. * Rollout training sessions conducted in Hyderabad, TAY, Malir, Umerkot, Tharparkar. * 2nd Batch—Ten (10) Districts: Mirpurkhas, Badin, TMK, Matiari, Karachi East, West, South, Central, Korangi, Kemari. * In three (03) Districts, reporting forms of PHC & SHC developed on DHIS2 were implemented, recording tools were provided * Hyderabad (Dec-2024), Tando Allahyar (March 2025), Karachi Malir (March 2025). * In District Umerkot data will be collected from June 2025 |
| Year-3 DLR | At least 15 districts have effectively implemented/rolled out DHIS2, 6 of which are lagging districts | 1. Allocation of budget on regular side for printing DHIS tools, trainings and other operational activities including dedicated HR at district and provincial level. 2. Training in remaining districts on DHIS2. |
| DLRs | DLR Description | Achievements and Implementation Plan |
|---|---|---|
| Year-1 DLR | 7.1: 70% of PHC facilities reporting no stock outs of FP and nutrition commodities and essential medicines, of which at least 20% are in lagging areas | 1. Essential Medicine and supplies list has been notified by the Health Department and circulated among all stakeholders to prevent stockouts. 2. Inclusion of all notified items in procurement plans / CRC of DoH, PPHI and other PPP partners with adequate budgetary allocations on regular side budget and Timely procurement, supply and availability of buffer stock of notified items at all PHC HFs to ensure "0" stock outs. 3. Gather data from MMU regarding stock position of drugs/ medicine / items whatever items they have monitored during last 6-9 months and share that with WB after analyzing the stock positions to conduct TPV. 4. Inclusion of all notified items in monitoring and supervisory check lists being used by DoH, PPHI, PPP partners and MMU. 5. Expedite rolling out of DHIS-2 (Trainings and Printing of Tools) by giving priority to 15 focused districts (CCT districts). |
| Year-3 DLR | 7.2: 80% of PHC facilities in at least 15 districts have at least 80% of the essential medicines, nutrition and family planning commodities |
| DLRs | DLR Description | Achievements and Implementation Plan |
|---|---|---|
| Year-1 DLR | Approved framework to improve traceability of expenditure for PHC in IFMIS | Target achieved in 2023-24. Public Finance Note (PFN) has been notified by the Finance Department |
| Year-3 DLR | Budget allocations for PHCs trackable within provincial IFMIS | 1. Separate cost centers of PHC facilities which are currently merged with DHO's cost centers by adding new DDO codes for activities and facilities. 2. PPHI to report HFs wise expenditures. 3. Develop and approve training modules for PFM in Health for budget officers at provincial health department secretariat and DG health, DAOs, health facility manager, DM PPHI and DHO. 4. Conduct trainings on newly developed rules. 5. Provision of SAP system connectivity at NHSP PMU. 6. Development of Expenditure Tracking Mechanism / System and Digital Dashboard |
| Year-4 DLR | New DLR: DLR 8.3. Timely budget release from the Finance Department to the Department of Health | 1. Prepare rationalized regular budgets for PHC services. 2. Actively follow-up with Finance Department for timely release of approved budgets. |
| DLRs | DLR Description | Achievements and Implementation Plan |
|---|---|---|
| Year-2 DLR | At least 10% of total public expenditure on health is on PHC in Years 1 and 2 | Over all 30% budget increased on regular/ recurrent side on PHC. Government of Sindh spent more than 25% on PHC. Expenditure report of PHCs is shared with WB for TPV. |
| Year-4 DLR | At least 15% of total public expenditure on health is on PHC in Years 3 and 4. A 5-percentage point increase in the % of total public health expenditure that is on PHC, average for the remaining two fiscal years of the Program, relative to the average of Yr 1 and Yr 2. | Increase 5% annually on expenditure of PHCs. Budget Proposals of all sectors will be submitted to Finance Department with 5-10% increment annually. |