Disbursement-Linked Indicators and Verification Protocols

The DLIs for the Program, a combination of outcome and intermediate results, are as follows. The DLI matrix and verification protocol in annex 3 indicate which DLIs are timebound, non-timebound, scaleable, and non-scaleable.

DLI#	DLI	Quality of Care	NCDs and Injuries	Equity	Cross Cutting
1	Implementation of quality improvement interventions in primary, secondary, and tertiary care facilities
2	Increased number of public facilities with quality certification (primary, secondary, and tertiary care facilities) (Prior Result: 11 primary and 34 secondary level facilities)
3	Increased share of adults with hypertension or diabetes whose blood pressure or blood sugar are under control
4	Improved provision of quality trauma care services
5	Increased utilization of reproductive and child health services inpriority districts
6	Strengthened content, quality, accessibility, and use of data for decision making
7	Strengthened coordination, integration, performance-based management, learning, and other cross-cutting functions for better results
8	Increased transparency and accountability through citizen engagement (voice, agency, and social accountability)

The achievement of the prior results and DLIs would trigger World Bank disbursements to the Program. The DLIs reflect the critical areas the GoTN has to address to push health sector performance to the next level. They indicate the combined effect of a set of specific technical interventions and institutional strengthening interventions. The verification protocol for the DLIs is described in detail in annex 3. An independent verification agency (IVA) will verify achievement of the DLIs based on the agreed protocol. In addition, to report progress on hypertension and diabetes management (DLI #3), a STEPwise approach to Surveillance (STEPS)19 survey will be conducted in Year 1 (to establish baseline), Year 3, and Year 5; a household survey will be conducted in Year 2 and Year 4 in priority districts to quantify utilization of RCH services (DLI #5).