Pipeline
| ID | INDIGO-PL-0056 |
|---|---|
| Project Name - (Value) | Outcomes Fund for Physical Rehabilitation in Pakistan |
| Contact - Name - (Value) | Zina Sanyoura (ICRC) |
| Contact - Email - (Value) | zsanyoura@icrc.org |
| State of Development - (Value) | Current |
| State of Development - (Source ID's) | source1 |
| Stage of Development - (Value) | Early stage |
| Stage of Development - (Source ID's) | source1 |
| Stage of Development - (Notes) | Early-stage design. |
| Type of instrument and project - Impact Bond - (Value) | No |
| Type of instrument and project - Outcomes Fund - (Value) | Yes |
| Type of instrument and project - Social Impact Incentives (SIINC) - (Value) | No |
| Type of instrument and project - Social Impact Guarantee - (Value) | No |
| Type of instrument and project - Payment-by-results (no pre-financing) - (Value) | Yes |
| Type of instrument and project - Technical Assistance and Market-building program (Must involve dedicated grant resources) - (Value) | No |
| (Source ID's) | source1 |
| Part of a larger outcomes-based financing program? - Part of a larger outcomes-based financing program? - (Value) | No |
| Part of a larger outcomes-based financing program? - (Source ID's) | source1 |
| Dates - Expected Launch Date - (Value) | Q2 - 2023 |
| Dates - Total expected project development time - (Value) | 12-24 months |
| Dates - Expected length of project (years) - (Value) | TBD |
| Dates - Project design process began - (Value) | Q3-2021 |
| Dates - (Source ID's) | source1 |
| Rationale for using outcome based finance - (Value) | The Outcomes Fund approach would facilitate building a data-driven business case during the term of the Outcome Fund that would serve to prove the economic benefit for government to expand healthcare coverage to PR services. This would also help build an evidence base about the cost of delivering quality PR services to different geographies and demographics. |
| (Source ID's) | source1 |
| Key challenges to launch - (Value) | The intervention is currently in the concept development phase, where the stakeholders are currently being engaged to convene on the model, mandate, and focus. Engaging the government on committing to expand the health insurance scheme will prove challenging. |
| (Source ID's) | source1 |
| Role of the domestic government - Outcomes funder - (Value) | No |
| Role of the domestic government - Service provider - (Value) | Yes |
| Role of the domestic government - Member of project committee - (Value) | No |
| Role of the domestic government - No formal role - (Value) | No |
| (Source ID's) | source1 |
| (Notes) | The government (Ministry of Health, Social Affairs, National Health Insurance Scheme) will be a critical actor in the structure as they will be needed to put in place the commitment to expand the list of services covered by the insurance scheme, in addition to policy development on prioritizing the PR space. |
| Service providers identified and selected - Request-for-proposals - (Value) | No |
| Service providers identified and selected - Direct contracting by outcome funder/investor/intermediary - (Value) | Yes |
| Service providers identified and selected - Provider-led deal development - (Value) | No |
| (Source ID's) | source1 |
| (Notes) | Work at province level. Selected amongst public clinics already suppported by ICRC (given min standard level). Provinces defined based on interest and support of local government. |
| Feasibility study - (Value) | Yes |
| (Source ID's) | source1 |
| Proposed financing instruments - Debt - (Value) | Yes |
| Proposed financing instruments - Equity - (Value) | No |
| Proposed financing instruments - Guarantee - (Value) | No |
| Proposed financing instruments - Grant - (Value) | Yes |
| (Source ID's) | source1 |
| (Notes) | A combination of financing instruments is foreseen |
| Technical assistance grant - Technical assistance grant - (Value) | No |
| Technical assistance grant - (Source ID's) | source1 |
| Overall project finance - Estimated Maximum potential outcome payment - Currency - (Value) | TBD |
| Overall project finance - Estimated Maximum potential outcome payment - Amount - (Value) | TBD |
| Overall project finance - (Source ID's) | source1 |
| Purpose and classifications - Social/Developmental challenge - (Value) | With a population of 220 million, there are currently more than 1.1 million people in need of mobility-focused assistive devices. There is significant demand, while the current infrastructure of the physical rehabilitation services is unable to meet this growing demand. In addition, most physical rehabilitation services are not covered by the healthcare insurance scheme, resulting in significant out of pocket expenses by patients.. The intervention seeks to address two key challenges: 1) Ensuring the sustainability of the provision of high-quality physical rehabilitation services, without requiring continued support from the ICRC and 2) Increasing government engagement to ensure sufficient coverage of physical rehabilitation services within the national health insurance scheme. |
| Purpose and classifications - Expected intervention model - (Value) | The end goal is for the government to expand the package of covered services within the national health insurance scheme. This would be achieved through building a data-driven business case during the term of the intervention that would serve to prove the economic and social benefit for the government to expand healthcare coverage to physical rehabilitation services. This would also help build an evidence base about the cost of delivering quality physical rehabilitation services to different geographies and demographics. The intervention envisions to pay physical rehabilitation service providers based on outcomes linked to quality of service delivery and reimburse the national health insurance scheme for the additional services included. |
| Purpose and classifications - Policy sector - Employment and private sector development - (Value) | No |
| Purpose and classifications - Policy sector - Education - (Value) | No |
| Purpose and classifications - Policy sector - Social protection - (Value) | No |
| Purpose and classifications - Policy sector - Criminal justice - (Value) | No |
| Purpose and classifications - Policy sector - Health - (Value) | Yes |
| Purpose and classifications - Policy sector - Agriculture - (Value) | No |
| Purpose and classifications - Policy sector - Environment and climate change - (Value) | No |
| Purpose and classifications - Policy sector - Water, Sanitation and Hygiene - (Value) | No |
| Purpose and classifications - Policy sector - Energy - (Value) | No |
| Purpose and classifications - Policy sector - Humanitarian - (Value) | No |
| Purpose and classifications - Secondary SDG goals - (Value) | 3,17 |
| Purpose and classifications - (Source ID's) | source1 |
| Purpose and classifications - (Notes) | Other sector: Physical Rehabilitation (PR) service provision |
| Service users and beneficiaries - Target population - (Value) | People with disabilities needing mobility-focused assistive devices. |
| Service users and beneficiaries - Targeted number of unique service users or beneficiaries (total) - (Value) | TBD |
| Service users and beneficiaries - Unit type of targeted service users or beneficiaries - (Value) | Individual |
| Service users and beneficiaries - Country Classification of Service and beneficiaries - Low-income - (Value) | No |
| Service users and beneficiaries - Country Classification of Service and beneficiaries - Lower-middle-income - (Value) | Yes |
| Service users and beneficiaries - Country Classification of Service and beneficiaries - Upper-middle-income - (Value) | No |
| Service users and beneficiaries - Country Classification of Service and beneficiaries - High-income - (Value) | No |
| Service users and beneficiaries - (Source ID's) | source1 |
| Notes - (Value) | Data for this pipeline project was last updated in April 2022. |
| Delivery Locations 1: Location - Name - (Value) | Pakistan |
| Delivery Locations 1: Location - Country - (Value) | PK |
| Service Provisions 1: Notes | Physcial Rehabilitation Centers (typically public) |
| Outcome Payment Commitments 1: Notes | TBD |
| Investments 1: Notes | TBD |
| Intermediary services 1: Organisation Role Category - (Value) | Other |
| Intermediary services 1: Notes | ICRC (current supporter of PR at national level, project design and structuring, advocacy, convener, etc.) |
| Outcome Metrics 1: Outcome Definition - (Value) | Specific metrics TBD at two levels: (1) impact/economic impact (social inclusion/number of people with disabilities back in active population), (2) service quality and efficiency |
| Outcome Metrics 1: Outcome validation Method - (Value) | Quasi-experimental |
| Outcome Metrics 1: Notes | Evaluation methodology to be determined |