Kathmandu. High-level performance agreements made with the objective of improving administrative accountability and service delivery of public health institutions appear to be limited to mere paper formalities. The effective monitoring and regulation of the indicators and targets set in the agreements have made their implementation challenging.Performance agreements primarily include key indicators such as policy, capital expenditure rate, project physical progress, and public grievance redressal. Similarly, making service delivery technology-friendly and clearing outstanding audits are considered the main work progress of the ministries.The annual performance evaluation, which assigns specific weightage, is expected to increase the productivity and governance accountability of ministers...