Impact Bond: The Utkrisht Impact Bond 
Stage of development: Complete
Policy sector: Health
Social challenge: Requiring that private sector facilities have high quality standards could improve health for many of the 1.4 billion people in India and make progress toward health-related Sustainable Development Goal 3. Private facilities—which provide 80 percent of all outpatient and 60 percent of all inpatient care in the country and house the vast majority of Indian physicians—are subject to limited regulations (Tripathi et al. 2019; Chakravarthi 2018). As a result, private facilities vary greatly in size, services, and quality. Private sector clients are subject to arbitrary costs, inconsistent clinical care, and variable treatment by facility staff—and they rarely have any formal means of seeking recourse or accountability should an issue occur in their care (Chakravarthi 2018; Shukla et al. 2018).
Intervention: Two service providers, Hindustan Latex Family Planning Promotion Trust (HLFPPT) and Population Services International (PSI), are supporting private facilities to improve the quality of care provided to new mothers and newborns. The service providers will also support the private facilities to become certified by the joint quality standard (JQS). 
Primary SDG goal: 3
Date outcomes contract signed: 2017-11
Start of service provision: 2018-05
Anticipated end of service provision: 2021-08
Actual end of service provision: 2021-04
Total investment commitment currency: USD
Total investment commitment: 2900000
Total investment commitment (USD): 2900000
Maximum potential outcome payment: 8000000 USD
Maximum potential outcome payment (USD): 8000000
Maximum potential return type: IRR
Maximum potential return: 0.08
Configuration of the contracting parties: Waterfall contracting structure
Target population: Private facilities across Rajasthan, meeting the following criteria for facility inclusion
Scale: Less than 100 beds, minimum of 20 deliveries per month
Infrasturcture: 24/7 electricity; 24/7 water supply; operating theatre; labour room
Staff: full-time gynecologist; at least three full-time midwives
Engagement: interest in quality improvement; willingness to share data
Compliance: pollution control registration
Targeted number of service users or beneficiaries: 10000
Targeted unit type: Individual
Actual number of service users or beneficiaries engaged: 13449
Actual unit type: Individual
Service and beneficiaries notes: Notes on beneficiaries: The Utkrisht Impact Bond supported private facilities across Rajasthan to improve the quality of care provided to new mothers and newborns. The initial aim of the DIB was to avert 10,000 maternal and neonatal deaths. At the end of the DIB, it is expected that quality of care achieved by participating Utkrisht DIB facilities will avert an estimated 13,449 maternal and neonatal deaths by 2023.