We provide technical assistance to the Department of Health, Meghalaya to enhance health service delivery through Internal Performance Agreements (IPAs)/Performance-Based Financing across the state. IPAs are strategic tools for planning, allocating, and utilizing resources based on identified needs, thereby improving overall health service quality. Through a comprehensive situational assessment conducted by HSTP with stakeholders like the Directorate of Health Services & the MHSSP, critical health interventions for Meghalaya were identified. HSTP also assessed the readiness of health facilities to implement IPAs, developing tailored frameworks & performance indicators. This effort prioritizes healthcare needs, enhances care quality, and optimizes resource utilization, improving healthcare delivery across Meghalaya.