This initiative sought improvement in public healthcare services by ensuring presence and punctuality of doctors and other staff during duty hours. A biometric attendance system was needed to ensure that all employees in health facilities mark their attendance on a daily basis, promoting a culture of health workers checking-in on time across the province. The PITB initiative was introduced in 27 district headquarters hospitals (DHQs) and 101 tehsil headquarters hospitals (THQs) across the Punjab by July 2015. CCTV cameras were also installed for surveillance purposes. Biometric-enabled tablets were also distributed among 2,667 basic health units (BHUs) and rural health centres (RHCs) by August 2016. All staff members now have to mark their daily attendance through these devices. Clinical and non-clinical attendance has improved significantly, from 58% in August 2016 to 90% in July 2017, across the Punjab. The system provides real-time data about attendance of all categories of government staff. It has improved services and strengthened the health delivery network. There are now 37,000 daily check-ins at all BHUs and RHUs and over 22,000 daily check-ins at DHQ and THQ hospitals. District coordination officers and district health authorities are also able to monitor the attendance of each healthcare facility.