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        "display_status": "shown_in_full",
        "review_channel": "text_anchored_annotation",
        "verification_requirements": []
      }
    ],
    "candidate_facts": [],
    "exact_contexts": []
  },
  "evidence_scorecard": {
    "country_id": "NRU",
    "audit_passed": true,
    "preparation_stage": "direct_typed_mapping",
    "preparation_stage_label": "Explicit analytical mappings",
    "scores": {
      "analytical_mapping_groups": {
        "denominator": 5,
        "numerator": 5,
        "score": 100,
        "unit": "explicit analytical object groups"
      },
      "controlled_domain_leads": {
        "denominator": 17,
        "numerator": 17,
        "score": 100,
        "unit": "controlled domains with displayed candidate leads"
      },
      "material_locator_coverage": {
        "denominator": 24,
        "numerator": 24,
        "score": 100,
        "unit": "material records with an exact locator"
      },
      "material_url_coverage": {
        "denominator": 24,
        "numerator": 24,
        "score": 100,
        "unit": "material records with at least one public URL"
      },
      "material_version_coverage": {
        "denominator": 24,
        "numerator": 24,
        "score": 100,
        "unit": "material records with an immutable source version"
      },
      "source_layer_presence": {
        "denominator": 3,
        "numerator": 3,
        "score": 100,
        "unit": "displayed candidate-source layers"
      }
    },
    "represented_domain_ids": [
      "actors",
      "government_responsibilities",
      "ownership",
      "decision_rights",
      "autonomy",
      "primary_care",
      "hospital_organization",
      "referral_design",
      "observed_referral",
      "networks",
      "facility_data",
      "utilization",
      "patient_flows",
      "governance",
      "market_structure",
      "reform_history",
      "authoritative_review"
    ],
    "missing_domain_ids": [],
    "direct_typed_domain_ids": [
      "actors",
      "government_responsibilities",
      "ownership",
      "decision_rights",
      "autonomy",
      "primary_care",
      "hospital_organization",
      "referral_design",
      "observed_referral",
      "networks",
      "facility_data",
      "utilization",
      "patient_flows",
      "governance",
      "market_structure",
      "reform_history",
      "authoritative_review"
    ],
    "priority_actions": [
      {
        "action_id": "annotate-country-synthesis",
        "detail": "All six preparation dimensions meet the target. Every source-linked finding and supporting material remains open for correction, qualification, and additional evidence through annotations.",
        "label": "Review and annotate the country synthesis"
      }
    ],
    "review_ready_material_ids": [
      "material:fabb539f44d82f7b743d5e99",
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      "material:f5e3c27b46bb38565c1a6f58",
      "material:d0155b70893cba54182b70fb",
      "material:cc8287afc45a7ffe32ce87ea"
    ],
    "full_scorecard_url": "https://wb-works.site/tools/health-organization/data/evidence-scorecards.json"
  },
  "materials": [
    {
      "analytical_mapping": {
        "mapping_basis": "Health and Medical Services Act 2025, Part 3; WHO health profile",
        "mapping_group": "decision_rights_and_autonomy",
        "mapping_id": "candidate-mapping:NRU:decision-autonomy:facility-autonomy-boundary",
        "source_projection_ids": [
          "country-improvement-source:NRU:health-medical-services-act-2025",
          "country-improvement-source:NRU:who-health-at-a-glance-2024"
        ],
        "support_state": "candidate_supported",
        "target_slot": "facility-autonomy-evidence-boundary",
        "target_view": "autonomy",
        "typed_fields": {
          "autonomy_boundary": "Neither source supplies a facility-specific delegation, board power, budget authority, procurement authority, workforce authority or clinical-scope decision record.",
          "formal_boundary": "The Act describes national offices and powers, while the WHO profile provides country-level indicator sections."
        }
      },
      "annotation_status": "open",
      "authors": [],
      "availability": {},
      "citation": "Republic of Nauru, Health and Medical Services Act 2025, Part 3; WHO, Health at a glance: Nauru, 2024.",
      "country_ids": [
        "NRU"
      ],
      "coverage_domains": [
        "authoritative_review",
        "autonomy",
        "decision_rights",
        "facility_data",
        "governance"
      ],
      "display_status": "shown_in_full",
      "document_type": null,
      "evidence_mode": "formal",
      "excerpt": "Health Statistics: Health Systems",
      "institution": null,
      "locator": {
        "description": "WHO PDF physical page 7, Health Statistics: Health Systems; Act PDF physical pages 10-13, Part 3."
      },
      "material_id": "material:a5cc972a1a5d1292724ea52d",
      "notes": [
        "Keep missing delegated authority as missing, rather than converting national authority into a facility autonomy claim."
      ],
      "origin": "candidate-analytical-mappings",
      "period": "WHO profile created 2024; Act certified 2025",
      "publication_date": null,
      "publication_year": null,
      "record_kind": "candidate_analytical_mapping",
      "record_kind_label": "Candidate Analytical Mapping",
      "screening": {
        "previous_boundary_detected": false,
        "previous_visibility": "previously_not_projected"
      },
      "source_layers": [
        "official"
      ],
      "source_system": null,
      "source_version": {
        "detected_media_type": "application/pdf",
        "file_sha256": "cfdeabe04324069259c3c1ad515b981367090241542ce335506cc9706aa10682",
        "response_sha256": "cfdeabe04324069259c3c1ad515b981367090241542ce335506cc9706aa10682"
      },
      "statement": "The available statute and country profile support national framing only. They do not substantiate a facility-autonomy score or any delegated operational power.",
      "tags": [],
      "territory": "Republic of Nauru",
      "title": "Facility autonomy remains unmeasured",
      "urls": [
        {
          "kind": "url",
          "source": "not supplied",
          "url": "https://srhdpeuwpubsa.blob.core.windows.net/whdh/DATADOT/COUNTRY/PDF/520_Nauru.pdf"
        },
        {
          "kind": "source_reference",
          "source": "Health and Medical Services Act 2025",
          "url": "https://ronlaw.gov.nr/assets/docs%2Facts%2F2025%2FHealth%20and%20Medical%20Services%20Act%202024.pdf"
        }
      ]
    },
    {
      "analytical_mapping": {
        "mapping_basis": "Health and Medical Services Act 2025, sections 8-13",
        "mapping_group": "decision_rights_and_autonomy",
        "mapping_id": "candidate-mapping:NRU:decision-autonomy:statutory-delegation",
        "source_projection_ids": [
          "country-improvement-source:NRU:health-medical-services-act-2025"
        ],
        "support_state": "candidate_supported",
        "target_slot": "statutory-delegation-of-health-functions",
        "target_view": "decisions",
        "typed_fields": {
          "boundary": "No delegation instrument, budget-signing schedule, procurement authority, staffing approval, or facility decision log is provided.",
          "formal_decision_rights": "The Act contains functions and powers of the Secretary and Director of Medical Services, and a provision on delegation of functions and powers."
        }
      },
      "annotation_status": "open",
      "authors": [],
      "availability": {},
      "citation": "Republic of Nauru, Health and Medical Services Act 2025, sections 8-13.",
      "country_ids": [
        "NRU"
      ],
      "coverage_domains": [
        "authoritative_review",
        "autonomy",
        "decision_rights",
        "governance",
        "government_responsibilities"
      ],
      "display_status": "shown_in_full",
      "document_type": null,
      "evidence_mode": "formal",
      "excerpt": "Delegation of functions and powers of the Secretary",
      "institution": null,
      "locator": {
        "description": "PDF physical pages 10-12, sections 8-13."
      },
      "material_id": "material:526a3dea159d3070afcac3ed",
      "notes": [
        "Do not describe permitted delegation as a documented delegation in force."
      ],
      "origin": "candidate-analytical-mappings",
      "period": "Act certified 29 August 2025; commencement not assumed",
      "publication_date": null,
      "publication_year": null,
      "record_kind": "candidate_analytical_mapping",
      "record_kind_label": "Candidate Analytical Mapping",
      "screening": {
        "previous_boundary_detected": false,
        "previous_visibility": "previously_not_projected"
      },
      "source_layers": [
        "official"
      ],
      "source_system": null,
      "source_version": {
        "detected_media_type": "application/pdf",
        "file_sha256": "cfdeabe04324069259c3c1ad515b981367090241542ce335506cc9706aa10682",
        "response_sha256": "cfdeabe04324069259c3c1ad515b981367090241542ce335506cc9706aa10682"
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      "statement": "The Act establishes a formal decision-rights frame and permits delegation. The operative allocation of decisions remains unobserved in this evidence wave.",
      "tags": [],
      "territory": "Republic of Nauru",
      "title": "Formal health decision rights and delegation",
      "urls": [
        {
          "kind": "url",
          "source": "not supplied",
          "url": "https://ronlaw.gov.nr/assets/docs%2Facts%2F2025%2FHealth%20and%20Medical%20Services%20Act%202024.pdf"
        }
      ]
    },
    {
      "analytical_mapping": {
        "mapping_basis": "MHMS Strategic Plan 2010-2015; World Bank PIC-9 Public Expenditure Review overview",
        "mapping_group": "time_and_reform",
        "mapping_id": "candidate-mapping:NRU:time-reform:historic-strategy-and-regional-review-context",
        "source_projection_ids": [
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          "country-improvement-source:NRU:world-bank-pic9-per-2023"
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        "support_state": "candidate_supported",
        "target_slot": "historic-strategy-and-regional-review-context",
        "target_view": "reforms",
        "typed_fields": {
          "boundary": "The sources do not confirm adoption, continuation, funding, implementation coverage or outcomes of any specific Nauru reform after the plan period.",
          "historic_reform_direction": "The 2010-2015 MHMS plan set strategic focus areas and an implementing structure. The 2023 World Bank overview places Nauru within a later regional public-expenditure-review scope."
        }
      },
      "annotation_status": "open",
      "authors": [],
      "availability": {},
      "citation": "Republic of Nauru MHMS, Strategic Plan 2010-2015; World Bank, Raising Pasifika, 2023.",
      "country_ids": [
        "NRU"
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      "coverage_domains": [
        "authoritative_review",
        "autonomy",
        "decision_rights",
        "governance",
        "government_responsibilities",
        "market_structure",
        "reform_history"
      ],
      "display_status": "shown_in_full",
      "document_type": null,
      "evidence_mode": "reported",
      "excerpt": "Implementing Structure and Schedule",
      "institution": null,
      "locator": {
        "description": "MHMS PDF physical pages 40-47, Implementing Structure and Schedule; World Bank PDF physical pages 1-2."
      },
      "material_id": "material:f6aec206352e857f2a8631f2",
      "notes": [
        "Keep plan actions and regional-review scope separate from implemented current policy."
      ],
      "origin": "candidate-analytical-mappings",
      "period": "2010-2015 strategy; regional review published 2023",
      "publication_date": null,
      "publication_year": null,
      "record_kind": "candidate_analytical_mapping",
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      "screening": {
        "previous_boundary_detected": false,
        "previous_visibility": "previously_not_projected"
      },
      "source_layers": [
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      ],
      "source_system": null,
      "source_version": {
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      "statement": "The 2010-2015 strategy records historical reform intent, while the 2023 World Bank overview records Nauru's inclusion in a regional finance review. Neither is proof of a current enacted reform.",
      "tags": [],
      "territory": "Republic of Nauru, with later PIC-9 regional review context",
      "title": "Historical health strategy and later regional review context",
      "urls": [
        {
          "kind": "url",
          "source": "not supplied",
          "url": "https://extranet.who.int/countryplanningcycles/sites/default/files/planning_cycle_repository/nauru/health-sector-strategic-plan-2010-2015.pdf"
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        {
          "kind": "source_reference",
          "source": "Raising Pasifika: Strengthening Government Finances to Enhance Human Capital in the Pacific",
          "url": "https://documents1.worldbank.org/curated/en/099051623182514230/pdf/P177734088f2b607808394012fd677c310d.pdf"
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    },
    {
      "analytical_mapping": {
        "mapping_basis": "WHO proMIND profile, Mental health within the general health system",
        "mapping_group": "delivery_and_referrals",
        "mapping_id": "candidate-mapping:NRU:delivery-referrals:historic-overseas-referral-committee",
        "source_projection_ids": [
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        "support_state": "candidate_supported",
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        "target_view": "referrals",
        "typed_fields": {
          "boundary": "No current committee membership, selection criteria, destination agreement, volume, denominator, completion rate, timeliness, cost or patient outcome is supplied.",
          "historic_reported_design": "The 2013 WHO profile states that an Overseas Referral Committee chaired by the Director of Medical Services prioritized cases recommended for overseas treatment under an overseas referral policy."
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      "annotation_status": "open",
      "authors": [],
      "availability": {},
      "citation": "World Health Organization, WHO proMIND: Republic of Nauru, 2013, Mental health within the general health system.",
      "country_ids": [
        "NRU"
      ],
      "coverage_domains": [
        "authoritative_review",
        "decision_rights",
        "governance",
        "networks",
        "observed_referral",
        "patient_flows",
        "referral_design"
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      "display_status": "shown_in_full",
      "document_type": null,
      "evidence_mode": "reported",
      "excerpt": "An Overseas Referral Committee chaired by the Director of Medical Services",
      "institution": null,
      "locator": {
        "description": "PDF physical pages 20-21, Mental health within the general health system."
      },
      "material_id": "material:16a9f46c8a66bfa56ce59521",
      "notes": [
        "Do not represent this historical description as a current referral policy or as evidence of completed patient transfers."
      ],
      "origin": "candidate-analytical-mappings",
      "period": "Profile published 2013",
      "publication_date": null,
      "publication_year": null,
      "record_kind": "candidate_analytical_mapping",
      "record_kind_label": "Candidate Analytical Mapping",
      "screening": {
        "previous_boundary_detected": false,
        "previous_visibility": "previously_not_projected"
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      "source_layers": [
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      "source_version": {
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        "response_sha256": "e9e4ba97184b013288165f5ce8e46a974c0ac2695bd908e5c701740c37cb5df9"
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      "statement": "The WHO profile gives a 2013 description of an overseas-referral committee and pathway. It does not establish a current referral design or observed performance.",
      "tags": [],
      "territory": "Republic of Nauru",
      "title": "Historical overseas-referral committee description",
      "urls": [
        {
          "kind": "url",
          "source": "not supplied",
          "url": "https://iris.who.int/bitstream/handle/10665/85305/9789241504164_eng.pdf?sequence=1"
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      ]
    },
    {
      "analytical_mapping": {
        "mapping_basis": "MHMS Strategic Plan 2010-2015, Health System / Services",
        "mapping_group": "actors_and_functions",
        "mapping_id": "candidate-mapping:NRU:actors-functions:historic-service-architecture",
        "source_projection_ids": [
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        ],
        "support_state": "candidate_supported",
        "target_slot": "historic-public-service-architecture",
        "target_view": "public-private",
        "typed_fields": {
          "market_boundary": "The plan's historical description cannot establish the 2026 ownership, private-provider availability, contracts or market share.",
          "reported_arrangement": "The 2010-2015 plan described the Republic of Nauru Hospital and Naoero Public Health Centre as service-delivery facilities in the historical plan period."
        }
      },
      "annotation_status": "open",
      "authors": [],
      "availability": {},
      "citation": "Republic of Nauru MHMS, Strategic Plan 2010-2015, Health System / Services.",
      "country_ids": [
        "NRU"
      ],
      "coverage_domains": [
        "actors",
        "authoritative_review",
        "hospital_organization",
        "market_structure",
        "ownership",
        "primary_care"
      ],
      "display_status": "shown_in_full",
      "document_type": null,
      "evidence_mode": "reported",
      "excerpt": "Health System / Services",
      "institution": null,
      "locator": {
        "description": "PDF physical pages 16-18, Health System / Services."
      },
      "material_id": "material:ac1d716a8dfcba0fc0483ae6",
      "notes": [
        "Preserve historical status and do not infer a contemporary ownership or private-sector map."
      ],
      "origin": "candidate-analytical-mappings",
      "period": "2010-2015",
      "publication_date": null,
      "publication_year": null,
      "record_kind": "candidate_analytical_mapping",
      "record_kind_label": "Candidate Analytical Mapping",
      "screening": {
        "previous_boundary_detected": false,
        "previous_visibility": "previously_not_projected"
      },
      "source_layers": [
        "official"
      ],
      "source_system": null,
      "source_version": {
        "detected_media_type": "application/pdf",
        "file_sha256": "564684afa0abb52ca1520342f2fdf928df56435868ba52866c706c6029cf184e",
        "response_sha256": "564684afa0abb52ca1520342f2fdf928df56435868ba52866c706c6029cf184e"
      },
      "statement": "The expired strategic plan describes a hospital and public-health-centre service architecture for 2010-2015. It cannot support a current public-private market claim.",
      "tags": [],
      "territory": "Republic of Nauru",
      "title": "Historical public service architecture",
      "urls": [
        {
          "kind": "url",
          "source": "not supplied",
          "url": "https://extranet.who.int/countryplanningcycles/sites/default/files/planning_cycle_repository/nauru/health-sector-strategic-plan-2010-2015.pdf"
        }
      ]
    },
    {
      "analytical_mapping": {
        "mapping_basis": "Nauru MICS 2023 Survey Findings Report, survey implementation and sample design",
        "mapping_group": "delivery_and_referrals",
        "mapping_id": "candidate-mapping:NRU:delivery-referrals:observed-household-survey-frame",
        "source_projection_ids": [
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          "country-improvement-source:NRU:who-health-at-a-glance-2024"
        ],
        "support_state": "candidate_supported",
        "target_slot": "observed-household-survey-frame",
        "target_view": "delivery",
        "typed_fields": {
          "boundary": "No quantitative service observation is projected here because a specific MICS table, indicator definition, denominator and estimate have not been extracted into this wave. Neither source is a referral register or facility-utilization census.",
          "observed_measurement_frame": "MICS provides 2023 national household-survey evidence for its defined indicators, and the WHO profile gives a separate country-indicator compilation."
        }
      },
      "annotation_status": "open",
      "authors": [],
      "availability": {},
      "citation": "Nauru Bureau of Statistics and UNICEF, Nauru MICS 2023 Survey Findings Report, 2024.",
      "country_ids": [
        "NRU"
      ],
      "coverage_domains": [
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        "facility_data",
        "observed_referral",
        "patient_flows",
        "primary_care",
        "utilization"
      ],
      "display_status": "shown_in_full",
      "document_type": null,
      "evidence_mode": "observed",
      "excerpt": "Nauru Multiple Indicator Cluster Survey 2023",
      "institution": null,
      "locator": {
        "description": "PDF physical pages 13-14, Survey implementation and Sample design."
      },
      "material_id": "material:818f916cf38cfbe66cdcc608",
      "notes": [
        "Add an indicator only with its table, year, denominator, target population and definition. Do not label a household-survey measure as a facility input or referral rate."
      ],
      "origin": "candidate-analytical-mappings",
      "period": "Survey fieldwork 2023; report published 2024",
      "publication_date": null,
      "publication_year": null,
      "record_kind": "candidate_analytical_mapping",
      "record_kind_label": "Candidate Analytical Mapping",
      "screening": {
        "previous_boundary_detected": false,
        "previous_visibility": "previously_not_projected"
      },
      "source_layers": [
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      ],
      "source_system": null,
      "source_version": {
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        "response_sha256": "0d7dddfec336b7512e60d15fd2ee20ca8afcf2535f5d5318777224995a966f42"
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      "statement": "MICS 2023 supplies a bounded household-survey frame. The wave intentionally does not convert its unextracted indicators into health-service inputs or referral performance measures.",
      "tags": [],
      "territory": "Republic of Nauru household population covered by the MICS sampling frame",
      "title": "Observed household-survey evidence frame",
      "urls": [
        {
          "kind": "url",
          "source": "not supplied",
          "url": "https://mics.ipums.org/mics/resources/enum_materials_pdf/report_nr2023a_eng.pdf"
        },
        {
          "kind": "source_reference",
          "source": "Health at a glance: Nauru",
          "url": "https://srhdpeuwpubsa.blob.core.windows.net/whdh/DATADOT/COUNTRY/PDF/520_Nauru.pdf"
        }
      ]
    },
    {
      "analytical_mapping": {
        "mapping_basis": "National Electronic Health Record Coverage in Pacific Island Countries and Territories: Environmental Scan",
        "mapping_group": "relationships_and_networks",
        "mapping_id": "candidate-mapping:NRU:relationships-networks:reported-digital-record-system",
        "source_projection_ids": [
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        ],
        "support_state": "candidate_supported",
        "target_slot": "reported-digital-record-system",
        "target_view": "delivery",
        "typed_fields": {
          "boundary": "The scan does not show which facilities use it, what modules are live, data completeness, interoperability, governance, patient consent, referral tracking or uptime.",
          "reported_information_network": "The regional scan names Tamanu as an EHR used in Nauru."
        }
      },
      "annotation_status": "open",
      "authors": [],
      "availability": {},
      "citation": "National Electronic Health Record Coverage in Pacific Island Countries and Territories: Environmental Scan, 2025.",
      "country_ids": [
        "NRU"
      ],
      "coverage_domains": [
        "authoritative_review",
        "facility_data",
        "governance",
        "networks",
        "patient_flows",
        "referral_design"
      ],
      "display_status": "shown_in_full",
      "document_type": null,
      "evidence_mode": "reported",
      "excerpt": "Tamanu (Nauru, Palau, Samoa, Kiribati",
      "institution": null,
      "locator": {
        "description": "Web section, Electronic health record systems currently used in Pacific Island Countries and Territories."
      },
      "material_id": "material:d0155b70893cba54182b70fb",
      "notes": [
        "Do not present the association as nationwide EHR coverage or functional referral interoperability."
      ],
      "origin": "candidate-analytical-mappings",
      "period": "Published 2025",
      "publication_date": null,
      "publication_year": null,
      "record_kind": "candidate_analytical_mapping",
      "record_kind_label": "Candidate Analytical Mapping",
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