BACKGROUND : There is always a need for a multidimensional approach to performance evaluation in health sector. Directorate of Public Health developed a multi-dimensional comprehensive primary healthcare ranking system to monitor the performance of PHCs in the state with twenty crucial programmatic indicators – 15 at PHC level covering institutional and community services and 5 at Health Unit Distirct level for NCDs. Each PHC was scored on each indicator as the percentile of a maximum score of 10, which is given for the best-performing PHC among the PHCs of the same type – Upgraded PHC, Urban PHC, or Additional PHC. We compared the median scores of each of the fifteen PHC level indicators during September 2022 and May 2023 by the type of PHC, to understand whether the new ranking system used during the review meetings improved the performance and documented our experiences. Overall, eight out of the 15 PHC level indicators showed an increase in the median (IQR) score, four showed no difference, and three showed a decrease in the median score. Based on our experiences, the new ranking system helped the administrators to concentrate on the weak domains by type of facilities and by districts, understand the challenges in the implementation of those domains and rectify them as required. It was also observed that during the review meetings, the district officials were able to articulate better on the reasons for low scores and helped them to get much involved and motivated to improvise focusing on the weaker domains.