The National Health Mission(NHM) was launched in the year 2005 with the goal “to improve the availability of and access to quality healthcare for people, especially for those residing in rural areas, the poor, women and children.” The Mission has led to considerable expansion of health services through rapid expansion of infrastructure, increased availability of skilled human resources and greater local level flexibility in operations, increased budgetary allocation and improved financial management. However, improvement in Quality of health services at every location has not been perceived, generally.
Perceptions of poor quality of health care may, infact, dissuade patients from using the available services because health issues are among the most salient of human concerns. Ensuring quality of the services will result in improved patient/client level outcomes at the facility level.
Ministry of Health and Family Welfare, Government of India is committed to support and facilitate a Quality Assurance Programme, which meets needs of Public Health System in the country and is sustainable. Main focus of proposed Quality Assurance Programme would be enhancing satisfaction level among users of the Government Health Facilities and reposing trust in the Public Health System.
District Quality Assurance Committee (DQAC)
Members:
1.District Collector/Dy. Commissioner, Chairperson.
2.Chief Medical Officer/Deputy Director/CDMO/District Health Officer/Equivalent (Convener).
3.District Family Welfare Officer/RCHO/ACMO/equivalent (Convener)
4.Deputy Superintendent/Civil Surgeon/Chief Medical Superintendent of District Hospital or equivalent.
5.In-charge of CHC & PHC (one each, by rotation).
6.Nodal Officer of Programme Divisions at Districts.
7.One empanelled gynaecologist (from public institutions).
8.One empanelled surgeon(from public institutions).
9.One Medical Specialist (from public institutions).
10.One anaesthetist (from public institutions).10. One paediatrician (from public institutions).
11.One representative from the nursing cadre.
12.One representative from the legal cell.
13.One member from an accredited private sector hospital/ NGO (health care sector).
14.One representative from medical professional bodies e.g. FOGSI/IMA/IAP/IAPSM/ Association of Public Health
Process of DQAC:
1.The district quality assurance committee will meet at least once in a quarter.
2.The convener will issue meeting notice at least seven working days before the scheduled date of the meeting with the approval of the chairperson.
3.While every attempt should be made to ensure that the chairperson is able to attend the meeting, however, in the absence of the chair, the Convenor shall have the right to convene the meeting. Under such circumstances, the minutes of the meeting should be sent to the Chairperson for information and ratification.
4.Member secretary will ensure the preparation of agenda notes, and action taken reports, which will be circulated in advance to all committee members preceding the DQAC meetings.
5.An attendance by at least one third of the Committee members will constitute the quorum required for a valid meeting.
6.Member secretary will ensure follow-up actions with responsibilities and timelines for the same.
7.The “District Family Planning Indemnity Subcommittee” would meet as often as warranted.
8.At least three members would constitute the quorum of this subcommittee
the regular cadre become available.
National Quality Assurance Standards (NQAS)
National Quality Assurance Standards have been developed keeping in the specific requirements for public health facilities as well global best practices. NQAS are currently available for District Hospitals, CHCs, PHCs and Urban PHCs. Standards are primarily meant for providers to assess their own quality for improvement through pre defined standards and to bring up their facilities for certification. The National Quality Assurance Standards are broadly arranged under 8 "Areas of Concern"– Service Provision, Patient Rights, Inputs, Support Services, Clinical Care, Infection Control, Quality Management and Outcome. These standards are ISQUA accredited and meets global benchmarks in terms of comprehensiveness, objectivity, evidence and rigour of development.
Kayakalp Award Scheme
Kayakalp Award Scheme aims to improve Cleanliness, Hygiene and Waste Management practices in Public Health Facilities. Facilities go through internal, peer and external assessment process against a predetermined criteria. The best facilities are given cash award as well as felicitation at state and National level.
Swachh Swasth Sarvatra Initiative
Swachh Swasth Sarvatra is an innovative scheme where two successful schemes (Kayakalp & Swachh Bharat Abhiyan Rural) complements each other by enabling their counterpart to improve. The Kayakalp winner PHC in each district strives get their adjoining gram panchayat open defecation free. similarly the ODF declared block promotes their CHC to meet Kayakalp criteria.
