Assessment of quality assurance programme of a department of health and family welfare of india

Background: Internationally there is growing recognition for increased focus on quality of care in population programs. Assessment was carried out with the overall aim of reviewing the whole process of Quality Assurance Programme (QAP), to identify gaps and to take corrective measures in accordance to the action plan that would originate from the assessment.
Methodology: A multi-stage sampling technique was used to select districts from the state being divided into 6 administrative regions. First, one district was selected randomly from each region. 4 PHCs and 2 CHCs were randomly selected from each of the selected districts based on the performance. Clients’ perspective about the quality of services was obtained through exit interviews of the clients from the selected facilities. To include the perspectives of the stakeholders directly related to QAP at various levels, Focus Group Discussions and In-depth interviews with the providers and managers were utilized.
Results & Conclusions: The findings suggest that the major area of improvement or positive outcome were mainly those related to INPUT section viz; physical infrastructure, equipments and overall improvements in labor rooms. Improvement was also observed for maintenance of privacy at the facilities. The areas that needed further attention were; Maintenance of records specifically those related to continuity of care, availability of service protocols and guidelines, RTI/STI Lab Services, MTP Services, monitoring & review of QAP, client provider interaction and supportive communication between district and facility level.
Recommendations: Additional inputs required such as training of grass root level workers, recruiting staff, improving infrastructure facilities to upgrade CHCs and PHCs.