Quality Assuarance & Kayakalp

QUALITY ASSUARNCE AND KAYAKALP, MIZORAM 

Quality Assurance Program was launched in November 2014 under National Health Mission. The program was started in the state of Mizoram since December 2015.

Vision: By the year 2030, QA aims in making all health facilities within the state to achieve the National Accreditation.

Objective: 1.To improve the overall health care quality in public health care facilities.

2.To increase the number ofpublic health facility users in india and reduce the amount of out of pocket expenditure spent on health related issues by the general population.

Target: To achieve NQAS certification in maximum number of public health care

facilities.

Under this program, all the State Government Health Facilities are assessed and reviewed as per Guidelines and Checklists under National Quality Assurance Standards (NQAS) Assessors Guidebook provided by the MoH & FW, GOI. The facilities who scored the required standard of above 70% in each departmental checklists as per the QA standards are then awarded an accreditation with financial incentives of Rs . QA aims in making the health facilities within the State achieve a National Accreditation by abiding with the National Quality Assurance Standards.So far,one district hospital i.e,Aizawl East District Hospital (Civil Hospital,Aizawl) has achieved NQAS Certification and felicitation Programme was held on August 2017.

Achievements 2022-23

Cleanliness activities where Public Health Facilities are having cleanliness competition. Under these activities during 2022-23 financial years – the final assessment was completed - 8 DH out of 9 DH, 11 SDH/CHC out of 11 SDH/CHC5, 47 PHC out of 59 PHC and 8 UPHC out of 8 UPHC and 57 HWC out of 228 HWCs qualified for Kayakalp Award. The award distribution ceremony is planning to be held during this financial year 2022-23.

• Training conducted during FY 2022-23:

1. Online Training on Kayakalp for all Health Workers at SC-HWC.
2. NQAS Internal assessor Training for State Consultant (PH) , PHM (NUHM), MSSHP, DQM, DHQM and Health and Wellness Officer.
3. Online meeting on Discussion on focused department/NQAS Area of Concern.
4. Online meeting on Patient Satisfaction Survey and SOP (Standard SOP (Standard Operating Procedure).
5. Online National Orientation Workshop of SaQushal-Safety and Quality: Self Assessment Tool for Health Facilities.

Achievements 2018-19

• National Quality Assurance Standards Certification

QA aims in making the health facilities within the State to achieve National Accreditation by abiding with the National Quality Assurance Standards. Two facilities – 

1)Aizawl East District Hospital(Civil Hospital, Aizawl)hadachieved more than 70% in the latest 2019 surveillance assessmentretaining the NQAS certification. 

2)ITI UPHC (with conditionality)has achieved National Accreditation.

• Two days Internal Assessors training and three days Service Provider Training were conducted for Chief Medical Officers of each District, Medical Superintendents, one Senior Medical Officers from each 9 District, Two Senior most Medical Officers of each District Hospital, one Nursing Superintendent of each 9 District Hospital, One Senior Staff Nurse of each 9 District Hospital, One Pharmacist of each 9 District Hospital, One Laboratory Technician of each 9 District Hospital. The total number of participants will be 90.Field visits and monitoring of 9 DH within the state were completed.
• Aibawk and ReiekPHC scored more than the minimum required points ie 70% in the State level QA external assessment
• Lunglei District Hospital also achieved the minimum required points in the internal assessment.

Kayakalp 

Award to public health facilities was launched in 2015 by the Health & Family Welfare Dept, Government of India. It is a National Initiative to give awards to those public health facilities that demonstrate high levels of cleanliness, hygiene and infection control. There are categories – District Hospital(DH), Sub-District Hospital/Community Health Centre (SDH/CHC), Primary Health Centre(PHC) and Urban Primary Health Centre (UPHC).

Achievements

• Master Trainingon Swachh Bharat Abhiyan and One day Awareness cum Internal Assessors Trainingwere conducted at State leveland also One Day Swachh Bharat Abhiyaan trainingis conducted at all facilities. 
• Out of 9 DH, 8 DH (89%) achieved more than 70% and received Kayakalp Award.

Out of 11 SDH/CHC , 5 SDH/CHC (46%) achieved more than 70% and received Kayakalp Award.

Out of 57 PHC, , 48 PHC (85%) achieved more than 70% and received Kayakalp Award.

Out of 8UPHC, , 5 UPHC (63%) achieved more than 70% and received Kayakalp Award.

During the year 2018-19, 78% of public health facility achieved Kayakalp Awards

Details of Kayakalp winners 2018-19:

       District Hospital

1^st Prize- Rs 5 lakhs (Lawngtlai District Hospital)

2^nd Prize-Rs 4 lakhs          (Champhai District Hospital)

3^rd Prize- Rs 3.5 lakhs (Civil Hospital, Aizawl)

Commendation Award- Rs 2lakhs each for 5 hospitals

Special Award-   Most Improved (Siaha DH)

                                   Most Beautiful (Lawngtlai DH)

Rs 0.75 lakh each is given for each health facility for the special award. 

Community Health Center

1^st Prize - Rs 8 lakhs (Biate CHC)

2^nd Prize- Rs 4 lakhs (Thenzawl  CHC)

3^rd Prize- Rs 2 lakhs (Vairengte CHC)

Commendation Award- Rs 1 lakh each for 2 health facilities

Special Award –      Most Improved (Thenzawl CHC)

                                   Most Beautiful (Sakawrdai CHC)

     Rs 0.75 lakh each is given for each health facility for the special award

Primary Health Center (PHC)

1^st Prize- Rs 2 lakhs 

2^nd Prize- Rs 94000

3^rdPrize – Rs 81100

Commendation Award - Rs 20000 to 22 PHC scoring more than 70% in PHC

Urban PHC

Best UPHC- Rs 2 lakhs (ITI UPHC)

2^nd Prize   - Rs 1 lakh (Chawlhmun UPHC)

Commendation Award –Rs 50000 given to 3 UPHCs

Special Award   - Most Inspiring (Sazaikawn UPHC)

                                Most Beautiful (ITI UPHC)

Cash prize of Rs 25000 is given for each special award

Performance of QA Program (Activities, target and achievement) during 2017-2018 is as follows:

Human Resource

The Training 

Monitoring Visit by SQAU

Review Meeting by SQAC

Kayakalp -Award topublic health care facilities was launched in 2015by the Family welfare Dept, Government of India. It is a National Initiative to give

Awards to those public health facilities that demonstrate high levels of cleanliness, hygiene and infection control.

The Objectives are as follows :

1. To promote cleanliness, hygiene and Infection Control Practices in

public Health Care Facilities.

2. To incentivize and recognize such public healthcare facilities that

show examplary performance in adhering to standard protocols of

cleanliness and infection control.

3. To inculcate a culture of ongoing assessment and peer review of

performance related to hygiene, cleanliness and sanitation.

4. To create and share sustainable practices related to improved

cleanliness in public health facilities linked to positive health.

Under Kayakalp. a competiton amongst the health care facilities is raised wherein they will be scored according to the checkpoints given by the GOI on facility wise criteria and those eligible for cash award will need to have a score of above 70%.

The achievements under Kayakalp during the Financial Year 2017-18

Training

Assessments

Kayakalp Award

The Kayakalp Award ceremony was held on 21^st December, 2017 where the Health Minister Government of Mizoram was the chief guest and handed over the award to the winning facilities.

Based on scoring, using a specific standard protocol wherein checkpoints are given, points are administered by an external Assessor Team who are trained for this assessment, and the Kayakalp State Level Award Nomination Committee adjusted the awards as follows for the year 2017:

District Hospital:

1^st Prize- Rs 6 lakhs (Aizawl East District Hospital)

2^nd Prize-Rs 5 lakhs (Lawngtlai District Hospital)

3^rd Prize- Rs 4 lakhs (Champhai District Hospital)

Commendation Award- Rs 3 lakhs each for 4 hospitals

Special Award- Best Landscape ( Kolasib DH)

Most Inspiring (Aizawl East DH)

Most Improved (Lawngtlai DH)

Sustenance Award (Champhai DH)

Rs 1 lakh each is given for each health facility for the special award.

Community Health Center:

1^st Prize- Rs 10 lakhs (Biate CHC)

2^nd Prize- Rs 5 lakhs (Sakawrdai CHC)

3^rd Prize- Rs 3 lakhs (Vairengte CHC)

Commendation Award- Rs 1 lakh each for 3 health facilities

Special Award –Best Landscape (Hnahthial CHC)

Most Inspiring (Biate CHC)

Most Improved (Sakawrdai CHC)

Sustenance Award (Vairengte CHC)

Rs 1 lakh each is given for each health facility for the special award

Primary Health Center (PHC): 

1^st Prize- Rs 2 lakhs

2^nd Prize- Rs 95000

3^rdPrize – Rs 85000

Commendation Award - Rs 18000 to 20 PHC scoring more than 70% in PHC

Urban PHC:

Best UPHC- Rs 2 lakhs (Chawlhhmun UPHC)

Consolation Prize- Rs 1 lakh (ITI UPHC)

Commendation Award –Rs 50000 UPHC given to 4 PHCs

Special Award- Most Inspiring (ITI UPHC)

–Best Landscape (ITI UPHC)

Cash prize of Rs 25000 for each special award

According to the Kayakalp guideline, each best facility will receive a cash award along with a citation, also, a commendation award will be given to those districts scoring above 70%. These cash incentives are expected to be utilized as a source for maintaining clean and hygienic practices in the facility and will also serve as an important source for Swachhta Drive and also the ongoing Kayakalp activities.

Pictures of before and after images and Immense positive feedbacks from the healthcare facility staffs and general public are the reflections of the success of this Program.

Certain issues have been encountered during the implementation of QA program. The lack of Common Waste Treatment Facility (CWTF) has been an huge obstacle in Biomedical Waste Management. Irregular supply of drugs and communities, and delayed release of funds have also been encountered by our public health facilities.

The State QA Committee has selected two district hospitals ,i.e Champhai and Kolasib District Hospitals to be the next focus for NQAS Certification.Keeping in mind the need for sustenance, KayakalpMonitoring visits has been planned to be conducted quarterly in the District Hospitals.

Swachhata Fortnight