Institutionalization of quality assurance within district health management: Experiences from Maharashtra and Karnataka

The Population Council, with financial support from UNFPA, provided technical assistance to the states of Maharashtra and Karnataka, India in implementing a quality assurance (QA) program and helped its institutionalization in the district level of health management. An analysis of all the facilities covered as of December 2007 revealed substantial gaps in the infrastructure and human resources available to provide good-quality services, as well as adherence to standards for providing the services. To build the capacity to undertake QA visits, the Population Council and state authorities organized a series of events to orient and train state and district officials, facility-level workers, and members of the District Quality Assurance Group. The district health officers of both districts have subsequently established a mechanism to monitor and assess the extent to which the facilities have taken initiatives to address the gaps identified during QA visits. There are indications that the QA process is being institutionalized in the overall National Rural Health Mission/Reproductive and Child Health program