its about overviewing the entertainment .

1. Overview

2. National Quality Assurance Standards
(Areas of Concern)
Service
Provision
Inputs Support
Services
Clinical
Care
Infection
Control
Quality
Management
Outcome
Patient Rights

3. 2nd October 2014
Launch of Swachh Bharat Abhiyaan
“A clean India would be the best tribute India could
pay to Mahatma Gandhi on his 150 birth anniversary
in 2019.”
15th May 2015 Launch of ‘Kayakalp’ as an
adaptation and Extension of ‘Swachh Bharat
Abhiyaan’.
To encourage and incentivize Public Health Facilities
(PHFs) in the country to demonstrate high levels of
cleanliness, hygiene and infection control practices.
Rejuvenating Public Healthcare Facilities

4. Swachhta: A Mission for All
SwachhBharat
Abhiyan
NQAS
Swachhta
Guidelines
‘KAYAKALP’
Clean
Facility

6. Objectives of KAYAKALP
• Promotion of Swachhta
• Enhancement of Quality of Care
• Internalisation of Quality Culture & On-going
Assessment
• Incentivisation & Recognition of ‘Exemplary
Performances’
• Improve patients satisfaction
Rejuvenating Public Healthcare Facilities

7. Institutional Arrangement
District Level Award Nomination Committee
Dissemination
Nomination
TA & Trainings
Finalisation of Awards for PHCs
State Award Committee
Dissemination
Training & Coordination
Constitution of External Assessment Team
Finalisation of Awards & Declaration
MoHFW/ NHSRC
Review and Mid-course Correction
Mobilisation of Technical Assistance &
Facilitatory Support

8. Institutional Framework-KAYAKALP
State Level Award
Committee
District level Award
Nomination
Committee
Hospital Cleanliness
& Infection Control
Committee
Chairperson: MD/Health Secretary.
Members: Senior officers from Health
Directorate, SQAC, Development
Partners, Medical Colleges, NGOs,
Public Health Engineering department,
Pollution Control Board, Water and
Sanitation department.
Chairperson: DM/CMO
Members: Zilla Panchayat Health
committee, DQAC, Civil society
representatives, RKS members
Medical Superintendent, Matron,
Hospital Manager, Pathologist/
Microbiologist , Departmental In
charges
Dissemination,
Assessors Team
constitution, Trainings,
coordinate &validate
Assessment, finalize
winners & award,
conflict resolution
Dissemination, internal
& peer assessment,
Trainings, monitoring,
nomination for awards.
Internal Assessment,
Action Planning , Gap
Closure, Hands on
Training , Monitoring
of cleanliness

9. Hospital upkeep
(100 Marks)
Sanitation & Hygiene
(100 Marks)
Support Services
(50 Marks)
Waste Management
(100 Marks)
Infection Control
(100 Marks)
Hygiene promotion
(Marks 50)
Beyond Hospital
Boundary(100 Marks)
ECO Friendly (100
Marks)

10. 3-Step Assessment
• Internal Assessment
• Peer Assessment
• External Assessment

11. External Assessment
• A Three-member team (Minimum)
• Trained – Internal Assessors under NQAS, Ext.
Assessors & Kayakalp Ext. Assessors
• As least one member should be from Non-
Government Sector

12. Assessment and Improvement Cycle
Assessment
& Scoring
Gap Analysis
Root Cause
Analysis
Action
Planning
Prioritizing
Actions
Gap closure

13. Trainings
Trainings Location Target Audience
Awareness
Training
State Capitals Half Day sensitization workshop at State level for Key
officials from ,State Health Directorate, State Health
Society ,Members of State level award Committee
Representatives of NGOs & Development Partners working
in state
External
Assessors
Training
State Capitals
/ NHSRC
One day Master Training of State level external assessors
for using the assessment tool
At least One officials should be nominated from every
district who can work as master trainer for district level
workshop.
Awareness
cum Internal
Assessors
Workshop
At all district
headquarters
4 Hour sensitization workshop at District Level on the
‘’Swacchh Bharat Abhiyan’’ and how to use assessment
tool targeted for Service Providers
Facility In charges Doctors, Nurses, Hospital Managers,
DPM , Members of District Quality Assurance Committees,
representatives of Development partners & NGOs working
at District Level.

14. Cash Awards: DH
Category No. of DHs Assessment Score Amount
(Rs. in Lakhs)
I. Category A 10-25 Highest (Best) Rs. 50.00
II. Category B 26 - 50 Highest (Best) Rs. 50.00
Ist Runner-up Rs. 20.00
II. Category C More than 50 Highest (Best) Rs. 50.00
Ist Runner-up Rs. 20.00
IInd Runner-up Rs. 10.00
Commendation & Cash Award
All States DH More than 70% Score Rs. 3.00

15. Cash Awards
Category Type of
Facility
Assessment Score Amount
(Rs. in Lakhs)
I. Large States
SDH/ CHC Highest (Best) Rs 15.00
Runner-up Rs. 10.00
PHC One in each District Rs. 2.00
II. Small States
(Less than 10
districts)
SDH/ CHC Highest (Best) Rs. 15.00
PHC One in each District Rs. 2.00
Commendation & Cash Award
All States
More than 70% Score
SDH/CHC Rs. 1.00
PHC Rs 0.50

16. S.No
.
No. of Health
Facilities
No. of Awards Award (In
Lakh Rs.)
Unit of
Allocation
UCHCs
1 10-25 One Winner 15.00 I per state and
each
of the 7
metros
2 25 or more One Winner 15.00 I per state and
each
of the 7
metros
One Runner 10.00
3 U-CHCs with >70%
in external
assessment
Commendation
Awards
1.00 All Eligible
facilities

17. S.No No. of Health
Facilities
No. of Awards Award
Amount (In
Lakh Rs.)
Unit of Allocation
UPHCs with & without beds
4 10 – 20 One Winner 2.00 For each cluster*
at state/metro as
the case may be
5 20 - 50 One Winner 2.00 I per district / zone
or region of 7 metro
1st Runner up 1.50
6 50 & above One Winner
1st Runner Up
2nd Runner Up
2.00 I per district / zone
or region of 7 metro
1.50
1.0
1.0
7 All U-PHCs scoring
70% or more in
External Assessment
Commendation
Awards
0.50 All eligible facilities

18. Kayakalp in
urban health
Kayakalp at
UCHCs
Kayakalp at
UPHCS
UPHCs with
bed
UPHCs
without bed
Seven Metro Cities would form a separate Group
(Ahmedabad, Bangalore, Chennai, Delhi, Hyderabad, Kolkata, Mumbai-Further
divided into zones/ regions/ districts)
Kayakalp Awards will depend on Number of functional
UCHCs and UPHCs in state/UT.

19. KAYAKALP: Measuring &
improving Swachhata.
If you can’t measure something, you can’t
understand it. If you can’t understand it, you
can’t control it. If you can’t control it, you
can’t improve it.”

20. KAYAKALP Measurement System
Thematic
areas
Broad areas or themes for assessing different
aspects of “Cleanliness” like Hospital/ Facility
upkeep, Sanitation & Hygiene, waste
Management, Infection Control, Support
services and Hygiene promotion.
Components
8
Statement of requirement for particular
aspect of Cleanliness 50
Checkpoint Tangible measurable checkpoints are those,
which can be objectively observed and scored.
250/1
50/10
0

21. Hospital upkeep
(100 Marks)
Sanitation & Hygiene
(100 Marks)
Support Services
(50 Marks)
Waste Management
(100 Marks)
Infection Control
(100 Marks)
Hygiene promotion
(Marks 50)
Beyond Hospital
Boundary(100 Marks)
ECO Friendly (100
Marks)

22. Hospital upkeep Sanitation & Hygiene
Support Services.
Waste Management
Infection Control Hygiene promotions
Criteria for Assessment
Section B: PHC with Beds
300
60 60 60
60 30 30

23. Hospital upkeep Sanitation & Hygiene
Support Services.
Waste Management
Infection Control Hygiene promotions
Criteria for Assessment
Section C: PHC without Beds
200
40 40 40
40 40 20

24. Theme D: Infection Control
D1 D2 D3 D4 D5
D6 D7 D8 D9 D 10

25. Hand Hygiene
Personal Protective Equipments
Personal Protective Practices
Disinfection & Cleaning
Spill Management
Infection Control Program
Infection Surveillance
Isolation & Barrier Nursing
Environmental Control
Infection Control
Theme D
D
Autoclaving & Sterilization
07-10-2022 QI-NHSRC

26. D2: Personal Protective Equipment
Use of gloves
during procedures
and examination
Use of Masks and
Head caps
Use of Heavy duty
gloves and gum
boots by waste
handlers
use of Aprons by
clinical staff.
Adequate supply of PPEs

27. Thematic
Area
Checkpoint
Complianc
e
Reference
No.
Assessment
Method
Means of
Verification
KAYAKALP—Anatomy of Score Card Page-14,
Kayakalp

28. Assessment Method
OBSERVATION (OB) STAFF INTERVIEW (SI)
RECORD REVIEW (RR) PATIENT INTERVIEW (PI)

29. Observation (OB)
Compliance to many of the checkpoints can be
assessed by directly observing the articles, processes
and surrounding environment. Few examples are
given below
• a) Enumeration of articles like house keeping equipment,
colour coded bins, drugs, etc
• b) Displays of signages, work instructions, important
information
• c) Facilities – layout, zoning of OT, patient amenities,
ramps, complaint-box, etc.
• d) Environment – cleanliness, loose-wires, seepage,
overcrowding, temperature control, drains, etc
• e) Procedures like mopping, segregation of biomedical
waste, etc.

30. Staff interview (SI)
• Interaction with the staff helps in assessing the
knowledge and skill level, required for performing job
functions.
• Examples –
• Competency testing – Quizzing the staff on knowledge
related to their job
• Demonstration – Asking staff to demonstrate certain
activities like hand-washing technique, use of PPEs, etc.
• Awareness - Asking staff about awareness of Antibiotic
Policy, disinfection, sterilization, autoclaving etc.
• Feedback about adequacy of supplies, problems in
performing work, safety issues, etc.

31. Record Review (RR)
It may not be possible to observe all procedures. Records also generate
objective evidences, which need to be triangulated with finding of the
observation. For example on the day of assessment, every colour coded
bins might be having liners, but if review of the liners supply and usage
register reveals poor supply pattern of liners, then more enquiries would
be required to ascertain on the adherence to biomedical waste
management protocols. Examples of the record review are given below –
• Review of sterilization records – Autoclaving Register,
• Review of department registers like BMW Register, Linen Register,
Kitchen Register, expenditure registers, Needle stick injury Register etc.
• Review of licenses, formats for legal compliances like Authorization for
BMW, Incident reporting, etc.
• Review of SOPs of BMW management and Infection control for
adequacy of process
• Review of monitoring records –culture surveillance report, calibration
records, etc.

32. Patient Interview (PI)
Interaction with patients/attendants/visitors may be
useful in getting information about cleanliness and
their experience in the hospital. It gives us users’
perspective. It should include –
• Feedback on staff behavior, food quality, Linen,
waiting times, etc.
• Their experiences during hospitalization/visit.
• Communication about personal cleanliness,
hygiene promotion

33. Compliance & Scoring Rules
Full
Compliance
Partial
Compliance
Non
Compliance
2
1
0
 All Requirements in Checkpoint are Meeting
 All Tracers given in Means of verification are
available
 Intent of check point is meeting
 Some of the requirements in checkpoints
are meeting
 All Least 50% of tracers in Means of
verification are available
 Intent of check point is partially meeting
 Most of the requirements are not meeting
 Less than 50% of tracers in Means of
verification are available
 Intent of Check point is not meeting

34. Level wise Measurement
System
Level of facility DH/SDH/CHC PHC (with Beds) PHC (without
Beds)
Theme 8 6 6
Component 60 50 50
Checkpoint 300 150 100
Marks 800 300 200

35. Prepare well before Assessment
Familiarise with components of Swachhata and
check points
Understand the Assessment Methods and
means of verifications
Gather information and evidence.
Compare the checkpoint and means of
verification
Arrive at conclusion of compliance and Score.

36. PAGE
77
Two sub-categories:
1. Best ‘eco-friendly’ District
Hospital: - In all States/UTs, the
top ranked DH will get best ‘eco-
friendly’ award in the District
Hospital category.
2. Best ‘eco-friendly’ CHC/SDH
Award: - In all States/UTs, the top
ranked CHC/SDH will receive an
‘eco-friendly’ award in CHC/SDH
category.
PAGE
76 Kayakalp overall score card

37. PAGE
79
Two sub-categories:
1. Best ‘eco-friendly’ District
Hospital: - In all States/UTs, the
top ranked DH will get best ‘eco-
friendly’ award in the District
Hospital category.
2. Best ‘eco-friendly’ CHC/SDH
Award: - In all States/UTs, the top
ranked CHC/SDH will receive an
‘eco-friendly’ award in CHC/SDH
category.
B. Eligibility criteria: at least 70% ‘’eco-
friendly’’ score under the Kayakalp
during external assessment.
PAGE
78 Kayakalp overall score card

38. Swachhta/Kayakalp Fortnight

39. Swachhta Fortnight
• MoHFW in partnership with state health
departments & public health institutions across
states & UTs celebrate Swachhta Pakhwada
(Cleanliness Fortnight) as part of Swachha Bharat
Bahiyan.
• During fortnight health facilities act as catalyst for
visible changes all around.
• Health departments/Hospitals take up focused
cleanliness drive to make hospital premises & it
surrounding neat &clean.
• During fortnight health facility collaborate with
schools, local civil bodies, PWD, Private hospitals &
NGOs etc. to promote these activities

40. Swachhta Fortnight
15 days event planned around themes such as Awareness
drive, cleanliness drive & sustenance
During fortnight suggested following activities are done:
• Inauguration of Swachhata Pakhwada by facility incharge,
administration of Swachhta Pledge,
• Display of IEC regarding cleanliness,
• distribution of Pamphlets, booklets, regarding hand
hygiene, promotion for use of toilet, water & hygiene,
• distribution of T short, badges, having logo of SBA,
• drawing competition on cleanliness,
• awareness about cleanliness through posters, videos,
• sorting of condemn material at facility,

41. Swachhta Fortnight
• removal of old posters,
• outdated IEC material, removal of garbage,
overgrown grass,
• repair & replacement of pipes,
• removal of stray animals,
• plantation of trees, improvement in landscaping,
• training of housekeeping staff

42. Swachh Swasth Sarvatra
A Joint Initiative of MoHFW & MDWS

43. Swachh Swasth Sarvatra
• Death due to diarroheal diseases
is 5th most common cause in India
across all age groups
• Unsafe water, inadequate
sanitation & poor hand hygiene
practices contribute 5% DALY
(Disability adjusted life year)
• Unsafe water & inadequate
sanitation impacts the poor
section of society
• Under SBA, MDWS has two main
objectives (1) Construction of
toilets (2) Enabling behavior
changes

44. Swachh Swasth Sarvatra
• Goal: Make India Open Defection
free (ODF) by 2nd Oct, 2019.
• To complement this effort
MoHFW join hands with MDWS
& launch Swachh Swasth
Sarvatra.
• SSS was launched Union Health
Minister J P Nadda and Union
HRD Minister Prakash Javadekar
on occasion of Good Governance
Day (29 December 2016)

45. Objective of SSS
• The objective of this
initiative is aimed at
strengthening community
health centres in 708 ODF
blocks across the country to
enable them to achieve
higher levels of cleanliness
and hygiene

46. Key Feature of Program
• Achieve better health outcomes through improved
sanitation and increase awareness on healthy
lifestyles.
• Its objective is to build on and leverage
achievements of two complementary programmes –
Swachh Bharat Mission (SBM) and Kayakalp.
• Under it, financial assistance of 10 lakh rupees will
be given to the community health centres so that
they can be strengthened to meet the standards of
sanitation, hygiene and infection control.

47. Overview of Activity

48. Scope & strategy

49. At PHC Level

50. At CHC

51. •Thank
you