Kayakalp

an assessment of Healthcare Fascilities

1. KAYAKALP (Rejuvenating Public Health Facilities ) By- Dr. Ruchi Kushwaha SGPGIMS , Lko

2. BACKGROUND A clean environment in a health facility is essential to the dignity and comfort of patients. It reflects the culture of concern for patients and respect to the staff and visitors. Cleanliness and hygiene in public health facilities are part of a continuum of the entire gamut of quality parameters. “A customer is the most important visitor on our premises; he is not dependent on us. We are dependent on him. He is not an interruption in our work. He is the purpose of it. He is not an outsider in our business. He is part of it. We are not doing him a favour by serving him. He is doing us a favour by giving us an opportunity to do so .” - Mahatma Gandhi

3. Swachh Bharat Mission is a National Initiative launched by Honorable Prime Minister on 145 th birth anniversary of Mahatma Gandhi on 2 nd October 2014 at Rajghat New Delhi, launched in remembrance of Mahatma Gandhi's words "Cleanliness is next to Godliness ". 'A clean India' will be a tribute to Mahatma Gandhi on his 150 th birth anniversary in 2019 . The Union Minister for Ministry of Health & Family Welfare, Govt. of India, Shri J. P. Nadda has launched a national initiative on 15 th of May, 2015 to promote cleanliness and enhance the quality of public health facilities . The purpose of this initiative is to appreciate and recognise their effort to create a healthy environment. The name of this initiative is “KAYAKALP”.

4. INTRODUCTION Swacchata : A Mission for All

5. OBJECTIVES To promote cleanliness, hygiene and Infection Control Practices in Public health care facilities. To incentivise and recognize such public healthcare facilities that show exemplary performance in adhering to standard protocols cleanliness and infection control. To inculcate a culture of ongoing assessment and peer review of performance related to hygiene, cleanliness and sanitation. To create and share sustainable practices related to improved cleanliness in public health facilities linked to positive health outcomes .

6. CRITERIA FOR ASSESSMENT HOSPITAL UPKEEP SANITATION & HYGIENE WASTE MANAGEMENT INFECTION CONTROL SUPPORT SERVICES HYGIENE PROMOTION

7. Criteria for application to the Awards Scheme Constituted a Cleanliness and Infection Control Committee . Instituted a mechanism of periodic internal assessment/peer assessment based on defined criteria. Achieved at least 70% score in the criteria during the peer assessment process.

8. Kayakalp Cash Awards to Public Health Facilities Category Facility Assessment Score Amount Rs. In Lakhs Large States DH Highest (Best) Rs. 50.00 Runner up First Rs. 20.00 Runner up Second Rs. 10.00 SDH/ CHC Highest (Best) Rs. 15.00 Runner up Rs. 10.00 PHC One in each District Rs. 02.00 DH & CHC Highest in the state in each Thematic Area @DH- Rs. 01.00 @CHC-Rs. 00.50 Commendation Award (70 % or more ) All States DH More than 70 % Rs. 03.00 SDH/CHC Rs. 01.00 PHC Rs. 00.50

9. INSTITUTIONAL FRAMEWORK State Level : A state level Award Committee is to be constituted under the chairpersonship of the Health Secretary/Mission Director. Suggested members include senior officers from Health Directorate, State Quality Assurance Committee, Development Partners working in the states, Superintendents of Medical College hospitals, NGOs working on health and sanitation themes, and representatives of other relevant departments like Public Health Engineering Department, Pollution Control Board and Water and Sanitation department.

10. External Assessment Teams- External Assessment team would be constituted for the proposed assessment and validation of the scores of nominated facilities. State Award Committee would identify and appoint external assessors. Following can be appointed as External assessors- State level program officers/ Officials from Health Directorate. Experts working with Developments Partners/ International Agencies/NGOs . Trained internal and external assessors for National Quality Assurance Standards/other quality standards . Faculty from medical Colleges/ SIHFWs/ Technical support institutions Retired senior health officials and other health experts .

11. District level Award Nomination committee – A three to five member committee at the district level under the chairpersonship of the DM/Chief Medical Officer (CMO). Suggested members include CMO/representative, Member of Zilla Panchayat Health Committee , District Quality Assurance Committee , civil society representatives and eminent RKS members as members of which at least one of the members should be a woman. This committee would undertake the following tasks : Disseminate details of award scheme and criteria to all health care facilities in the district . 2. Ensure the process of internal and peer assessment in the district through: Training facility staff in undertaking internal/peer assessments Allocation of teams for peer assessments and providing logistic support “

12. Monitor implementation of internal and peer assessments, and Review of scores and support facilities to fill identified gaps . 3. Nominate facilities for award based on the scores obtained by internal/ peer assessment for finalization at the state level . National Level :- At the national level, a National Committee under the Chairpersonship of the Mission Director w ould review this National Initiative periodically for any necessary modifications.

13. ASSESSMENT PROCESS STEP - 1 STEP - 2 STEP - 3 Internal Assessment Peer assessment External Assessment Hospital Staff Periodic Exercise Scores to be reported to District committee Followed by Action Plan Hospital Staff Periodic Exercise Scores to be Reported to District Followed by Action Plan Staff from other Hospital facilities Once 70% score is achieved in Internal Assessment Essential for nomination for State level External Assessment By Team of trained external assessor Once nomination is received from District nomination committee Essential for State level award & commendation

14. SCORE CARD

15. THEMATIC SCORES

16. AWARD DECLARATION State Award Committee will rank facilities according to the scores obtained in external assessment and identify the top two ranked for award. The list of selected facilities would be formally disseminated through circular and displayed at official website of the state health department. The state committee would also declare the eligible facilities for the Certificate of Commendation.

17. Cash Award 75 % of the cash award amount will go to the Rogi Kalyan Samities for investments in improving the amenities, upkeep and services, while 25% of the cash award will be given to the facility teams as a team incentive.

18. The Winners of Kayakalp 2015-2016 1 st Award -Rs. 50.00 Lakhs - Ram Manohar Lohia Hospital, Lucknow 2 nd Award – Rs.20.00 Lakhs - Dr. BRA District Hospital, Etawah Commendation Award to 9 Hospitals - 1. Rani Laxmi Bai Hospital, lucknow 2. Balrampur Hospital, lucknow (Rs. 3.00 Lakhs Each) 3. T.B. Hospital, Hathras 4. District Hospital, jalaun 5. District Hospital, Jhansi 6. District Women Hospital, Shahjahanpur 7. District Women Hospital, Farrukhabad 8. District Women Hospital, Allahabad 9. District Women Hospital, Meerut

19. The Winners of Kayakalp 2016-2017 1 st Award - Rs.50.00 Lakhs - Dr. BRA District Hospital, Etawah 2 nd Award – Rs.20.00 Lakhs - District Women Hospital, Lalitpur 3 rd Award – Rs.10.00 Lakhs - VAB Mahila Chikitsalaya, Lucknow Commendation Award to 10 Hospitals - 1 . RML Hospital , lucknow 2. SPM Civil Hospital, Lucknow (Rs.3.00 Lakhs Each) 3 . Pt.DDU Govt. Hospital, Lucknow 4 . VJB Women Hospital, Lucknow 5.District Hospital, Jhansi 6 . District Women Hospital, Muzaffar Nagar 7 . Balrampur Hospital, lucknow 8 . TB Sapru Hospital , Allahabad 9. DCH Hospital, Ghaziabad 10. District Women Hospital, Meerut

20. The Winner CHCs – 2016-2017 1 st CHC – Rs.15.00 Lakhs – Muradnagar , District Ghaziabad 2 nd CHC – Rs. 10.00 Lakhs – Sidhauli , Sitapur Commendation Award to 9 CHCs – ( Rs.1.00 lakhs Each ) Sl. No. District CHCs 1 Gorakhpur Pipraich 2 Varanasi Cholapur 3 Lucknow Chinhat 4 Lucknow BKT 5 Lucknow Malihabad 6 Hapur Garh Mukteshwar 7 Saharanpur Fatehpur 8 Hardoi Sandeela 9 Lucknow Gosaiganj

21. The Winner PHCs 2016 -2017 @Rs.2.0 Lakhs Sl. No. Districts PHCs 1 Jhansi Sakrar 2 Kanpur Dehat Sarvankheda 3 Gorakhpur Brahmpur 4 Lucknow Nigoha 4 Basti Marwatiya 6 Unnao Bichiya 7 Kanpur Bithoor 8 Allahabad Dhanupur 9 Meerut Bhoodharal 10 Lalitpur Jhakora 11 Sitapur Kamlapur 12 Raebareli Harchanpur 13 Jalaun Dakor 14 Bareilly Kuwatanda Sl. No. District PHCs 1 Jhansi Barua Sagar 2 Lucknow Sarojini Nagar 3 Jhansi Bamaur 4 Jhansi Ambabay Commendation Award to PHCs @ Rs.0.50 Lakhs

22. Winners Under the Central Govt.Hospitals Category 2016-2017 1 st Award - Rs.5 Crore – All India Institute of Medical Sciences (AIIMS), New Delhi 2 nd Award – Rs.3 Crore – North Eastern Indira Gandhi Regional Institute of Health & Medical Sciences (NEIGRIHNS), Shillong 3 rd Award – Rs.1 Crore- Postgraduate institute of Medical Education & Research (PGIMER), Chandigarh Commendation Award to 3 Hospitals – 1. AIIMS, Raipur ( Rs. 50 Lakhs Each ) 2. AIIMS, Jodhpur 3. National Institute of Tuberculosis and Respiratory Diseases (NITRD), Delhi