Document Type


Publication Date



A quality assurance (QA) procedure was pilot-tested and subsequently scaled up throughout the state of Gujarat, India, after demonstrating that a 65-item checklist is an efficient tool for identifying and remedying gaps in service delivery. From 2004–06, FRONTIERS developed and tested a standardized QA procedure. The State Ministry of Health and Family Welfare (MOHFW) used the procedure to assess health-care services in rural clinics in two pilot districts each in the states of Gujarat and Maharashtra. Based on positive results, the State MOHFW expanded the QA procedure in a phased manner throughout all 25 districts of Gujarat. The model is now being introduced in six more states. In the QA procedure, the MOHFW selects district QA teams of two or three district-level officials. The teams conduct three quarterly visits to each facility. During each visit, the QA team uses a 65-item checklist to assess and grade each facility in terms of infrastructure, staff training and technical competence, supplies, procedures, interactions with clients, and services delivered, including family planning, maternal care, and detection and treatment of sexually transmitted infections. As noted in this brief, the team suggests measures to address any gaps identified.






Frontiers in Reproductive Health