National Journal of Community Medicine│Volume 10│Issue 11│Nov 2019 Page 593 ORIGINAL RESEARCH ARTICLE pISSN 0976 3325│eISSN 2229 6816 Open Access Article www.njcmindia.org Implementation of Quality Assurance in Reproductive & Child Health Services Project in Maharashtra State Prakash P Doke 1 , Abhijit R Khanvilkar 2 Financial Support: None declared Conflict of Interest: None declared Copy Right: The Journal retains the copyrights of this article. However, re- production is permissible with due acknowledgement of the source. How to cite this article: Doke PP, Khanvilkar AR. Implementa- tion of Quality Assurance in Reproduc- tive & Child Health Services Project in Maharashtra State. Natl J Community Med 2019;10(11):593-599 Author’s Affiliation: 1 Professor, Department of Community Medicine, Bharati Vidyapeeth Deemed University Medical College, Pune; 2 Director, Prognosis Management and Research Consultants Private Limited Correspondence Dr. Prakash Prabhakarrao Doke prakash.doke@gmail.com Date of Submission: 06-04-19 Date of Acceptance: 21-11-19 Date of Publication: 30-11-19 ABSTRACT Introduction: Globally ‘quality health care’ and particularly the domain of Reproductive and Child Health (RCH) services attract substantial attention. United Nations Population Fund (UNFPA) implemented Quality Assurance in Reproductive and Child Health Services Project in India. This study was conducted to doc- ument evolution and process of implementation of that project. Methodology: It was a descriptive study using mixed methods. Authors analysed statistics generated through reviewing second- ary data, visits to health care institutions, interviewing various stake holders and focused group discussions. Results: Regular visit to health institutions by a multidisciplinary trained team was the core strategy. The districts in the project were added in four phases. In each selected district institutions were added in rounds. The number of institutions covered in first three phases was 1,231. Checklists and grades were prepared for differ- ent types of institutions. Government trained 903 personnel for paying visits to institutions. Only 53.65% planned visits were actu- ally paid. There was improvement in grades. The women appreci- ated the quality improvement activities. Conclusions: The process of expansion adopted in this project demonstrates its applicability in any large geographical areas and particularly resource-crunch areas. The involvement of in-house multidisciplinary team is effective and self-sustaining. Keywords: Checklists, Team, Assessment, Visits, Grading INTRODUCTION Globally ‘quality health care’ and particularly the domain of Reproductive and Child Health (RCH) services has recently received substantial attention 1 . Although improving quality services had been one of the objectives of RCH program in India since inception in 1997; the focus on quality health services was enhanced after launching National Rural Health Mission (NRHM) in 2005. As a result Indian Public Health Standards (IPHS), exclusively for institutions in public sector and National Ac- creditation Board for Hospitals and Healthcare Providers (NABH) were established. International- ly the Population Council devised a framework for Quality of Care (QOC) for family planning ser- vices, which outlined the fundamental elements of care while capturing both technical and interper- sonal, dimensions 2-4 . The Client-Oriented, Provid- er-Efficient (COPE) framework of quality assess- ment gave further impetus to efforts for operation- alizing QOC in health services 5 . An Indian experi- ence of the project which can be replicated else- where is presented here. The quality of RCH ser- vices has been criticized in 2003 by Ramakant Rai and in 2012 by Devika Biswas through Public In- terest Litigations against Union Government of In- dia. Supreme Court gave directives to Government of India, for ensuring quality of family planning services. As one of the fallout of these directives, United Nations Population Fund (UNFPA) initiat- ed Quality Assurance in Reproductive and Child Health Services Project in India from 2006-07 in six