Development of a quality assurance procedure for reproductive health services for district public health systems: Implementation and scale-up in the state of Gujarat

This project was carried out in India, in two districts each in Gujarat and Maharashtra states. It confirmed that quality assurance (QA) checklists and an implementation manual, developed by the USAID-funded Frontiers in Reproductive Health (FRONTIERS) Program of the Population Council in collaboration with UNFPA/India, are useful and effective tools that the Ministry of Health and Social Welfare (MOHFW) can use to monitor the quality of services provided by health facilities. It also demonstrated that this QA mechanism can be easily institutionalized at the district level management. One key lesson has been the critical role that the commitment of state officials plays in the success of such interventions and their scale up and institutionalization. The proven effectiveness of the QA mechanism and its scaling up in Gujarat State has prompted the national MOHFW to introduce it into six other states, with a slightly enlarged scope for the QA visits. FRONTIERS, PATH, and EngenderHealth are providing technical assistance to support this scale up, with funding from USAID, UNFPA, and GTZ.