Assets and obstacles in obtaining National Quality Assurance Standards Certification: Lessons learnt from Certified Public health facilities in Tamil Nadu

Background: National Quality Assurance standards certification is a Govt of India initiative through the Ministry of Health and Family Welfare to certify the quality of care in public health facilities across the country based on predefined criteria. As Tamil Nadu is in the process of scaling up this certification to all its health facilities, it is important to learn the experience from its certified facilities for strategic planning. Objective: The main objective is to comprehend the various lessons learnt from National Quality Assurance Standard certification process. Materials & Methods: Lessons Learnt Analysis was done with various stakeholders involved in the certification process in the primary and secondary level public health facilities from four districts of Tamil Nadu using qualitative research methods – In depth interviews and Focus group discussions. Results: Involvement of the healthcare providers, team work, in house training, multiple funding sources, support from state and district administrators were enabling factors for obtaining certification, while inadequate staff especially basic level health workers, lack of need based and timely funding, existing infrastructure not in line with the norms and inability of CHCs to obtain certification as per the criteria and maintenance of multiple registers emerged as major challenges. Conclusion: Health planners and service providers should work towards sustaining the gains achieved and bring in relevant policy changes and provide necessary support to address the challenges identified for smooth scaling of the certification.