(GIST OF YOJANA) Kayakalp: Transforming
Public Health Facilities [JANUARY-2020]
Kayakalp: Transforming Public Health
Facilities
Introduction:
Kayakalp initiative of the Ministry of Health & Family Welfare began in 2015
with the aim of improving infrastructure upkeep, hygiene and sanitation, and
infection control practices in Central Government institutions and public health
facilities in all the States and UTs.
Major highlights of the scheme:
- Health facilities are assessed and scored on a number of parameters, and
every year the highest-scoring facilities at each level receive recognition
though Kayakalp Awards that carry cash, apart from the citation.
- The scheme has resulted in significant improvement in the level of the
cleanliness, hygiene, and infection control practices at public healthcare
facilities and has inculcated a culture of ongoing assessment and peer
review to promote hygiene, cleanliness, and sanitation. For ensuring the
objective assessment of “Swachhata” at the public health facilities,
assessment is done under seven thematic areas.
- Training is provided for not only undertaking the assessment but also
for implementation of correct protocols and practices. Trained assessors
undertake the final assessment and generate a score for short-listed health
facilities. Kayakalp has not only been able to facelift the public health
facilities but has made significant contributions towards moulding the
behavioural practices of the public.
- This paradigm shift is well reflected in the number of “satisfied"
patients as reported through “Mera Aspataal '', an ICT-based patient
feedback system. Kayakalp made a modest beginning in its first year with
assessing only the District Hospitals (DH). Subsequently, within a span of
three years, all the Sub District Hospitals, Community Health Centres, and
Primary Health Centres (Rural and Urban) have also been brought under its
ambit.
- The number of facilities participating in Kayakalp has increased
manifold. Starting with participation of 700 DHs, in the last financial
year, approximately 26,000 health facilities have participated in Kayakalp.
Not only the number of facilities participating under the initiative has
multiplied, the number of facilities scoring 70% (passing criteria) or more
has also increased manifold over the years.
- Apart from the gargantuan participation of the primary and
secondary-level healthcare facilities, tertiary-level healthcare facilities
participate with the same vigour and enthusiasm. With participation of 10
facilities in year 2015-16, the number has risen to 24 Central Government
institutions in the year 2018-19. Taking a step ahead, from FY 2019-20,
Kayakalp has now been introduced to Ayushman Bharat Health and Wellness
Centres (ABHWCs). Also, in order to ensure that “voice of patients, the
health clients” is heard and their feedback is obtained for each of the
facilities visited by them, the data of ‘Mera Aspataal’ household toilets
have been Kayakalp scoring for DHs.
- In the current year, for holistic and comprehensive improvement across
the health sector, the Kayakalp scheme has been extended to the private
sector health facilities. Quality Council of India (QCI) through its
constituent National Accreditation Board for Hospital & Healthcare Providers
(NABH) conducted Kayakalp assessment in the private hospitals. The
assessments were conducted as per the Kayakalp guidelines established by
MoHFW encompassing parameters viz. hospital/facility upkeep, sanitation and
hygiene, waste management, infection control, hospital support services, and
hygiene promotion. QCI conducted Kayakalp assessments in 653 private
hospitals pan India within a duration of two months.
- The hospitals were classified in three categories and out of the 653
facilities, 635 hospitals were found compliant with Kayakalp Guidelines.
- MoHFW has also used the platforms of Village Health Sanitation and
Nutrition Committees (VHSNCs) under the National Health Mission and Mahila
Arogya Samitis (MAS) under the National Urban Health Mission (NUHM) to
promote sanitation in the vulnerable urban communities.
- Many States have adopted innovative practices in making VHSNCs and MAS
effective. Accredited Social Health Activists (ASHs) also work with VHSNCs
to mobilise the community for construction and use of toilets. MAS are
recently established community groups of about 12 to 20 women from primarily
poor and vulnerable populations in urban areas, and they are working for
mobilizing communities on a range of issues, including sanitation.
- Not only healthcare professionals or health departments, MoHFW has
worked on inter-ministerial collaboration for hygiene and sanitation.
Leveraging the momentum achieved under Kayakalp, MoHFW and Ministry of Jal
Shakti started an integrated scheme, the “Swachh Swasth Sarvatra” in
December 2016. Under this initiative, resources have been provided to CUCs
located in Open Defecation Free (ODF) blocks which are yet to meet the
Kayakalp criteria. In 2019, the country’s three best PHCs under Kayakalp
from Andhra Pradesh, Gujarat, and Karnataka were also felicitated by
Ministry of Jal Shakti.
- Efforts made under Kayakalp and Swachh Bharat Abhiyan have been well
recognised by the WHO as well, which mentions that nearly all (97%) DHs now
have some or the other form of proper waste management.
- Swachh Bharat Abhiyan along with Kayakalp has given thrust to the
country’s efforts to achieve Sustainable Development Goal 3 (Good health and
well-being) and Goal 6 (Clean water and sanitation) respectively.
- As reported by the WHO, it is expected that Swachh Bharat Abhiyan will
result in averting more than 3,00,000 deaths (diarrhoea and protein-energy
malnutrition) between 2014 and October 2019. More than 14 million DALYs
(Disability Adjusted Life Years) are estimated to be avoided (diarrhoea and
protein energy malnutrition) between 2014 and October 2019.
- The achievements under the Swachh Bharat Abhiyan are applaudable. As
many as one crore household toilets have been built since its launch in
October 2014, almost 6 lakhs villages have been declared ODF villages and 35
States/UTs too are now ODF.
Way forward:
- The initiative has been able to create a ripple of improvement in the
public health sector and has been possible because of the collaborative
efforts of all States. This being said, the overall activities to maintain
hygiene have now developed into a habit, sustaining a Kayakalp certification
or an ODF certification has led to people practicing hygiene practices in
their daily lives.
- Not only have hygiene habits lead to overall positive health outcomes
(reduction in hospital-acquired infection, reduction on antibiotic use etc.)
the clean facilities have given a takeaway message to people to also keep
their home and surroundings clean and that is an impact beyond the four
walls and boundaries of a public health facility, indeed. The synergy and
momentum achieved under Swachh Bharat Mission shall continue to expand and
deliver a ‘Clean India, a Healthy India’.