Table 2

Components of the district level quality improvement programme (hub-and-spoke) in project districts of Maharashtra (Wardha) and Delhi (North/North West)

S.no.ComponentActivities done
1Quality improvement (QI) plan for the districtsEach district had one medical college as hub and two district health facilities as spokes.
Staff from hub facilities supported/coached the teams from spoke facilities in implementing QI projects.
QI network coaches/mentors supported staff from both the hub and spoke facilities to implement respective QI projects.
2QI training of facility teamsPOCQI trainings were conducted for facility staff to help them understand how to use QI approaches to improve care and measure the improvements achieved.
3Ongoing QI mentoring supportQI coaches guided staff of selected facilities in applying these methods to deliver better care.
4Peer-to-peer learning and experience sharingExperience sharing cum learning sessions was conducted at both the project sites to provide opportunities for staff from different facilities to learn from each other’s experiences and to motivate each other.
5Programme management structuresProgress of facility QI teams was regularly monitored by network mentors in collaboration with hub facility and district leadership.
6District leadership supportLeadership support was sought from both the district level and facility level leaders and their active participation facilitated by QI network coaches. As this was of critical importance for success and sustenance of the improvements.
7Support system for the project: funding, HR, documentation of learnings and so on.Funding and HR support was provided by WHO-SEARO and managed by QI network. Representative case studies were developed for wider dissemination.
  • POCQI, point of care quality improvement.