Table 1

Details of QI intervention strategies

QI implementation strategy
States/districts where QI projects were undertaken under this strategyPopulation (in millions) that was affected by the QI intervention(s)*Stakeholders involved in implementing this model (besides the QI network)Pivotal human resourceImprovement observed at
Standalone QI support
(from 2016 to 2018 active phase, 2018 until as the sustenance phase)
Across three states in India
Delhi, Maharashtra, Karnataka
3.0Three government medical colleges, two district hospitals, three private hospitalsFacility-level care providers (like doctors, nurses, paramedics, personnel from the administration, drug/general store, pharmacy, ambulance driver, etc.Health facility level
Bottle Neck Analysis followed by introducing QI24
(2015–2016 active phase; 2016–2017 sustenance phase)
Across one state Meghalaya
(five districts)
3.7State Health Department (NHM), USAID-ASSIST, QI Cell in a Medical College HospitalFacility-level care providers, district and state health department officialsHealth facility level and at state level
QI with Nursing Profession
(since August 2017 to date)
(two districts)
3.0Continued Nursing Education (CNE) cell and QI cell of a medical college hospitalNurses deployed in health facilities/nursing colleges.Health facility level and nursing college level
QI with Medical and Nursing students25
(since March 2018–until)
Seven medical colleges and one nursing college across Delhi, Karnataka, Sikkim, GujaratNot applicableSix government medical colleges, one private medical college, one nursing college and the QI cell of a medical college hospitalUndergraduate students of nursing and medical colleges across. QI Mentors form the medical and nursing college teaching hospitalsStudent level - with constant and in supportive and clinical areas of the health facility
State Health Department (NHM)-led QI for nursing students (nursing schools/colleges)
Madhya Pradesh
(two districts)
1.9Govt. Colleges of Nursing, Respective District Hospitals, State Health Department (NHM MP), Development partnersUndergraduate students of nursing colleges in state of Madhya Pradesh, India.Student level - with constant and in supportive and clinical areas of the health facility
Hub and Spoke model for QI (rural)(26)
(July, 2018–June, 2019. Inclusive of both active and sustenance phase)
(one district)
2.0Medical college hospital, district level health facilities, NHM Maharashtra (District and State officials), WHO-SEARO, QI Cell of a medical college hospital, New DelhiHub facility-based mentors as focal point of handholding spoke facilities to develop their QI skillsFacility-level with development of QI linkage between tertiary care centres (medical college) and secondary care (district hospital, community health centre, etc.)
Hub and Spoke model for QI (urban)(26)
(July, 2018–June, 2019. Inclusive of both active and sustenance phase)
(two districts)
3.0NHM Delhi, Medical college hospital, district level hospitals, WHO-SEARO, QI Cell of a Medical college hospital, New Delhi--same as above----same as above--
QI mentoring integration with national perinatal care initiative in district hospitals
(September 2018–August 2019)
Madhya Pradesh
(nine districts)
14.5NHM MP, UNICEF MPHealthcare providers (doctors, nurses, etc.) from Special newborn care unitsSpecial newborn care unit’s level
QI mentoring integration with national perinatal care initiative in teaching hospitals
(July 2019–until)
12 medical colleges, across India71.5Maternal Health Division, MOHFW, NHSRC, State NHM Offices, WHO-SEARO, New Delhi, UNICEF (country and state offices),Obstetricians, Paediatricians and Senior Nurses (as part of a quality-of-care network).Facility-level (tertiary care centres that is, medical college level)
(MICRO, with constant MACRO level support)
QI mentoring integration with national perinatal care initiative
(July 2019–January 2020)
Uttar Pradesh (three districts)11.5NHM UP, UNICEF UPDistrict-level quality consultantsFacility-level improvement with impact at district level
Online Community of Practice (Digital Platform)
(Ongoing since August 2020)
Online platform with participants from around the world
(USA, UK, Qatar, Bangladesh and India)
Not applicableWHO-SEARO,
Ministry of Health & Family Welfare,
BMJ India,
Oxford University Hospitals, NHS, University Research Company, MGIMS, Wardha,
Aastarika technologies,
QI champions from all facilities associated with the network, national and state health departments, development partners, QI teams from South Asia region.MICRO-LEVEL,
  • *Extrapolated data for 2019 from baseline data about district populations from Census 2011.

  • †Aspirational districts are those districts in India, that are affected by poor socio-economic indicators. These are aspirational in the context that improvement in these districts can lead to the overall improvement in human development in India.