Details of QI intervention strategies
| QI implementation strategy (duration) | States/districts where QI projects were undertaken under this strategy | Population (in millions) that was affected by the QI intervention(s)* | Stakeholders involved in implementing this model (besides the QI network) | Pivotal human resource | Improvement observed at (MACRO/MESO/ MICRO) |
| Standalone QI support (from 2016 to 2018 active phase, 2018 until as the sustenance phase) | Across three states in India Delhi, Maharashtra, Karnataka | 3.0 | Three government medical colleges, two district hospitals, three private hospitals | Facility-level care providers (like doctors, nurses, paramedics, personnel from the administration, drug/general store, pharmacy, ambulance driver, etc. | Health facility level (MICRO) |
| Bottle Neck Analysis followed by introducing QI24 (2015–2016 active phase; 2016–2017 sustenance phase) | Across one state Meghalaya (five districts) | 3.7 | State Health Department (NHM), USAID-ASSIST, QI Cell in a Medical College Hospital | Facility-level care providers, district and state health department officials | Health facility level and at state level (MICRO AND MESO) |
| QI with Nursing Profession (since August 2017 to date) | Delhi (two districts) | 3.0 | Continued Nursing Education (CNE) cell and QI cell of a medical college hospital | Nurses deployed in health facilities/nursing colleges. | Health facility level and nursing college level (MICRO) |
| QI with Medical and Nursing students25 (since March 2018–until) | Seven medical colleges and one nursing college across Delhi, Karnataka, Sikkim, Gujarat | Not applicable | Six government medical colleges, one private medical college, one nursing college and the QI cell of a medical college hospital | Undergraduate students of nursing and medical colleges across. QI Mentors form the medical and nursing college teaching hospitals | Student level - with constant and in supportive and clinical areas of the health facility (MICRO) |
| State Health Department (NHM)-led QI for nursing students (nursing schools/colleges) (January–March) | Madhya Pradesh (two districts) | 1.9 | Govt. Colleges of Nursing, Respective District Hospitals, State Health Department (NHM MP), Development partners | Undergraduate students of nursing colleges in state of Madhya Pradesh, India. | Student level - with constant and in supportive and clinical areas of the health facility (MICRO) |
| Hub and Spoke model for QI (rural)(26) (July, 2018–June, 2019. Inclusive of both active and sustenance phase) | Maharashtra (one district) | 2.0 | Medical college hospital, district level health facilities, NHM Maharashtra (District and State officials), WHO-SEARO, QI Cell of a medical college hospital, New Delhi | Hub facility-based mentors as focal point of handholding spoke facilities to develop their QI skills | Facility-level with development of QI linkage between tertiary care centres (medical college) and secondary care (district hospital, community health centre, etc.) (MICRO and MESO) |
| Hub and Spoke model for QI (urban)(26) (July, 2018–June, 2019. Inclusive of both active and sustenance phase) | Delhi (two districts) | 3.0 | NHM 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) | 14.5 | NHM MP, UNICEF MP | Healthcare providers (doctors, nurses, etc.) from Special newborn care units | Special newborn care unit’s level (MICRO) |
| QI mentoring integration with national perinatal care initiative in teaching hospitals (July 2019–until) | 12 medical colleges, across India | 71.5 | Maternal 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) | 11.5 | NHM UP, UNICEF UP | District-level quality consultants | Facility-level improvement with impact at district level (MICRO) |
| 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 applicable | WHO-SEARO, Ministry of Health & Family Welfare, ISQua, BMJ India, Oxford University Hospitals, NHS, University Research Company, MGIMS, Wardha, Aastarika technologies, 3M, CAHO | QI champions from all facilities associated with the network, national and state health departments, development partners, QI teams from South Asia region. | MICRO-LEVEL, MESO-LEVEL MACRO 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.