Community health centres in Tamil Nadu fail to crack national quality tests
The cross-sectional study by DPHPM was conducted to analyse the reasons why a few CHCs are failing to meet the requirements for NQAS certification in external assessments.
DTNEXT Bureau
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CHENNAI: A total of 478 National Quality Assurance Scheme (NQAS) certificates have been received by the healthcare facilities in Tamil Nadu over the past 10 years, including 239 certificates in the last one year alone. However, a study by the Directorate of Public Health and Preventive Medicine (DPHPM) reveals significant shortcomings in quality management, support services, clinical care, and human resources in Community Health Centres (CHCs).
The cross-sectional study by DPHPM was conducted to analyse the reasons why a few CHCs are failing to meet the requirements for NQAS certification in external assessments. The study recommends strengthening quality management systems, enhancing support services, prioritising clinical care, addressing HR constraints and improving linkage services.
The National Quality Assurance Standards (NQAS) programme aims to enhance the quality of care provided in public health facilities nationwide. There are several parameters to analyse healthcare delivery in community settings, particularly in CHCs. NQAS standards are established to ensure high-quality promotive, preventive, and primary healthcare services, early screening and identification of health issues, timely referrals, and regular follow-ups.
The data from the external NQAS assessment checklist of 12 items revealed quality deficiencies in selected health centres. The checklists include – accident and emergency, outpatient department, labour room, inpatient department, operation theatre, pharmacy, laboratory, radiology, blood storage, newborn stabilization unit, and general administration and auxiliary services.
The study, co-authored by Dr T S Selvavinayagam, Director of Public Health and Preventive Medicine, stated that out of the 423 CHCs in Tamil Nadu, a total of 130 CHCs participated in the NQAS assessment, including 40 CHCs in 2022-23. This implies that only 30.7 per cent had participated in the assessment and about seven per cent of the participating CHCs failed the assessment.
Of the total CHCs that failed the assessment, 80 per cent had scored low on quality management. The study also stated that CHCs have scored less than 70 per cent in five out of ten departments.
“Around 40 per cent of non-recommended CHCs failed in quality management standards related to policy, continuous improvement, and quality assurance. Over 60 per cent failed in blood storage management, underscoring a critical need for improved practices in this area,” the study stated.
The study recommended that clinical care entails ensuring adherence to standard treatment guidelines, strengthening emergency preparedness, and establishing adequate blood storage and transfusion practices. “Addressing Human Resources constraints involves allocating adequate resources for staffing, prioritising training programmes for healthcare personnel, and exploring financial support options from stakeholders at the state and district levels,” the study said.
