• The National Health Mission (NHM) Strives to Provide Quality Health care to all citizens of the country in an equitable manner. For improving the quality of careat public health facilities for children up to 12 year of age group Government of India has setup the MusQan initiative.
• The goal of MusQan initiative to ensure provision of quality child friendly services in public health facilities to reduce preventable newborn and child morbidity and mortality.
• Assessment methods under GoI MusQan, Observations (Ob), Staff Interview (SI), Record Review (RR), Patient Interview (PI)
• Quality of care is an important pillar for Universal Health Coverage & India is committed to provide safe & quality services to newborn, infants and children. To improve gaps in access, safety & quality it is important that measurable standards and improvement tools are applied uniformly & consistently in all level of healthcare institutions.
• The key strategy of MusQan is to
  • Strengthen clinical protocols and management process,
  • Children and parent attendant friendly ambience and infrastructure,
  • Strengthen referral and follow-up services
  • Provision of respectful and dignified care
• The Scope of services under MusQan is as:

Through ‘MusQan’, the country aims to make newborn & childcare services friendly, for which the targeted facilities will undertake following rapid improvement cycles. Each cycle will be of two months and its progress will be rigorously supervised by states and district level teams.

MusQan Rapid Improvement (RI) cycles:

1. Timely initiation of emergency treatment of sick newborn and children and referral.
2. Improvement in breastfeeding, hypothermia (temperature maintenance), KMC practices in eligible neonates and developmentally supportive care.

• Ensuring improvement in infection prevention practices and reduction in Hospital Acquired Infections (HAIs)

1. Improving documentation and record management practices. This RI cycle include timely recording and updation of information.
2. Ensuring implementation of Clinical Protocols ex. rational use of antibiotics, oxygen, fluid etc.
3. Respectful care and improving engagement of mother / attendant in newborn care and ensuring enhancement of parent/ attendant’s satisfaction who are seeking care in public healthcare facilities.

• Steps of certification

(a) Internal assessment, (2) State certification, (3) National certification.

• Norms for certification:
  • 70 % and more as per NQAS protocols of SNCU/ NBSU, Paediatric Ward, OPD and NRC
  • 75 % and More Facility level indicators
  • 80 % Patient satisfaction
• Incentivisation:

District Hospital and FRU- CHCs could be given incentives of Rs. 3 Lakhs and 2 Lakhs (for each department) respectively on achieving National certification & compliance to facility-level targets.

• 25% of this amount may be used for staff incentivisation and 75% of the amount can be used for branding activities like display of logo on signages, and for undertaking facility improvement activities, for which funds from other sources are not available.
• Incentive will be awarded for three consecutive years subject to submission of surveillance report by the state to QI division NHSRC and Child Health division of MoHFW. Surveillance will be done to ascertain status of the NQAS scores, sustenance or further improvement of targets and parent-attendant group satisfaction scores.