Now cleanliness at hospitals to be an important criteria for quality certification
Government funding for states and union territories is conditional on their health facilities getting the necessary NQAS certification—a set of standards for assessing and certifying the quality of public health facilities in India.
The development comes against the backdrop of growing incidence of hospital infections.
Hospital-acquired infections (HAIs) pose a significant risk, impacting patient health and healthcare costs. In India, a 2022 Lancet report indicated a rate of 1.73 HAI cases per 1,000 patient days. This represents a slight increase from the 1.61 cases per 1,000 patient days reported in 2021.
This strategic linkage uses Kayakalp to directly drive facilities towards achieving and maintaining high NQAS quality benchmarks, contributing to the "Ease of Living" for citizens. This will motivate public health facilities to achieve higher standards of hygiene, sanitation, waste management and overall upkeep, with a national goal for all facilities to attain NQAS certification by December 2026.
A senior official in a communication to the State/UT government emphasized the health ministry's priority on quality certification for healthcare facilities for improving health indicators and achieving NQAS certification.
According to the health ministry's communication dated 7 July 2025, seen by Mint, the new policy introduces a crucial change to the Kayakalp scheme. Previously, incentives were provided for Kayakalp (cleanliness and hygiene) performance and also upon achieving National level NQAS certification.
The letter stated that now, facilities will only receive Kayakalp incentives if they apply for state-level NQAS certification within three months of receiving their Kayakalp results in the same financial year. This ensures a direct pathway from foundational improvements to formal quality recognition.
Furthermore, to encourage progression from state to national certification, the union health ministry has decided that states can claim 25% of the national certification incentive once a facility achieves state-level NQAS certification.
This partial incentive release is based on several strict criteria, i.e. the State Quality Assurance Committee is satisfied that the state certification has been conducted as per the protocol defined by the National Health System Resource Centre (NHSRC).
'The overall score of the facility in state certification is 80% and the score against each standard is 70%. There are no conditional requirements or pending compliances. The facility has applied for the NQAS certification within two months of getting the state certification. The remaining 75% of the incentive will be claimed after national certification is achieved," the letter said.
Notably, out of 1.75 lakh (175,000) health facilities targeted for quality certification by next year, only 22,787 had achieved NQAS certification by December of last year.
According to a Lancet report from 2018, India could potentially save a significant number of lives by improving healthcare quality. The study indicated that about 1.6 million deaths each year in the country are linked to substandard care, and that providing quality healthcare could prevent three out of five of these fatalities. There haven't been any newer studies in India on this specific issue since then.
'Cleanliness and quality are not luxuries in healthcare—they are fundamental rights of every patient. The Government of India's move to integrate Kayakalp with the NQAS is a vital step toward institutionalizing a culture of excellence in public health facilities. Certification under NQAS not only ensures better infection control, hygiene and patient safety but also builds public trust and staff morale. Having worked closely with accreditation systems and quality frameworks (NABH , CAHO and QCI) in India, I believe this structured and incentivized approach will significantly uplift standards of care across the country—especially when implemented with the full engagement of healthcare providers and state leadership. Clean, safe and quality-assured hospitals are the cornerstone of a healthier, more resilient India," said Dr. Alexander Thomas, founder and patron, Association of National Board Accredited Institutions (ANBAI) and Association of Healthcare Providers India (AHPI).
Queries sent to the health ministry spokesperson remained unanswered.
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