The Swachh Bharat Abhiyan; Kayakalpa

The Swachh Bharat Abhiyan was launched by the Prime Minister on 2nd October 2014, focusing on promoting cleanliness in public spaces. Public health care facilities are serving the large segments of the population. Cleanliness and hygiene in hospitals play an important role in preventing infections. As the first principle of healthcare is “to do no harm” it is essential to have our health care facilities clean and to ensure adherence to infection control practices. To complement this effort, the Ministry of Health & Family Welfare, Government of India is launching a National Initiative to give Awards to those public health facilities having high levels of cleanliness, hygiene and infection control.

The Awards will be finalized based on the weighted average Score of Kayakalp Score & Mera Aspataal Score.

Kayakalp scores obtained under following parameters:

a. Hospital/Facility Upkeep

b. Sanitation and hygiene

c. Waste Management

d. Infection control

e. Support Services

f. Hygiene Promotion

g. Cleanliness beyond Hospital/facility Boundary wall

Kayakalpa is purely a Voluntary and self improvement competition in Cleanliness & hygiene to improve the quality among the public health facilities.

Before awarding as the best, the facility will be assessed by self, peer and external assessment. Each time the facility will be assessed by using a check list regarding cleanliness and hygieneand Identificationof gap in achieving targets & filling gaps with root cause analysis. As it is a team work and needs cooperation from each worker and each department in afacility, everybody should be oriented with regarding all the targets in kayakalpa before assessment.

After implementation of NHM with liberal flow of public funds, the healthcare facilities have had a face lift done with improved basic needs in providing quality service to meet the expectations of community and attracts more patients from private facilities at low affordable cost in achieving health for all. At each level of facility manpower, infrastructure, reagents,and medicines are being supplied without any interruption hence patients are satisfied with the services, wastage & unnecessary expenditure also has been reduced due to e- hospital implementation. Importance was given to Hospital team building and training them on Hospital infection control practices, BMW management and segregation of waste generated at source like wards,lab, OTs and storage of same at designated places followed by proper disposal of BMW within 48 hours. Staff orientation on personal protective equipments, post exposure prophylaxis, display of hygiene promotion messages and also to maintain cleanliness in ward toilets by providing continuous water supply, taps at good working condition, display of pictures of how to use toilet and how to dispose sanitary pads.

Most of the facilities have taken measures for hospital up keep like control of stray animals in the premises,mosquito free environment by providing mesh to the windows, curtains, Landscaping, Parks in open areas with herbal garden.Many good things are happening to take health beyond boundaryby promoting Swacch Bharat Mission in surrounding areas, making communities aware of cleanliness by organizing camps and also making community Open air Defecation Free, all this is done by involving Local leaders and philanthropists to take up Corporate Social Responsibilities.

But there are many challenges like where the public health facility with a high case load, it is very difficult to maintain the cleanliness and the quality compared to a facility with less case load.Other challenges are Staff attitude, lack of team leadership and spirit,poor community cooperation, old non functional buildings which are difficult to renovate, water scarcity. After inspection or awarding there are also chances of staff losing interest in maintaining the same cleanliness drive or they might feel relaxed and getback to old dirty smell in wards and toilets etc. Another challenge is that where facilities were doing good work on cleanliness, might get discouraged if they don’t get appreciation eventhough they maintain cleanliness throughout the year hence a surprise inspection to the facility may address this challenge.