Uploaded : June' 2014


Action Plan                              Standard of NHC                           Present Status


 Government Hospital

 Private Hospitals & Clinics

 Private Diagnostic Centre

 Private Blood Bank

 Medical Board

 Medical Waste Management

 Referral System

 Hospital Accreditation

 Quality Assurance

 Risk Management

 Total Quality Management

 Clinical Protocol

 Management Development 

 Emergency Management

 Poisoning Management

 Hospital Autonomy

 Safe Blood Transfusion

 Community Participation

 Operational Plan

 Women Friendly Hospital 

 EOC & Gender

 Capacity Development

 Establishment of Shishu
 Bikash Kendra at 14MCHs


 The Director General of Health Services  is committed to provide the best quality care to patients and users of health services, in order to meet their expectations and needs, and to improve service delivery.

The MOHFW, with support from its national level  for effective implementing of national standards. Achieving compliance with these standards will assist in proactively putting the systems in place to avoid the most important risks to poor quality care or reduce their impact.

 In order to ensure the Core standards will be accessible and easy to understand for wider distribution and use. Standards should be read in conjunction with the main document if more understanding and clarity are needed.

 A Standard is a quality, or qualities, which serve as a basis to which others conform or by which the quality of others is judged; the degree of excellence required for a particular purpose.” (Canadian Oxford dictionary)

 “A Criterion is a rule or test on which a judgment or decision regarding the achievement of a standard can be assessed.”

 During the last two sector programme, many key interventions aimed at improving the efficiency, quality, safety of and access to care have been introduced. A Patients’ Rights Charter was launched, with accompanying norms  for primary health care ,district hospitals and Medical College hospitals were formulated. The plan and the framework for the Modernization of Tertiary Services were developed.

 National guideline for  on Quality in Health Care and on Infection Prevention & Control were developed to encourage an environment conducive to quality care and the development of the needed capacity.

 In order to continue to strengthen these efforts to improve performance and quality of care, national core standards will be formed for introducing effective quality of care in which all establishments and services could be  benchmark themselves are needed. The gap between these standards and the actual level of compliance must be documented through a structured and nationally accepted measurement system - however a challenge has been to have an adequate tool to establish the evidence on what the real impact of many of our efforts has been.



The main purpose of the National Core Standards is to:

 Develop a common definition of quality of care, which should be found in all health establishments in Bangladesh  as a guide to the public and to managers and staff at all levels;

 Establish a benchmark against which health establishments can be assessed, gaps identified, strengths appraised; and

 Provide a national framework to certify health establishments as compliant with standards.



 To develop core national standards, criteria and indicators and the tools for assessment in health establishments.

 To establish a baseline in an initial set of all level of health care to inform the development of Facility Improvement Plans

 To develop the process and methodology for developing the national core standards and mechanisms for their assessment.

 To introduce the national core standards in all level of health care services, step wise



 National Health care standards will be  internationally recognized and used as a means of establishing expected minimum safety standards required across a health system as well as desired best practice.

 In Bangladesh , while formal standards exist in some areas, in many other areas expected practice is expressed in broad policies and guidelines. Standards or guidelines will be  developed at the national level and in many cases their efforts wiil be mirrored or adapted at all level of care.

 Professional bodies and even private organizations also develop standards and guidelines. These contributions will made in different formats and with differing monitoring systems; making the task of performance assessment, benchmarking and implementing effective and integrated corrective action at delivery level very difficult.

 Roles and accountabilities for establishing levels of performance against standards will be well-defined between the significant role-players.

 An appraisal will therefore be carried out of the performance of facilities against a set of core standards, which will benchmark them against a set of criteria to determine whether performance is good, adequate or poor. Starting with a small group of health facilities in the short term, this will provide, in a phased manner, an objective and comparable assessment. Areas of basic patient safety and dignity, and essential management activities, will be weighted in determining poor performance, as these will have the greatest impact on outcomes.


 Measuring how well we meet the national standards

In order to be compliant with standards, managers and staff need to know what the standards are as well as what their current situation is – that is, how far their performance is from meeting the standards.

For measuring purposes, the standards set out in this abridged document are then broken down further in other documents: firstly into a number of “criteria” that spell out what is needed in order for a standard to be met; and secondly into a questionnaire or audit tool and a number of checklists.

The audit tool will be used for measurement has been set up as part of the routine Health Management Information System (the DHIS or District Health Information System) and all managers will have access, undergo training and receive support to be able to use it. The system lists the “evidence” needed to prove that the health establishment complies with the standards.

Management of hospitals and districts, are expected to use the standards and the tools themselves to assess and close the gaps in complying with standards through:


 Prioritizing our attention for implementation

 The process of improving quality recognizes that service delivery and providing quality care for patients is our most important function, with UHC, DH & MCH organized to assist managers to achieve this. An important part of this assistance is to solve the main obstacles preventing hospitals, clinics and districts from working well and meeting the standards; and therefore enable and require managers to manage effectively.

 Ensuring implementation of, or compliance with, the standards, is a critical part of improving the quality of health services through reducing the risks of poor care and inadequate management. Based on the major concerns expressed by patients through surveys, complaints and media reports, six priority areas have been identified for fast-track improvement. Forming part of the core standards, these six priorities are:

 1. Improving staff values and attitudes

2. Waiting times,

3. Cleanliness

4. Patient safety and security

5. Infection prevention and control, and

6. Availability of medicines and supplies


 Structure of the National Core Standards (Proposed)

The standards are intended to be universally applicable – that is, they cover services in hospitals in the public and private sectors. They have been developed into seven cross-cutting areas (called “domains”) where service quality or safety can be at risk.

 These domains are dependent on each other. They are as follows:

 1. Patient Rights

2. Patient Safety, Clinical Governance & Care

3. Clinical Support Services

4. Public Health

5. Leadership & Corporate Governance

6. Operational Management

7. Facilities & Infrastructure

The activity will be started from 2011-2012 FY




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Action Plan: Development of National Health Care Standard








Formation of core committee





















Development of National Health Care standard





















Capacity development of the service provider





















Introduction of National Health care Standard in all hospital





















Printing material





















Monitoring & supervision

























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Present Status : 

New Activity for HPNSDP, Activities will be started from October,11