In health sector, there are not many model centers, which could be replicated to other areas or institutions. This is especially true for the peripheral institutions in the states.

Engender Health implemented quality improvement in 4 selected facilities in Uttaranchal. This was a successful experiment and is sustaining. On the similar lines it is proposed to create a group of interdependent institutions as model centers i.e. one district hospital, two CHCs, four PHCs and eight sub-centers. A team of experts from Institute of Health Manangement Research, Bangalore would study these centers and identify major problem areas, prioritize the issues, which could solved at local level and the issues, which require higher-level interventions. Based on the identified problems, a 3 to 5 day training program would be designed. All the staff in the selected facilities would be trained (on-site and whole-site training) on the concept of quality, parameters of quality and how to operationalise it as well as the local issues of the institutions. Through group work the participants would develop an action plan for improving the quality of services in their institution.

After the training, fortnightly reviews will be carried out by the experts for about 3 months to see what all has been achieved and what could not be achieved and explore the reasons for the same. The experts would also coordinate with the higher authorities for their support in problem solving.

During the process, trainers could be identified among the participants and groomed for carrying out further training.

Once these institutions achieve the desired level of standards, they could be designated model centers. The staff from nearby facilities could be trained at the model centers by the local staffs, which are also good trainers. The further trainings could be of shorter duration, as the participants will get ready material for observation and study. In this way the program can be self-sustaining and the activities could be expanded faster.