ArticleCureus2025
Integrating Facility Metrics With Grassroots Insights: A Mixed-Methods Study to Improve Kayakalp Outcomes at Health and Wellness Centres in Ganjam, Odisha.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
backgroundThe Kayakalp initiative by the Government of India aims to improve cleanliness, hygiene, and infection control across public health facilities, including health and wellness centres (HWCs). While facility-level assessments offer objective measurements, the lack of community perspectives limits the depth of quality evaluations.
objectivesThis study aimed to (i) evaluate the performance of HWCs using standard Kayakalp criteria, (ii) explore community healthcare workers' perceptions regarding hygiene, service quality, and cleanliness, and (iii) develop community-driven recommendations for sustainable quality improvement. METHODOLOGY: A mixed-method design was employed. The quantitative component involved a cross-sectional assessment of 36 selected HWCs using a structured Kayakalp checklist. Facilities were included based on operational status, infrastructure, manpower, and logistics. The qualitative component followed a phenomenological approach with purposive sampling. In-depth interviews (IDIs) and key informant interviews (KIIs) were conducted with frontline workers and analyzed through inductive content analysis.
resultsA total of 36 facility assessments revealed significant gaps in operational efficiency, manpower deployment, and adherence to hygiene protocols. Qualitative findings from 16 interviews highlighted frontline workers' concerns about irregular cleaning staff, limited funding for sanitation, and challenges in community engagement. Thematic analysis identified key issues: manpower inadequacy, inaccessible facility locations, inconsistent waste management, and lack of community participation. A novel HYGIENE (Harness, Yield, Guide, Implement, Evaluate, Nurture, Enhance) model was proposed for improving Kayakalp compliance.
conclusionIntegrating community insights with formal assessments exposed critical gaps in the implementation of Kayakalp at the grassroots level. Addressing these gaps requires policy-driven solutions, including dedicated funding, recruitment of cleaning staff, strategic relocation of HWCs, and community-led monitoring mechanisms. The study proposes scalable interventions to strengthen quality care and public satisfaction through enhanced hygiene practices and participatory governance.
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