In India, public health reforms began with the National Health Policy 2017, which places strong emphasis on UHC. The policy stipulates that healthcare should be accessible, affordable and of assured quality, without causing financial hardship to citizens. It underlines the need to strengthen primary healthcare, improve patient safety, reduce extra expenditure and ensure standardised services across the country.
While elaborating policy, the government has not treated only quality as an optional goal but as an overall change. The mere improvement in infrastructure will not suffice unless services are safe, reliable, and patient-centric. In this context, quality assurance mechanisms such as the National Quality Assurance Standards play a crucial role in translating policy intent into action at the ground level.
What is NQAS and Why It Matters
The National Quality Assurance Standards (NQAS) is a quality framework that was developed by the Ministry of Health and Family Welfare, aiming to enhance the performance of public healthcare facilities. The NQAS project was rolled out in 2015, aiming at ensuring that the standards of public health institutions in regards to quality, safety, cleanliness and patient satisfaction were met.
When the program began, only 10 healthcare facilities were NQAS-accredited. Today, this dataset includes 10 NQAS-accredited healthcare facilities. Over the years, the categories of healthcare facilities included in NQAS membership have increased. These categories include District Hospitals (DH), Sub-District Hospitals (SDH), Community Health Centres (CHC), Primary Health Centres (PHC), Urban Primary Health Centres (UPHC) and Sub-Health Centres (SHC).
As of December 31, 2025, the country has reached a significant milestone, with 50,373 public health institutions accredited under NQAS across all States & Union Territories of India. This not only indicates the Government’s focused effort to make quality an integral part of healthcare delivery systems, but also to adopt a move-on attitude.
The NQAS Framework: How Quality is Assessed
The NQAS system is founded on a clear set of measurable standards. It focuses on broad categories and views key areas in terms of service delivery, patient rights, inputs, supporting services, care delivery, infection control, and outcomes. Measures are based on the presence or absence of systems and the adherence to those systems.
One of NQAS’s greatest strengths is its structured assessment process. The facilities undergo internal assessments to identify deficiencies. After that, they are referred to external assessments by trained personnel. Virtual assessments began, and these steps reduce the time for certification.
The framework emphasises the importance of quality improvement and its ongoing daily maintenance. In turn, the objective of the described quality system for healthcare institutions will not end with certification but continue with continuous daily quality improvement.
There has been a significant increase in the number of NQAS certifications over a short period. As of December 2023, India had 6,506 NQAS-certified facilities. It further increased to 22,786 in December 2024 and then surged to 50,373 in December 2025.
This phenomenal growth in one year draws attention to the effects of digital tools and the capacity development of assessor resources, as well as to the collaborative efforts of the Centre and States.
Of the total accredited facilities, 48,663 are Ayushman Arogya Mandirs, including Sub-Health Centres, Primary Health Centres, and Urban Primary Health Centres, while the remaining 1,710 are secondary care facilities, including Community Health Centres, Sub-District Hospitals and District Hospitals. The data reveal that quality assurance and improvement are no longer confined to large hospitals and are extended down to the grassroots level for providing healthcare services.
Role of Ayushman Arogya Mandirs and Primary Healthcare
The presence of many Ayushman Arogya Mandirs accredited under NQAS is an encouraging aspect of India’s healthcare infrastructure. It is also quite true that these are generally the first points of contact for many people, mostly in rural areas. All in all, it is an added strength in preventive care services, early diagnosis, non-communicable diseases, MCH programs, and basic emergency care.
Quality improvements at the primary level decrease pressure on hospitals at higher levels, which is consistent with a primary healthcare strengthening with a vision articulated in the country’s National Health Policy, which will support in achieving Universal Health Coverage.
Governance Readiness for the Future
The crossing of 50,000 in NQAS certification represents good coordination between the central government and the States and Union Territories. Despite health being a State subject for legislation, it was expected that most States would not adhere to NQAS; however, since its adoption is widespread, it represents a good effort towards common quality standards. It promotes equity by providing equal access to healthcare for all citizens, regardless of location.
The government has an interim target to ensure that at least 50 per cent of its health facilities attain NQAS by March 2026. This will require continuous training, monitoring, and support for health providers. NQAS is turned out to be a useful instrument in achieving the vision of the National Health Policy 2017. With the integration of quality, safety, and patient care in public health care, the nation is moving towards a better, patient-oriented health care delivery system.
