Introduction
Despite the emphasis on comprehensive primary health care (CPHC) under the Ayushman Bharat (AB) program, significant gaps remain in the care cascade for non-communicable diseases (NCDs), particularly hypertension and diabetes at the primary care level. These gaps span screening, diagnosis, treatment initiation, referral, and follow-up, leading to incomplete care pathways and suboptimal health outcomes.
ACT-QI is a district-level quality improvement intervention implemented in Kalahandi, Odisha, under the IPSI project, aimed at strengthening diagnosis and treatment coverage for hypertension and diabetes. The intervention adapts the WHO South-East Asia Region point of care quality improvement (POCQI) model, which has been successfully used to improve maternal and child health services, and applies it for the first time to NCD care within routine primary health services.
By building local capacity for quality improvement, the POCQI approach empowers frontline health workers and facility teams to identify service gaps, test context-specific solutions, and sustain improvements through a team-based, data-driven process. Aligned with Ayushman Bharat and the 75/25 campaign, ACT-QI seeks to strengthen CPHC for NCDs and contribute to broader goals of Universal Health Coverage by improving access to quality care where it is needed most
The intervention is being rolled out across participating facilities through bi-monthly in-person facilitation visits by facilitators. The first round of facility-level visits commenced in December 2025 and is currently ongoing and will be continued across the intervention phase. These visits are jointly conducted by district QI team members (facilitators) and IPSI district team members. Facility-wise micro-plans have been developed to guide implementation, with two visits scheduled per facility each month, typically during the second and fourth weeks. The micro-plans outline the proposed date and time of each visit, along with the facilitators.
