Why accreditation in health care matters
This article is authored by Pompy Sridhar, director, India programmes, MSD for Mothers.
As demand for health services continues to rise, so does the imperative to ensure that care is delivered with both equity and efficacy. The provision of health care must extend beyond accessibility and availability to encompass quality, representing a steadfast commitment to improving outcomes for all individuals. This necessitates the need to build a robust, universal health system capable of addressing the needs of vulnerable populations, including last-mile communities, elderly, women, and children.
In context of a larger population and public health goals, the World Health Organization describes quality in healthcare as “the level of attainment of health systems’ intrinsic goals for health improvement and responsiveness to legitimate expectations of the population”. A system providing quality health care should be safe, effective, patient-centric, timely, efficient, and equitable. One of the most recommended mechanisms for assuring quality in Low-and Middle-Income Countries (LMICs) is through accreditation.
Accreditation plays a critical role in advancing health care quality by providing a structured framework for continuous improvement, by ensuring that health care facilities adhere to nationally and globally recognised standards. More than a compliance tool, accreditation is a catalyst for building resilient, accountable, and equitable health systems.
In India, the accreditation ecosystem is evolving. The National Accreditation Board for Hospitals and Healthcare Providers (NABH), established under the Quality Council of India, is the most recognised accrediting body, specifically developed to meet the demands of the Indian health care landscape. Similarly, in the public sector, the National Quality Assurance Standards (NQAS) provide a framework to evaluate government health facilities. Irrespective of the accrediting body, the focus must remain on the credibility, consistency, and comprehensiveness of the standards being applied.
Accreditation brings wide-ranging benefits across the health care value chain. It reduces variability in clinical practice and strengthens overall service delivery by aligning facilities with evidence-based protocols. Importantly, it fosters trust among patients by signaling transparency, safety, and accountability. For payers, accreditation enables more strategic purchasing—insurers and public schemes like Ayushman Bharat can confidently contract services from facilities that meet quality benchmarks. In fact, NABH-accredited hospitals under Ayushman Bharat are eligible for higher reimbursement rates, creating a tangible incentive for private providers to pursue accreditation.
However, as India continues its journey towards universal health coverage, accreditation must go beyond operational and infrastructural metrics. A robust accreditation system must embed clinical excellence at its core. This includes rigorous evaluation of clinical protocols, outcomes, and competencies. Strengthening the clinical dimensions of accreditation will not only elevate the quality of care but also position India’s health system as an exemplar for the world.
Realising the full potential of accreditation will depend on how effectively clinical excellence is embedded into its design and execution. This goes beyond recognising the gap, it involves defining how clinical quality can be consistently measured, implemented, and incentivised across health systems.
One pathway is to develop clinical standards that are specialty-specific and co-created with professional bodies, ensuring alignment with current evidence and practice realities. Accreditation assessments should begin to evaluate not just infrastructure and documentation, but also clinical decision-making, case management, and complication readiness. This shift would enable facilities to move from procedural compliance to performance-based evaluation.
An example of this approach is the collaboration between the Federation of Obstetric and Gynaecological Societies of India (FOGSI) and NABH to benchmark women’s health care by integrating FOGSI’s clinical standards into NABH’s certification programmes. This collaboration brings clinical nuance into the quality assurance process and reflects a growing recognition that excellence in health care must be defined as much by outcomes as by operations. By anchoring accreditation in clinical expertise, such models have the potential to equip facilities to respond more effectively to complications, streamline care pathways, and improve patient safety, especially in high-risk and time-sensitive disciplines like maternal health care.
To build a case for accreditation within the health care system, there is a need to demonstrate its value through measurable outcomes, such as improved health safety, enhanced quality of care, and better health indicators. Current accreditation practices are beginning to track key metrics in quality improvement to codify learnings and address evidence gaps in health impact across settings, emphasising the value of data collection in achieving consistent advancements in care. By tracking outcomes, accreditation can help health care facilities build an evidence-backed strategy to patient care and an evidence base that can prove the impact of accreditation, reinforcing it as a cornerstone of quality in health care.
Accreditation, therefore, to be truly transformative, must expand beyond hospitals to include the entire continuum of care. Accrediting frontline platforms such as anganwadi centres, primary health centres, and wellness clinics can help ensure the delivery of high-quality, patient-centric care for all. This approach sets a precedent for extending similar quality frameworks to sectors such as nutrition, early childhood development, and elder care. Accreditation, then, becomes more than a health care tool—it becomes a national strategy for equity and excellence.
This article is authored by Pompy Sridhar, director, India programmes, MSD for Mothers.
