Managing geographical monopoly and quality issues
It is not uncommon to find a DHS the sole provider in a
district; a geographical monopoly of health services in the
locality. It was not possible not to contract such a DHS even
though it was not accredited by the Healthcare Accreditation
Institute (HAI) as people had no choice; travelling to neighbouring
DHS was expensive and inconvenient. In such case, a
strict application of quality condition such as accreditation or
re-accreditation status for entering to contractual agreement
was not viable.
A financial incentive was offered by NHSO in 2007 by
recognizing a stepwise quality improvement initiated by HAI in
2003. Step 1 means risk identification system was installed;
step 2 means quality assurance and quality improvement were