Closing the Surveillance Gap: A Digital Dashboard Framework for Continuous Monitoring of Public Health Facility Standards Between Quality Certification Cycles in India

India certifies public health facilities against the National Quality Assurance Standards (NQAS) and specifies what those facilities must have and do through the Indian Public Health Standards (IPHS).Certification of a district hospital requires at least 70 per cent overall and in each of eight areas of concern, and remains valid for three years.The intervening period is the least observed phase of the cycle, and it is also the phase in which the conditions that certification measured are most likely to change.This paper sets out a design for a lightweight digital dashboard that would monitor facility standards continuously between certification cycles, built on data systems that already exist rather than on new data collection.Published assessments of facility compliance and certification, national programme documents and the operating national health information systems were reviewed to establish what is already captured, at what frequency and with what reliability.From that audit, seven design principles and a four-layer architecture were derived: data sources, a validation layer, an analytical layer applying statistical process control, and a governance layer with defined escalation.Fifteen indicators are proposed, each mapped to an IPHS domain and an NQAS area of concern, and each drawn from a system that already generates the value.Eleven of the fifteen are machine-generated and require no additional entry by facility staff.Values are reported as variation over time on run and control charts rather than as a single ranked score, and every signal carries a named owner and a defined response time.Continuous monitoring between certification cycles is achievable at low marginal cost because most of the required data is already collected; what is missing is not measurement but the reconciliation, analysis and escalation that would turn existing data into a signal someone is obliged to act on.The framework is presented for evaluation and requires piloting before adoption.