This Report contains the results of the Performance Audit on ‘District Hospitals in Uttarakhand’, covering the period 2014-19. An attempt has been made in this Report to assess the outcome based quality of medical services and patient care provided in the District Hospitals. we have tried to evaluate the outcome, status and standards of delivery of healthcare services to the population. This report aims to inform, clarify, strengthen and prioritize the role of the Government in shaping health systems in Uttarakhand. The broad objectives of the performance audit were to assess whether: • Policy framework was robust enough to improve the quality of healthcare. • Adequate provisions for line services such as out-patient services, in-patient services, emergency services, maternity services, etc. were made and these services were delivered in an efficient and effective manner. • Efficient support services with regards to diagnostic services, maintenance of equipment, storage of drugs, dietary services, laundry services, etc. were present in hospitals. • Hospitals had adequate resources viz., human, drugs, consumables, equipment, etc. as per prescribed norms and these resources were utilised efficiently and effectively. • Norms and practices for hygiene, infection control, employee and patient safety were followed within the premises of hospitals.