Community Health Officers (CHOs) in Health and Wellness Centres play a significant role in primary health Care. The competence assessment of CHOs is a critical driver for enhancing primary healthcare performance. While several countries have developed competency frameworks for primary healthcare teams, such frameworks are lacking in the Indian context.

This study aimed to develop a competency assessment framework for in-service CHOs in Indian public primary healthcare settings. A five-stage consultative process was followed. In the first stage, a systematic literature review was conducted to identify CHO competencies. Expert consultations were then organized to build consensus on competencies and behaviours. Competency assessment tools were developed based on the literature and experts' agreements. Another round of expert consultation was conducted to achieve consensus on the competency assessment tools. At present, the tools are tested in Health and Wellness Centers in Odisha.

The systematic literature review identified 50 competencies and 100 associated behaviors distributed across 3 domains: Clinical care provider, public health care provider and manager. Expert consultations resulted in the consensus on 2 subdomains; Direct Community Care Provider (DCCP) and Direct Community Care Supervisor (DCCS). The CHO Competency Assessment Tool kit consists of 120 knowledge and attitude items and 51 DOPS, Mini-CEX and SimEx exercises with means of verification for competency assessment of CHOs in India.