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Background: Maintenance of a clean environment in a hospital is challenging and at the same time crucial for patient safety. The importance of the hospital environment in patient care has received worldwide attention, especially in infection prevention and control. The Ministry of Health and Family welfare launched "Kayakalp Yojna," an initiative to promote cleanliness and enhance the quality of public health facilities. Objective: This study was undertaken to assess the impact of the implementation of the Kayakalp initiative in public health-care facilities of Himachal Pradesh. Material and Methods: This analytical study was conducted to assess the impact of Kayakalp Yojna in six thematic areas; hospital/facility upkeep, sanitation and hygiene, waste management, infection control (IC), supportive services, and hygiene promotion in government hospitals using the Kayakalp assessment tool in the state of Himachal Pradesh in 2017-2018. Results: Post implementation of Kayakalp Yojna, there was an average improvement of 20% in the total scores of the hospitals from internal assessment to external assessment. Four of the 12 district hospitals, three of the 89 community health centers, and 26 of the 475 public health centers scored more than 70% in the external assessment. Conclusion: The Kayakalp assessment results give an insight to the problem areas and present a possibility to improve the public health facilities. [ABSTRACT FROM AUTHOR]