LaQshya: A National Initiative for Quality in Labour Rooms and Maternity OTs

LaQshya, meaning “target” in Hindi, is a quality improvement initiative by the Ministry of Health and Family Welfare, Government of India, focused on enhancing the quality of care in labor rooms and maternity operation theaters (OTs) in public health facilities. This program aims to ensure respectful and high-quality care for every pregnant woman during delivery and the immediate postpartum period.

Objectives of the LaQshya Initiative

The primary objectives of LaQshya are:

1. Reduce Maternal and Neonatal Mortality: To significantly reduce preventable maternal and newborn mortality, morbidity, and stillbirths associated with delivery.

2. Improve Quality of Care: To enhance the quality of care during delivery and the immediate postpartum period, ensuring stabilization of complications and timely referrals.

3. Enhance Patient Satisfaction: To improve the satisfaction of beneficiaries visiting health facilities and provide Respectful Maternity Care (RMC) to all pregnant women.

Key Strategies for Implementation

The LaQshya initiative employs several key strategies to achieve its objectives:

• Reorganization of Facilities: Reorganizing labor rooms and maternity OTs as per the guidelines for standardization issued by the Ministry of Health and Family Welfare.

• Focus on Quality: Implementation of quality assurance standards and protocols to ensure adherence to best practices.

• Training and Skill Enhancement: Training healthcare providers on essential skills, including respectful maternity care, infection control, and management of complications.

• Use of Checklists: Implementation of safe birth checklists and surgical safety checklists in labor rooms and maternity OTs.

• Data Collection: Use of real-time partographs to monitor labor progress and documentation of key indicators.

• Patient-Centric Approach: Emphasis on patient rights, privacy, and ensuring a comfortable and supportive environment.

• Incentivization: Providing incentives and awards to recognize and encourage high-performing facilities and staff.

• Continuous Monitoring: Regular monitoring and review of progress to identify areas for improvement.

• Partnership: Galvanizing partnerships between government, medical colleges, professional bodies, and development partners.

Key Interventions under LaQshya

The program focuses on several key interventions:

• Structural Improvements: Upgrading infrastructure, including labor rooms, maternity OTs, and equipment.

• Human Resource Augmentation: Ensuring adequate staffing levels and skill upgradation of healthcare providers.

• Process Improvement: Implementing clinical protocols, safe birth checklists, and guidelines for managing complications.

• Quality Circles: Forming and training quality circles at the facility level to identify and address gaps in service delivery.

• Rapid Improvement Cycles: Implementing short cycles of improvement to achieve quick and measurable results.

Targeted Outcomes and Indicators

The LaQshya initiative aims to achieve specific outcomes and indicators, including:

• Reduction in maternal and newborn mortality and morbidity.

• Increased compliance with clinical protocols and guidelines.

• Improved patient satisfaction and respectful maternity care.

• Enhanced competencies of healthcare providers.

• Reduction in surgical site infections.

• Increased rates of breastfeeding initiation.

• Improved rates of antenatal corticosteroid administration in preterm labor.

• Reduced rates of new-born asphyxia and sepsis.

Phased Implementation

The implementation of LaQshya is divided into four phases:

1. Preparatory Phase (2 Months): Dissemination of the scheme, team formation, and orientation workshops.

2. Assessment Phase (2 Months): Baseline assessment, gap analysis, and resource allocation.

3. Improvement Phase (12 Months): Rapid improvement cycles, sustaining improvements, and coaching team visits.

4. Evaluation Phase (2 Months): Evaluation of achievements, quality certification, and awards.

Monitoring and Supervision

• The program will be monitored by the National Health Mission (NHM) and State Quality Assurance Committees.

• Regular visits by coaching teams and external assessors will be conducted to assess the implementation of the scheme.

• Data will be collected and analyzed to track progress and identify areas for improvement.

Conclusion

The LaQshya initiative is a transformative program that aims to create a positive birthing experience for every woman in India. By focusing on quality, respect, and evidence-based practices, the scheme is set to contribute significantly to reducing maternal and neonatal mortality and morbidity, and ensuring a healthier future for mothers and newborns.