LaQshya

The Ministry of Health and Family Welfare (MoHFW) launched the LaQshya (Labour Room and Quality Improvement) Initiative on 11 December 2017. The MoHFW launched the LaQshya initiative to ensure the quality of care during the intrapartum and immediate postpartum period in a healthcare facility.

It is estimated that approximately 46% of maternal deaths, over 40% of newborn deaths and 40% of stillbirths take place on the delivery day itself. There is a necessity for intervention during the intrapartum and immediate postpartum period to reduce preventable death at the place where the birth takes place, i.e. labour room and maternity OT.

Thus, the government launched the LaQshya programme to benefit newborns and pregnant women in public health institutions. The NQAS (National Quality Assurance Standards) will monitor quality improvements in the labour rooms and maternity Operation Theatres (OTs).

Objectives of LaQshya Initiative

The objectives of the LaQshya initiative are as follows:

• Reduce newborn and maternal morbidity and mortality.
• Improve the quality of care during delivery and the immediate postpartum period.
• Enhance positive birthing experience, the satisfaction of beneficiaries, and provide Respectful Maternity Care (RMC) for all pregnant women availing public health facilities.

Features of LaQshya Initiative

The features of the LaQshya initiative are as follows:

• It envisages improving the quality of care in maternity OT and the labour room.
• Adoption of a multi-pronged strategy, such as ensuring availability of essential equipment, improving infrastructure upgradation, capacity building of health care workers, providing adequate human resources and improving quality processes in the labour room.
• Implement fast-track interventions, such as NQAS assessment, mentoring, training, reviews, etc.
• Improving quality processes in the labour room and capacity-building of healthcare workers by skill-based training.
• Operationalise dedicated obstetric ICUs at the medical college hospital levels and obstetric HDUs at district hospitals to strengthen critical care in obstetrics.

LaQshya Initiative Beneficiaries

The beneficiaries of the LaQshya program are all pregnant women and newborns delivering in public health institutions. The LaQshya initiative will improve the quality of care for pregnant women in the labour rooms, maternity OTs, obstetrics Intensive Care Units (ICUs) and High Dependency Units (HDUs).

Implementation of LaQshya Initiative

The LaQshya initiative is implemented in the following healthcare facilities:

• All government medical college hospitals.
• All district hospitals and equivalent health facilities.
• All designated First Referral Unit (FRUs) and high case-load Community Health Centers (CHCs) with over 100 deliveries in a month (60 deliveries per month in desert and hills areas).

Strategies of LaQshya Initiative

• Reorganising or aligning maternity OT, labour room layout and workflow as per the ‘Maternal and Newborn Health Toolkit’ and ‘Labour Room Standardisation Guidelines’ issued by the MoHFW.
• Ensuring that all government medical college hospitals and high case-load district hospitals have obstetric HDUs as per MOHFW guidelines to manage complicated pregnancies requiring life-saving critical care.
• Ensuring stabilisation of the complications before referral to higher centres and strict adherence to clinical protocols for management.

Monitoring of LaQshya Initiative

The LaQshya program activities, such as assessment, labour room and OT reorganisation, training, progress on establishing HDU, visits of coaching teams, etc., are monitored through a dedicated web-based tracking system. The LaQshya website contains relevant guidelines, updates, resource materials and progress reports.