‘LaQshya’ programme (Labour Room Quality Improvement Initiative)
Source: Press Information Bureau
Background
After launch of the National Health Mission (NHM), there has been a substantial increase in the number of institutional deliveries. However, this increase in the numbers has not resulted in commensurate improvements in the key maternal and new-born health indicators. It is estimated that approximately 46% maternal deaths, over 40% stillbirths and 40% newborn deaths take place on the day of the delivery. A transformational change in the processes related to the care during the delivery, which essentially relates to intrapartum and immediate postpartum care, is required to achieve tangible results within a short period of time. Prerequisite of such an approach would also hinge upon the health system’s preparedness for prompt identification and management of maternal and newborn complications.
‘LaQshya’ programme of the Ministry of Health and Family Welfare aims at improving the quality of care in the labour room and maternity Operation Theatre (OT).
Goal
To reduce preventable maternal and newborn mortality, morbidity and stillbirths associated with the care around delivery in Labour room and Maternity OT and ensure respectful maternity care.
Objectives of the programme
- To reduce maternal and newborn mortality & morbidity due to Antepartum haemorrhage (APH), Postpartum bleeding or postpartum hemorrhage(PPH), retained placenta, preterm, preeclampsia & eclampsia, obstructed labour, puerperal sepsis, newborn asphyxia, and sepsis, etc.
- To improve Quality of care during the delivery and immediate postpartum care, stabilization of complications and ensure timely referrals, and enable an effective two-way follow-up system.
- To enhance satisfaction of beneficiaries visiting the health facilities and provide Respectful Maternity Care (RMC) to all pregnant women attending the public health facility.
Strategies
- Reorganizing/aligning Labour room & Maternity Operation Theatre layout and workflow as per ‘Labour Room Standardization Guidelines’ and ‘Maternal & Newborn Health Toolkit’ issued by the Ministry of Health & Family Welfare, Government of India.
- Ensuring that at least all government medical college hospitals and high caseload district hospitals have dedicated obstetric HDUs as per GoI MOHFW Guidelines, for managing complicated pregnancies that require life-saving critical care.
- Ensuring strict adherence to clinical protocols for management and stabilization of the complications before referral to higher centres.
Institutional arrangement to support the programme
Under the National Health Mission, the States have been supported in creating Institutional framework for the Quality Assurance – State Quality Assurance Committee (SQAC), District Quality Assurance Committee (DQAC), and Quality Team at the facility level. These committees will also support implementation of LaQshya interventions. For specific technical activities and program management, special purpose groups have been suggested, and these groups will be working towards achievement of specific targets and program milestones in close coordination with relevant structure.
