LaQshya Programme: Elevating Maternal and Neonatal Care In India

Pregnancy and infancy are the two most critical phases of one’s life that lay the foundation for growth and development. From deliveries at homes that posed a risk of maternal deaths and stillbirths to institutional births, India has travelled a long way when it comes to caring for pregnant women's and newborn babies' health.

To address and avoid such challenges, the government of India launched the Labour Room and Quality Improvement Initiative (LaQshya Programme) in 2017 under the Ministry of Health and Family Welfare (MoHFW). The government introduced the government scheme to provide quality healthcare services to pregnant women during and after their pregnancy, ensuring safer childbirth and proper care for both the mothers and their newborn babies.

According to the National Family Health Survey’s Report (NFHS-4), institutional births have increased from 38.7% to 78.9% in 2016. It is crucial to support both the mother and the baby during and after pregnancy to ensure their optimal health and to avoid any risky complications.

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Aim

The LaQshya program aims to improve the quality of maternity care for pregnant women. It focuses on ensuring safety and respect during deliveries. Here are its main goals:

• Ensure safe deliveries to minimise preventable maternal and newborn deaths.

• Maternity OTs and labour rooms provide high-quality healthcare.

• All pregnant women should receive respectful maternity care (RMC).

Objectives

The main objective of the LaQshya Program is to promote the well-being of pregnant women and newborn babies in their most critical periods of life. Some of its key objectives are:

• Reducing maternal mortality: The government scheme aims to bring down maternal mortality rates by enabling people to access quality healthcare with professionals.

• Reducing neonatal mortality: The LaQshya scheme also considers newborns and makes sure they receive the best care possible so they can live healthy, disease-free lives in the future.

• Improving the condition of Labour Rooms and Maternity OTs: The government program equips the LRs and Maternity OTs with quality equipment and focuses on improving the infrastructure to ensure safe and secure treatment of patients.

• Dignified care: LaQshya’s main aim is to ensure that expecting mothers and their babies receive quality care with respect, care, and compassion during such critical and vulnerable times of their lives.

Eligibility Criteria

You must meet certain eligibility requirements to participate in the LaQshya Program. These criteria ensure that only qualified health facilities can join the program. Here’s who is eligible:

• The following entities are eligible to participate in the government scheme:

1. All government medical college hospitals.

2. This includes all district hospitals and comparable health facilities.

3. In hilly and desert areas, First Referral Units (FRU) and Community Health Centers (CNC) handle more than 100 deliveries each month.

Documents Required

To apply for the LaQshya Program, healthcare facilities need to submit specific documents. These documents help evaluate their readiness and compliance with the government scheme. Here’s the list of required documents:

• Assessment reports.

• Improvement plans.

• Staff training records.

• The audit reports focus on maternal and neonatal deaths.

Strategies Of The Laqshya Program

The LaQshya Program uses specific strategies to improve maternity care services. These strategies focus on better facilities, skilled staff, and safe practices. Here are the main strategies:

• The guidelines for labour room standardisation dictate the reorganisation of labour rooms and OTs.

• They offer round-the-clock blood transfusion services at the PHC level, along with diagnostic assistance and drug accessibility.

• Simulations and drills serve as a teaching-learning strategy for the staff.

• Use a safe birth checklist and surgical safety checklist.

Institutional Arrangement

The National Health Mission (NHM) manages the LaQshya Scheme through a structured setup. Different committees and teams ensure its smooth implementation. Here’s how it is organised:

• The state level employs State Quality Assurance Committees (SQACs) for monitoring.

• District Quality Assurance Committees (DQACs) are responsible for carrying out activities at the district level.

• Facility Quality Teams are responsible for executing tasks at the local level.

Targets

The LaQshya Program has clear goals to improve maternity care in different timeframes. These targets focus on assessment, training, and quality certification. Here are the key targets:

Immediate Goals (0-4 Months)

• Assess 80% of labour rooms and OTs using quality checklists.

• Set up quality circles and facility-level quality teams.

Short-term goals (up to 8 months)

• Train 80% of the staff on labour room protocols.

• Increase breastfeeding within one hour of birth by 30%.

Long-term goals (up to 18 months)

• Ensure quality certification for 60% of the labour rooms.

• Link 50% of labour rooms to obstetric ICUs and HDUs.

Interventions

The LaQshya Program includes specific interventions to enhance maternity care services. These focus on training staff, improving care quality, and using technology. Here are the main interventions:

• Staff Development: Conduct periodic competency evaluations using the OSCE mode of assessment, along with providing training.

• Respectful Maternity Care: Employees receive training on polite client interactions.

• Audits involve a systematic study of maternal and neonatal mortality to identify needs and enhance services.

• Use of technology: The introduction of e-partographs aims to enhance the real-time tracking of labour progress.

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Conclusion

The government has taken the crucial step of implementing the Labour Room and Quality Improvement Initiative (LaQshya Program) to guarantee that every expecting mother and newborn baby receives exceptional medical treatment for their healthy development.

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