LaQshya Scheme {लक्ष्य योजना}

Updated on Aug 22, 2020

Overview

LaQshya- Labour, quality improvement initiative, is a scheme launched by the Union Ministry of Health and Family welfare on 11th December 2017, to improve the quality of care given in the labour room and maternity operation theatres in Government Medical College Hospitals, District Hospitals, Sub-District Hospitals, and other essential health facilities.

Aims and Goals

Its aim is the reduction of maternal newborn mortality, morbidity, and stillbirths that are directly associated with the care and measures taken around Delivery in the labour room and maternity operation theatres. Its overall aim is to give support and provide a healthy and safe environment for a good labour room experience for all pregnant women!

Background

The Mental Mortality Ratio (MMR) in India, has gone down from 301(2001-03) to 167(2013)

The Infant Mortality Rate has reduced from 66(2001) to 34(2016) While there is a right amount of reduction in these rates. Still, they remain unacceptably high in comparison with developed countries. So there is a requirement and enormous scope to bring improvements in the critical maternal newborn health indicators in our country. This is why LaQshya has been launched!

Objectives

  • Reduction of maternal and newborn mortality and morbidity, which is caused due to APH, retained placenta, PPH, preterm, pre-eclampsia and eclampsia, puerperal sepsis, obstructed labour, newborn asphyxia, etc.
  • Another objective of LaQshya is to improve the quality of care that is provided to a woman, during the Delivery and even the immediate postpartum care and stabilization of compilations, to make sure of timely referrals and to make possible, an effective two-way follow-up system.
  • The objectives of this initiative also aim at heightening of beneficiaries visiting the health care facilities and to provide a nurturing and Respectful Maternity Care (RMC) to all the women who are pregnant and are attending the public health facility.

Strategies

  • Reorganization and alignment of Labour room Maternity Operation Theatre layout according to the 'Labour Room Standardization Guidelines' and 'Maternal & Newborn Health Toolkit' that is issued by the Ministry of Health & Family Welfare, Government of India.
  • Making sure that at least all the government medical college hospitals and large case-load district hospitals have systematic obstetric HDUs as per the government of India, MOHFW Guidelines that are necessary for managing complicated pregnancies that need life-saving critical care.
  • Ensuring strict follow-up to clinical protocols for accurate management and stabilization of the complications before any referral to higher centres.

Scope

The facilities that would be taken under LaQshya initiative on priority by the ministry are-

  • All of the government medical college hospitals.
  • District Hospitals & other essential health facilities.
  • All the designated FRUs and high case-load CHCs is over 100 deliveries and 60 (per month) in hills and desert areas.

Targets

Immediate Targets (0-4 Months) 

  • Assessment of quality and staff competence of 80% of the selected Labour rooms & Maternity OTs using defined NQAS checklists and OSCE.
  • Setup of functional quality circles and facility-level quality teams of the 80% of Labour rooms & Maternity OTs.

Short Term (up to 8 Months)

  • 80% of Labour Room and OT Quality Circles are oriented according to the latest labour room protocols, quality improvement processes, and respectful maternity care (RMC). 
  • 50% of deliveries take place in the presence of the Birth Companions.
  • 60% of shipments conducted using a safe birth checklist and Safe Surgery Checklist in Labour Room & Maternity OT, respectively. 
  • 60% of the purchases are done using real-time par to the graph.
  •  30% increase in Breast Feeding within one hour of Delivery. 
  • 80% of labour rooms and Maternity OTs take microbiological samples from defined areas every month.
  • 30% reduction in surgical site infection rate in r/o planned surgery in the Maternity OT.

Intermediate-Term (Up to 12 Months) 

  • 30% increase in antenatal corticosteroid administration in case of preterm labour.
  • 2. 30% reduction in pre-eclampsia, eclampsia & PIH related mortality.
  • 30% reduction in APH/PPH related mortality.
  • 20% reduction in newborn asphyxia related admissions in SNCUs for inborn deliveries. 
  • 20% reduction in newborn sepsis rate in SNCUs for inborn deliveries. 
  • 20% reduction in Stillbirth rate.
  • 80% of all beneficiaries are either satisfied or highly satisfied.
  • 60% of the labour rooms are reorganized as per 'Guidelines for Standardization of Labor Rooms at Delivery Points'. 
  • 80% of labour rooms have staffing as per defined norms.
  • 100% compliance with the administration of Oxytocin, immediately after birth.
  • 30% improvement in OSCE scores of labour room staff. 
  •  100% Maternal death, Neonatal 
  •  Death audit and clinical discussion on near-miss/maternal and neonatal complications.
  • 80% Labor Room and OTs are reporting zero stock-outs of drugs and consumables. 

Long Term (up to 18 Months)

  • 60% of labour rooms achieve quality certification against the NQAS. 
  • 50% of labour rooms are linked to Obstetrics HDU/ICU.
  • 15% improvement in short term & Intermediate targets. 
  • After 18 months, this initiative would be continued through sustained mentoring.

Financial Arrangement

According to the Gap Analysis, the state may budget the financial resource requirements and request for allocation of the funds in the appropriate financial heads through the NHM PIPs. The PIP would include proposals for strengthening the Labor rooms & maternity OTs in the government medical colleges as well.

Certification, Incentives & its Branding

Assessment through National Quality Assurance Standards (NQAS) will be done to keep a check on the Quality Improvement in the labour room and maternity OT. Every facility that achieves the 70% score goal on NQAS will get certified as the LaQshya certified facility. And as per the NQAS score, branding of LaQshya certified facilities will also take place which is like icing on the cake. To top it all, Facilities scoring more than 70%, 80%, and 90% will be honoured with silver, gold, platinum badges accordingly.

The facilities that will be achieving NQAS certification, and will have defined quality indicators, and 80% satisfied beneficiaries will be given the incentive of Rs. 6 lakhs, Rs.3 lakhs, and Rs.2 lakhs for Medical College Hospital, District Hospital, and FRUs respectively.

LaQshya's Web Portal

All the information, all the data, the statistics related to LaQshya will be uploaded on the portal for next generation of reports as well as visualization of the dashboard to stay updated with the progress in critical maternal newborn indicators at several levels (National, District, Sub-District and Health facilities).

Visit the online portal to learn more.

Frequently Asked Questions

Q. Who launched LaQshya?

This scheme was launched by the Union Ministry of Health and family welfare.

Q. When did the Union Ministry of Health and Family launch LaQshya Scheme?

Union Ministry of Health and family welfare launched LaQshya on 11th December 2017.

Q. What is the aim of LaQshya?

LaQshya's aim is to improve the quality of care given in the labour room and maternity operation theatres in Government Medical College Hospitals, District Hospitals, Sub-District Hospitals, and other essential health facilities.


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WRITTEN BYVarsha Verma

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