The Laqshya programme, initiated in Karnataka in 2018-19, aims to improve quality in maternity care by reducing maternal and newborn mortality and enhancing respectful maternity practices. Key objectives include achieving high patient satisfaction, ensuring adherence to clinical protocols, and enhancing the overall quality of labor rooms and operating theaters. The initiative also emphasizes training, structural improvements, and systematic monitoring to foster better health outcomes and management of complications during childbirth.

1. LAQSHYA PROGRAMME
Dr. Pavithra R
DCQM-QA
Raichur

2. LAQSHYA- LABOUR ROOM QUALITY
IMPROVEMENT INITIATIVE GUIDELINE
 Started in 2018-19 in karnataka
 Goal- To reduce preventable maternal and
newborn mortality, morbidity and still births
associated with care around delivery in
labour room and maternity OT
 To ensure respectful maternity care.

4. LaQshya is all about improving Quality of Care
around birth
1. Quality Certification of Labour Room and/or
OT – through the existing system
2. Attainment of 75% of Facility level targets
3. At least 80% beneficiaries are satisfied with
the care

5. LABOUR ROOM
DO’S DON’TS
 Providing privacy to pregnant women
during the intrapartum period, by way
of separate labour room or at least a
private cubicle
 Presence of birth companion during
the labour
 Freedom to choose a comfortable
position during birthing (squatting,
standing, etc.)
 Adherence to Clinical protocols for
management of labour
 Use of Labour beds instead of tables y
 Place baby on mother’s abdomen y
 Initiation of Breast feeding within one
hour of birth
 Induction and augmentation of labour
without sound clinical indications
 Any verbal or physical abuse of the
pregnant women
 Insisting on conventional lithotomy
position for the delivery
 Immediate clamping and cutting of the
umbilical cord
 Separating baby from the mother for
routine care & procedure
 ‘Out of Pocket Expenditures (OOPE)
on drugs, diagnostics, including
demand by the staff for gratuitous
payment by families for celebration of
the baby’s birth

6. OBJECTIVES
 1. To reduce maternal and newborn mortality &
morbidity due to APH, PPH, retained placenta,
preterm, preeclampsia & eclampsia, obstructed
labour, puerperal sepsis, newborn asphyxia, and
sepsis, etc.
 2. To improve Quality of care during the delivery and
immediate post-partum care, stabilization of
complications and ensure timely referrals, and enable
an effective two-way follow-up system.
 3. To enhance satisfaction of beneficiaries visiting the
health facilities and provide Respectful Maternity
Care (RMC) to all pregnant women attending the
public health facility.

7. NQAS: AREAS OF CONCERN
Service
Provision
Inputs Support
Services
Clinical
Care
Infection
Control
Quality
Management
Outcome
Patients’
Rights

8. HIERARCHY OF LAQSHYA TEAM

9. PHASING OF ACTIVITIES

10. MODEL

11. INTERVENTIONS
Improved QoC & supports
Cognitive Development
Delivery of Respectful
Maternity Care (RMC)
Rapid Improvement
Events
Adherence to Clinical
Protocols
Structure – Infrastructure,
HR, Equipment, Drugs &
Supplies

12. PROMOTING RESPECTFUL MATERNITY CARE &
COGNITIVE DEVELOPMENT OF BABY

13. RAPID IMPROVEMENT EVENTS
 Cycle 1: Real-time Partograph generation including shift to
electronic partograph & usage of safe birth check-list & surgical
safety check-list and strengthening documentation practices for
generating robust data for driving improvement.
 Cycle 2: Presence of Birth companion during delivery, respectful
maternity care and enhancement of patients’ satisfaction.
 Cycle 3: Assessment, Triage and timely management of
complications including strengthening of referral protocols.
 Cycle 4: Management of Labour as per protocols including
AMTSL & rational use of Oxytocin.
 Cycle 5: Essential and emergency care of Newborn & Pre-term
babies including management of birth asphyxia and timely
initiation of breast feeding as well as KMC for preterm newborn.
 Cycle 6: Infection Prevention including Biomedical Waste
Management.

14. STRUCTURAL IMPROVEMENT
 Upgrading the infrastructure as per norm &
realistic case-load
 Human Resource augmentation and upskilling
 Ensuring availability of functional & calibrated
equipment, as per need
 Strengthening supply chain of drugs &
consumables

15. PROCESS IMPROVEMENT
 Assessment and Triage
 Enablers for Respectful care
 Management of Labour including Active Management
of Third stage of labour
 Management of complications and High-Risk
Pregnancies
 Management of referral services
 Perioperative processes for C-Section
 New-born care and resuscitation
 Management of required Support services

16. OPERATION THEATRE

17. ZONING IN OT
1. PROTECTIVE - Reception, Waiting, Trolley
Bay, Change Rooms, Rooms for administrative
staff, Stores & Record, Conference Room, etc.
2. CLEAN AREA – Pre-operative, Post-operative,
Plaster Room, Staff lounges, Stores, etc.
3. STERILE AREA Operating Theatre, Scrub
Room, Anaesthesia, Setup Room
4. DISPOSAL AREA - Dirty Utility, Disposal areas
from each OT & Corridor leading to disposal
zone, Disposal Corridor

18. OPERATION THEATRE
 Functional Pre and post-operative area
 Dedicated nursing staff for pre and post-
operative area
 Availability of Essential Equipment,
maintenance & calibration
 Cleaning & disinfection protocol
 Availability of Anaesthesia Services
 Monitoring Indicators

19. LIST OF FACILITIES UNDER LAQSHYA
PROGRAMME- RAICHUR DISTRICT
 RIMS
 Manvi TH
 Deodurga TH
 Sindanuru TH
 Lingasuguru TH
 Arkere CHC

20. POINTS TO DISCUSS
 Checklist of labour room and maternity OT
 Monthly report submission
 OSCE-training

21. Thank You