Maternal mortality continues to be a major global health concern,
particularly in low- and middle-income countries. India, with its vast
population, has made progress in addressing maternal and neonatal health
challenges, but the situation remains dire in many parts of the country. To
address these persistent issues, the Government of India launched the “LaQshya”
(Labor Room Quality Improvement Initiative) program in 2018. LaQshya aimed to
improve the quality of care in labour rooms and maternity operation theatres in
public healthcare facilities by focusing on key areas such as infrastructure
enhancement, infection control, staffing, and adherence to standardised evidence
based practices, such as the WHO Safe Surgical Checklist. By improving hygiene
practices and strengthening infection prevention protocols, LaQshya sought to
reduce the incidence of infections that could lead to severe complications.
Furthermore, the initiative sought to address the issue of insufficient
healthcare staff by ensuring that hospitals were appropriately staffed with
trained professionals, particularly in critical care areas like labour rooms
and operating theatres.
Additionally, LaQshya focused on improving patient
experience by ensuring that healthcare facilities were well-equipped and
capable of managing obstetric emergencies efficiently. Regular training
sessions for healthcare providers were integrated into the initiative to keep
them updated on the latest evidence-based practices, thus helping to ensure
that patient care was consistent and safe.
However, while LaQshya has been widely implemented across
India, there remains a gap in understanding its specific impact in high-volume
tertiary care centers. This study aimed to fill that gap by evaluating the
impact of the LaQshya initiative in a tertiary care hospital.
A retrospective observational study was conducted over 8
months comparing outcomes from the pre-implementation phase (May– August 2024)
and the post-implementation phase (September–December 2024) of the LaQshya
initiative. Key metrics included adverse anesthesia events, drug stock-outs,
patient satisfaction scores, WHO Safe Surgical Checklist compliance and
critical equipment downtime.
Implementation of the LaQshya initiative significantly
improved outcomes. Adverse anesthesia events decreased from 7.3 to 2.3 per 100
cesarean sections. Drug stock-outs reduced from 5 to 1 per month, patient
satisfaction scores rose from 62% to 92%, WHO checklist compliance improved
from 56% to 95%, and critical equipment downtime decreased by 75%.
The findings from this study demonstrate that the LaQshya
initiative has had a significant positive impact on maternal care, leading to
noticeable improvements in several key areas. These include a reduction in
adverse anaesthesia events, drug stock-outs, and critical equipment downtime,
as well as increased patient satisfaction and better adherence to the WHO Safe
Surgical Checklist. One of the most striking results of the LaQshya initiative
was the sharp decrease in adverse anaesthesia events from 8.5 per 100 caesarean
sections to just 2.3 per 100 caesarean sections (p < 0.001). This marked
improvement suggests that LaQshya helped strengthen anaesthesia safety
protocols.
Overall, the LaQshya initiative has had a substantial
positive impact on several critical aspects of maternal care, including anaesthesia
safety, drug availability, patient satisfaction score, surgical safety, and
equipment reliability. These findings supports the idea that structured quality
improvement programs can significantly enhance clinical outcomes. Moving
forward, it is important to continue refining and implementing such initiatives
to maintain and further improve the quality of care for mothers. Further
research will also be necessary to explore the long-term sustainability of
these improvements and the broader applicability of the LaQshya initiative in
other healthcare settings.
Source: Ramasamy et al. / Indian Journal of Obstetrics and
Gynecology Research 2025;12(3):462–468