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
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