Govt launches initiative to implement labour room guidelines

Government today launched a country-wide initiative to ensure proper implementation of the existing labour room protocols in order to reduce maternal and newborn mortality.
Ensuring privacy to the mother-to-be, stressing a comfortable position during delivery, no-tolerance policy for any verbal or physical abuse of the woman and no demand for gratuitous payment by staff are some of the guidelines under the programme 'Lakshya'.
Union Health Minister J P Nadda released the Operational Guidelines for Obstetric High Dependency Units (HDUs) and Intensive Care Units (ICUs) along with a mobile application for health workers who manage normal and complicated deliveries in peripheral areas.

"There is enough evidence that supports the fact that improving the quality of care in labour rooms especially on the day of birth, is central to maternal and neonatal survival," said the Health Ministry in a statement.
The idsue of whether hospitals were adhering to labour room protocols has come into fresh focus in recent days after a newborn was wrongly declared dead by a private hospital in Delhi and he died after a few days.
According to the ministry, the Lakshya initiative, which will prevent the undesirable adverse outcomes associated with childbirth, will be implemented in government medical colleges besides district hospitals, and high delivery load sub- district hospitals and community health centres.

"Under the 'Lakshya', labour room teams will be financially rewarded if they meet the strict benchmarks and achieve targets in a time-bound manner as defined in the labour room guidelines," a health ministry official said citing the guidelines.

The targets described include reduction of preventable maternal and new-born mortality, still birth rates, reductions in related morbidities such as obstetric fistula, puerperal sepsis, birth asphyxia and newborn sepsis, he said.
Steps to be taken to improve environment of natural delivery process include avoiding unnecessary induction, providing privacy to the mother during the intrapartum period, by way of separate labour room, or at least a private cubicle, use of labour beds instead of tables and a no-tolerance policy for any verbal or physical abuse of the woman.

Also, it should be ensured that the mother and the child bond immediately after birth, stressing a comfortable position during delivery rather than insisting on a universal "lying down" position.
'Out of pocket expenditures (OOPE)' including demand by facility staff, for gratuitous payment by families for celebration of the baby's birth should be abolished.
"All these are required to avoid undue stress in mothers," the official said stressing on the need to reorganise the labour room care processes to facilitate natural delivery process.
These will enable not only adherence to quality standards and clinical protocols, but also address issues such as respectful maternity care, the official said.

According to a Lancet study published in 2014, birth is the time of greatest risk of death and disability. The study highlighted that 40 per cent of still births, 25 per cent of under 5 mortality and 46 per cent of maternal deaths occur at the time of birth.
The launch was held during an event to mark the Universal Health Coverage, 2017. Union Minister of State for Finance SP Shukla was also present at the function.