Juvenile idiopathic arthritis is a chronic disorder distinguished by continuous joint inflammation; the usual indicators of joint inflammation include pain, swelling and limitation of mobility. "Idiopathic" indicates that we do not know the aetiology of the disease and "juvenile", in this situation, means that the beginning of the symptoms generally occurs before 16 years of age. JIA is categorized into oligoarticular, polyarticular, systemic, psoriatic, enthesitis-related and undifferentiated arthritis. To assist better comprehend JIA for research objectives; generally agreed categorization criteria are applied. Although these are not diagnostic, they can assist guide physicians when treating a youngster with arthritis. One of the most extensively used categorization criteria was developed by the International League of Associations for Rheumatology (ILAR) in 1995 by expert consensus, and has undergone additional adjustments. In this nation, the number of JIA is huge: the estimated prevalence ranges from 350 000 to 1.3 million. Almost all children with arthritis experience chronic or recurring pain with 70 percent impairment in physical activities. Approximately half of patients with JIA have limited use of upper limbs or hands and difficulty with hand strength.

Background: The low-middle income countries continue to contribute to a high proportion of neonatal and child mortality globally. The reduction in mortality rates requires low-cost interventions such as early initiation of breastfeeding (EIBF). The study objective was to improve the rate of EIBF in all the healthy term newborns born in our institute from a baseline rate of 10% to at least 70% over 3 months through a quality improvement (QI) approach. Methods: This study was conducted in the labor room and operation theatre of a tertiary care center in Uttar Pradesh. All the healthy term mother-newborn pairs born in the study period were included and the Point Of Care Quality Improvement model was followed. After the baseline assessment of the problem, a QI team was formed which did the root-cause analysis and generated the change ideas to be implemented by small Plan-Do-Study-Act (PDSA) cycles initially then systematically expanded to the larger level. Outcome Measure: The effect of a PDSA cycle was measured by the percentage of newborns breastfed within the first hour of birth at the end of each cycle. Results: The EIBF improved from the baseline rate of 10% to 70.5% at the end of 5 PDSA cycles and was maintained at 70.7% during the sustainability phase. Conclusion: The QI approach can be utilized to improve EIBF, while the sustainability depends on continuous efforts like education programs, counselling, and supportive supervision. The inclusion of simulation-based training for staff can build confidence and improve results.