Developing a Co‐Designed Strategy to Improve Labor Monitoring and Management in India Using the World Health Organization Labour Care Guide: A Mixed‐Methods Formative Study.

Introduction: Nearly half of all perinatal deaths occur during the intrapartum period due to inadequate labor monitoring and intervention. The partograph, a paper‐based labor monitoring tool, can assist providers in recognizing and acting on early signs of fetal–maternal distress if used effectively...

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Publicado en:Birth: Issues in Perinatal Care Vol. 53; no. 1; pp. 120 - 129
Autores principales: Armari, Elizabeth, Vernekar, Sunil S., Pujar, Yeshita, Pingray, Veronica, Althabe, Fernando, Gibbons, Luz, Berrueta, Mabel, Ciganda, Alvaro, Rodriguez, Rocio, Kumar, Jayashree Ashok, Patil, Shruti Bhavi, Karinagannanavar, Aravind, Anteen, Raveendra R., M. R., Pavithra, Bendigeri, Savitri, Shetty, Shukla, Latha, B., H. M., Megha, Gaddi, Suman S., Chikkagowdra, Shaila
Formato: pictorial research tables/charts Journal Article
Publicado: Wiley-Blackwell Mar2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2026
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Developing a Co‐Designed Strategy to Improve Labor Monitoring and Management in India Using the World Health Organization Labour Care Guide: A Mixed‐Methods Formative Study.
      aug:
        au:
          Armari, Elizabeth
          Vernekar, Sunil S.
          Pujar, Yeshita
          Pingray, Veronica
          Althabe, Fernando
          Gibbons, Luz
          Berrueta, Mabel
          Ciganda, Alvaro
          Rodriguez, Rocio
          Kumar, Jayashree Ashok
          Patil, Shruti Bhavi
          Karinagannanavar, Aravind
          Anteen, Raveendra R.
          M. R., Pavithra
          Bendigeri, Savitri
          Shetty, Shukla
          Latha, B.
          H. M., Megha
          Gaddi, Suman S.
          Chikkagowdra, Shaila
        affil: Women's, Children's and Adolescents' Health Program, Burnet Institute, Melbourne Victoria,, Australia
      sug:
        subj:
          Monitoring, Physiologic Standards
          World Health Organization Standards
          Labor
          Health Care Delivery
          Quality of Health Care
          Guideline Adherence
          Implementation Science
          Human
          Community-Institutional Relations
          Conceptual Framework
          Hospitals, Public India
          India
          Purposive Sample
          Health Services Accessibility
          Multimethod Studies
          Data Analysis Software
          Decision Making, Clinical
          Intrapartum Care
          Patient Centered Care
          Health Personnel Education
          Audit
          Feedback
          Descriptive Statistics
      ab: Introduction: Nearly half of all perinatal deaths occur during the intrapartum period due to inadequate labor monitoring and intervention. The partograph, a paper‐based labor monitoring tool, can assist providers in recognizing and acting on early signs of fetal–maternal distress if used effectively. In 2020, the World Health Organization (WHO) developed a "next generation" partograph called the Labour Care Guide. There is limited evidence of how to optimize the use and impact of this new tool. This study describes the development of a co‐designed LCG implementation strategy in Karnataka, India. Methods: A targeted literature review, primary research across four public maternity hospitals (provider survey and facility assessment), and a 2‐day co‐design workshop with stakeholders were conducted. Findings were mapped to six target behaviors using the Theoretical Domains Framework (TDF) and the Capability, Opportunity, and Motivation‐Behavior (COM‐B) model to identify potential barriers and facilitators to LCG use. Consultations with local stakeholders explored these factors, and a 1‐week pilot informed final refinements of the strategy. Results: The LCG implementation strategy comprised an evidence‐based provider training program centered on "low dose, high frequency" principles, and monthly audit and feedback cycles, which in turn, relies on an enabling practice environment (supportive national policy frameworks, facility‐level guidelines, external partnerships, senior support, defining provider roles and expectations and adequate equipment and resources) to support its implementation. Conclusion: Effective use of the LCG needs a robust, context‐sensitive implementation strategy. We present the first evidence‐based, co‐designed LCG implementation strategy which can be used to support LCG dissemination and uptake.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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