Implementing the WHO Labour Care Guide to reduce the use of Caesarean section in four hospitals in India

The new World Health Organization (WHO) Labour Care Guide (LCG) is an innovative partograph that emphasises women-centred, evidence-based care during labour and childbirth. Together with clinicians working at four hospitals in India, we will develop and test a strategy to implement the LCG into routine care in labour wards of these hospitals.

Objective 

We used a stepped-wedge randomised trial to introduce the LCG strategy sequentially in each of the four hospitals. We collected data on all women giving birth and their newborns during this period, and analyse whether the LCG strategy has any effects on the use of Caesarean section, women’s and newborn’s health outcomes, and women’s experiences during labour and childbirth.

While the trial was being conducted, we also collected qualitative and quantitative data from doctors, nurses and midwives working in these hospitals, to understand their perspectives and experiences of using the LCG in their day-to-day work. In addition, we collected economic data to understand how much the LCG strategy costs, and how much money it might save if it is effective.

Timeline

2021–2022.

Approach

The new World Health Organization (WHO) Labour Care Guide (LCG) is an innovative partograph that emphasises women-centred, evidence-based care during labour and childbirth. Together with clinicians working at four hospitals in India, we will develop and test a strategy to implement the LCG into routine care in labour wards of these hospitals.