Effects of World Health Organization Labour Care Guide Utilization for Safe Motherhood during Intrapartum Period through Midwives

Authors

  • Rukhsana Dost Muhammad
  • Sarfraz Masih
  • Muhammad Afzal

Keywords:

Intrapartum period, Midwives, Safe motherhood, World Health Organization Labour Care Guide

Abstract

Background: The World Health Organization's (WHO) Labour Care Guide (LCG) is a critical document designed to advance maternal and newborn outcomes in the course of Labour. It is vital to uphold high-quality intrapartum care that responds to international global health standards.

Objective: Effects of the WHO LCG by midwives to promote safe motherhood during the intrapartum period.

Methodology: This multi-centered quasi-experimental study includes data from 216 delivery cases, collected through 43 midwives who fulfilled the inclusion criteria, i.e., minimum 2 years of job experience and running an independent maternity clinic, using the WHO LCG. 43 midwives from 15 centers in Quetta, Pakistan, were selected to assess their competency level after training about the WHO LCG. Descriptive statistics were applied for the competency level of midwives, a chi-square test was used to compare the safe motherhood outcome pre- and post-implementation of WHO LCG. p<0.05 was considered significant.

Results: The mean competency level score of midwives was 93.1 ± 3.6 percent, which is excellent. The maternal health care outcomes pre and post implementation of LCG guideline improved significantly except obstructed Labour (p=0.068) and uterine rupture (p= 0.082), which improved insignificantly, with pre-training occurrence of 12 (5.6%) and 3 (1.4%) cases, respectively. Neonatal outcomes also show significant improvement except stillbirth cases (p=0.082), which improve insignificantly with pre-implementation of LCG, occurring cases of 3 (1.4%).

Conclusion: WHO LCG has a significant effect on maternal and neonatal health care. Moreover, the competency level of midwives was also improved after training

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

References

Vogel JP, Comrie‐Thomson L, Pingray V, Gadama L, Galadanci H, Goudar S, et al. Usability, acceptability, and feasibility of the world health organization labour care guide: a mixed‐methods, multicountry evaluation. Birth. 2021;48(1):66-75.

Kanyottu MW, Karonjo J, Karani A. TO DETERMINE THE KNOWLEDGE OF MIDWIVES ON UTILIZATION OF PARTOGRAPH AT SELECTED HOSPITALS IN KENYA. medRxiv. 2023:2023.09. 06.23294812.

Nnagbo JE, Agu PU, Eze MI, Ugwu GO, Adiri CO, Odoh GU, et al. Introducing the World Health Organization Labour Care Guide in Nigeria: Knowledge, Perceptions, and Impediments by Doctors and Nurses at 3-Tier Hospitals in Enugu, Nigeria. Nigerian Journal of Basic and Clinical Sciences. 2024;21(3):221-8.

Arif A, Sherani A, Uzma Q, Alam B, Thom E, Abro A, et al. Maternal and perinatal death surveillance and response in Balochistan, Pakistan-causes & contributory factors of maternal deaths. Journal of Gynecology and Obstetrics. 2022;10(1):1-5.

Kumar V, Ali BS, Choudry E, Khan S, Baig K, Durrani NUR, et al. Quality of Neonatal Care: A Health Facility Assessment in Balochistan Province, Pakistan. Cureus. 2022;14(3).

Hagos AA, Teka EC, Degu G. Utilization of Partograph and its associated factors among midwives working in public health institutions, Addis Ababa City Administration, Ethiopia, 2017. BMC pregnancy and childbirth. 2020;20:1-9.

Mutema EH, Mhlanga M. Midwives’ Knowledge, Perceptions and Practices on Utilization of the Partograph at Mbuya Nehanda Maternity Hospital. Frontiers. 2024;4(3):74-90.

OLEBO D, MASEREKA E, MUHINDO B, Nalikka J, Kayiira M. Assessing Partograph Quality and its Impact on Neonatal Outcomes: A Study at Fort Portal Regional Referral Hospital. Uganda J BioMed Adv Clin Res. 2023;2(1):1-14.

Raina N, Khanna R, Gupta S, Jayathilaka CA, Mehta R, Behera S. Progress in achieving SDG targets for mortality reduction among mothers, newborns, and children in the WHO South-East Asia Region. The Lancet Regional Health-Southeast Asia. 2023;18.

Ottah UN, Okokon EO, Okoi NO, Akpan UB, Etokidem AJ, Asibong IU, et al. Use of the partograph among obstetric care providers in government healthcare facilities in Uyo Senatorial District, Akwa Ibom State, Nigeria. Afr J Medical Health Sci. 2023;23(3):34-42.

Mugyenyi GR, Byamugisha J, Tumuhimbise W, Atukunda E, Yarine FT. Labour Care Guide implementation as a decision-making tool for monitoring labour among healthcare providers in Uganda: protocol for a mixed-methods study. BMJ open. 2024;14(4):e079216.

Sharma S, Parwez S, Batra K, Pareek B. Enhancing safe motherhood: Effect of novel partograph on Labour outcomes and its utility: An Indian perspective. Journal of family medicine and primary care. 2022;11(11):7226-32.

Vogel JP, Pujar Y, Vernekar SS, Armari E, Pingray V, Althabe F, et al. Effects of the WHO Labour Care Guide on cesarean section in India: a pragmatic, stepped-wedge, cluster-randomized pilot trial. Nature Medicine. 2024;30(2):463-9.

Bahizi A, Lwanga D, Victor T. Assessment of partograph utilization and its association with pregnancy outcomes in Uganda: A case of Kamwenge District. British Journal of Healthcare and Medical Research-Vol. 2022;9(3).

Haddad S, Souza R, Cecatti J, Group WICAW. Management of maternal pulse and blood pressure abnormalities during labour and childbirth: evidence‐based algorithms for intrapartum care decision support. BJOG: An International Journal of Obstetrics & Gynaecology. 2024;131:67-78.

Organization WH. WHO Labour Care Guide, user’s manual. Geneva 2020. World Health Organization WHO recommendations: intrapartum care for a positive childbirth experience Geneva. 2018.

Umar A, Ibrahim S, Liman I, Chama C, Ijaiya M, Mathai M, et al. Implementation and Evaluation of Obstetric Early Warning Systems in tertiary care hospitals in Nigeria. PLOS Global Public Health. 2022;2(7):e0000225.

Eze P, Lawani LO, Chikezie RU, Ukaegbe CI, Iyoke CA. Perinatal outcomes of babies delivered by second-stage Caesarean section versus vacuum extraction in a resource-poor setting, Nigeria–a retrospective analysis. BMC pregnancy and childbirth. 2020;20:1-7.

Oriji P, Allagoa D, Briggs D, Chika M, Mariere U, Ikoro C, et al. A 5-year review of obstructed labour and its sequalae in the Federal Medical Centre, Yenagoa, South-South, Nigeria. Int J Clin Obstet Gynaecol. 2021;5(5):6-12.

Desta M, Mekonen Z, Alemu AA, Demelash M, Getaneh T, Bazezew Y, et al. Determinants of obstructed labour and its adverse outcomes among women who gave birth in Hawassa University referral Hospital: A case-control study. Plos one. 2022;17(6):e0268938.

Godfrey MR, Wilson T, Esther AC, Leevan T, Joseph N, Musa K, et al. Effectiveness of the modified WHO labour care guide to detect prolonged and obstructed labour among women admitted at publicly funded facilities in rural Mbarara district, Southwestern Uganda: an ambispective cohort study. medRxiv. 2024.

Wormer KC, Jamil RT, Bryant SB. Acute postpartum hemorrhage. StatPearls [Internet]: StatPearls Publishing; 2023.

Mubambe M, Mwanza J, Moyo E, Dzinamarira T. Enhancing maternal health in Zambia: a comprehensive approach to addressing postpartum hemorrhage. Frontiers in Global Women's Health. 2024;5:1362894.

Hofmeyr GJ, Moreri-Ntshabele B, Qureshi Z, Memo N, Hanson S, Muller E, et al. Improving management of first and second stages of labour in low-and middle-income countries. Best Practice & Research Clinical Obstetrics & Gynaecology. 2024:102517.

Famutimi E. Partograph Utilization and Clinical Decision Making: A Veritable Tool in Reducing Maternal Mortality in the 21st Century. EC Gynaecology. 2023;12:01-9.

Jena BH, Biks GA, Gete YK, Gelaye KA. Determinants of birth asphyxia in urban south Ethiopia. Scientific Reports. 2024;14(1):30725.

Adelaiye S, Wanonyi I, Adanikin A, Mairiga A, Kadas A, Morrupa J, et al. Determinants of obstructed labour and associated outcomes in referral hospitals in Nigeria. BJOG: An International Journal of Obstetrics & Gynaecology. 2024;131:55-63.

.

Downloads

Published

2025-05-22

How to Cite

1.
Dost Muhammad R, Masih S, Afzal M. Effects of World Health Organization Labour Care Guide Utilization for Safe Motherhood during Intrapartum Period through Midwives. J Neonatal Surg [Internet]. 2025May22 [cited 2025Nov.2];14(26S):462-7. Available from: https://www.jneonatalsurg.com/index.php/jns/article/view/6308