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

Past project

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.

Partners

Funding partners

Gates Foundation

Collaborators

  • Women’s and Children’s Health Research Unit, KLE University’s Jawaharlal Nehru Medical College, Belgaum 590010 Karnataka India
  • Department of Mother & Child Health, Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina

Project contacts

Professor Joshua Vogel

Professor Joshua Vogel

Co-Program Director, Women’s, Children’s and Adolescents’ Health; Co-Head, Global Women’s and Newborn’s Health Group; Senior Principal Research Fellow
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Project team

Dr Elizabeth Armari

Dr Elizabeth Armari

PhD Candidate and Senior Research Officer
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Jenny Cao

Jenny Cao

International Health Project Officer
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Katherine Eddy

Katherine Eddy

International Health Project Officer
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Professor Caroline Homer AO

Professor Caroline Homer AO

Deputy Director – Gender Equity, Diversity & Inclusion; Co-Head, Global Women's and Newborn Health; Co-Head, Immunisation and Health Systems Strengthening
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Associate Professor Nick Scott

Associate Professor Nick Scott

Head, Modelling and Biostatistics
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Professor Joshua Vogel

Professor Joshua Vogel

Co-Program Director, Women’s, Children’s and Adolescents’ Health; Co-Head, Global Women’s and Newborn’s Health Group; Senior Principal Research Fellow
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