Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia.
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Birth. 2021 Mar;48(1):66-75. doi: 10.1111/birt.12511. Epub 2020 Nov 22.
The World Health Organization's (WHO) Labour Care Guide (LCG) is a "next-generation" partograph based on WHO's latest intrapartum care recommendations. It aims to optimize clinical care provided to women and their experience of care. We evaluated the LCG's usability, feasibility, and acceptability among maternity care practitioners in clinical settings.
Mixed-methods evaluation with doctors, midwives, and nurses in 12 health facilities across Argentina, India, Kenya, Malawi, Nigeria, and Tanzania. Purposively sampled and trained practitioners applied the LCG in low-risk women during labor and rated experiences, satisfaction, and usability. Practitioners were invited to focus group discussions (FGDs) to share experiences and perceptions of the LCG, which were subjected to framework analysis.
One hundred and thirty-six practitioners applied the LCG in managing labor and birth of 1,226 low-risk women. The majority of women had a spontaneous vaginal birth (91.6%); two cases of intrapartum stillbirths (1.63 per 1000 births) occurred. Practitioner satisfaction with the LCG was high, and median usability score was 67.5%. Practitioners described the LCG as supporting precise and meticulous monitoring during labor, encouraging critical thinking in labor management, and improving the provision of woman-centered care.
The LCG is feasible and acceptable to use across different clinical settings and can promote woman-centered care, though some design improvements would benefit usability. Implementing the LCG needs to be accompanied by training and supportive supervision, and strategies to promote an enabling environment (including updated policies on supportive care interventions, and ensuring essential equipment is available).
世界卫生组织（WHO）的劳动保健指南（LCG）是一种基于 WHO 最新产时保健建议的“下一代”产程图。它旨在优化向妇女提供的临床护理和她们的护理体验。我们评估了 LCG 在临床环境中母婴保健从业者中的可用性、可行性和可接受性。
在阿根廷、印度、肯尼亚、马拉维、尼日利亚和坦桑尼亚的 12 个卫生机构中，采用混合方法对医生、助产士和护士进行评估。有针对性地选择和培训的从业者在低危妇女分娩期间使用 LCG，并对经验、满意度和可用性进行评分。邀请从业者参加焦点小组讨论（FGD），分享他们对 LCG 的经验和看法，这些经验和看法将进行框架分析。
136 名从业者在管理 1226 名低危妇女的分娩和分娩过程中使用了 LCG。大多数妇女自然分娩（91.6%）；有两例产程中死产（每 1000 例活产 1.63 例）。从业者对 LCG 的满意度很高，中位数可用性评分为 67.5%。从业者描述 LCG 支持分娩期间的精确和细致监测，鼓励在分娩管理中批判性思维，并改善以妇女为中心的护理。
LCG 在不同的临床环境中是可行和可接受的，可以促进以妇女为中心的护理，但一些设计改进将提高可用性。实施 LCG 需要培训和支持性监督，并采取策略促进有利环境（包括更新支持性护理干预政策，并确保提供基本设备）。
