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
- Autores
- Armari, Elizabeth; Vernekar, Sunil S.; Pujar, Yeshita; Pingray, María Verónica; Althabe, Fernando; Gibbons, Luz; Berrueta, Amanda Mabel; Ciganda, Alvaro; Rodriguez, Rocio; Kumar, Jayashree Ashok; Patil, Shruti Bhavi; Karinagannanavar, Aravind; Anteen, Raveendra R.; Pavithra, M. R.; Bendigeri, Savitri; Shetty, Shukla; Latha, B.; Megha, H. M.; Gaddi, Suman S.; Chikkagowdra, Shaila; Raghavendra, Bellara; Homer, Caroline S. E.; Somannavar, Manjunath; Goudar, Shivaprasad S.; Vogel, Joshua P.
- Año de publicación
- 2025
- Idioma
- inglés
- Tipo de recurso
- artículo
- Estado
- versión publicada
- Descripción
- 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 evidencebased, co-designed LCG implementation strategy which can be used to support LCG dissemination and uptake.
Fil: Armari, Elizabeth. Burnet Institute; Australia
Fil: Vernekar, Sunil S.. Kle Academy Of Higher Education And Research; India
Fil: Pujar, Yeshita. Kle Academy Of Higher Education And Research; India
Fil: Pingray, María Verónica. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Althabe, Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
Fil: Gibbons, Luz. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Berrueta, Amanda Mabel. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Ciganda, Alvaro. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Rodriguez, Rocio. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Kumar, Jayashree Ashok. Gadag Institute Of Medical Sciences; India
Fil: Patil, Shruti Bhavi. Gadag Institute Of Medical Sciences; India
Fil: Karinagannanavar, Aravind. Gadag Institute Of Medical Sciences; India
Fil: Anteen, Raveendra R.. General Hospital Of Gokak; India
Fil: Pavithra, M. R.. General Hospital Of Gokak; India
Fil: Bendigeri, Savitri. General Hospital Of Gokak; India
Fil: Shetty, Shukla. Jjm Medical College; India
Fil: Latha, B.. Jjm Medical College; India
Fil: Megha, H. M.. Jjm Medical College; India
Fil: Gaddi, Suman S.. Ballari Medical College And Research Center (bmcrc); India
Fil: Chikkagowdra, Shaila. Ballari Medical College And Research Center (bmcrc); India
Fil: Raghavendra, Bellara. Ballari Medical College And Research Center (bmcrc); India
Fil: Homer, Caroline S. E.. Burnet Institute; Australia
Fil: Somannavar, Manjunath. Kle Academy Of Higher Education And Research; India
Fil: Goudar, Shivaprasad S.. Kle Academy Of Higher Education And Research; India
Fil: Vogel, Joshua P.. Burnet Institute; Australia - Materia
-
implementation strategy
labour monitoring
labour care guide - Nivel de accesibilidad
- acceso abierto
- Condiciones de uso
- https://creativecommons.org/licenses/by/2.5/ar/
- Repositorio
.jpg)
- Institución
- Consejo Nacional de Investigaciones Científicas y Técnicas
- OAI Identificador
- oai:ri.conicet.gov.ar:11336/291584
Ver los metadatos del registro completo
| id |
CONICETDig_e348c3dd04c95322e808bdda68032cad |
|---|---|
| oai_identifier_str |
oai:ri.conicet.gov.ar:11336/291584 |
| network_acronym_str |
CONICETDig |
| repository_id_str |
3498 |
| network_name_str |
CONICET Digital (CONICET) |
| spelling |
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 StudyArmari, ElizabethVernekar, Sunil S.Pujar, YeshitaPingray, María VerónicaAlthabe, FernandoGibbons, LuzBerrueta, Amanda MabelCiganda, AlvaroRodriguez, RocioKumar, Jayashree AshokPatil, Shruti BhaviKarinagannanavar, AravindAnteen, Raveendra R.Pavithra, M. R.Bendigeri, SavitriShetty, ShuklaLatha, B.Megha, H. M.Gaddi, Suman S.Chikkagowdra, ShailaRaghavendra, BellaraHomer, Caroline S. E.Somannavar, ManjunathGoudar, Shivaprasad S.Vogel, Joshua P.implementation strategylabour monitoringlabour care guidehttps://purl.org/becyt/ford/3.3https://purl.org/becyt/ford/3Introduction: 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 evidencebased, co-designed LCG implementation strategy which can be used to support LCG dissemination and uptake.Fil: Armari, Elizabeth. Burnet Institute; AustraliaFil: Vernekar, Sunil S.. Kle Academy Of Higher Education And Research; IndiaFil: Pujar, Yeshita. Kle Academy Of Higher Education And Research; IndiaFil: Pingray, María Verónica. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Althabe, Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Gibbons, Luz. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Berrueta, Amanda Mabel. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Ciganda, Alvaro. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Rodriguez, Rocio. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Kumar, Jayashree Ashok. Gadag Institute Of Medical Sciences; IndiaFil: Patil, Shruti Bhavi. Gadag Institute Of Medical Sciences; IndiaFil: Karinagannanavar, Aravind. Gadag Institute Of Medical Sciences; IndiaFil: Anteen, Raveendra R.. General Hospital Of Gokak; IndiaFil: Pavithra, M. R.. General Hospital Of Gokak; IndiaFil: Bendigeri, Savitri. General Hospital Of Gokak; IndiaFil: Shetty, Shukla. Jjm Medical College; IndiaFil: Latha, B.. Jjm Medical College; IndiaFil: Megha, H. M.. Jjm Medical College; IndiaFil: Gaddi, Suman S.. Ballari Medical College And Research Center (bmcrc); IndiaFil: Chikkagowdra, Shaila. Ballari Medical College And Research Center (bmcrc); IndiaFil: Raghavendra, Bellara. Ballari Medical College And Research Center (bmcrc); IndiaFil: Homer, Caroline S. E.. Burnet Institute; AustraliaFil: Somannavar, Manjunath. Kle Academy Of Higher Education And Research; IndiaFil: Goudar, Shivaprasad S.. Kle Academy Of Higher Education And Research; IndiaFil: Vogel, Joshua P.. Burnet Institute; AustraliaWiley Blackwell Publishing, Inc2025-08info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/291584Armari, Elizabeth; Vernekar, Sunil S.; Pujar, Yeshita; Pingray, María Verónica; Althabe, Fernando; et al.; 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; Wiley Blackwell Publishing, Inc; Birth-issues in Perinatal Care; 53; 1; 8-2025; 120-1280730-7659CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://onlinelibrary.wiley.com/doi/10.1111/birt.70004info:eu-repo/semantics/altIdentifier/doi/10.1111/birt.70004info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2026-08-25T14:46:11Zoai:ri.conicet.gov.ar:11336/291584instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982026-08-25 14:46:12.072CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse |
| dc.title.none.fl_str_mv |
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 |
| title |
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 |
| spellingShingle |
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 Armari, Elizabeth implementation strategy labour monitoring labour care guide |
| title_short |
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 |
| title_full |
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 |
| title_fullStr |
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 |
| title_full_unstemmed |
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 |
| title_sort |
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 |
| dc.creator.none.fl_str_mv |
Armari, Elizabeth Vernekar, Sunil S. Pujar, Yeshita Pingray, María Verónica Althabe, Fernando Gibbons, Luz Berrueta, Amanda Mabel Ciganda, Alvaro Rodriguez, Rocio Kumar, Jayashree Ashok Patil, Shruti Bhavi Karinagannanavar, Aravind Anteen, Raveendra R. Pavithra, M. R. Bendigeri, Savitri Shetty, Shukla Latha, B. Megha, H. M. Gaddi, Suman S. Chikkagowdra, Shaila Raghavendra, Bellara Homer, Caroline S. E. Somannavar, Manjunath Goudar, Shivaprasad S. Vogel, Joshua P. |
| author |
Armari, Elizabeth |
| author_facet |
Armari, Elizabeth Vernekar, Sunil S. Pujar, Yeshita Pingray, María Verónica Althabe, Fernando Gibbons, Luz Berrueta, Amanda Mabel Ciganda, Alvaro Rodriguez, Rocio Kumar, Jayashree Ashok Patil, Shruti Bhavi Karinagannanavar, Aravind Anteen, Raveendra R. Pavithra, M. R. Bendigeri, Savitri Shetty, Shukla Latha, B. Megha, H. M. Gaddi, Suman S. Chikkagowdra, Shaila Raghavendra, Bellara Homer, Caroline S. E. Somannavar, Manjunath Goudar, Shivaprasad S. Vogel, Joshua P. |
| author_role |
author |
| author2 |
Vernekar, Sunil S. Pujar, Yeshita Pingray, María Verónica Althabe, Fernando Gibbons, Luz Berrueta, Amanda Mabel Ciganda, Alvaro Rodriguez, Rocio Kumar, Jayashree Ashok Patil, Shruti Bhavi Karinagannanavar, Aravind Anteen, Raveendra R. Pavithra, M. R. Bendigeri, Savitri Shetty, Shukla Latha, B. Megha, H. M. Gaddi, Suman S. Chikkagowdra, Shaila Raghavendra, Bellara Homer, Caroline S. E. Somannavar, Manjunath Goudar, Shivaprasad S. Vogel, Joshua P. |
| author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author |
| dc.subject.none.fl_str_mv |
implementation strategy labour monitoring labour care guide |
| topic |
implementation strategy labour monitoring labour care guide |
| purl_subject.fl_str_mv |
https://purl.org/becyt/ford/3.3 https://purl.org/becyt/ford/3 |
| dc.description.none.fl_txt_mv |
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 evidencebased, co-designed LCG implementation strategy which can be used to support LCG dissemination and uptake. Fil: Armari, Elizabeth. Burnet Institute; Australia Fil: Vernekar, Sunil S.. Kle Academy Of Higher Education And Research; India Fil: Pujar, Yeshita. Kle Academy Of Higher Education And Research; India Fil: Pingray, María Verónica. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Althabe, Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina Fil: Gibbons, Luz. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Berrueta, Amanda Mabel. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Ciganda, Alvaro. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Rodriguez, Rocio. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Kumar, Jayashree Ashok. Gadag Institute Of Medical Sciences; India Fil: Patil, Shruti Bhavi. Gadag Institute Of Medical Sciences; India Fil: Karinagannanavar, Aravind. Gadag Institute Of Medical Sciences; India Fil: Anteen, Raveendra R.. General Hospital Of Gokak; India Fil: Pavithra, M. R.. General Hospital Of Gokak; India Fil: Bendigeri, Savitri. General Hospital Of Gokak; India Fil: Shetty, Shukla. Jjm Medical College; India Fil: Latha, B.. Jjm Medical College; India Fil: Megha, H. M.. Jjm Medical College; India Fil: Gaddi, Suman S.. Ballari Medical College And Research Center (bmcrc); India Fil: Chikkagowdra, Shaila. Ballari Medical College And Research Center (bmcrc); India Fil: Raghavendra, Bellara. Ballari Medical College And Research Center (bmcrc); India Fil: Homer, Caroline S. E.. Burnet Institute; Australia Fil: Somannavar, Manjunath. Kle Academy Of Higher Education And Research; India Fil: Goudar, Shivaprasad S.. Kle Academy Of Higher Education And Research; India Fil: Vogel, Joshua P.. Burnet Institute; Australia |
| description |
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 evidencebased, co-designed LCG implementation strategy which can be used to support LCG dissemination and uptake. |
| publishDate |
2025 |
| dc.date.none.fl_str_mv |
2025-08 |
| dc.type.none.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://purl.org/coar/resource_type/c_6501 info:ar-repo/semantics/articulo |
| format |
article |
| status_str |
publishedVersion |
| dc.identifier.none.fl_str_mv |
http://hdl.handle.net/11336/291584 Armari, Elizabeth; Vernekar, Sunil S.; Pujar, Yeshita; Pingray, María Verónica; Althabe, Fernando; et al.; 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; Wiley Blackwell Publishing, Inc; Birth-issues in Perinatal Care; 53; 1; 8-2025; 120-128 0730-7659 CONICET Digital CONICET |
| url |
http://hdl.handle.net/11336/291584 |
| identifier_str_mv |
Armari, Elizabeth; Vernekar, Sunil S.; Pujar, Yeshita; Pingray, María Verónica; Althabe, Fernando; et al.; 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; Wiley Blackwell Publishing, Inc; Birth-issues in Perinatal Care; 53; 1; 8-2025; 120-128 0730-7659 CONICET Digital CONICET |
| dc.language.none.fl_str_mv |
eng |
| language |
eng |
| dc.relation.none.fl_str_mv |
info:eu-repo/semantics/altIdentifier/url/https://onlinelibrary.wiley.com/doi/10.1111/birt.70004 info:eu-repo/semantics/altIdentifier/doi/10.1111/birt.70004 |
| dc.rights.none.fl_str_mv |
info:eu-repo/semantics/openAccess https://creativecommons.org/licenses/by/2.5/ar/ |
| eu_rights_str_mv |
openAccess |
| rights_invalid_str_mv |
https://creativecommons.org/licenses/by/2.5/ar/ |
| dc.format.none.fl_str_mv |
application/pdf application/pdf |
| dc.publisher.none.fl_str_mv |
Wiley Blackwell Publishing, Inc |
| publisher.none.fl_str_mv |
Wiley Blackwell Publishing, Inc |
| dc.source.none.fl_str_mv |
reponame:CONICET Digital (CONICET) instname:Consejo Nacional de Investigaciones Científicas y Técnicas |
| reponame_str |
CONICET Digital (CONICET) |
| collection |
CONICET Digital (CONICET) |
| instname_str |
Consejo Nacional de Investigaciones Científicas y Técnicas |
| repository.name.fl_str_mv |
CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas |
| repository.mail.fl_str_mv |
dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar |
| _version_ |
1874774635512332288 |
| score |
13.24418 |