Labour Care Guide implementation as a decision-making tool for monitoring labour among health care providers in Southwestern Uganda: A protocol for a multisite Effectiveness-Implementation study

BackgroundThe new WHO Labour Care Guide, also regarded as the "next-generation partograph" basing on recent evidence has been recorded as a core component of the 2018 consolidated set of guidelines on intrapartum care for positive child birth experience. The Ugandan Ministry of Health is in the process of adopting the new WHO Labour Care Guide (LCG) with no local context specific data to inform this transition. This study will employ evidence-based research frameworks to identify challenges, and potential opportunities that would inform and refine the implementation strategy and scale-up of this highly promising LCG. We will also seek to utilize best practices to evaluate implementation effectiveness of the new LCG, through employing measurable implementation matrices (implementation, service, patient outcomes). MethodsThis study will be a multisite effectiveness-implementation study across all basic and comprehensive emergency obstetric and newborn care facilities in Mbarara district and Mbarara City in Southwestern Uganda. We will employ both quantitative and qualitative methods to evaluate the use of the newly recommended WHO Labor Care Guide in monitoring labor among all health care providers actively engaged in deliverying women across all public maternity health facilities in Mbarara district and Mbarara City. No participant has been recruited at hie point in time Results and DiscussionThis study will offer an opportunity to ascertain whether the new WHO Labour Care Guide tool is an effective decision-making tool to monitor labor among healthcare providers conducting routine deliveries in publicly funded facilities in Southwestern Uganda. We will also identify practical, context-specific and actionable strategies for achieving optimal implementation effectiveness in a rural low resource setting.