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

Background: The 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). Methods: This 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 Discussion: This 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. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The author(s) received no specific funding for this work ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethical clearance was obtained from the Research Ethics committee (REC) (Protocol number: MUST-2023-808) at Mbarara University of Science and Technology. Study site administrative permission was obtained from Mbarara Regional Referral Hospital, Mbarara District Health officer and the City Health Officer for Mbarara City. We obtained approval from the National Council for Science and Technology in Uganda (HS2864ES) and will obtain written informed consent from all study participants before enrolment in the study. No data has been collected so far I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All relevant data from this study will be made available upon study completion.