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An exploration of midwives' views of the latest World Health Organization labour care guide

Effective labour monitoring is integral to intrapartum care. Yet, to date, tools to facilitate this have not reached their potential. This study aims to explore midwives' initial reactions to the latest World Health Organization labour care guide, which is a replacement to the existing partograph, to enable adaptations to be made and to inform implementation strategies. This was a qualitative study that used interviews and focus groups to gather data from a convenience sample of midwife delegates from six sub-Saharan Africa countries who were attending a midwifery conference in Malawi. Data were analysed thematically. A total of 43 participants participated; six focus groups and 12 individual interviews were conducted. Participants expressed both positive and negative views of the guide. Three main themes were found. The theme ‘sticking to what is familiar’ demonstrated reluctance to change; ‘chart based on usual or optimum practice’ suggested that midwives wanted a chart that reflects the routine care provided as opposed to the evidence-based care they should provide; and ‘measures for effective implementation’ highlighted the importance of having carefully considered and robust strategies for implementing the guide. This rapid evaluation provided a snapshot of midwives' initial reactions to the new labour care guide. Although the existing partograph has not reached its full potential, midwives showed a reluctance to change it for something new. Feedback from participants has been fed into the development phase of the guide, informing its presentation, contents and field testing.