Readiness for transition from partograph to who labour care guide: A narrative review
DOI: https://doi.org/10.33024/min.v9i7.4347
Intrapartum Care Labour Care Guide Midwives Partograph Readiness for Change
Abstract
Background: Introduced by World Health Organization (WHO) in 2020, the Labour Care Guide (LCG) is an evidence-based successor to the conventional partograph that combines systematic maternal and fetal monitoring with woman-centered intrapartum care. Its successful implementation depends on both clinical validity and health-worker readiness.
Purpose: To synthesize evidence on the transition from the conventional partograph to the WHO LCG, determinants of health-worker readiness, and their relevance to independent midwifery practice in Indonesia, particularly Aceh.
Method: A narrative literature review synthesized literature on LCG development and implementation, limitations of the conventional partograph, health-worker readiness, and factors influencing adoption of new clinical tools. Literature was thematically synthesized around the rationale for LCG transition, implementation evidence, readiness determinants, and the Indonesian and Acehnese context.
Results: The conventional partograph has limitations due to rigid assumptions about labour progression and inconsistent use. Evidence supports the LCG’s feasibility and potential clinical value, including reduced unnecessary obstetric interventions. Implementation depends on provider readiness, including knowledge, attitudes, resources, training, and organizational support, while evidence among independently practicing midwives remains limited.
Conclusion: Successful transition depends on provider knowledge, attitudes, training, resources, supervision, and organizational support. Evidence on LCG readiness among independent midwives in Indonesia and Aceh remains limited, highlighting the need for context-specific research.
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References
Abore, K. W., Debiso, A. T., Birhanu, B. E., Bua, B. Z., & Negeri, K. G. (2022). Health professionals’ readiness to implement electronic medical recording system and associated factors in public general hospitals of Sidama region, Ethiopia. PLoS One, 17(10), e0276371.
Aceh Provincial Health Office. (2023). Aceh Health Profile 2022. Retrieved from: https://dinkes.acehprov.go.id/detailpost/profil-kesehatan-aceh-tahun-2022/?utm_source
Ahmed, S. A. E., Mahimbo, A., & Dawson, A. (2023). Quality intrapartum care expectations and experiences of women in sub-Saharan African low and low middle-income countries: A qualitative meta-synthesis. BMC Pregnancy and Childbirth, 23, 27.
Awol, S.M., Birhanu, A.Y., Mekonnen, Z.A., Gashu, K.D., Shiferaw, A.M., Endehabtu, B.F., Kalayou, M.H., Guadie, H.A. and Tilahun, B. (2020). Health professionals’ readiness and its associated factors to implement electronic medical record system in four selected primary hospitals in Ethiopia. Advances in medical education and practice,147-154.
Betran, A. P., Ye, J., Moller, A. B., Souza, J. P., & Zhang, J. (2021). Trends and projections of caesarean section rates: global and regional estimates. BMJ global health, 6(6), e005671.
Demissie, D. B., Kaura, D. K., & Schreve, K. (2025). Mapping innovations in partograph technologies: a scoping review from 2000 to 2025. Frontiers in Global Women's Health, 6, 1618317.
Diba, F., Ichsan, I., Muhsin, M., Marthoenis, M., Sofyan, H., Andalas, M., Monfared, I., Richert, K., Kaplan, L., Rogge, L. and Doria, S., 2019. Healthcare providers’ perception of the referral system in maternal care facilities in Aceh, Indonesia: a cross-sectional study. BMJ open, 9(12), p.e031484.
Ghulaxe, Y., Tayade, S., Huse, S., & Chavada, J. (2022). Advancement in partograph: WHO’s labor care guide. Cureus, 14(10).
Ministry of Health of the Republic of Indonesia. (2023). Indonesian Health Survey (SKI) 2023. Retrieved from: https://www.badankebijakan.kemkes.go.id/en/hasil-ski-2023/
Mugyenyi, G. R., Byamugisha, J., Tumuhimbise, W., Atukunda, E., & Yarine, F. T. (2024). Labour Care Guide implementation as a decision-making tool for monitoring labour among healthcare providers in Uganda: protocol for a mixed-methods study. BMJ open, 14(4), e079216.
Mugyenyi, G.R., Tumuhimbise, W., Atukunda, E.C., Tibaijuka, L., Ngonzi, J., Kayondo, M., Kanyesigye, M., Musimenta, A., Yarine, F.T. and Byamugisha, J.K. (2025). Effectiveness of the modified WHO labour care guide to detect prolonged and obstructed labour among women admitted at eight publicly Funded, Midwife-Led community health facilities in rural Mbarara District, Southwestern uganda: an ambispective cohort study. International Journal of Women's Health, 271-285.
Olavesen, E. S., Helseth, S., Wentzel‐Larsen, T., Haga, S. M., Sundrehagen, T. G., Valla, L., & Drozd, F. (2025). Attitudes to Evidence‐Based Interventions and Individual Readiness to Change in Maternity and Child Health Care: A Cross‐Sectional Study Among Midwives and Public Health Nurses. Worldviews on Evidence‐Based Nursing, 22(4), e70046.
Shea, C. M., Jacobs, S. R., Esserman, D. A., Bruce, K., & Weiner, B. J. (2014). Organizational readiness for implementing change: a psychometric assessment of a new measure. Implementation science, 9(1), 7.
Yunitawati, D., Latifah, L., Suryaputri, I. Y., & Laksono, A. D. (2024). A higher maternal education level could be a critical factor in the exceeded cesarean section delivery in Indonesia. Iranian Journal of Public Health, 53(1), 219.
Vogel, J.P., Comrie‐Thomson, L., Pingray, V., Gadama, L., Galadanci, H., Goudar, S., Laisser, R., Lavender, T., Lissauer, D., Misra, S. and Pujar, Y. (2021). Usability, acceptability, and feasibility of the world health organization labour care guide: a mixed‐methods, multicountry evaluation. Birth, 48(1), 66-75.
Vogel, J.P., Pujar, Y., Vernekar, S.S., Armari, E., Pingray, V., Althabe, F., Gibbons, L., Berrueta, M., Somannavar, M., Ciganda, A. and Rodriguez, R. (2024). Effects of the WHO Labour Care Guide on cesarean section in India: a pragmatic, stepped-wedge, cluster-randomized pilot trial. Nature medicine, 30(2), 463-469.
Weiner, B. J. (2009). A theory of organizational readiness for change. Implementation Science, 4, 67.
World Health Organization. (2018). WHO recommendations: Intrapartum care for a positive childbirth experience. Retrieved from: https://www.who.int/publications/i/item/9789241550215?utm_source
World Health Organization. (2020). WHO labour care guide: User's manual. Retrieved from: https://www.who.int/publications/i/item/9789240017566?utm_source
World Health Organization. (2025). WHO labour care guide: Implementation resource package. Retrieved from: https://www.who.int/publications/i/item/9789240109346?utm_source
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