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The world health organization’s labour care guide’s knowledge, usability, acceptability, and practicability among midwives in selected health facilities in Enugu State, Nigeria: a pilot feasibility assessment study
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DOI：10.1186/s12884-026-09788-6.png)
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Abstract
En 中文
Partographs have been used for nearly 50 years to assess labour progress, although their accuracy has been questioned. The World Health Organization (WHO) has recommended the Labour Care Guide (LCG) as a more robust tool for improving the quality of labour monitoring. This pilot feasibility study aimed to assess the knowledge, usability, acceptability, and practicability of the WHO Labour Care Guide (LCG) among midwives who were early adopters of the guide in selected health facilities in Enugu State, Nigeria. This cross-sectional study was conducted between April and July 2024. A total of 43 midwives working in labour wards were purposively selected from three hospitals: Poly General Hospital, Asata; Mother of Christ Specialist Hospital, Holy Ghost; and the University of Nigeria Teaching Hospital, Ituku-Ozalla. Data were collected using a validated, self-developed instrument for demographic characteristics and an adapted questionnaire. Descriptive statistics were used to summarize the data, while Fisher’s exact test was used to test the study hypothesis at a 0.05 level of significance using SPSS version 25. A total of 43 midwives participated in the study. Overall, 67.4% demonstrated good knowledge of the WHO Labour Care Guide; the prevalence of LCG use was 58.1%; usability was rated high by 96.0% of users; acceptability was 69.8% among all midwives and 100% among those who were aware of the LCG; and practicability was rated high by 33.3% of those who were aware of the guide. The usability of the LCG was not significantly associated with the midwives’ educational qualifications (p = 0.917), and knowledge of the LCG was not significantly associated with years of professional experience. Midwives demonstrated high levels of knowledge and acceptability of the WHO Labour Care Guide (LCG). Although the prevalence of LCG use was moderate, its usability was rated highly. However, practicability was perceived to be low, suggesting that challenges remain in the routine implementation of the LCG in clinical practice. As this was a pilot feasibility study involving early adopters of the WHO LCG, the findings should be interpreted with caution and should not be considered representative of all midwives in Enugu State, Nigeria. Nevertheless, the findings suggest that training, awareness campaigns, and institutional support may help address implementation challenges, facilitate broader adoption of the LCG, and ultimately improve maternal care outcomes.
Keywords:
Pregnancy
Labour care guide
Midwives
Maternal mortality
Perinatal mortality
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