TABLE 4.

Problem-Based Approach and Actions Required to Improve Adherence to Evidence-Based Intrapartum Practices in Labor Rooms

LevelProblemActions Required
Individual (service provider)

  • Attitude of the service provider

  • Perceptions regarding time constraint

  • Perceptions regarding increased workload in the labor room

  • Traditional beliefs and intrapartum practices

  • Lack of knowledge regarding the latest evidence-based practices

  • Lack of training and technical difficulty in practicing evidence-based practices

  • Poor skills of the junior service provider

  • Upgradation of knowledge and skills of the service providers regarding evidence-based practices through continuous medical education

  • Teaching and training of junior doctors in recommended practices

  • Imparting skills on effective time management

  • Reinforce existing good practices by monitoring, supervision, and providing incentives

  • Advocacy with medical councils regarding revised curriculum to include evidence-based practices and related provision of infrastructure

  • Advocacy with the textbook writers to include evidence-based practices

Institute

  • Lack of sufficient number of beds

  • Lack of space

  • Inadequate human resources

  • Minor labor room modifications to allow non-supine positions

  • Train existing manpower on evidence-based practices

Community

  • The prevailing perception of the laboring women regarding intrapartum practices

  • Sensitization of women during antenatal period regarding recommended evidence-based intranatal practices