Introducing the World Health Organization Labour Care Guide in Nigeria: Knowledge, Perceptions, and Impediments by Doctors and Nurses at 3-Tier Hospitals in Enugu, Nigeria

Abstract

Abstract Context: It is speculated that obstetrics health workers in Nigeria may be lacking adequate knowledge of the Labour Care Guide (LCG) tool. Aim: To determine the awareness, level of knowledge, perceptions, and impediments toward use of the LCG tool for management of labor by doctors and nurses in Nigeria. Materials and Methods: This is a mixed-method study of 201 doctors and nurses at six selected health facilities in Enugu, Nigeria, over a 1-month period. For the quantitative component of the study, eligible and consenting participants were randomly selected and interviewed using a pretested questionnaire, while for the qualitative component, the six heads of labor ward nurses were purposively selected and in-depth interview conducted on the use, reasons for nonuse, and impediments to the use of LCG. Statistical Analysis: Statistical analysis was performed using IBM Statistical Package for Social Sciences for Windows, version 24.0 (Armonk, NY) for quantitative data. It was descriptive and inferential. The level of significance was set at P < 0.05. For qualitative data, thematic analysis was done. Result: A total of 168 (83.6%) were aware of LCG; 60 (35.7%) had poor knowledge (mean score: 20.1 ± 7.5), and 89 (53.0%) had negative perception (mean score: 0.11 ± 0.11). Impediments to LCG use included being time-consuming, insufficient manpower, insufficient knowledge, and lack of training. Negative perception was associated with poor knowledge of LCG (P < 0.001, AOR =60.9, CI =13.9-267.1). Conclusion: One in three obstetric care workers has poor knowledge of LCG in labor care. We recommend creating training opportunities for them at all levels of healthcare on the use of LCG.