protocolSection identificationModule nctId: NCT06273007, orgStudyIdInfo id: EFP_2023_02_19, briefTitle: Improving Intrapartum Care for Saving Life at Birth in Ethiopia Through PartoMa Approach, acronym: PartoMa-Eth, statusModule overallStatus: RECRUITING, startDateStruct date: 2023-06-01, primaryCompletionDateStruct date: 2025-12-31, completionDateStruct date: 2027-12-31, studyFirstPostDateStruct date: 2024-02-22, lastUpdatePostDateStruct date: 2024-02-22, sponsorCollaboratorsModule leadSponsor name: Haramaya Unversity, class: OTHER, collaborators name: University of Copenhagen, collaborators name: Leiden University Medical Center, collaborators name: Laerdal Foundation, descriptionModule briefSummary: Overall ObjectiveTo introduce PartoMa approach (locally agreed and achievable intrapartum guidelines and a continual in-house training program) to Ethiopian context through continuous fetal heart rate (FHR) monitoring using MOYO device and co-creation of context specific intrapartum care guideline for improving decision making in intrapartum care in Eastern Ethiopia.Interventions1. Locally agreed and achievable intrapartum guidelines2. Low dose high frequency trainings (LDHF)3. Partograph Overall DesignA quasi-experimental pre-post study (PartoMa study)SettingDepartment of Obstetrics and Gynaecology Haramaya Hospital and Hiwot Fana University Hospital, Ethiopia.PopulationLaboring women delivering at the study site from February 2023 to March 2025 and their offspring, as well as health providers. Women and their offspring will be enrolled at/after onset of labour and followed until discharge.EndpointsThe primary endpoint is perinatal mortality. For further description and secondary outcomes, please see below.Study TimeData collection from June 2023 to May 2025.Specific Objectives i. To assess FHR monitoring practice and use of obstetric guideline for decision making in Hiwot Fana University Hospital ii. To improve feto-maternal outcome through applying PartoMa approach in Hiwot Fana University Hospital.iii. To determine the feasibility, acceptability and sustainability of low-dose high frequency trainings and PartoMa seminars in Hiwot Fana University Hospital.iv. To document changes in pregnancy outcomes after the introduction of PartoMa approaches-seminars, low dose high frequency trainings, continuous FHR monitoring and tailored interventions-in Hiwot Fana University Hospital.SettingPartoMa Ethiopia will be implemented at Haramaya General Hospital and Hiwot Fana Comprehensive Specialized University Hospital, which are both busy maternity units in Eastern Ethiopia. Both are government hospitals with an annual delivery number of around 5,000., conditionsModule conditions: Stillbirth, conditions: Obstetric Complication, conditions: Maternal Death, conditions: Perinatal Death, conditions: Perinatal Morbidity, designModule studyType: INTERVENTIONAL, phases: NA, designInfo allocation: NON_RANDOMIZED, interventionModel: SINGLE_GROUP, primaryPurpose: TREATMENT, maskingInfo masking: NONE, enrollmentInfo count: 500, type: ESTIMATED, armsInterventionsModule interventions name: PartoMa intervention(Locally achievable intrapartum care guideline), in house LDHF trainings, outcomesModule primaryOutcomes measure: stillbirth, primaryOutcomes measure: Birth Asphyxia, secondaryOutcomes measure: Maternal death, secondaryOutcomes measure: Cesarean sections and vacuum extractions, secondaryOutcomes measure: Process indicators of quality of intrapartum care, secondaryOutcomes measure: Birth attendant's perception of their work condition in the labour and delivery rooms, secondaryOutcomes measure: The women's experience of care received during delivery., eligibilityModule sex: FEMALE, minimumAge: 18 Years, maximumAge: 50 Years, stdAges: ADULT, contactsLocationsModule locations facility: Haramaya Hospital, status: RECRUITING, city: Harar, state: Oromia, country: Ethiopia, contacts name: Roba Ararsa, MD, role: CONTACT, geoPoint lat: 9.31387, lon: 42.11815, locations facility: Hiwot Fana University Hospital, status: NOT_YET_RECRUITING, city: Harar, country: Ethiopia, contacts name: Redwan Ahmed, MD, role: CONTACT, geoPoint lat: 9.31387, lon: 42.11815, hasResults: False