Implementation of a labour companionship model in three public hospitals in Arab middle-income countries

Abstract

Aim: To assess the feasibility, acceptability, effectiveness and cost of the integration of a tailored labour companionship model in three public hospitals in Egypt, Lebanon and Syria.

Methods: Phased implementation research using mixed methods. Implementation strategies consisted of steering committees in hospitals, seminars for healthcare providers, information, education and communication materials, and adjustments in labour rooms. The labour companionship model consisted of (i) identification of a female relative as labour companion by women; (ii) provision of information, education and communication materials to women and companions; and (iii) allowing companions to accompany women throughout the first stage of labour. Semi-structured interviews with women, labour companions and healthcare providers were used to assess feasibility and acceptability of the model. Effectiveness was assessed through structured interviews with women, information abstracted from medical records and cost data. The comparison was made between the pre-implementation and the implementation phases.

Results: This model was found to be feasible, acceptable, effective and cost-beneficial. Women's satisfaction and perception of control improved and caesarean section rates were reduced significantly.

Conclusion: This model can be adopted for these countries and elsewhere with comparable health systems. It enhances the quality of care and the provision of equitable and respectful maternity services.

Keywords: Arab countries; implementation research; lay companion; support during labour.