Kagera — In a busy maternity ward at Kabyaile Health Centre in Misenyi District, Kagera Region, Happiness Kokuhumbya Tibaijuka, a midwife with 12 years of experience, begins her shift by checking on women in labour, monitoring progress and preparing for deliveries. But today, her work is different from just a few years ago.
“I used to rely on tools that were not always easy to follow. Now, with the Labour Care Guide, I can clearly track what is happening and act quickly when something is not right,” she says.
In 2024, the Ministry of Health led the adaptation of the Labour Care Guide for nationwide use, reinforcing its commitment to improving the quality of maternal and newborn care. Originally published by the World Health Organization in 2020, the guide supports a positive childbirth experience and strengthens the monitoring of labour by enabling health workers to track progress more accurately and make timely, evidence-based, shared decisions that can save lives.
Before the introduction of the Labour Care Guide, monitoring labour was inconsistent, especially in busy or resource-constrained settings. Now, the structured guide allows health workers to assess both the clinical condition and the overall well-being of the mother and baby, ensuring more responsive and empowering care.
By the end of 2025, a total of 22 out of the 26 regions in the mainland Tanzania were routinely using the Labour Care Guide to support the provision of intrapartum care.
“I felt safe because the nurses were always checking on me and explaining what was happening. They noticed when I was in pain and helped me immediately,” says Adriana Adriani, who recently delivered her baby at the facility.
The journey toward adopting the Labour Care Guide began in 2022, building on the country’s participation in a global evaluation led by WHO. A national consultative process brought together more than 100 experts and practitioners to thoughtfully contextualize the guide in line with national priorities and service delivery needs. This collaborative effort resulted in the development of a national user manual and a comprehensive training package aligned with reproductive, maternal, newborn, child, and adolescent health services. The adaptation of the tool to the national context, the training of an initial cohort of trainers of trainers, and its phased introduction in one region were undertaken with financial and technical support from the World Health Organization.
“The decision to replace the Partograph with the Labour Care Guide marks a crucial advancement. We are not just changing a form; we are changing the mindset of the workforce. By integrating Respectful and Compassionate Care, we are ensuring that the next generation of doctors and nurses value the mother’s dignity as much as her clinical safety,” said Ms Ziada Sellah, Director of Nursing and Midwifery Services (DNMS), Ministry of Health.
To ensure countrywide reach, the Ministry of Health rolled out the Labour Care Guide through a cascade training approach, starting with national trainers of trainers, followed by regional and council health management teams, and finally, frontline health workers in public and private facilities.
Continuous mentorship and supportive supervision have helped frontline providers like Tibaijuka gain confidence in using the tool. Its integration into the e-learning platform offers continued medical professional education. “The training really helped. We are now more confident in identifying complications early and responding faster,” she says.
“The adaptation of the Labour Care Guide is a significant step towards improving the quality of care during childbirth. By supporting health workers with practical, evidence‑based tools, we are helping ensure safer deliveries and better outcomes for mothers and newborns,” says Dr Edwin Swai, WHO expert on maternal, newborn, child and adolescent health and healthy ageing.
To sustain these gains, the Labour Care Guide has also been integrated into pre-service competence-based curriculum in nine medical universities and four zonal training institutions of mid-level nursing and midwifery, ensuring that future generations of health workers are equipped with the skills to provide safe, respectful and high-quality care.
“This tool is helping us give better care and every safe delivery reminds us why it matters,” says Tibaijuka.
