Abstract Objective South Sudan's maternal and neonatal indicators remain among the lowest in the world. This is attributable to limits in health‐care infrastructure, inadequate funding, a lack of skilled birth attendants, and insufficient adherence to evidence‐based labor monitoring systems. The WHO's Labor Care Guide (LCG) was created to promote respectful, safe, and high‐quality intrapartum care. Recognizing the need to improve labor management and improvement of maternal and newborn indicators, the Association of Gynecologists and Obstetricians of South Sudan (AGOSS) conducted a feasibility study to evaluate the LCG's implementation at selected health facilities around the country. The present study was conducted to assess feasibility of replacing partograph with the LCG, facilities readiness and success of its implementation in a low health setting such as a fragile health system in South Sudan. Methods This was a descriptive study conducted in seven public selected health facilities across five geographical states in South Sudan, from March to August, 2024, utilizing the lottery methods. The study was done in two phases; Phase 1 to survey the facilities which met the assessment, and Phase 2 for carrying out the study. A convenience sampling technique was used to recruit 105 healthcare workers serving in the maternity department. Data were selected and entered into SPSS 27 for descriptive analysis. Results The study involved 105 participants from labor ward health workers, predominantly female (68.6%) and mainly midwives (50.5%), with smaller proportions of doctors, nurses, and clinical officers. Although most respondents (92%) had received training on the LCG, many learned through on‐the‐job mentorship, and a notable proportion still found the tool challenging. Only one‐third rated LCG as easy to use, while 40% reported difficulties, particularly with the fetal monitoring section. Across seven health facilities, LCG utilization was low: only 41% of the 2645 women who delivered during the study period were monitored using LCG. Despite this, acceptance of the tool was high, with over 90% of respondents recommending its use over the traditional partograph, either outright or with additional training. Major barriers to effective LCG implementation included lack of basic equipment in 63% of facilities, high workload, shortages of healthcare staff and supplies, inadequate patient records, language barriers, illiteracy among traditional birth attendants, and weak health information systems. Overall, while LCG was viewed positively and widely supported, significant training, resource, and system constraints limited its practical use. Conclusion There are possibilities for the labor care guide adaption in South Sudan. The study advises that healthcare providers be trained on LCG, that facilities be equipped with appropriate equipment and supplies, that skilled health professionals be deployed, and that working circumstances be improved so that healthcare workers can use the LCG effectively.
Malel et al. (Mon,) studied this question.