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Table 1 The three groups of interventions included in the WHO recommendations: non-clinical interventions to reduce unnecessary caesarean section [1]. Interventions are grouped according to their target population: women, healthcare professionals, and health organizations, facilities or systems

From: Optimising the use of caesarean section: a generic formative research protocol for implementation preparation

A. Interventions targeted at women

 1.0 Health education for women, including childbirth training workshops, nurse-led applied relaxation training programmes, psychosocial couple-based prevention programmes, and psychoeducation (context-specific recommendation, only with targeted monitoring and evaluation).

B. Interventions targeted at healthcare professionals

 2.1 Implementation of evidence-based clinical practice guidelines, combined with structured, mandatory second opinion for caesarean section indication (context-specific recommendation, only in settings with adequate resources and senior clinicians able to provide mandatory second opinion)

 2.2 Implementation of evidence-based clinical practice guidelines, caesarean section audits and timely feedback to healthcare professionals (recommended)

C. Interventions targeted at health organisations, facilities or systems

 3.1 Collaborative midwifery-obstetrician model of care (e.g.: a model of staffing based on care provided primarily by midwives, with a 24-h obstetrician back up who provides in-house labour and delivery coverage without other competing clinical duties) (context-specific recommendation, only in the context of rigorous research)

 3.2 Financial strategies (e.g. insurance reforms equalising physician fees for vaginal births and caesarean sections) for healthcare professionals or healthcare organizations (context-specific recommendation, only in the context of rigorous research)