The Better Outcomes in Labour Difficulty (BOLD) initiative, launched by the World Health Organization and M4ID seeks to research and design a set of new tools to support health workers in providing appropriate care during childbirth and to increase demand for respectful, quality care among communities in low resource settings.

Labour difficulties result in deaths and long-term disabilities for thousands of mothers and newborn babies every year, particularly in under-served communities. The BOLD innovation project, supported by the Bill and Melinda Gates Foundation, aims to improve labour outcomes through a combined health facility and community-based approach. WHO will carry out research to develop a new model for a simplified and effective labour monitoring-to-action tool. This project will revisit and build on the principles of the partograph (the paper-based tool currently in use to monitor the progress of labour) and aims to support monitoring and decision-making during labour. In parallel, M4ID will together with community groups and care providers, design novel solutions to improve access to respectful, quality care at the time of birth for pregnant women and their families.

The two-year project will be implemented in two sub-Saharan African countries.  The final set of tools will then be piloted and tested across multiple low-resource countries over the next five years.