Development of algorithm
After collating the evidence, a selection process for inclusion of the evidence in the algorithm took place. Selection was based on relevance of the evidence to the key decision points and severity of the condition targeted by an intervention. The selection also accounted for the strength of evidence and applicability and feasibility in a LMIC context. If there were inconsistencies among guidelines, the most up-to-date guideline and evidence were reviewed and used to inform the algorithms in consultation with the WHO Intrapartum Care Algorithms Working Group. Algorithms were structured to cover criteria that should be used to suspect a deviation from normal parameters in labour, initial assessment, probable causes and potential differential diagnosis, further assessments to reach the most probable diagnosis, and management of the condition. Draw.io, an open source diagramming online software was used to construct the algorithm in a flowchart format. The algorithm was composed of standardised but variable shaped boxes, representing either a clinical state (rounded rectangle), decision point (diamond or hexagon), action task (rectangle), or link (oval) to a different algorithm. Each box was numbered and joined to other boxes via arrows, to orientate the reader to the direction of flow. The numbers also corresponded to a table of evidence, showing the evidence source for the action and decision points. The algorithms underwent internal peer review by the WHO Intrapartum Care Algorithms Working Group.