{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T19:55:30Z","timestamp":1781812530712,"version":"3.54.5"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100010661","name":"Horizon 2020 Framework Programme","doi-asserted-by":"publisher","award":["847567"],"award-info":[{"award-number":["847567"]}],"id":[{"id":"10.13039\/100010661","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe the Appropriate Use of Cesarean Section Through Quality Decision\u2010Making (QUALI\u2010DEC) intervention\u2014a multifaceted strategy to optimize the use of cesarean section in low\u2010 and middle\u2010income countries\u2014using the Template for Intervention Description and Replication (TIDieR) checklist to enable replication and scale\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The QUALI\u2010DEC intervention was implemented between July 2022 and April 2024 in 32 hospitals among Argentina, Burkina Faso, Thailand, and Viet Nam. Following the 12\u2010item TIDieR checklist, we report in detail the four components of the intervention: (i) opinion leaders to promote evidence\u2010based practices, (ii) audit and feedback using the Robson Ten Group Classification System, (iii) a Decision Analysis Tool to support informed decision\u2010making by women, and (iv) companionship during labor and childbirth. Implementation processes, training, resources, and contextual adaptations were systematically documented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Opinion leaders were pivotal in training staff, leading audits, and sustaining implementation. Healthcare workers from participating facilities were trained in using clinical algorithms, the Ten Group Classification System, audit report forms, the Decision Analysis Tool, and the World Health Organization model of companionship. The intervention was coupled with online technology to facilitate training, data collection, and feedback loops. Overall, the QUALI\u2010DEC intervention was feasible across diverse contexts, with variations reflecting local culture, infrastructure, and policy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Appropriate cesarean section use is shaped by women, providers, and organizational factors, making behavioral change complex. The QUALI\u2010DEC intervention provided a pragmatic, team\u2010based strategy to empower women and engage healthcare providers in evidence\u2010based and patient\u2010centered decision\u2010making. Using the TIDieR checklist ensured a detailed description, supporting replication, implementation, and monitoring in other maternity units in low\u2010 and middle\u2010income countries.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial registration<\/jats:bold>\n                      : ISRCTN67214403.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70817","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T10:10:54Z","timestamp":1769076654000},"page":"219-228","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reporting the\n                    <scp>QUALI<\/scp>\n                    \u2010\n                    <scp>DEC<\/scp>\n                    intervention to optimize cesarean section use in low\u2010 and middle\u2010income countries: A\n                    <scp>TIDieR<\/scp>\n                    \u2010based 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