Table 3 Operational definitions of conditions used in constructing truth tables

Actionable recommendations: each audit and feedback cycle produced actionable recommendations that healthcare providers could act upon until next cycle

Active dissemination of CS indications: implementation CS indications, such as clinical algorithms on when to conduct CS, through guidelines or protocol implementation, information, education and communication (IEC) materials, or reminder systems)

Dictated nature of intervention: intervention which used top-down enforcement where mandate to reduce CS was imposed

Frequent audit and feedback cycle: frequent audit and feedback cycle which classified either weekly or monthly

Healthcare providers’ willingness to change: providers willingness to adopt to change and adhere to the intervention. Willingness to change was added as it becomes and overarching factor across qualitative evidence syntheses [28, 86] and discussion section of trials reports [34, 44] – where both providers and trialists mentioned that the underlying factor of success lies on providers’ beliefs about CS and vaginal birth, as well as whether providers are willing to step out of their comfort zone to change

Individual dissemination of audit and feedback results: dissemination of audit and feedback results to providers individually instead in group settings

Internal policies that support vaginal birth: whether internal policies that support vaginal birth or the intervention exists outside of the intervention. This include national consensus in improving CS rates where CS is nationally treated as a measure of institutional and individual practice quality [44], recommended maternity practices supporting physiologic birth [39, 41, 43, 45], national guidelines on vaginal birth after caesarean (VBAC) [67], equipment and technical support for local healthcare facilities [63], implementation of new care models favouring physiologic birth [65], additional rooms to support physiologic birth [65], hire full-time obstetricians [34], and increase staffing in the labour ward [34]

Multidisciplinary collaboration: when the intervention involved different cadre of health workers in caring for women, which could include team of obstetricians, midwives, nurses, and doctors working together

Reflective nature of intervention: Leveraged bottom-up approach through discussions and consultations

Training to improve providers’ knowledge and skills: implementation of theory-based or practical education session for healthcare providers to improve their knowledge and skills on labour management