This manual was designed to guide the implementation of the study at the facility level. It is expected that this document will help to clarify any uncertainties in the study procedures and data collection. This manual of operations is the reference document for researchers and all staff in the participating centres. The hospital coordinator and participating staff should be familiar with this manual of operations before data collection starts and refer to it when there is doubt about the study procedures. It is fundamental that the project is carried out exactly as described in the protocol and that all information is appropriately collected for all eligible women.