QUALI-DEC aims to develop and evaluate a strategy to implement four components aimed to decrease the use of unnecessary caesarean sections in four countries. All these components are interrelated and actions should be country specific designed to interact in the field. Women’s decision making is a key component closely related to maternity care performance in each country. The Decision Analysis Tool aims to inform women and to facilitate intercommunication between women and health professionals. DAT has to be adapted to the context in which it is used. Adaptation includes societal, cultural and clinical aspects to be considered previous to translation.