Skip to main content
Top
Published in: Reproductive Health 1/2017

Open Access 01-12-2017 | Research

Documentation of the partograph in assessing the progress of labour by health care providers in Malawi’s South-West zone

Authors: Chrispin Mandiwa, Collins Zamawe

Published in: Reproductive Health | Issue 1/2017

Login to get access

Abstract

Background

There is some evidence that appropriate use of partograph in monitoring the progress of labour could decrease delivery related complications. The documentation of parameters of partographs is however, poorly understood. The aim of the present study was to determine the extent to which health care workers are making use of the partograph in monitoring the progress of labour through checking the documentation of the parameters of the partographs.

Methods

A hospital-based descriptive study involving retrospective review of partographs for births that occurred in 2016 was conducted in Malawi’s South-West zone. A total of 1070 partographs that were used to monitor labour in two public hospitals were reviewed to determine the documentation of the parameters of partographs and descriptive statistics were computed using statistical package for the social science software version 22.0.

Results

Of the total 1070 partographs reviewed, 58.6% (n = 627) of the partographs had no recording of maternal blood pressure and 65.3% (n = 699) of the partographs had no temperature documentation. Moulding was not recorded in 25.4% (n = 272) of the partographs, foetal heart rate was not recorded in 14.9% (n = 159) of the partographs and descent of the foetal head was not recorded in 12.0% (n = 128) of the partographs.

Conclusion

There is poor documentation of vital parameters of the partographs. This suggests insufficient monitoring of the progress of labour, which may lead to adverse pregnancy outcomes. To improve the accurate documentation of parameters of the partograph, there is a need to understand the problem and provide tailor-made solutions to address them and ultimately improve pregnancy outcomes. In the meantime, in-service refresher courses on partograph use to health care workers need to be conducted regularly. Supportive supervision to obstetric care providers and regular partograph audit could also improve documentation.
Literature
2.
go back to reference Harrison MS, Griffin JB, McClure EM, Jones B, Moran K, Goldenberg RL. Maternal mortality from obstructed labor: a MANDATE analysis of the ability of technology to save lives in sub-Saharan Africa. Am J Perinatol. 2016;33(9):873–81. 10.1055/s-0036-1571322. CrossRefPubMed Harrison MS, Griffin JB, McClure EM, Jones B, Moran K, Goldenberg RL. Maternal mortality from obstructed labor: a MANDATE analysis of the ability of technology to save lives in sub-Saharan Africa. Am J Perinatol. 2016;33(9):873–81. 10.​1055/​s-0036-1571322.​ CrossRefPubMed
3.
go back to reference Asibong U, Okokon IB, Agan TU, Oku A, Opiah M, Essien EJ, et al. The use of the partograph in labor monitoring: a cross-sectional study among obstetric caregivers in general hospital, Calabar, Cross River state, Nigeria. Int J Women’s Health. 2014;6:873. Asibong U, Okokon IB, Agan TU, Oku A, Opiah M, Essien EJ, et al. The use of the partograph in labor monitoring: a cross-sectional study among obstetric caregivers in general hospital, Calabar, Cross River state, Nigeria. Int J Women’s Health. 2014;6:873.
4.
go back to reference Mathai M. The partograph for the prevention of obstructed labor. Clin Obstet Gynecol. 2009;52(2):256–69.CrossRefPubMed Mathai M. The partograph for the prevention of obstructed labor. Clin Obstet Gynecol. 2009;52(2):256–69.CrossRefPubMed
5.
go back to reference Levels and causes of maternal mortality and morbidity. In: Black RE, Laxminarayan R, Temmerman M, Walker N, editors. Reproductive, maternal, newborn, and child health: disease control priorities, third edition (volume 2). Washngton, DC: The International Bank for Reconstruction and Development/The World Bank; 2016. Chapter 3. p.51–70. Levels and causes of maternal mortality and morbidity. In: Black RE, Laxminarayan R, Temmerman M, Walker N, editors. Reproductive, maternal, newborn, and child health: disease control priorities, third edition (volume 2). Washngton, DC: The International Bank for Reconstruction and Development/The World Bank; 2016. Chapter 3. p.51–70.
6.
go back to reference Kayiga H, Ajeani J, Kiondo P, Kaye DK. Improving the quality of obstetric care for women with obstructed labour in the national referral hospital in Uganda: lessons learnt from criteria based audit. BMC Pregnancy Childbirth. 2016;16(1):152.CrossRefPubMedPubMedCentral Kayiga H, Ajeani J, Kiondo P, Kaye DK. Improving the quality of obstetric care for women with obstructed labour in the national referral hospital in Uganda: lessons learnt from criteria based audit. BMC Pregnancy Childbirth. 2016;16(1):152.CrossRefPubMedPubMedCentral
7.
go back to reference Kabakyenga JK, Östergren P-O, Turyakira E, Mukasa PK, Pettersson KO. Individual and health facility factors and the risk for obstructed labour and its adverse outcomes in south-western Uganda. BMC Pregnancy Childbirth. 2011;11(1):73.CrossRefPubMedPubMedCentral Kabakyenga JK, Östergren P-O, Turyakira E, Mukasa PK, Pettersson KO. Individual and health facility factors and the risk for obstructed labour and its adverse outcomes in south-western Uganda. BMC Pregnancy Childbirth. 2011;11(1):73.CrossRefPubMedPubMedCentral
8.
go back to reference Mukasa PK, Kabakyenga J, Senkungu JK, Ngonzi J, Kyalimpa M, Roosmalen VJ. Uterine rupture in a teaching hospital in Mbarara, western Uganda, unmatched case-control study. Reprod Health. 2013;10(1):29.CrossRefPubMedPubMedCentral Mukasa PK, Kabakyenga J, Senkungu JK, Ngonzi J, Kyalimpa M, Roosmalen VJ. Uterine rupture in a teaching hospital in Mbarara, western Uganda, unmatched case-control study. Reprod Health. 2013;10(1):29.CrossRefPubMedPubMedCentral
9.
go back to reference Kushwah B, Singh AP, Singh S, Kushwah B, Campus S, Huzur R. The partograph: an essential yet underutilized tool. J Evol Med Dent Sci. 2013;2(24):4373–9.CrossRef Kushwah B, Singh AP, Singh S, Kushwah B, Campus S, Huzur R. The partograph: an essential yet underutilized tool. J Evol Med Dent Sci. 2013;2(24):4373–9.CrossRef
10.
go back to reference Sayinzoga F, Bijlmakers L, van Dillen J, Mivumbi V, Ngabo F, van der Velden K. Maternal death audit in Rwanda 2009–2013: a nationwide facility-based retrospective cohort study. BMJ Open. 2016;6(1):e009734.CrossRefPubMedPubMedCentral Sayinzoga F, Bijlmakers L, van Dillen J, Mivumbi V, Ngabo F, van der Velden K. Maternal death audit in Rwanda 2009–2013: a nationwide facility-based retrospective cohort study. BMJ Open. 2016;6(1):e009734.CrossRefPubMedPubMedCentral
11.
go back to reference Mgawadere F, Unkels R, Adegoke A, van den Broek N. Measuring maternal mortality using a reproductive age mortality study (RAMOS). BMC Pregnancy Childbirth. 2016;16(1):291.CrossRefPubMedPubMedCentral Mgawadere F, Unkels R, Adegoke A, van den Broek N. Measuring maternal mortality using a reproductive age mortality study (RAMOS). BMC Pregnancy Childbirth. 2016;16(1):291.CrossRefPubMedPubMedCentral
12.
go back to reference Souza JP, Oladapo OT, Bohren MA, Mugerwa K, Fawole B, Moscovici L, et al. The development of a simplified, effective, labour monitoring-to-action (SELMA) tool for better outcomes in labour difficulty (BOLD): study protocol. Reprod Health. 2015;12(1):49.CrossRefPubMedPubMedCentral Souza JP, Oladapo OT, Bohren MA, Mugerwa K, Fawole B, Moscovici L, et al. The development of a simplified, effective, labour monitoring-to-action (SELMA) tool for better outcomes in labour difficulty (BOLD): study protocol. Reprod Health. 2015;12(1):49.CrossRefPubMedPubMedCentral
13.
go back to reference Lavender T, Hart A, Smyth R. Effect of partogram use on outcomes for women in spontaneous labour at term. Cochrane Database Syst Rev. 2013;7:CD005461. Lavender T, Hart A, Smyth R. Effect of partogram use on outcomes for women in spontaneous labour at term. Cochrane Database Syst Rev. 2013;7:CD005461.
14.
go back to reference Kwast B, Lennox C, Farley T, Olayinka I. World health organization partograph in management of labour. Lancet. 1994;343(8910):1399. Kwast B, Lennox C, Farley T, Olayinka I. World health organization partograph in management of labour. Lancet. 1994;343(8910):1399.
15.
go back to reference Khonje M. Use and documentation of partograph in urban hospitals in Lilongwe-Malawi: health workers perspective: a cross sectional study on use and documentation of partograph and factors that prevent optimal utilization of the partograph: perspectives of health workers at Bwaila and Ethel Mutharika Maternity Units in Lilongwe-Malawi. 2012. https://www.duo.uio.no/handle/10852/30053. Accessed 27 Apr 2017. Khonje M. Use and documentation of partograph in urban hospitals in Lilongwe-Malawi: health workers perspective: a cross sectional study on use and documentation of partograph and factors that prevent optimal utilization of the partograph: perspectives of health workers at Bwaila and Ethel Mutharika Maternity Units in Lilongwe-Malawi. 2012. https://​www.​duo.​uio.​no/​handle/​10852/​30053. Accessed 27 Apr 2017.
16.
go back to reference National Statistical Office (NSO)[Malawi] and ICF. Malawi demographic and health survey 2015–16. Zomba, Malawi, and Rockville, Maryland, USA: NSO and ICF; 2017. National Statistical Office (NSO)[Malawi] and ICF. Malawi demographic and health survey 2015–16. Zomba, Malawi, and Rockville, Maryland, USA: NSO and ICF; 2017.
17.
go back to reference Simwaka BN, Theobald S, Amekudzi YP, Tolhurst R. Meeting millenium development goals 3 and 5: gender equality needs to be put on the African agenda. Brit Med J. 2005;331(7519):708–9. Simwaka BN, Theobald S, Amekudzi YP, Tolhurst R. Meeting millenium development goals 3 and 5: gender equality needs to be put on the African agenda. Brit Med J. 2005;331(7519):708–9.
18.
go back to reference Markos D, Bogale D. Documentation status of the modified World Health Organization partograph in public health institutions of bale zone, Ethiopia. Reprod Health. 2015;12(1):81.CrossRefPubMedPubMedCentral Markos D, Bogale D. Documentation status of the modified World Health Organization partograph in public health institutions of bale zone, Ethiopia. Reprod Health. 2015;12(1):81.CrossRefPubMedPubMedCentral
19.
go back to reference Yisma E, Dessalegn B, Astatkie A, Fesseha N. Completion of the modified World Health Organization (WHO) partograph during labour in public health institutions of Addis Ababa, Ethiopia. Reprod Health. 2013;10(1):23.CrossRefPubMedPubMedCentral Yisma E, Dessalegn B, Astatkie A, Fesseha N. Completion of the modified World Health Organization (WHO) partograph during labour in public health institutions of Addis Ababa, Ethiopia. Reprod Health. 2013;10(1):23.CrossRefPubMedPubMedCentral
20.
go back to reference Rotich E, Maina L, Njihia A, Christensson K. Evaluating partograph use at two main referral hospitals in Kenya.African. J Midwifery Women's Health. 2011;5(1):21–4. Rotich E, Maina L, Njihia A, Christensson K. Evaluating partograph use at two main referral hospitals in Kenya.African. J Midwifery Women's Health. 2011;5(1):21–4.
21.
go back to reference Mathibe-Neke J, Lebeko F, Motupa B. The partograph: a labour management tool or a midwifery record? Int J Nurs Midwifery. 2013;5(8):145–53.CrossRef Mathibe-Neke J, Lebeko F, Motupa B. The partograph: a labour management tool or a midwifery record? Int J Nurs Midwifery. 2013;5(8):145–53.CrossRef
22.
go back to reference Nyamtema A, Urassa D, Massawe S, Massawe A, Lindmark G, Van Roosmalen J. Partogram use in the Dar es salaam perinatal care study. Int J Gynecol Obstet. 2008;100(1):37–40.CrossRef Nyamtema A, Urassa D, Massawe S, Massawe A, Lindmark G, Van Roosmalen J. Partogram use in the Dar es salaam perinatal care study. Int J Gynecol Obstet. 2008;100(1):37–40.CrossRef
23.
go back to reference Ogwang S, Karyabakabo Z, Rutebemberwa E. Assessment of partogram use during labour in rujumbura health sub district, Rukungiri district, Uganda. Afr Health Sci. 2009;9(Suppl 1):27–34. Ogwang S, Karyabakabo Z, Rutebemberwa E. Assessment of partogram use during labour in rujumbura health sub district, Rukungiri district, Uganda. Afr Health Sci. 2009;9(Suppl 1):27–34.
24.
go back to reference Qureshi Z, Sekadde-Kigondu C, Mutiso S. Rapid assessment of partograph utilisation in selected maternity units in Kenya. East Afr Med J. 2010;87(6):235–41.PubMed Qureshi Z, Sekadde-Kigondu C, Mutiso S. Rapid assessment of partograph utilisation in selected maternity units in Kenya. East Afr Med J. 2010;87(6):235–41.PubMed
25.
go back to reference Sama CB, Takah NF, Danwe VK, Melo UF, Dingana TN, Angwafo IIIFF. Knowledge and utilization of the partograph: a cross-sectional survey among obstetric care providers in urban referral public health institutions in northwest and southwest Cameroon. PLoS One. 2017;12(2):e0172860.CrossRefPubMedPubMedCentral Sama CB, Takah NF, Danwe VK, Melo UF, Dingana TN, Angwafo IIIFF. Knowledge and utilization of the partograph: a cross-sectional survey among obstetric care providers in urban referral public health institutions in northwest and southwest Cameroon. PLoS One. 2017;12(2):e0172860.CrossRefPubMedPubMedCentral
Metadata
Title
Documentation of the partograph in assessing the progress of labour by health care providers in Malawi’s South-West zone
Authors
Chrispin Mandiwa
Collins Zamawe
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Reproductive Health / Issue 1/2017
Electronic ISSN: 1742-4755
DOI
https://doi.org/10.1186/s12978-017-0401-7

Other articles of this Issue 1/2017

Reproductive Health 1/2017 Go to the issue