Partograph: An Essential Tool for Midwives to Manage Labor at Public Health Institutions in Tigray, Northern Ethiopia

Abstract

Abstract

A partograph is a graphical presentation of a woman’s progress of labour. Once the woman has true signs of labour and reaches active first stage of labor, the midwife initiates the use of the partograph to record her findings. Prolonged labor; mainly due to cephalopelvic disproportion (CPD), which may result in obstructed labor, maternal dehydration, ruptured uterus, obstetric fistulae, fetal asphyxia, fetal brain damage, infection and death of both mother and neonate. Among the cost effective interventions, partograph is one of the best effective, pragmatic midwifery tool for monitoring labor and prevent prolonged or obstructed labor which accounts for about 22% of maternal deaths in Ethiopia. Partograph thus serves as an ‘early warning system and assists in early decision on transfer, or intervention. The objective of the study was to assess determinants of partograph utilization among obstetric care givers at public health institutions in Tigray region. A facility based cross-sectional study design was conducted from October/2015 to June/2015 among 233 obstetric care givers at Tigray region. Stratified sampling technique was employed by stratifying all public health institutions and from all public hospitals, five hospitals; and from all health centers, 35 health centers were selected by simple random sampling technique. The total sample size of the study was distributed over each of the institute proportional to their size. And the required number of study subjects were selected randomly from each health facility. Data was entered and cleaned using Epi-info version 3.5.1, and was analyzed using SPSS window version 20 software. Both bivariate and multivariate analysis with 95% CI was applied to avoid any confounding variables. Finally, the results were presented in texts, tables and graphs. Knowledge about the partograph was fair: 156 (53.4%) of all the respondents correctly answered above the median value of the total questions of partograph components. The study showed that, 167 (57.4%) of the obstetric care givers at public health institutions reportedly utilized modified WHO partograph to monitor progress of labor and condition of both the mother and fetus. Those who had previous obstetric training were 2.1 time more likely to have fair knowledge of the partograph than others (AOR=2.1, 95% CI=(1.3, 3.7)). A significant percentage of obstetric care givers had fair knowledge of the modified WHO partograph. Presence of prior training, participants’ sex and profession were the variables that had influenced the level of knowledge of the partograph and obstetric care. Thus, periodic on-job training regarding the partograph should be provided to all obstetric care providers and regular supportive supervision is also needed to motivate staffs to utilize the modified WHO partograph and help them become dedicated to record and document their findings.

Keywords: Child birth, parthograph, utilization, knowledge, obstetric care provider

Cite this Article

Haftom Gebrehiwot, Samson Mulugeta, Tsige Araya, et al. Partograph: an essential tool for midwives to manage labor at public health institutions in Tigray, Northern Ethiopia. Research and Reviews: Journal of Immunology. 2015; 5(3): 23–29p.