Completeness of Partographs used by Midwives in a Sub County Hospital in Kenya

Jonah kipngetich Sigei

Abstract


Background: The partograph is a tool used globally to record labour progress and identify any complications early. Although it has the potential to improve maternal and fetal outcomes it is not used effectively and correctly by midwives thus poor labor outcomes. The world health organization (WHO) recommends using it with the objective to improve health care and reduce maternal and fetal morbidity and death. The objective was to determine completeness and perception on usefulness of partographs among midwives at Kapkatet sub county hospital.  

Methodology:  It was a cross-sectional study design involving both qualitative and quantitative approaches where 177 partographs were audited and 15 midwives interviewed. Data was collected using questionnaires, in-depth interview schedules and observation checklist.

Findings: Out of the 177 partographs audited,44.9(25.4%) were complete and on admission data, date and time was done on 112(63.3%) partographs, mothers name  was  documented on 149(84.2%) while parity, gravidity was evident on 105(59.3%)  and 61(35%) respectively. Cervical dilatation and descent were documented in 131(74%) and 96(54%) respectively. Moulding and caput were documented in this uterine contraction at 87(49.7%) and blood pressure at 23(46.9%). There was a significant relationship between importance of the partograph in labor management and frequency of use of partograph (χ2=12.000, p=0.030).

Conclusion: Factors hindering completeness were increased workload, inefficient supervision, poor attitude, lack of motivation and supervision. Adequate training, supervision, motivation and improvement of midwife: patient ratio should be enhanced to improve on partograph completeness.


Keywords


partograph;labor;fetal heart rate

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References


References

Hogan, M., &Naghavi, M. (2008). A systematic analysis of progress towards millennium

Johnson,A. (2013). Theory building in applied discipline, San Francisco,LA. Berreit-Koehler publishers 2013.

Khonje,M., (2012). A cross sectional study onuse and documentation of partograph and factorsthatprevent optimal utilization of the partograph: Perspectives ofhealth workersat

BwailaandEthel Mutharika MaternityUnits in Lilongwe–Malawi, University of Oslo, Norway,1-155.

Kitila, S. (2014).Utilization of partograph during labor and birth outcomes at Jimmauniversity. Pregnancy and child health.

Kongnyuy, E. (2008). Establishing standards for obstructed labour in low income countries. Rural remote health 8(3)1022-1030

Lavender, T., &Wilkshaw, S. (2008). Effect of different partograph action lines on birth outcomes.A randomized control trials. Journal of obstetrics and gynecology 108:295-302

Lavender, T., &Malcolmson, l. (1999). Is the partograph a help or a hindrance?. An explorative study of midwives views. Practicing midwife 2:23-27

Lavender, T., &Wilkishaw, S. A. (1999). Managing labour using partograph with different action lines. A prospective study of women’s views. British Journal of obstetrics and gynecology 1999; 26:89-96

Lavender,T. (2012).Effect of partogram use of outcomes in spontaneous labor at term. Cochrain Database Systematic Reviews 2013 4(7)

Levin,K.(2011).Use of the partograph. Effectiveness, training, modifications, and barriers.Newyork;Engenderhealth/Fistula care

Maimbolwa, M.C., Ransjo, A.B., Ngandu, N., Sikazwe, N., Diwan, V.K. (1997). Routine care of women experiencing normal deliveries in Zambian maternity wards. A pilot study: midwifery 13(3):125-131

Mercer, S.W.,&Sevar, K. (2006). Using clinical audit to improve quality 0f obstetric care at Tibetan Delek Hospital in North India. A longitudinal study. Reproductive health 3 (40)1010-1050

Polit,D.F, &Beck,C. (2001). Essentials of Nursing Research Methods appraisals and utilization. Lippincott, Philadelphia.

Qureshi, Z., &Kigondu, C. (2010). Rapid assessment of partograph utilization in selected maternity units in Kenya. East African medical journal 87(6)235-241

Ronsman, C. (2006). Maternal mortality: who, when, where, and why. Lancet 2006;368:1189-1198

Sachs, J., & Graham, W. (2005). The millennium project: A plan for meeting the millennium development: Lancet 2005;365:347-353

World Health Organization partograph in management of labour (WHO, 1994) World health organization maternal health and safe motherhood programme. Lancet 1994:343:1399-1404

World health organization report 2005. Making every mother and child count. W.H.O Geneva


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