Utilization of the partograph to monitor progress of labour by midwives at the three public Hospitals in Zambia

Abstract

A partograph is a graphic pre-printed paper that provides visual display of recorded observations carried-out on a mother and foetus during labour for early detection of abnormalities. The World Health Organisation (WHO) has advocated and recommended compulsory use of partograph in the monitoring process of labour. Despite WHO’s position, partographs are still being under-utilised especially in developing countries including Zambia. Most health workers do not document findings on a partograph after reviewing a labouring woman. Hence, labour progress may not be closely monitored or labour monitoring may not translate into actions required when need arises. The present research was done to determine the utilisation of the partograph to monitor progress of labour by midwives at Kamuchanga District Hospital, Ronald Ross General Hospital in Mufulira and University Teaching hospital in Lusaka. The objectives of the study were to: establish existence of utilisation of the partograph and to review records of partographs retrospectively to identify maternal, foetal and labour parameters which were not completely recorded. This was a quantitative descriptive cross-sectional study comprising 27 midwives from Kamuchanga, 18 from Ronald Ross General hospital and 42 from University Teaching Hospital. Data were collected by use of questionnaires. Partographs were also reviewed in retrospective from Kamuchanga (26), Ronald Ross General Hospital (38) and University Teaching Hospital (320). A two stage sampling technique was used to sample both midwives and partographs. Convenient sampling was used to select study sites while random sampling was applied to choose respondents. Data analysis was done with the assistance of computer software Statistical Package for Social Sciences (SPSS) version 20. The analysed data were presented in frequency tables and cross tabulations. The major findings of the study showed that 88.5% of respondents were utilising the partograph. For respondents who were using partographs, 89.7% indicated that pre-printed partographs were available in delivery centres with 58.6% saying that there was no shortage of pre-printed partographs at their centres. On the other hand, 63.8% of respondents who had never attended any workshop or orientation on partographs used them. Respondents who said that they had protocols on partograph use at their delivery centres were 84.5%. The study recommend that further research should be done to determine best ways midwives can utilise the partograph and probably adopt other ways that could be as feasible and sustainable as a partograph to monitor labour. Key words: partograph, partograph utilization, labour management tool, progress of labour.