Completion of the modified World Health Organization (WHO) partograph during labour in public health institutions of Addis Ababa, Ethiopia

Reproductive Health

Nebreed Fesseha³  Ayalew Astatkie¹  Berhanu Dessalegn²  Engida Yisma⁴ 

[1] School of Public and Environmental Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia;Department of Nursing and Midwifery, School of Allied Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia;JSI L10k Research and Training Institute, Addis Ababa, Ethiopia;Department of Nursing, Faculty of Medical and Health Sciences, Samara University, Samara, Ethiopia

关键词: Ethiopia;    Addis Ababa;    Public health institutions;    Completion;    Modified WHO partograph;   

Others  :  811635
DOI  :  10.1186/1742-4755-10-23

 received in 2013-02-12, accepted in 2013-04-15,  发布年份 2013

【 摘 要 】

Background

The World Health Organization (WHO) recommends using the partograph to follow labour and delivery, with the objective to improve health care and reduce maternal and foetal morbidity and death. The partograph consists of a graphic representation of labour and is an excellent visual resource to analyze cervix, uterine contraction and foetal presentation in relation to time. However, poor utilization of the partograph was found in the public health institutions which reflect poor monitoring of mothers in labour and/or poor pregnancy outcome.

Methods

A retrospective document review was undertaken to assess the completion of the modified WHO partograph during labour in public health institutions of Addis Ababa, Ethiopia. A total of 420 of the modified WHO partographs used to monitor mothers in labour from five public health institutions that provide maternity care were reviewed. A structured checklist was used to gather the required data. The collected data were analyzed using SPSS version 16.0. Frequency distributions, cross-tabulations and a graph were used to describe the results of the study.

Results

All facilities were using the modified WHO partograph. The correct completion of the partograph was very low. From 420 partographs reviewed across all the five health facilities, foetal heart rate was recorded into the recommended standard in 129(30.7%) of the partographs, while 138 (32.9%) of cervical dilatation and 87 (20.70%) of uterine contractions were recorded to the recommended standard. The study did not document descent of the presenting part in 353 (84%). Moulding in 364 (86.7%) of the partographs reviewed was not recorded. Documentation of state of the liquor was 113(26.9%), while the maternal blood pressure was recorded to standard only in 78(18.6%) of the partographs reviewed.

Conclusions

This study showed a poor completion of the modified WHO partographs during labour in public health institutions of Addis Ababa, Ethiopia. The findings may reflect poor management of labour or simply inappropriate completion of the instrument and indicate the need for pre-service and periodic on-job training of health workers on the proper completion of the partograph. Regular supportive supervision, provision of guidelines and mandatory health facility policy are also needed in support of a collaborative effort to reduce maternal and perinatal deaths.

【 授权许可】

   
2013 Yisma et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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