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

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.