Assessment of usage of the modified World Health Organisation (WHO) partograph by midwives within the Accra Metropolitan Health Facilities, Ghana

The use of Partograph reduces maternal mortality and morbidity by highly significant margins. Partograph is a simple chart for recording information about the progress of labour while monitoring the condition of the woman as well as her baby during labour. Accepted at the 1987 Safe Motherhood conference held in Nairobi after producing, testing and approving its use during labour to reduce complications it is dreadful to observe its poor utilization by midwives. The partograph was designed to record the history and observations on labour, to alert the care giver and prompt her on the action to be taken, but its parameters are not well monitored by care givers. Even though the World Health Organization (WHO) accepted and encouraged the use of partograph as one of the five pillars that were identified to help reduce maternal and infant morbidity and mortality, midwives in Ghana and many parts of the world have demonstrated little interest in the significance of its use. This study was conducted to assess the acceptability and usage of WHO modified Partograph by midwives in some selected delivery centers of the Accra Metropolis. Methods: The study is a cross sectional design. The researcher designed a structured questionnaire containing questions based on the objectives of the study. The questionnaires comprised both open-ended and closed-ended questions. A checklist was also used to assess the consistency of maternal and foetal recordings on the partograph. Non probability sampling technique specifically purposive was used to select 73 practicing midwives in the labour wards at random for interview using carefully designed questionnaires. About 300 filled partograph were sampled within the period of June and July and used as a secondary source of data. Data from structured questionnaire was analyzed by use of SPSS version 16.0 and cross referenced with data from checklist and secondary data to ensure rigor, reliability and scalability. ` Results: The results showed that majority of midwives (89.0%) said Partograph use in monitoring labour is very good and that it should be made compulsory. The results further showed that midwives see it necessary to use partograph. However, it will require effective monitoring to ensure that entries are complete and that there is regular utilization. Also Partograph that are filled are incomplete. The result further showed insufficient in-service training and refresher courses for midwives on the use of Partograph. Conclusion and Recommendation: In the final analysis, an assessment of the usage of WHO Partograph shows a highly positive impact. Effective use of the Partograph does not require much effort or scarce resources but institutional, environmental and personnel permissiveness consistently hinder Partograph utilization to the detriment of the safe motherhood. The study cautiously recommended re-enforcing the use of Partograph and acknowledging the facilities that use Partograph to monitor labour. Monthly peer review on the use of Partograph and recommended prizes awarded on its appropriate use is also suggested and the need for refresher or in-service training on the use of Partograph is recommended. Lastly, it was recommended that further studies on Partograph utilization should be undertaken using a qualitative approach.

Source: KNUST