The use of the partograph in labor monitoring: a cross-sectional study among obstetric caregivers in General Hospital, Calabar, Cross River State, Nigeria

Abstract

Background

Prolonged and obstructed labor is a significant cause of maternal morbidity and mortality in Nigeria, one of the six countries contributing significantly to the global maternal mortality crisis. The use of the partograph would engender a remarkable reduction in the number of these deaths since abnormal markers in the progress of labor would be identified early on.

Objective

This study aimed to evaluate the non-physician obstetric caregivers’ (OCGs) knowledge of partograph use, assess the extent of its use, determine the factors that impede its usage, and unravel the relationship between years of experience and partograph use among the respondents (OCGs) in General Hospital, Calabar, Nigeria.

Methodology

Using a self-administered semi-structured questionnaire, a cross-sectional descriptive study was conducted among 130 purposely selected and consenting OCGs working in the General Hospital, Calabar, Nigeria.

Results

The majority of the respondents (70.8%) had good general knowledge of the partograph but lacked detailed and in-depth knowledge of the component parts of the partograph. Knowledge of partograph (χ²=12.05, P=0.0001) and partograph availability (χ²=56.5, P=0.0001) had a significant relationship with its utilization. Previous training (χ²=9.43, P=0.002) was significantly related to knowledge of partograph. Factors affecting utilization were: little or no knowledge of the partograph (85.4%), nonavailability (70%), shortage of staff (61.5%), and the fact that it is time-consuming to use (30%).

Conclusion

Lack of detailed knowledge of the partograph, nonavailability of the partograph, poor staff numbers, and inadequate training are factors that work against the effective utilization of the partograph in the study facility. Usage of this tool for labor monitoring can be enhanced by periodic training, making partographs available in labor wards, provision of reasonable staff numbers, and mandatory institutional policy.

Keywords:

• knowledge
• utilization
• partograph
• obstetric caregivers
• labor monitoring
• Nigeria

Acknowledgments

The authors wish to express their appreciation to the management of General Hospital, Calabar, particularly the Medical Superintendent, Dr Aya Nkanu and the Chief Nursing Officer in-charge, Mrs Janet Agorye. We are also grateful to the Medical Record staff of the hospital, for their cooperation and attitude to duty and research.

Disclosure

The authors report no conflicts of interest in this work.