The Challenge of Improving Perinatal Care in Settings with Limited Resources. Observations of Midwifery Practices in Mozambique

Christensson, Kyllike; Petterson, Karen Odberg; Bugalho, António; Cunba,; Manuela, Maritza; Dgedge., Clemencia; Johansson, Eva; Bergström, Staffan

doi:10.2307/30032443

Cited by 10 publications

(13 citation statements)

References 21 publications

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“…Midwives adhered to resuscitation steps that concerned prevention of heat loss and obstruction of airway. Similar results were reported by Christtensson, et al [11] from Mozambique and Berglund, et al [12] from Sweden. However, most of the crucial steps that lead to neonate prolonged exposure to moisture were not adhered to.…”

Section: Midwives' Adherence To Resuscitation Guidelinessupporting

confidence: 81%

“…According to Singhal & Bhuta [13], more than half of newborns requiring resuscitation could be identified before birth if the mother is monitored appropriately for risk factors. Similar results were reported by Christensson et al [11] in Mozambique where partographs were used to monitor only half of the deliveries. The results show that young and less experienced midwives had problems with partograph use.…”

Section: Midwives Ability To Identify Warning Signs Of Birth Asphyxiasupporting

confidence: 78%

“…Participants failed to score despite the fact that the scoring charts were readily available in the labor ward cubicles. Instead the midwives gave Apgar scores to the neonates using their experiences as also reported by Christtensson, et al [11]. Scoring babies based on experience is not a recommended practice, hence a risk factor because the babies might have been given a wrong Apgar score that compromised the quality of care.…”

Section: Midwives Ability To Identify Warning Signs Of Birth Asphyxiamentioning

confidence: 99%

“…The fetal heart rate for example was not monitored according to the guidelines. Instead of checking the fetal heart half hourly, it was monitored every 2 hours or was not monitored at all as also reported from Mozambique [11] in which the fetal heart was not monitored on half of the partographs despite having the risk factor of asphyxia. Color of liquor which is supposed to be monitored together with fetal heart to assess the fetal condition was also not done according to the guidelines.…”

Section: Midwives Ability To Identify Warning Signs Of Birth Asphyxiamentioning

confidence: 99%

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Midwives’ adherence to guidelines on the management of birth asphyxia in Malawi

Chikuse¹,

Chirwa²,

Maluwa³

et al. 2012

OJN

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A study was conducted to determine midwives adherence to guidelines on management of birth asphyxia at Queen Elizabeth Central Hospital in Blantyre district, Malawi. The study design was descriptive cross sectional using quantitative data analysis method on 75 midwives that were working in the maternity unit of the hospital. A structured questionnaire was used to collect data on participant's demographic characteristics and midwives' comprehension of birth asphyxia and an observational check list was used to observe midwives' adherence to WHO resuscitation guidelines. In addition midwives were observed on their adherence to the Integrated Maternal and Neonatal Health guidelines that were developed by the Malawi Ministry of Health. The findings indicate that the midwives had knowledge of birth asphyxia in general. However, there were gaps in their ability to identify warning signs of birth asphyxia through partograph use. In addition the midwives did not adhere to 9 out of the 21 steps of the resuscitation guideline. Generally there was substandard adherence to guidelines on identification of warning signs of birth asphyxia and neonatal resuscitation. On the other hand, the facility did not have adequate resuscitation equipment and supplies. The results are discussed in relation to the importance of adhering to resuscitation guidelines in the management of birth asphyxia for babies that do not breathe at birth. Training of the midwives on partograph use and resuscitation to improve neonatal outcomes is recommended. It is recommended further that the health facility should have adequate resuscitation equipment and supplies.

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Section: Midwives' Adherence To Resuscitation Guidelinessupporting

confidence: 81%

Section: Midwives Ability To Identify Warning Signs Of Birth Asphyxiasupporting

confidence: 78%

Section: Midwives Ability To Identify Warning Signs Of Birth Asphyxiamentioning

confidence: 99%

Section: Midwives Ability To Identify Warning Signs Of Birth Asphyxiamentioning

confidence: 99%

See 2 more Smart Citations

Midwives’ adherence to guidelines on the management of birth asphyxia in Malawi

Chikuse¹,

Chirwa²,

Maluwa³

et al. 2012

OJN

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“…Low awareness of the partograph itself was an issue [17, 32, 34], and lack of knowledge was widely reported, often within a wider deficit of knowledge and skills in maternity care [1, 15, 16, 18, 19, 32, 34, 35, 39–46]. Other barriers included attitude and limited confidence [15, 18], variation in commitment [34], and inadequate interaction with women [47]. …”

Section: Resultsmentioning

confidence: 99%

Barriers to and incentives for achieving partograph use in obstetric practice in low- and middle-income countries: a systematic review

Ollerhead¹,

Osrin²

2014

BMC Pregnancy Childbirth

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BackgroundThe partograph is a graphic display of the progress of labour, recommended by the World Health Organization, but often underused in practice in low- and middle-income countries. We were interested in going beyond demonstration of potential efficacy – on which the existing literature concentrates - through a systematic review to identify barriers to and incentives for achieving partograph use.MethodsWe searched Ovid MEDLINE, Ovid Maternity and Infant Care, POPLINE, Web of Science, and Scopus, from 1st January 1994 to 30th September 2013, using the term ‘partogra*’ to include ‘partograph’, ‘partogram’, or ‘partogramme’. The selection criteria were for primary or secondary research describing barriers to and incentives for partograph use in low- and middle-income countries, in English, reported in peer-reviewed publications since 1994. Thematic analysis of text on partograph use was applied to a commonly used framework for change in clinical practice, with levels describing the innovation, the individual professional, the woman, and social, organisational, economic and political contexts.ResultsReported barriers to and incentives for partograph use related to the partograph itself, professional skills and practice, clinical leadership and quality assurance, and the organisational environment within the wider provision of obstetric care. Neither the evidence base for its effectiveness, nor its credibility, was reported as a barrier to use.ConclusionIdentifying and addressing local barriers and incentives in low- and middle-income countries, based on those in published research, could inform strategies to improve partograph use. Emerging technologies could be used to address some barriers. The thresholds for essential maternity care at which the partograph adds value should be further evaluated.

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Barriers and incentives influencing the use of partograph in Nigeria: A comprehensive review

Elendu,

Davidson,

Wali

et al. 2024

Medicine

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This comprehensive review examines the barriers and incentives influencing the use of partographs in maternal healthcare within Nigeria. Maternal mortality remains a critical concern in the country, making it imperative to evaluate the factors that shape the adoption of essential tools like the partograph. The literature review underscores the global significance of partograph utilization, emphasizing its role in improving maternal outcomes. A particular focus is placed on existing studies and findings relevant to Nigeria, providing a nuanced understanding of the challenges and opportunities faced by healthcare providers. The article delves into the barriers hindering the widespread adoption of partographs in Nigeria, including issues related to training, resource availability, and cultural considerations. Additionally, it explores the incentives that can positively influence healthcare practitioners and facilities to integrate partographs into their maternal care protocols. Government policies and initiatives in Nigeria related to maternal healthcare and partograph use are also analyzed, shedding light on the broader contextual factors impacting implementation. Through examining case studies, the review presents real-world examples that illustrate successful and challenging instances of partograph implementation. The article concludes with actionable recommendations to overcome identified barriers and enhance incentives for effectively integrating partographs into maternal healthcare practices in Nigeria. This study contributes valuable insights to the ongoing discourse on improving maternal healthcare, emphasizing the need for tailored strategies in the Nigerian context.

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The Challenge of Improving Perinatal Care in Settings with Limited Resources. Observations of Midwifery Practices in Mozambique

Cited by 10 publications

References 21 publications

Midwives’ adherence to guidelines on the management of birth asphyxia in Malawi

Midwives’ adherence to guidelines on the management of birth asphyxia in Malawi

Barriers to and incentives for achieving partograph use in obstetric practice in low- and middle-income countries: a systematic review

Barriers and incentives influencing the use of partograph in Nigeria: A comprehensive review

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