The Use and Perceived Barriers of the Partograph at Public Health Institutions in East Gojjam Zone, Northwest Ethiopia

Abstract

Introduction:The partograph is a vital tool used to reduce maternal and fetal mortality and morbidity and to prevent prolonged and obstructed labor, as well as postpartum hemorrhage and fistula formation. This study explored the use and barriers of the partograph among obstetric caregivers in East Gojam Zone, Northwest Ethiopia.Methods and materials:A cross-sectional study design consisting of both quantitative and qualitative methods was utilized. Data was collected through a structured clinical observation checklist and semistructured questions. The content of the checklists was developed according to modified WHO partograph. Thematic analysis was employed using open code software version 3.6. Coding was done immediately after the data was collected. The coded data was defined and categorized into groups. Once the categories were identified and the names given, the data was related to the objectives of the study. Data was crosschecked to ensure consistency between the themes and the categories. Then we summarized the themes and drew conclusions that gave answers to the research questions.Results and conclusion:This study showed that participants believed partograph is an essential tool used to reduce maternal and fetal mortality and morbidity and to prevent prolonged and obstructed labor, as well as postpartum hemorrhage. They explained that work overload, lack of skill and competency, negligence, lack of motivation and a shortage of infrastructure and resources hindered utilization of the partograph.

Perception and utilization of partograph among midwives across selected health care facilities in Abuja metropolis, Abuja: A comparative study

“…They however, had negative perceptions on how cumbersome using the partograph is (mean 2.3(1.6)) and identified excessive work-load as a barrier to partograph use (mean 2.9(1.7). This finding is in consonance with findings from the study of Zelellw and Tegegne (2018), where less than half of care providers were not following WHO recommended standards for maternal and foetal conditions, such as moulding (19/43), maternal pulse (10/43), maternal blood pressure (13/43), maternal temperature (6/43) and urine volume, urine protein and urine ketone (1/43). This is supported by qualitative data showing that shortage of staff, lack of awareness, lack of skill and competency, knowledge gaps, lack of commitment, negligence and misunderstanding were the main reasons that participants were not using the partograph routinely.…”

Acceptability and Barriers to Use of the ASMAN Provider-Facing Electronic Platform for Peripartum Care in Public Facilities in Madhya Pradesh and Rajasthan, India: A Qualitative Study Using the Technology Acceptance Model-3

“…Similar findings have been reported in Africa. In Ethiopia, health care providers recognized that the e-partograph could reduce maternal and neonatal mortality, but staff shortages, lack of skills/competence, and lack of motivation were mentioned as barriers for partograph utilization [ 55 ]. Studies from Kenya and Tanzania found that even where e-partograph is acceptable and has high perceived ease of use, its feasibility in settings with high delivery load, staff shortages, and lack of infrastructure is limited [ 56 , 57 ].…”

A study to assess the perceived barriers in utilization of partograph

“…As per the study conducted by Zelellw et al, shortage of staff was one of the barriers in the health facilities which causes inefficient use of the partograph in the labour as there are only one or two midwives in many health centres. 10 Lack of supervision was the factor reported by the participants in the discussions conducted in the present study. Around 20.4% of the participants in the study conducted by Hagos et al reported the same factor for the non-utilization of the partograph.…”