Factors affecting partograph utilization in Kiryandongo district: A case study of midwives in lower health units

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Kampala International University, School of Health Sciences
Background: Uganda is still one of the developing countries with high maternal mortality ratio, currently estimated at 336/100,000 live birth. World health organization (WHO) recommends using the partograph to monitor labor and delivery, with the objective to improve health care and reduce maternal and fetal morbidity and death. The present study therefore, examined the extent of utilization of partogram among midwives in Kiryandongo lower health units. Methods: A descriptive quantitative and cross-sectional research design was used in this study. Data was collected from 60 midwives using a self- administered questionnaire. A statistical package for social sciences (SPSS 21.0) was used to capture and analyze data. Results: The mean age of participants was 31.1 years (SD=7.6), with majority (88.3%) certificate holders. 57 (95%) of the respondents knew what the partograph is and all 60(100%) knew the function of a partograph. Only 53 (88.3%), knew the function of alert line but all (100%) knew what action line means. However, only 20 (33.3%) were using the partograph properly. Challenges included, understaffing where all (100%) reported working one midwife per duty and lack of in-service training on how to use the partogram. Factors that were found significant on the use of partogram, included, professional qualification (P=0.001), years of professional experience (P=0.033) and in-service training received (P=0.000). Conclusion and recommendations: A significant percentage of midwives in this study had fair knowledge of the partogram. However, a large percentage of participants were reported to poorly complete the partogram. Years of professional experience, having received in-service training on managing pregnant mothers in labour and qualification level were found to be predictors for the likelihood for the proper use of partogram. The key recommendations therefore, include, improving staffing of midwives, training of midwives on job on how to use the partogram and a continuous monitoring team on partogram utilization. Further research is required to assess the use of the partogram in other primary, secondary and tertiary level facilities to establish pattern of utilization and documentation which would help to improve monitoring of pregnant mothers in labour and hence reduce maternal and neonatal mortality rates
A research report submitted to the Faculty of Clinical Medicine and Dentistry in partial fulfillment of the requirements for the award of a degree of Bachelor of Medicine and Surgery of Kampala International University
Partograph utilization, Kiryandongo District, Midwives, Lower health units