knowledge and utilization of partograph in the management of labour among the obstetrics care givers

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BACKGROUND TO THE STUDY

The partograph is an instrument that can be used for a variety of purposes, including the monitoring of labor (Ogwang, Karyabakabo & Rutebemberwa, 2009:27). The utilization of the partograph is a well-known best practice for quality monitoring of labor and, as a result, the prevention of obstructed and prolonged labor, according to Yisma et al. (2013:13), who carried out a cross-sectional quantitative study in Ethiopia. Their findings were published in the journal Obstetrics and Gynecology. Despite this, there are still some cases of obstructed labor that occur in healthcare facilities due to the inadequate quality of the intrapartum care that is provided to the patients. The researcher suggested that pre-service and on-the-job training for obstetric care givers on how to use partographs should be prioritized for effective monitoring of pregnant mothers while they are in labor. This would allow for more accurate tracking of the progress of labor. Training on how to make use of partographs would fall under this category.

In 2014, research was carried out by the World Health Organization (WHO) that led to the discovery of a result based on a test that was carried out on 35,484 women hailing from Southeast Asian countries. It was concluded that a partograph was an essential tool for the efficient management of labor, and it was also recommended that it should be universally adopted for use in all medical facilities in order to reduce the rates of maternal mortality and infant morbidity. These recommendations were adopted. The findings of the study were presented in a paper that was published in The Lancet. The findings of the research indicate that there has been a sizeable reduction in the number of cases that call for prolonged augmentation, as well as emergency cesarean sections and stillbirths, to name a few of the aforementioned occurrences. Because of the stringent regulations that must be followed when using partographs, medical facilities in developing countries have been forced to place severe restrictions on their use.

 

As a consequence of this, in reference to the partograph published by the World Health Organization in 2014, it can be seen that many developing countries designed their partograph to cater to the immediate medical problems that they were facing. This, in turn, led to the rebirth of a variety of different methods of partograph. In conclusion, the partograph that is used by the World Health Organization underwent revision in the year 2014. Another thing that was noticed was that when these methods were used, the ending point of a partograph became an exception rather than the standards that were based on the client’s record. In previous research that was conducted at specific general hospitals in Kenya, Gichangi, Ndavi, and Wamwana (2010) came to the conclusion that partograph was utilized in 11% of cases. This was determined based on their findings. In addition to this, Delvaux(2011) came to the conclusion that in only nine percent of cases in urban maternity wards in Côte d’Ivoire, a partograph was completed, and contractions were monitored. This is in contrast to the ninety-one percent of cases that were observed in rural maternity wards. These two sets of numbers are derived from studies that were carried out in the country of Côte d’Ivoire. In excess of sixty percent of all deliveries were recorded on partographs that were completed after delivery at two of the fields that were utilized in the study. According to the guidelines that governed its application, it was intended to be used solely as a tool for record-keeping and not as a tool for monitoring.

 

Njoroge (2013) found that fifty percent of health practitioners in rural Kenya have little to no knowledge on the use of partographs, and their capability on the usage of the parameters of partograph indecision was below expectation. This is a problem because partographs are used to help diagnose and treat diseases. Sixty percent of health practitioners were unable to use the findings that were derived from the utilization of partographs in the decision-making process regarding the active management of labor. Delvaux (2011) found that providers did an inaccurate job of assessing the conditions of women when they were admitted; vital signs and the progression of labor were not properly monitored in the maternity ward; neither was correctly measured in the majority of cases; and the provider’s assessment of the women’s conditions was inaccurate. In addition, Delvaux (2011) found that providers did an inaccurate job of assessing the conditions of women when they were admitted. The authors also took issue with the common method of determining whether or not there is a problem with maternal health by counting the number of births that were witnessed by a trained medical professional. They argued that this is an insufficient measure. They also brought up the point that having a skilled attendant does not automatically equate to having skilled and appropriate care provided for you. In forty-nine developing countries, maternal and neonatal services were evaluated by Bulatao and Ross (2009) as part of a research project. When attempting to refer cases of obstructed labor to specialized facilities in these countries, the results of their research led them to the conclusion that health facilities in these countries did not make use of partographs and had limited access to transportation.

Partograph is an instrument that can be used appropriately in settings where there is basic training in obstetric skills to enable effective performance in normal delivery, vaginal examinations, and assessment of cervical dilations with reference to the availability of partograph. As a result of this, partograph is an instrument that can be used appropriately in settings where there is basic training in obstetric skills. In addition to a comprehensive training program that covers supervision and quality assurance, as well as detailed training that covers the mechanics of using a partograph, there should be an evaluation of the level of understanding and skills possessed by the health care staff. This evaluation should take place in conjunction with the implementation of a training program. In addition to this, it is necessary to carry out a successful supply and introduction at the same time as this evaluation.

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