Factors influencing partograph recording among skilled birth attendants at Mzuzu Central Hospital, Northern Malawi

Abstract

Background/Aims Malawi has very high maternal and neonatal mortality rates, often resulting from complications during labour and delivery. Complete recording of a partograph during labour monitoring has been associated with a reduction and prompt management of fatal complications. Although the partograph is an essential tool for monitoring women during labour, there is limited evidence on the status of its recording and associated factors among skilled birth attendants in northern Malawi. The aim of this study was to assess partograph recording and explore factors affecting its recording among skilled birth attendants at the Mzuzu Central Hospital in Malawi. Methods The study used a descriptive cross-sectional design with mixed methods. The study involved a retrospective review of 369 patient partographs, using a data extraction sheet to gather quantitative data, which were analysed using descriptive statistics. Qualitative data were collected through individual in-depth interviews with seven skilled birth attendants working at the hospital, using a semi-structured interview guide and analysed by content analysis. Results Of the 369 partographs that were reviewed, recording was complete in only 12.7% of fetal assessments, 13.3% of maternal assessments and 24.7% of sections recording the progress of labour. The most completely recorded parameter was liquor (71.8%), followed by cervical dilatation (70.5%). The least completely recorded parameters were temperature (13.6%) and urine protein (2.2%). Factors that influenced the recording of a partograph included skilled birth attendants' general knowledge on the partograph, the availability of equipment for assessments, supportive supervision, staffing levels, attendance to in-service training and clients' perception of the frequency of assessments. Conclusions Skilled birth attendants at Mzuzu Central Hospital partially complete partographs during labour. Staffing levels, availability of equipment for assessments, in-service training and supportive supervision are all factors that affect complete partograph recording. Therefore, it is essential to implement strategies that can promote complete partograph recording in order to reduce maternal and newborn morbidity and mortality at this health facility.