PARTOGRAPH CHART USE AMONG OBSTETRIC CAREGIVERS IN PUBLIC HEALTH INSTITUTIONS OF WEST SHEWA ZONE, OROMIA REGIONAL STATE, ETHIOPIA, 2015

Abstract

ABSTRACT BACKGROUND: Partograph chart is recommended by WHO for developing countries to be used as an early warning system to identify prolonged labour and allow timely transfer. In Ethiopia, although most health institutions have been using partograph chart, there is limited information about its proper use and challenges faced by health workers. OBJECTIVE: The aim of this study was to assess the magnitude of partograph use, factors that affect its use and challenges faced among obstetric caregivers in public health institutions of West Shewa Zone, Oromia Regional State, Ethiopia. METHODS: The study used both quantitative and qualitative research approaches from December 2014 to February 2015. It was conducted in two randomly selected hospitals and five health centres. The study used logistic regressions model to assess independent predictors of partograph use among health providers. RESULT: Out of 44 clients in the labour ward, only five items out of fifteen parameters listed on the partograph were completed. A fourth (24.7%) of all professionals did not know when to start partograph mapping and 36% had unfavourable attitude toward partograph use. Most (73%) indicated that partograph predisposes labouring women for unnecessary and untimely intervention. Midwives (AOR=13 CI=2.6-66.2), health workers who had knowledge about partograph use (AOR=7, CI= (2.8-21.8) and who work in facilities who had access to the tool (AOR=8.8 CI: 2.8-27.6), were more likely to use partograph. Health workers in higher institutions (hospitals) were less likely to use partograph (AOR=0.09, CI: 0.03-0.26). CONCLUSION: Most health workers do not complete the tool properly. Lack of knowledge about the right start time of partograph plotting and its benefits has affected proper identification of the action line which will farther affect maternal and fetal outcome. In-service and pre-service training on partograph use, continuous mentoring, supervision and staff motivation could improve the proper use of the tool. KEY WORDS: Partograph, knowledge, obstetric caregivers, public health institutions, Oromia Regional State, Ethiopia. (Ethiopian Journal of Reproductive Health 2017;9:36-44)