Use of the partograph among midwives at University Teaching Hospital, Lusaka: a LAMRN project in Zambia

Abstract

Background: Globally, 830 women die every day from pregnancy- or childbirth-related complications, 99% of whom are in developing regions. In Zambia, the maternal mortality ratio is 398 maternal deaths per 100 000 live births, yet the majority of these deaths could have been prevented by using the partograph to detect abnormal progress of labour. Aim: To determine the use, practices, and level of knowledge among midwives on the labour ward at the University Teaching Hospital in Lusaka. Methods: A cross-sectional design was implemented to determine the use of the partograph among 110 skilled birth attendants. This involved a self-administered, semi-structured questionnaire and a checklist, which was used to assess the completion of 370 partographs from the records. Findings: In the initial audit 40 (36%) of 110 skilled birth attendants who worked in labour ward completed the questionnaire. Of these, 35 (87.5%) used the partograph all the time. When asked for the reasons why the partograph was not used, 3 (7.5%) cited non-availability; 4 (10%) said lack of knowledge and 6 (15%) said emergencies. In the initial audit, only 7.5% of the midwives were knowledgeable on use of the partograph, but this improved to 95.5% in the re-audit. Conclusions: The study revealed low knowledge and under use of the partograph among skilled birth attendants at the University Teaching Hospital in Lusaka.