Documentation of the partograph in assessing the progress of labour by health care providers in Malawi's South-West zone

Abstract

Background: There is some evidence that appropriate use of partograph in monitoring the progress of labour could decrease delivery related complications. The documentation of parameters of partographs is however, poorly understood. The aim of the present study was to determine the extent to which health care workers are making use of the partograph in monitoring the progress of labour through checking the documentation of the parameters of the partographs. Methods: A hospital-based descriptive study involving retrospective review of partographs for births that occurred in 2016 was conducted in Malawi's South-West zone. A total of 1070 partographs that were used to monitor labour in two public hospitals were reviewed to determine the documentation of the parameters of partographs and descriptive statistics were computed using statistical package for the social science software version 22.0. Results: Of the total 1070 partographs reviewed, 58.6% (n = 627) of the partographs had no recording of maternal blood pressure and 65.3% (n = 699) of the partographs had no temperature documentation. Moulding was not recorded in 25.4% (n = 272) of the partographs, foetal heart rate was not recorded in 14.9% (n = 159) of the partographs and descent of the foetal head was not recorded in 12.0% (n = 128) of the partographs. Conclusion: There is poor documentation of vital parameters of the partographs. This suggests insufficient monitoring of the progress of labour, which may lead to adverse pregnancy outcomes. To improve the accurate documentation of parameters of the partograph, there is a need to understand the problem and provide tailor-made solutions to address them and ultimately improve pregnancy outcomes. In the meantime, in-service refresher courses on partograph use to health care workers need to be conducted regularly. Supportive supervision to obstetric care providers and regular partograph audit could also improve documentation.