Use of the Partogram in the Bamenda Health District, North-West Region, Cameroon: A Cross-Sectional Study
DOI:
https://doi.org/10.17140/GOROJ-2-124Keywords:
Partogram, Maternal mortality, Labor, Perinatal mortalityAbstract
Background: The partogram is an effective instrument in the follow-up of labor. It enables timely diagnoses of abnormalities and helps in decision-making.
Objectives: This study was carried out to 1) establish and compare the proportion of labor cases followed up with the partogram in primary and secondary healthcare facilities in the Bamenda Health District and 2) appraise the attitudes of the health workers towards the partogram and how those attitudes impact outcomes.
Methods: A cross-sectional study was carried out in which 383 files were reviewed and 42 questionnaires were administered to health workers. The information extracted from the files focused mainly on the number of partograms used and the standard criteria under study were: cervical dilatation, station, the state of the amniotic fluid and maternal temperature monitored every four hours. Maternal blood pressure, pulse rate and Fetal Heart Rate (FHR) were monitored every hour. Each of the parameters was judged as correctly filled if they met the above criteria; as not correctly filled if the criteria were not met; and as not filled if no information was recorded. Statistical analysis was with Epi-Info™.
Results: The results showed that 223(58.2%) deliveries were followed up with the partogram, only 4(1.0%) of which had all the parameters filled to standard. Two hundred and six (86.2%) deliveries in the Bamenda Regional Hospital and 17(11.8%) in the primary healthcare facilities were followed up with the partogram. Forty (95.2%) health workers agreed that the partogram was useful in following up labor.
Conclusions: The health workers had a positive attitude towards the partogram, but on the whole it was incorrectly used. The instrument was for the most part unavailable, and even where it was, poor supervision and absence of guidelines on its use led to poor diagnoses. We recommend that supportive supervision and regular in-service training be encouraged; and that partograms and guidelines be made available.
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