Contribution of Completed Modified World Health Organization Partograph on Maternal and Foetal Mortality Reduction in Health Facilities in Makueni County, Kenya
Central African Journal of Public Health
Volume 5, Issue 6, December 2019, Pages: 227-236
Received: Aug. 8, 2019;
Accepted: Sep. 16, 2019;
Published: Oct. 10, 2019
Views 151 Downloads 82
Urbanus Mutiso Muthusi, Department of Population, Reproductive Health & Community Resource Management, Kenyatta University, Nairobi, Kenya
Mokua Gladys Nyamoita, Department of Pharmacology, Pharmaceutical Chemistry and Pharmaceutics & Industrial Pharmacy, Kenyatta University, Nairobi, Kenya
Macharia Stephen, Department of Human Anatomy, School of Medicine, Kenyatta University, Nairobi, Kenya
Background: Maternal and foetal mortality is one of the major health problem facing low income countries as compared to the high income countries. This burden is mostly felt in sub Saharan Africa and Southeast Asia where 99% of the global burden of maternal death is found. The World Health Organization (WHO) promotes partograph use in the monitoring and management of mothers in labour enabling timely decision-making regarding interventions to be undertaken. Objective: To assess the relationship between complete modified world health organization partograph and maternal and foetal outcomes in health facilities in Makueni County, Kenya Methods: This was a cross sectional study design. The study used a structured questionnaire to collect data from the partographs retrospectively. Data analysis was done using SPSS version 20.0 and chi-square tests were used to assess the relationship of variables. The cut off point for the level of significance was 0.05. Phi and Cramer’s V test was used to determine the strength of association Findings: Descriptive statistics and frequency tables were used to describe the extent to which the partograph was used. The use of partograph had effects on both foetal and maternal outcomes. The study established method of delivery had a significance association with foetal monitoring (foetal heart rate, liquor, and moulding), labour progress monitoring (descent, contractions and cervical dilatation) and referral monitoring at α = 0.05. The study also found significant association between foetal outcome and contraction, gravidity, parity, foetal heart rate and moulding at α = 0.05. Conclusion: There is a significant association between maternal, foetal outcomes and labour progress and partograph completeness in Makueni County. The study therefore recommends increased mobilization and routine check by supervisors to ensure partographs are filed on time and hospitals to embrace training programme to enable midwifery care-providers acquire relevant skills to complete partographs during the labour process.
Urbanus Mutiso Muthusi,
Mokua Gladys Nyamoita,
Contribution of Completed Modified World Health Organization Partograph on Maternal and Foetal Mortality Reduction in Health Facilities in Makueni County, Kenya, Central African Journal of Public Health.
Vol. 5, No. 6,
2019, pp. 227-236.
Khan, K. S., Wojdyla, D., Say, L., Gulmezoglu, A. M., Van Look, P. F. WHO analysis of causes of maternal death: a systematic review. Lancet. 2006; 367 (9516): 1066–74.
Monchari, R., Nangulu, A. K., & Broerse, J. E. W. Perceived causes of adverse pregnancy outcomes and remedies adopted by Kalenjin women in ruralKenya, 2018, 5, 1-16.
Kone, S., Hurlimann, E., Baikoro, N., Dao, D., Bonfoh, B., Goran, E. K. N., …Jaeger, F. N. (2018). Pregnancy-related morbidity and risk factors for fatal foetal outcomes in the Taabo health and demographic surveillance system, Cote d’Ivoire, 2018 1-14.
Mathai, M. The partograph for the prevention of obstructed labor. Clinical Obstetrics and Gynecology, vol. 52, no. 2, pp. 256–269, Jun. 2009.
Echoka, E. Makokha, A, Nyandieka, L & Byskov, J. L. Barriers to emergency obstetric care services : accounts of survivors of life threatening obstetric complications in Malindi District, Kenya, 2014 17 (Supp 1), 15–20 https://doi.org/10.11694/pamj.supp.2014.17.1.3042.
Ochako, R., & Gichuhi, W. Pregnancy wantedness, frequency and timing of antenatal care visit among women of childbearing age in Kenya. Reproductive Health, 2016 1–8. https://doi.org/10.1186/s12978-016-0168-2.
Nyongesa, C. et al. ‘Factors influencing choice of skilled birth attendance at ANC : evidence from the Kenya demographic health survey’. BMC Pregnancy and Childbirth, 2018 362, pp. 4–9.
Anokye, R. et al.‘Use and completion of partograph during labour is associated with a reduced incidence of birth asphyxia : a retrospective study at a peri-urban setting in Ghana’. Journal of Health, Population and Nutrition, 2019 7, pp. 1–8.
Souza, J. P., Oladapo, O. T., Bohren, M. A., Mugerwa, K., Fawole, B., Moscovici, L., … WHO BOLD Research Group. The development of a Simplified, Effective, Labour Monitoring- to- Action (SELMA) tool for Better Outcomes in Labour Difficulty (BOLD): study protocol. Reproductive health, 2015 12, 49. doi: 10.1186/s12978-015-0029-4.
World Health Organization. Programme Budget 2012-2013 Mid-Term Review Report, 2013.
Kabakyenga, J. K., Östergren, P. O., Emmelin, M., Kyomuhendo, P., & Odberg Pettersson, K. The pathway of obstructed labour as perceived by communities in south- western Uganda: a grounded theory study. Global health action, 2011 4, doi: 10.3402/gha.v4i0.8529.
Ansari, N., Manalai, P., Maruf, F., Currie, S., Stekelenburg, J., van Roosmalen, J., … Tappis, H. Quality of care in early detection and management of pre- eclampsia/eclampsia in health facilities in Afghanistan. BMC pregnancy and childbirth, 2019 19 (1), 36. doi: 10.1186/s12884-018-2143-0.
Gans-Lartey, F., O’Brien, B. A., Gyekye, F. O., & Schopflocher, D. The relationship between the use of the partograph and birth outcomes at Korle-Buteaching hospital. Midwifery. 2013; 29 (5): 461–7.
Levin, K. & Kabagema, J. Use of the partograph: effectiveness, training, modifications, and barriers. Engender health, 2011.
United Nations. The Millennium Development Goals Report. pp. 1–80, Jun. 2010.
Qureshi, Z. P., Sekadde-Kigondu, C. & Mutiso, S. M. Rapid assessment of partograph utilization in selected maternity units in Kenya, East African Medical Journal, vol. 87, no. 6, pp. 235-241, Jun 2010.
Lavender, T., Omoni, G., Lee, K., Wakasiaka, S., Watiti, J., & Mathai, M. Students’ experiences of using the partograph in Kenyan labour wards. African Journal of Midwifery and Womens' Health, 2011 vol. 5, no. 3, pp. 117–122.
Zelellw, D. A., & Tegegne, T. K. Level of partograph utilization and its associated factors among obstetric caregivers at public health facilities in East Gojam Zone, Northwest Ethiopia. PloS one, 2018 13 (7), e0200479. doi: 10.1371/journal.pone.0200479.
Opoku BK & Nguah SB. Utilization of the modified WHO partograph in assessing the progress of labour in a metropolitan area in Ghana. Res J of Womens Health. 2015; 2: 2.
Yisma et al. Knowledge and utilization of partograph among obstetric care givers in public health institutions of Addis Ababa, Ethiopia. BMC Pregnancy and Childbirth 2013 13: 17. doi: 10.1186/1471-2393-13-17.
Bogale D. and Markos M. Knowledge of obstetric danger signs among child bearing age women in Goba district, Ethiopia: a cross-sectional study. BMC Pregnancy and Childbirth, 2015 15: 77 DOI 10.1186/s12884-015-0508-1.