Factors Affecting Partograph Utilization In Kiryandongo District: A Case Study Of Midwives In Lower Health Units

ABSTRACT

Background: Uganda is still one of the developing countries with high maternal mortality ratio, currently estimated at 336/100,000 live birth. World health organization (WHO) recommends using the partograph to monitor labor and delivery, with the objective to improve health care and reduce maternal and fetal morbidity and death. The present study therefore, examined the extent of utilization of partogram among midwives in Kiryandongo lower health units. Methods: A descriptive quantitative and cross-sectional research design was used in this study. Data was collected from 60 midwives using a self- administered questionnaire. A statistical package for social sciences (SPSS 21.0) was used to capture and analyze data. Results: The mean age of participants was 31.1 years (SD=7.6), with majority (88.3%) certificate holders. 57 (95%) of the respondents knew what the partograph is and all 60(100%) knew the function of a partograph. Only 53 (88.3%), knew the function of alert line but all (100%) knew what action line means. However, only 20 (33.3%) were using the partograph properly. Challenges included, understaffing where all (100%) reported working one midwife per duty and lack of inservice training on how to use the partogram. Factors that were found significant on the use of partogram, included, professional qualification (P=0.001), years of professional experience (P=0.033) and in-service training received (P=0.000). Conclusion and recommendations: A significant percentage of midwives in this study had fair knowledge of the partogram. However, a large percentage of participants were reported to poorly complete the partogram. Years of professional experience, having received in-service training on managing pregnant mothers in labour and qualification level were found to be predictors for the likelihood for the proper use of partogram. The key recommendations therefore, include, improving staffing of midwives, training of midwives on job on how to use the partogram and a continuous monitoring team on partogram utilization. Further research is required to assess the use of the partogram in other primary, secondary and tertiary level facilities to establish pattern of utilization and documentation which would help to improve monitoring of pregnant mothers in labour and hence reduce maternal and neonatal mortality rates.  

TABLE OF CONTENTS 

DECLARATION................................................................................................................................................ i

APPROVAL OF SUBMISSION......................................................................................................................... ii

DEDICATION................................................................................................................................................. iii

ACKNOWLEDGEMENT ................................................................................................................................. iv

TABLE OF CONTENTS .................................................................................................................................... v

LIST OF TABLES ........................................................................................................................................... vii

LIST OF FIGURES ......................................................................................................................................... vii

LIST OF ABBREVIATIONS ........................................................................................................................... viii

OPERATIONAL DEFINITIONS ....................................................................................................................... ix

ABSTRACT ..................................................................................................................................................... x

CHAPTER ONE: INTRODUCTION ...........................................................................................................1

1.1 Background .................................................................................................................................1

1.2 Problem statement ......................................................................................................................2

1.3 Significance of the study.............................................................................................................3

1.4 Objectives of the study................................................................................................................3

1.4 .1 Main objective of the study ..........................................................................................................3

1.4.2 Specific Objectives .........................................................................................................................3

1.5 Research questions......................................................................................................................4

CHAPTER TWO: LITERATURE REVIEW ...................................................................................................5

2.1 Introduction.................................................................................................................................5

2.2 Knowledge on utilization of the partograph.............................................................................5

CHAPTER THREE: METHODS..................................................................................................................10

3.1 Introduction...............................................................................................................................10

3.2 Study design...............................................................................................................................10

3.3 Population and sample..............................................................................................................10

3.4 Setting of the study....................................................................................................................10

3.5 Methods of data collection........................................................................................................11

3.5.1 Data collection tool.......................................................................................................................11

3.5.1.1 Variables under study...............................................................................................................11

3.5.2 Validity and reliability.................................................................................................................11

3.5.2 Procedure for data collection......................................................................................................11

3.6 Data analysis..............................................................................................................................11

3.6 Ethical clearance .......................................................................................................................12

CHAPTER FOUR: PRESENTATION OF FINDINGS....................................................................13

4.1 Introduction...............................................................................................................................13

4.2 Sociodemographic data.............................................................................................................13

4.3 Midwives’ knowledge of partogram........................................................................................14

4.4 Characteristics of partogram utilization and challenges.............................................................15

4.5 Distribution of respondents according to utilization of partogram......................................17

4.6 Factors influencing the use of the partogram..............................................................................17

CHAPTER FIVE: DISCUSSIONS, CONCLUSION AND RECOMMENDATIONS .........................................19

5.1 Introduction...............................................................................................................................19

5.2 Discussion of findings ...............................................................................................................19

5.2.1 Knowledge and use of partogram among Midwives.................................................................19

5.2.2 Challenges facing midwives during utilization of partogram ..................................................20

5.2.3 Factors that facilitate the use of partogram among midwives.................................................21

5.3 Conclusion of the study.............................................................................................................22

5.4 Limitations of the study............................................................................................................22

5.5 Recommendations.....................................................................................................................22

REFERENCES................................................................................................................................................24

ANNEX.........................................................................................................................................................28

ANNEX I: CONSENT FORM..................................................................................................................28

ANNEX II: QUESTIONNAIRE ON PARTOGRAM ...............................................................................29

ANNEX III: BUDGET...........................................................................................................................36

ANNEX IV: WORKPLAN.....................................................................................................................37

ANNEX V: INTRODUCTORY LETTER .................................................................................................38

ANNEX VI: ACCEPTANCE LETTER ......................................................................................................39

ANNEX VII: MAP OF KIRYANDONGO DISTRICT.................................................................................41

ANNEX VIII: MAP OF UGANDA SHOWING KIRYANDONGO DISTRICT ...............................................42