ABSTRACT

To assess the impact of training health workers at the primary healthcare level in partograph use on maternal and perinatal outcome in peripheral health units in a developing country.

Experimental design in which pre- and post-intervention measurements were conducted after a training programme on partograph use in labour management. Duration of labour, level of transfer in labour, obstructed and prolonged labour, maternal and perinatal outcome were determined as outcome measures. Data were analysed using the SPSS statistical software package for personal computers. Discrete variables were expressed as percentages and presented as frequency tables and cross tabulations. Chi-square was employed as the test of association between proportions of respondents. Whenever expected cell frequencies were less than five, the likelihood-ratio Chi-square values were quoted rather than Pearson’s. Statistical significance was accepted at P-values of <0.05.

Data on labour outcome on 242 labouring women who fulfilled inclusion criteria were collected prior and post training of fifty-six healthcare workers in the use of WHO Partograph. There was increase in transfer in labour (p=0.013), but reduction in the duration of labour (p=0.0001), obstructed labour (p=0.0001); postpartum hemorrhage (p=0.0001), genital sepsis (p=0.0001); perinatal mortality (p=0.0040), and better neonatal Apgar scores at 1 and 5 minutes (p=0.0001) after introduction of partograph. Though augmentation of labour increased and caesarean section rates decreased following partograph use there was no significant difference. There was one uterine rupture and 2 maternal deaths before introduction of partograph but none after partograph introduction.

Introduction of partograph in peripheral health units in a developing country reduced labour complications with resultant reduction in maternal and perinatal mortality and morbidity.

Keywords: Partograph, obstetric outcome, peripheral health units