Midwives’ Knowledge, Perceptions and Practices on Utilization of the Partograph at Mbuya Nehanda Maternity Hospital

Abstract

Globally, maternal death has been an issue of concern, while obstructed and prolonged labour are among the top five causes of these deaths in Africa and Zimbabwe particularly. Proper and effective utilization of the Partograph significantly helps in preventing and reducing the high numbers of birthing complications of such a nature. A Partograph is a labour monitoring chart that provides a pictorial overview of maternal and foetal well-being during the intrapartum period. The study aimed to assess the knowledge, perceptions, and practices on the utilization of the Partograph among midwives working at Mbuya Nehanda Maternity Hospital. A descriptive cross sectional design was used, and a semi-structured questionnaire was administered to 60 participants chosen using the purposive sampling technique. Data were collected and analysed using the Statistical Package for Social Sciences (SPSS version 22) and presented using charts, tables, and narration. The study identified that midwives were knowledgeable, although they had a negative attitude towards the Partograph attributed by a lack of motivation caused by the absence of support from mentors and supervisors, lack of workshops, and on-the-job training on the use of the graphical chart. Underutilization of the tool, which pointed to poor practice, was attributed to understaffing of midwives, high workload, and burnout syndrome among the labour ward midwives. These implications could lead to omissions, litigations, poor maternal service delivery, and lawsuits. Periodic workshops, symposiums, on-the-job training would go a long way in improving attitudes. The study concluded that the Partograph is a very important tool that should be effectively used in the labour ward so that complications are picked up early, thereby improving maternal outcomes. Support for the midwives, supervision, mentorship, non-monetary incentives, and increased staffing with an acceptable midwife-patient ratio of probably 1:2 would improve practice and yield a positive birthing outcome of a live and healthy mother and baby.