MekelleUniversity, College of Health Sciences, Mekelle, Ethiopia.
Tigray Health Research Institute, Mekelle, Ethiopia.
BMC Pregnancy Childbirth. 2020 Oct 23;20(1):647. doi: 10.1186/s12884-020-03344-6.
The period around childbirth and the first 24 hours postpartum remains a perilous time for both mother and newborn. Health care providers' compliance to the World Health Organization modified partogram across the active first stage of labor is a graphic representation of a mother's condition that is used as a guide in providing quality obstetrics care. However, little evidence is documented on the health providers' adherence to the use of the partograph in Ethiopia, which limits health care providers' ability to improve quality care services. Therefore, this study assessed the adherence of partograph use and associated factors in Ethiopia.
Data from the Ethiopian 2016 National Emergency Obstetric and Newborn Care survey of 3,804 health facilities that provided maternity services were used. We extracted 2611 partograph charts over a 12 months period prior to the survey to review the proper recording of each component. Data analyses were performed using SPSS version 22.0 software. A logistic regression analyses was used to identify the association of explanatory variables with the outcome variable. A p-value of <0.05 was considered as cut off point to declare the significance association in the multivariable analysis.
Of the total 2611 partographs reviewed, 561(21.5%) of them were fully recorded as per the WHO guideline. Particularly, molding in 50%, color of liquor in 70.5%, fetal heart beat in 93.3%, cervical dilation in 89.6%, descent in 63.2%, uterine contraction in 94.5%, blood pressure in 80.5%, pulse rate in 70.5%, and temperature in 53% were accurately recorded. The odds of adherence to partograph use were 1.4 in rural health facilities when compared to their counterparts (AOR=1.44; 95% CI: 1.15, 1.80, P- 0.002).
This study revealed a poor level of adherence in partograph use in Ethiopia. Molding, maternal temperature and decent were the least recorded parameters of the partograph. The odds of completion of partograph were high in rural facilities. Strong supporting supervision and mentoring the health workers to better record and use of partograph are needed mainly in urban health facilities. Moreover in the future, interventional research should be conducted to improve the current rate of adherence.
分娩前后的时期和产后 24 小时仍然是母婴面临危险的时期。卫生保健提供者对世界卫生组织修改的活跃第一产程产程图的遵守情况是母亲状况的图形表示，用作提供优质产科护理的指南。然而，在埃塞俄比亚，几乎没有记录卫生保健提供者遵守使用产程图的证据，这限制了卫生保健提供者改善优质护理服务的能力。因此，本研究评估了埃塞俄比亚产程图使用的依从性及其相关因素。
使用了埃塞俄比亚 2016 年国家紧急产科和新生儿护理调查的 3804 家提供产妇服务的卫生机构的数据。我们在调查前 12 个月内提取了 2611 份产程图，以审查每个组成部分的正确记录。使用 SPSS 版本 22.0 软件进行数据分析。使用逻辑回归分析来确定解释变量与结果变量之间的关联。在多变量分析中，p 值<0.05 被认为是宣布显著关联的截止点。
在审查的 2611 份产程图中，有 561 份（21.5%）完全按照世卫组织指南记录。特别是，模具成型占 50%，羊水颜色占 70.5%，胎儿心跳占 93.3%，宫颈扩张占 89.6%，下降占 63.2%，子宫收缩占 94.5%，血压占 80.5%，脉搏率占 70.5%，体温占 53%。与相应机构相比，农村卫生机构使用产程图的依从性的几率为 1.4（AOR=1.44；95%CI：1.15，1.80，P-0.002）。
本研究显示，埃塞俄比亚产程图使用的依从性水平较低。模具成型、产妇体温和下降是产程图记录最少的参数。农村机构完成产程图的几率较高。需要对卫生工作者进行强有力的支持性监督和指导，以更好地记录和使用产程图，这主要在城市卫生机构中需要。此外，在未来，应该进行干预性研究，以提高目前的依从率。
