Ayele Mulat, Lake Eyob Shitie, Yilak Gizachew, Kumie Getinet, Abate Biruk Beletew, Zemariam Alemu Birara, Tilahun Befkad Derese
Department of Midwifery, College of Health Science, Woldia University, Woldia, Ethiopia.
Department of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia.
Front Glob Womens Health. 2025 Jan 27;6:1339685. doi: 10.3389/fgwh.2025.1339685. eCollection 2025.
Effective use of the partograph is crucial in identifying abnormal labor (prolonged and obstructed labor) and taking appropriate actions. However, in Ethiopia, the prevalence of obstructed labor is much higher at 11.8% and contributes to 14.4% of the total maternal deaths due to underutilization of the partograph by obstetric caregivers. Although a previous systematic review and meta-analysis (SRMA) had been conducted, they were not representative on a national level as they included a limited number of studies and did not evaluate the current prevalence of partograph utilization beyond July 2019. Since then, there have been inconsistent studies assessing the proportion of partograph utilization and its associated factors. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of partograph utilization and its associated factors in Ethiopia.
Comprehensive literature searches were conducted in PubMed, Google Scholar, and HINARI from 1 September 2013 to 23 October 2023. A random-effects model was used to estimate pooled prevalence and adjusted odds ratio. Stata (version 11.0) was used to analyze the data. Cochrane statistics were computed to assess heterogeneity among studies. A subgroup analysis was done based on the study region to minimize underlying heterogeneity. Funnel plot and Eggers test were conducted to assess publication bias.
Overall, 661 articles were retrieved, and finally, 23 studies were included in this systematic review, including 7,649 participants. The pooled prevalence of partograph utilization was 54.92% (95% CI: 43.38-66.45). The subgroup analysis showed that partograph utilization was highest in the Dire Dawa region and lowest in the Amhara region. Factors such as partograph training [adjusted odds ratio (AOR) = 3.63, 95% CI: 2.57-5.25], good knowledge about partograph (AOR = 2.63, 95% CI: 1.62-4.26), a favorable attitude toward partograph (AOR = 1.95, 95% CI: 1.35-2.82), partograph availability (AOR = 0.89, 95% CI: 2.24-6.61), and being in the midwifery profession (AOR = 0.09, 95% CI: 1.78-5.25) were significantly associated with partograph utilization.
The pooled prevalence of partograph utilization in Ethiopia was low. Partograph training, good knowledge about partograph, favorable attitude toward partograph, partograph availability in the health facility, and being in the midwifery profession were significantly associated with partograph utilization.
https://www.crd.york.ac.uk/prospero/, identifier (CRD42023475818).
有效使用产程图对于识别异常分娩（产程延长和梗阻性分娩）并采取适当措施至关重要。然而，在埃塞俄比亚，梗阻性分娩的患病率要高得多，为11.8%，由于产科护理人员未充分利用产程图，其导致的孕产妇死亡占孕产妇死亡总数的14.4%。尽管之前已经进行了系统评价和荟萃分析（SRMA），但它们在国家层面上并不具有代表性，因为它们纳入的研究数量有限，并且没有评估2019年7月以后产程图使用的当前患病率。从那时起，评估产程图使用比例及其相关因素的研究一直不一致。因此，本系统评价和荟萃分析旨在估计埃塞俄比亚产程图使用的合并患病率及其相关因素。
于2013年9月1日至2023年10月23日在PubMed、谷歌学术和HINARI中进行了全面的文献检索。使用随机效应模型估计合并患病率和调整后的优势比。使用Stata（版本11.0）分析数据。计算Cochrane统计量以评估研究之间的异质性。基于研究地区进行亚组分析以尽量减少潜在的异质性。进行漏斗图和Egger检验以评估发表偏倚。
总体而言，检索到661篇文章，最终，本系统评价纳入了23项研究，包括7649名参与者。产程图使用的合并患病率为54.92%（95%CI：43.38 - 66.45）。亚组分析表明，产程图使用在迪雷达瓦地区最高，在阿姆哈拉地区最低。产程图培训[调整后的优势比（AOR）= 3.63，95%CI：2.57 - 5.25]、对产程图的良好了解（AOR = 2.63，95%CI：1.62 - 4.26）、对产程图的积极态度（AOR = 1.95，95%CI：1.35 - 2.82）、产程图的可获得性（AOR = 0.89，95%CI：2.24 - 6.61）以及从事助产专业（AOR = 0.09，95%CI：1.78 - 5.25）等因素与产程图使用显著相关。
埃塞俄比亚产程图使用的合并患病率较低。产程图培训、对产程图的良好了解、对产程图的积极态度、医疗机构中产程图的可获得性以及从事助产专业与产程图使用显著相关。
