The Determinants of Partograph Utilisation among Obstetric Care Providers at Primary Healthcare Level in South-East Nigeria: A Mixed-Methods Study

Okoroafor N.L., Esievo N.J., Ijeoma M., Ijeoma O.
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Abstract

BACKGROUND Prolonged and obstructed labour is responsible for 8% of maternal deaths can be prevented by using partograph during labour since complications can be discovered early and avoided. The goal of this study was to determine the factors that influence partograph utilisation (barriers and facilitators) among Obstetric caregivers in primary healthcare centres, Orlu local government area of Imo State, southeast Nigeria. METHOD A mixed method design was adopted for the study. For quantitative and qualitative data collection, a semi-structured questionnaire and an interview guide were utilised. A structured validated proforma was also used to collect data from patient records in all the health centres. The qualitative study consisted of oral interviews conducted among 22-unit heads in the 22 health centres. The data were analysed using simple descriptive statistics such as frequency and percentages, and the results were presented in tables. RESULTS According to the findings, the use of partograph among Obstetric caregivers in primary Healthcare centres in Orlu L.G.A was determined by personal factors such as skill incompetency in carrying out an assessment with the partograph (2.6±0.87); time constraint (2.8±0.55), institutional factors influencing the use of partograph included, non-availability of partograph (2.9±0.92), Lack of adequate orientation (3.4±0.58), Lack of training (3.3±0.47). The qualitative data revealed barriers to the use of the partograph to include unavailability of partograph, inadequate number of staff, increased workload and poor supervision. For partograph utilisation to improve among obstetric caregivers, further training and employment of more staff are needed, provision of partograph forms are also important factors to consider.
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尼日利亚东南部初级卫生保健水平的产科护理提供者使用产褥的决定因素:一项混合方法研究
背景分娩时间过长和难产造成8%的产妇死亡。在分娩过程中使用产程图可以预防,因为并发症可以及早发现并避免。这项研究的目的是确定影响尼日利亚东南部伊莫州奥卢地方政府区初级保健中心产科护理人员使用产程图的因素(障碍和促进者)。方法采用混合法设计。对于定量和定性数据收集,使用了半结构化问卷和访谈指南。一份经过结构化验证的形式表也被用于从所有卫生中心的患者记录中收集数据。定性研究包括对22个卫生中心的22个部门负责人进行的口头访谈。使用频率和百分比等简单的描述性统计数据对数据进行分析,结果以表格形式呈现。结果根据研究结果,奥卢L.G.A初级保健中心产科护理人员使用产程图是由个人因素决定的,如在用产程图进行评估时的技能不合格(2.6±0.87);时间限制(2.8±0.55),影响使用partgraph的制度因素包括:无法使用partgraph(2.9±0.92),缺乏适当的指导(3.4±0.58),缺乏培训(3.3±0.47)。定性数据显示,使用partgraph存在障碍,包括无法使用partdiagram、工作人员数量不足、工作量增加和监督不力。为了提高产科护理人员的产程图利用率,需要进一步培训和雇佣更多的工作人员,提供产程图表格也是需要考虑的重要因素。
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