ASSESSMENT OF PARTOGRAPH COMPLETION AND HEALTHCARE WORKER PERSPECTIVE ON ITS UTILIZATION IN ATTAT PRIMARY HOSPITAL, SOUTHWEST, ETHIOPIA, 2023

Abstract

Background: Pantograph is a cost-effective, single sheet of paper that is used to follow maternal and fetal conditions and the progress of labor. The World Health Organization recommends the utilization of pantographs for all laboring mothers. The appropriate use of the Pantograph allows early identification of labour related complications and prevents deaths. However, several maternal and fetal deaths occur in health facilities due to poor quality of labor follow-up. Therefore, we sought to determine the level of Pantograph completion and healthcare worker perspectives towards its utilization in Attat Primary Hospital, Southern Ethiopia. Objective: To assess pantograph completion and healthcare worker perspective on its utilization in Attat primary hospital, southwest, Ethiopia. Method: From May 25 - June 25, 2023 a hospital-based cross-sectional study was conducted. This study had two components; descriptive chart review at the Attat Primary Hospital, South west, Ethiopia and a qualitative study involving interview with ward nurses, and midwives. A total of 347 sampled obstetric chart were randomly selected. A semi-structured questioner was used to collect data. SPSS version 22 was used to analyze it. The quantitative data were summarized using descriptive statistical analysis, means and proportions. Data from the interview were analyzed using thematic content analysis in Open Code software. Results: Among the 347 Pantographs charts reviewed, 34.8% only had full documentation of the pantograph components. In about 55.4%, the specific parameters for fetal monitoring, 56.2% maternal monitoring and 65.2% labor progress were incomplete. From the interview, the healthcare workers reported being unable to complete the Pantographs due to the overwhelming numbers of expectant mothers and other staff responsibilities. Congestion in the maternity ward reduced the Pantograph completion rates. The limitation in skills, the state of the mother at the presentation to the hospital all made Pantograph use and completion challenging. Conclusions: The majority of Pantographs started by health workers were incomplete. The time required to document, health system challenges, status of mother at presentation, and the high workload undermined completion of the Partograph at this high volume facility.