How the digital partograph will help in early identification and management of complications.
The utilisation of the partograph is considered one of the vital steps to ensuring high quality care of both the mother and the newborn during labour. The partograph records key maternal and fetal data to provide a detailed record of the status of labour. Key measurements such as cervical dilation, fetal heart rate, duration of labour and vital signs are recorded in graph format. In this way, the progress of labour is monitored so that any delay or abnormality can be detected and treated quickly. Unfortunately, in many under-resourced facilities there is often not enough staff to utilise the partograph effectively. In Kenya, the use of the partograph ranges from as little as 25% in lower level facilities to about 56% in hospitals.
Through support from the CICF, Save the Children will be piloting a project introducing digital partographs into health facilities in Bungoma County. During recent visits to health facilities in the region, the team gained key insights into the challenges faced by health workers in using the paper partograph. Some of the challenges include a shortage of trained staff leading to increased workload, inadequate finances to pay for materials to print out paper partographs, lack of staff motivation or inadequate knowledge on how to correctly fill out and use the partograph, an overwhelming amount of paperwork and lack of supportive supervision. Because of these obstacles, health workers expressed enthusiasm about replacing the paper partograph with the digital one.
“A digital partograph will reduce the bulk of paperwork as files and registers are too many,” said Anne, a nurse in the maternity unit at Bungoma County Referral Hospital. “The digital partograph will also help to improve the system through timely referral. A well-filled partograph can avoid many complications during the management of labour. We hope the introduction of the digital partograph will aid in identifying some of the gaps and challenges health workers face in managing labour and how to address them. Ultimately, we will be able to provide quality maternal and newborn health services to our clients,” she said.
“Paper partographs are not well filled, there are too many omissions. The digital partograph will assist in the partograph being filled completely,” added Bruce Olindi, a nurse tutor at Bungoma Kenya Medical Training College. “Sometimes files get lost and important information disappears with them. A digital partograph will make it easy to retain patient information and to access client data,” he emphasized. “The prompts and alerts will help the health workers make timely decisions and be accountable through timely reporting,” he added.
Mr. Olindi recommended that students in the training institutions also receive training on the use of the digital partograph, as they too would be taking care of patients during their training.
“A partograph is the best tool to monitor the progress of labour and if used properly it can save both the life of the mother and baby. I hope the digital partograph will be able to support us in this,” he concluded.