Background
Complications during labour can lead to severe health consequences for both the mother and baby and put their lives in danger. A partograph is a graphic record that can be used to monitor the progress of labour and help the midwives identify and manage any abnormalities at an early stage. In Lower Mulago Labour Suite, at Mulago National Referral and Teaching Hospital in Kampala, only 4% of the deliveries are monitored using a partograph – despite the World Health Organization’s recommendation that this should be done for all deliveries. The hospital staff reported that the reasons for the low use included lack of space, an overwhelming number of mothers in labour, lack of knowledge amongst the staff and negative attitudes towards partograph use.

About the project
This project was created to increase the use of partograph to monitor labour at Lower Mulago Hospital Labour Suite. The project team trained and sensitized the hospital’s midwives, obstetricians, interns and students on partograph use. The midwives received weekly trainings combined with support in their day-to-day work, in order to strengthen their skills and enable them to use the partograph independently. The project team also involved the hospital management to make a number of organizational changes to create more space for the patients and improve the midwives’ working conditions.

Results
By the end of the project, the number of deliveries monitored using a partograph increased from 4% to 12% and partographs were included in all mothers’ patient files. All 38 midwives working at the labour suite completed the training on how to use the partograph to monitor women in labour. The attitude of the health workers improved and all mothers examined by midwives are now being monitored using partograph. This project received strong support from the hospital management, who will ensure that this positive change is sustained going forward.

Year: 2008/2009