4.3. Demographic data
4.3.4 Diagnosis that can be made through the use of Partograph
As presented in Table 4.6, significantly 93.4% (n=114) responded ‘agree’ that obstructed labour could be diagnosed on the Partograph. Only 3.3% (n=4) responded ‘disagree’ and 3.3%
(n=4) responded ‘neither agree nor disagree’. There was a significant majority 96.7% (n=118) who responded ‘agree’ that a diagnosis of prolonged labour could be made on the Partograph.
Only 2.5% (n=3) responded ‘disagree’ and 0.8% (n=1) responded ‘neither agree nor disagree’.
There was a significant majority 96.7% (n=118) who responded ‘agree’ that poor progress of labour could be diagnosed on the Partograph. Only 2.5% (n=3) responded ‘disagree’ and 0.8%
(n=1) responded ‘neither agree nor disagree’. Furthermore, the table 4.6 indicates that regarding the diagnosis of CPD, 95.9 %( n=117) responded with ‘ agree’ that this diagnosis could be made, 2.5 % (n=3) replied with ‘strongly disagree’, while only 1.6 % (n=2) replied that they neither agreed nor disagreed that this diagnosis could be made.
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There was a significant majority 73% (n=89) who responded ‘agree’ that foetal distress could be diagnosed on the Partograph. Only 17.2% (n=21) responded ‘disagree’ and another 9.8%
(n=12) responded ‘neither agree nor agree’. Most participants 91.8% (n=112) agreed that diagnosis could be made for the need for augmentation of labour whilst 4.1% (n=5) ‘disagree’
and ‘neither agree nor disagree’. The majority of participants 72.9% (n=89) responded ‘agree' that the need for caesarean section could be diagnosed on the Partograph and 14% (n=17) said
‘disagree’ while the rest 13.1% (n=16) ‘neither agree nor disagree’.
Table 4.6: Diagnosis that can be made through use of a partograph
A score was calculated in order to get the overall perception regarding the use of partograph for Diagnosis purposes, and 7 items in the table 4.6 were computed. The responses ranged from 1=strongly disagree to 5=strongly agree. The higher the score is, the more participants have got a positive perception, and the low the score is, the less participant perceive the use of partograph for diagnosis purposes. The minimum score was 7, and the maximum score was 35.
The mean score was 31.833, median 34, and the mode was 35.
An average of 50% of the responded had a score of at least 34 which indicated a high positive perception to towards the use of partograph for diagnosis purposes (Figure 4.1).
Diagnoses that can be made through Partograph usage are…..
Strongly disagree
Disagree Neither agree nor disagree
Agree Strongly agree
Freq % Freq % Freq % Freq % Freq %
Obstructed
labour 4 3.3 0 0 4 3.3 11 9.0 103 84.4
Prolonged
labour 3 2.5 0 0 1 0.8 11 9.0 107 87.7
Poor progress 3 2.5 0 0 1 0.8 12 9.8 106 86.9
CPD 3 2.5 0 0 2 1.6 15 12.3 102 83.6
Foetal distress
10 8.2 11 9.0 12 9.8 19 15.6 70 57.4
Need for
augmentation of
labour 2 1.6 3 2.5 5 4.1 16 13.1 96 78.7
Need for caesarean section (C/S)
13 10.7 4 3.3 16 13.1 16 13.1 73 59.8
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Figure 4. 1: The use of partograph for diagnosis purposes
4.4 Kruskal-Wallis and Mann-Whitney tests
Kruskal-Wallis Test and Mann-Whitney Test were run in order to establish the association between socio demographics and the use of partograph for diagnosis purpose. There was no significant association as displayed in table 4.7.
Table 4. 7: Association between the socio demographics and the use of partograph for diagnosis purpose
Age group Gender Race Academic qualification
Categories of practice
Years of experience Use of
partograph for diagnosis purpose
X2=2.943;
p=0.938
U=443.5;
P=0.960
X2=0.246, p=0.620
X2=1.940;
p=0.379
X2=7.840;
p=0.098
X2=2.868;
p=0.580
4.4.1 The understanding of the partograph by midwives
The results shown in Table 4.8 above indicate 75.4% (n=92) of participants agreed that a Partograph may be used in decision making for referral decisions in the health centres, while 79.5% (n=97) agreed that it may also be used in the decision making interventions in different institutions. A big percentage of 68.8 % (n=84) of participants acknowledged the use of partograph in the reduction of maternal deaths and maternal morbidity.
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96.7% (n=118) agreeing that this tool plays a key role towards reducing neonatal deaths and perinatal morbidity. 90.9% (n=111) of participants agreed that this tool is used to diagnose early complications, 95.1% (n=116) only also assist midwife to make correct interventions for both mother and neonate. 86.9% (n=106) mentioned that Partograph does not replace adequate screening for pregnant women who require immediate intervention A huge percentage of 95.9% (n=117) of participants acknowledge the use of partograph to identify problems in labour, only minimum of 1.6% (n=2) disagree. Participants representing 29.5% (n=36) agreed that, composition of a partograph is seen as difficult, with only 51.6% (n=63) disagree.
Table 4. 8: The understanding of the partograph by midwives
Variables Strongly
Disagree
Disagree Neither agree nor disagree
Agree Strongly agree
Freq % Freq % Freq % Freq % Freq %
A Partograph may be used in decision making referral decision in health centres
4 3.3 9 7.4 17 13.9 16 13.1 76 62.3
A Partograph may be used in decision making: intervention
decision in different institutions 5 4.1 8 6.6 12 9.8 19 15.6 78 63.9 A Partograph will contribute to
the reduction of maternal
deaths and maternal morbidity 9 7.4 16 13.1 13 10.7 17 13.9 67 54.9 A Partograph will contribute to
the reduction of neonatal deaths
and perinatal morbidity 2 1.6 0 0 2 1.6 15 12.3 103 84.4
A Partograph is a tool used during monitoring of the progress of labour for early diagnosis of complications
3 2.5 5 4.1 3 2.5 12 9.8 99 81.1
A Partograph is a decision making tool to assist a midwife to make the correct
interventions for both mother and neonate
2 1.6 0 0 4 3.3 13 10.7 103 84.4
A Partograph does not replace adequate screening for a pregnant woman who requires immediate interventions
2 1.6 4 3.3 10 8.2 14 11.5 92 75.4
Accurate use of the Partograph leads to improved maternal and neonatal outcomes
2 1.6 1 0.8 2 1.6 22 18.0 95 77.9
A Partograph is used to identify
problems in labour 2 1.6 0 0 3 2.5 14 11.5 103 84.4
The composite of a Partograph
is seen as difficult 30 24.6 33 27.0 23 18.9 17 13.9 19 15.6
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In Figure 4.2 below a score was calculated in order to get the overall understanding of the partograph, the responses ranged from 1=strongly disagree to 5=strongly agree. The higher the score is, the more participants have got a positive perception, and the low the score is, the less participant perceive the overall understanding of the partograph. The minimum score was 10 and the maximum score was 50. The mean score was 43.363, median 46, and the mode was 45. An average of 50% of the responded had a score of at least 47 which indicated a high positive perception to towards an overall understanding of the partograph.
Figure 4. 2: Overall understanding of the partograph
4.4.2 Composition of the partograph
In Table 4.9 as illustrated; 97.6% (n=119) of participants agreed that contents of the
partograph includes patient’s details, furthermore 96.7% (n=119) of participants also agreed that type of labour, duration of labour and maternal condition are composition of the
partograph. Another 97.5% (n=119) also agreed that latent and active phase medication given also from composition of the partograph. A significant majority of participants 97.6%
(n=119) agree that Partograph consist of time of rupture of membranes, risks factors, foetal condition, and progress of labour as well as contractions
45 Table 4. 9 Contents of the partograph
The Partograph consists of……
Strongly disagree
Disagree Neither agree nor disagree
Agree
Strongly agree Freq % Freq % Freq % Freq % Freq % Patient's details (
age, parity and gestation)
2 1.6 0 0 1 0.8 8 6.6 111 91.0
Pelvic assessment 3 2.5 4 3.3 1 0.8 13 10.7 100 82.0 Time of rupture
of membranes 2 1.6 0 0 1 0.8 9 7.4 110 90.2
Risk factors 2 1.6 0 0 1 0.8 9 7.4 110 90.2
Type of labour (spontaneous or induced)
2 1.6 0 0 2 1.6 10 8.2 108 88.5
Duration of
labour 2 1.6 1 0.8 1 0.8 12 9.8 106 86.9
Latent phase and
active phase 2 1.6 0 0 1 0.8 10 8.2 109 89.3
Foetal condition 2 1.6 0 0 1 0.8 9 7.4 110 90.2
Progress of
labour 2 1.6 0 0 1 0.8 9 7.4 110 90.2
Contractions 2 1.6 0 0 1 0.8 9 7.4 110 90.2
Maternal
condition 2 1.6 1 .08 1 0.8 11 9.0 107 87.7
Medication given 2 1.6 0 0 1 0.8 11 9.0 108 88.5
Figure 3 below show that a score was calculated in order to get the overall knowledge of the contents of the partograph. The higher the score is, the more participants have got a positive perception, and the low the score is, the less participant perceive the overall knowledge of the content of the partograph. The minimum score was 12 and the maximum score was 99. The mean score was 58.158, median 60, and the mode was 60. An average of 50% of the responded had a score of at least 60 which indicated a high positive perception to towards an overall knowledge of the contents of the partograph.
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Figure 4. 3: Overall knowledge of the contents of the partograph