Feasibility and acceptability of an e-partogram application for monitoring maternal and fetal parameters during labour in Rwanda: A pilot study in one university teaching hospital in Rwanda

Abstract

Introduction: Effective monitoring of maternal and fetal parameters during labour plays a crucial role in ensuring a safe delivery process. However, conventional paper-based partograms exhibit limitations in terms of accuracy in documentation, accessibility of information, and comprehensive data analysis. In contrast, electronic partograms (e-partograms) present promising solutions by furnishing precise data, enhancing productivity, and augmenting data quality. Notably, Rwanda is actively advocating for the integration of technology within its healthcare sector. Nevertheless, the application of technology, specifically the use of epartograms, in monitoring labour progression and birthing procedures remains relatively unexplored. Scarce evidence exists regarding the viability of e-partograms in effectively monitoring maternal and fetal parameters throughout labour. Furthermore, the feasibility of epartogram implementation is impeded by various challenges, including limited computer availability, inadequate IT proficiency, and suboptimal working conditions.

Aim: This research endeavours to pilot the utilization of an e-partogram application for the monitoring maternal and fetal parameters. Additionally, it seeks to identify challenges associated with optimizing the application's usage among midwives in the hospital. Methods: In this research, both qualitative and quantitative methods were used. The OpenClinic software used at the University Teaching Hospital of Kigali includes an unused e-partogram feature that we used in pilot. Fourteen midwives underwent personalized one-hour training to understand the e-partogram. Data on the e-partogram's feasibility and acceptance during labour were collected via structured questionnaires. Statistical analysis involved spreadsheet manipulation, frequency tabulation, and visualization plots. Results: During the research, 54 labour progression instances were recorded. However, only 14 cases using the e-partogram were analyzed. The other cases showed reasons for not adopting the e-partogram. As noted before, while the e-partogram was acceptable, feasibility was difficult due to reasons like simplicity and popularity of the traditional method.