Incompleteness of partogram in maternity ward of Byumba District Hospital

Abstract

There is a low rate of partogram completeness in maternity ward at Byumba District hospital. The partogram is a tool developed by WHO to be used by midwives for decision making during labor. If properly filled in all maternity ward it can play an important role in saving women's lives and babies. It is an effective clinical guideline used during labor surveillance for early diagnosis of complication including reduction of cesarean sections during delivery. The objective of the study was to increase the completeness of partogram in maternity ward at Byumba District Hospital from 15% to 50% in November, 2016 to April, 2017. Pre interventional survey was carried out where Two hundred partograms was purposively taken, audited and evaluated to measure the magnitude of the problem. The process to identify the root cause was also done by a team Post intervention was followed based on identified root causes. The intervention included, recruitment of two more staff, increasing vital sign equipment as well as establishing supervision plan. Two hundred partograms were audited in pre and post interventions and the overall completion rate was increased significantly from 15% to 90% with P<0.001. In identification part, the rate increased from 54% to 90%, with .P<0.001 with P< 0.001, The last part was postpartum and rate increased from 64.5% to 97%, with P<0.001.the completion rate was statistically significant Others parts were not analyze because had low rate of incompleteness of partograms. With the help of strategic problem solving, a pre and post intervention study on increasing completeness of partogram was conducted successfully. The intervention included the recruitment of two more staff in Maternity department, purchasing extra three electronic blood I-vi pressure machines, four thermometers and establishment of supervision plan. The completeness of partogram in maternity department of Byumba District Hospital increased considerably from 15% to 90%. It is strongly recommended that Hospital Management ensure the continuity of supervising completeness of partogram for the sustainability of the project