Assessing Intrapartum Care Practices in Ntcheu, Malawi: Current Use of the Partograph Tool Público

Abstract

Despite the existence of many interventions for the reduction of maternal mortality and morbidity in low-resource areas, death and disability related to pregnancy and childbirth persist at unacceptable levels throughout the world, and especially in sub-Saharan Africa. Appropriate implementation of interventions to improve the quality of maternal health services is essential for reduction of maternal mortality in low-resource countries. One such intervention is the partograph - a tool used during labor to monitor progress over time. However, evaluations of its use are limited. This thesis project is an assessment of current use of the partograph by health workers in the rural district of Ntcheu, Malawi. Specifically, the aims of this project are to explore the extent of partograph use, the extent of partograph use as intended by global guidelines, and to assess for evidence of appropriately implemented obstetric interventions based on partograph indicators. Data from partographs collected in the study setting were analyzed and compared to World Health Organization standards of partograph use. Of an original sample of 196 births, only 44 partographs could be located and analyzed. The partographs that were found were often incomplete, with multiple indicators missing. In addition, information connecting indicators on the partographs to obstetric interventions was extremely limited. Further study is needed to evaluate partograph the extent of use and quality of use of the partograph and other maternal health interventions in developing country settings.

Table of Contents

Chapter 1: Introduction

INTRODUCTION AND RATIONALE

THE PARTOGRAPH TOOL

CARE MALAWI PROJECT

PROBLEM STATEMENT

PURPOSE STATEMENT

SIGNIFICANCE STATEMENT

Chapter 2: Literature Review

INTRODUCTION

OBSTRUCTED LABOR AS AMAJOR CAUSE OF MATERNAL MORTALITY

THE PARTOGRAPH: A TOOL FOR PREVENTING OBSTRUCTED LABOR

RESEARCH ON THE PARTOGRAPH

QUALITY OF CARE IN MATERNAL HEALTH

SUMMARY OF CURRENT PROBLEM AND RELEVANCE

Chapter 3: Manuscript

ABSTRACT

INTRODUCTION

METHODS

RESULTS

DISCUSSION

REFERENCES

Chapter 4: Discussion

SUMMARY OF FINDINGS

INTERPRETATION OF FINDINGS

RECOMMENDATIONS

PERSONAL RESPONSE

Chapter 5: Thesis References

About this Master's Thesis

Rights statement

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Palabra Clave	maternal mortality quality of care malawi partograph
Committee Chair / Thesis Advisor	Spangler, Sydney A, Emory University
Partnering Agencies	International Non-governmental organization (e.g., CARE, Inc.)

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