The Partograph: A Simple Tool That is Quite Complicated
The partograph is often referred to as a simple tool (see here, here, here). The word simple often appears in a definition of partograph. However, if one thing became clear over the course of a two day meeting to discuss the partograph, it is that the partograph is not as simple as we like to believe it is. In fact, it some ways, it’s a terribly complicated tool. Not only is there complexity in getting the partograph to be used to monitor labor, there is complexity in the tool itself.
According to a number of studies discussed by Tina Lavender, nearly all practitioners believe the partograph is a useful tool, but only a small minority actually uses it (25% in Nigeria, 11% in Kenya, 5% in Cote d’Ivoire). Additionally, there have been 3 iterations of the partograph from WHO (original, modified and simplified), while there are at least 58 variations of the partograph in use in the UK alone.
Acknowledging the complexity of the partograph may help in promoting its use. Putting the partograph (essentially a piece of paper) in the hands of midwives or other practitioners and telling them to use it, isn’t enough. Training, both pre-service and in-service, is needed to ensure that clinicians know how to use the tool.
Categories: Maternal Health