Assessment of the use of partographs in the region of Analamanga
Keywords:
Partograph, Maternal and Neonatal Mortalities, Analamanga-MadagascarAbstract
Background: Maternal mortality is associated with an ever-worrying trend in Madagascar. The partograph, set up by the WHO, is topical when it comes to maternal and child mortality-reducing strategies, especially in developing countries. This study assesses the effect of partograph use on maternal and neonatal mortality in maternity wards of ten basic health centres (BHC) and three hospitals located in the districts of Avaradrano, Atsimondrano, Ambohidratrimo, including the district hospital (DH) of Ambohidroa.
Methods: Across-sectional survey was conducted in selected districts, using parturients’ medical records during year 2010. Data were derived from the partographs of women meeting the following criteria: a spontaneous onset of labour, an uniparous pregnancy, a term birth, a foetal cephalic presentation, with no extra complication.
Results: Neither maternal nor neonatal death was found where a partograph has been used. Partograph use rate is 64.8%. The main reasons for not using partographs include absence of training and lack of skilled health personnel. 128 abnormalities were identified with a correct management rate of 60.9%.
Conclusions: Although implementation of the partograph appears to be easy and inexpensive, its use still collides with huge difficulties. It requires a qualified aid and a suitable environment to have a positive and significant impact on maternal and perinatal mortalities related to birth.
Metrics
References
Lawn J. 1.16 million neonatal deaths in Africa: How can we save lives through existing programmes? AIP/UNAPSA/PAN/Abuja meeting Nigeria: October 2006. The Lancet Neonatal Survival 2005: 9-12.
OMS, UNICEF, UNFPA, BanqueMondiale. Analyse etinterprétation des estimations de 2005. In: Mortalitématernelle en 2005: estimations de l’OMS, l’UNICEF, l’UNFPAet la Banquemondiale. Editions de l’OMS, Genève; 2008:16-19.
Hill K, Thomas K, AbouZahr C, Walker N, Say L, Inoue M et al. Estimates of maternal mortality worldwide between 1990 and 2005: an assessment of available data. Lancet. 2007;370:1311-19.
Hyder AA, Wali SA, McGuckin J. The burden of disease from neonatal mortality: a review of South Asia and Sub-Saharan Africa. BJOG 2003; 110:894-901.
United Nations. The Millennium Development Goals Report. New York: United Nations Department of Economic and Social Affairs; 2009.
INSTAT, EnquêteDémographique de Santé à Madagascar EDSMD III. 2003-2004. Antananarivo: Institut National de Statistique; 2004:442.
Barrère B, Barrère M. Mortalitématernelle. In: Enquête Démographiqueet de Santé de Madagascar 2008-2009. Antananarivo: INSTAT and ICF Macro; 2010:221-28.
World Health Organization. The partograph: a managerial tool for the prevention of prolonged labour. The principle and strategy. A user’s manual. Facilitator’s guide. Guidelines for operations research on the application of the partograph. WHO/MCH, 1989; Section 1; 2; 3; 4.
Masson El. The partogram: a well-known tool useful for assessing quality of obstetric care. Br J Obstet Gynaecol 2007;36:2-7.
Bouyer J, Hémon D, Cordier S, Derriennic F, Stücker I, Stengel B et al. Epidémiologie : Principes et méthodes quantitative. Paris: INSERM; 1995: 498.
De Groof D, Vangeenderhuysen C, Juncker T, Favi RA. Impact of the introduction of a partogram on maternal and perinatal mortality. Study performed in a maternity clinic in Niamey, Niger. Ann Soc Belg Med Trop 1995;75:321-33.
Diarra I, Camara S, Maiga MK. Assessment of the use of partogram at the districte maternity hospital of commune II in Bamako area. Mali Med 2009;2:10.
Bamba M. Etude critique des paramètres du partogramme dans le centre de santé de référence de la commune V de 1994-1995 à propos de 3878 cas. Thèse de Doctorat en Médecine n° 52. Bamako; 1998.
World Health Organization.Laprévention des anomalies dans la durée du travail: Partie IV: Principes de rechercheopérationnelle. WHO/FHE/MSM, 1993;11.
Prual A. La réduction de la mortalitématernelle dans les pays en développement :Théorie et pratique. Med Trop 2004;64:569-75.
Friedman E, Neff RK. Labor and delivery: impact on offspring. Littlton: PSG Publishing Company; 1987.
Institut National de Statistique. Enquête Démographiqueet de Santé 1997-1998. Institut National de Statistique, 1998.
ONU. Nous, les enfants: examen de fin de décennie du suivi de la Conférencemondiale pour les enfants: Rapport du Secrétairegénéral (A/S-27/3). New York: ONU; 2001.
MINSANPFPS. Plan de Développement du Secteur Santé et de la Protection Social. Antananarivo: MINSANPFPS;2007:23.
Jaffré Y. La bataille des femmes. Afrique de l’Ouest. Faustroll Descartes;2009:200.
UNFPA. Evaluation des besoins en matière de soins obstétricaux et néonatales d’urgence à Madagascar. Antananarivo: UNFPA, 2010.
Graham WJ, Bell JS, Bullough Colin HW. L’assistance qualifiée à la naissance peut-elle réduire la mortalité maternelle dans les pays en développement? Scotland;2010:30.
