NURSES AND MIDWIVES KNOWLEDGE ASSESSMENT ON COMPLETION OF THE PATOGRAPH WITHIN SELECTED FACILITIES IN KENYA.

Abstract

Globally, the top five causes of maternal mortality in women of all ages include hemorrhage, hypertensive disorders, abortions and sepsis, accounting for over 75% of all maternal fatalities. The partograph is a simple, low-cost tool recommended by the World Health Organization (WHO) for monitoring labor and identifying potential complications. The World Health Organization (WHO) recommends universal use of the partograph during labor to support decision-making in diagnosing and managing prolonged or obstructed labor. Despite its simplicity and low cost, studies conducted in many developing countries have shown that the use of the partograph remains limited. This study aimed to assess the knowledge of nurses and midwives regarding completion and use of the partograph in managing labor. The study was conducted in maternity units within selected facilities in Meru County, Kenya. This study employed a mixed-methods approach, incorporating both qualitative and quantitative techniques. A case study design was used to evaluate the knowledge and skills of participants during the intrapartum period, through completion of partographs. The sample consisted of 78 nurses and midwives. Data was collected using case-based partograph scenarios, with quantitative data analyzed using SPSS version 26 to generate descriptive statistics, while qualitative data was analyzed thematically. Despite availability of Basic Emergency Obstetric and Newborn Care (BEmONC) guidelines, significant gaps were identified in the accuracy of completing the partograph (mean score = 1.7). Participants demonstrated limited knowledge and skills, as evidenced by incorrect charting of fetal parameters and inaccurate documentation. A number of participants experienced difficulty in using the partograph, citing challenges such as staff shortages. One participant stated, “We are very few staff during the shifts, so I don’t think it will be possible to fill this partograph.” Other reported barriers included lack of training, inadequate staffing, and unavailability of partographs. Although efforts have been made to maintain clinical competence, the study revealed persistent gaps in correct use and completion of the partograph. There is need for continuous training and capacity-building initiatives to improve quality of care and strengthen clinical practice among nurses and midwives.