Factors Affecting Utilisation of Partograph among Healthcare Workers in Bukoba District Council, Kagera Region, Tanzania
Abstract
The World Health Organization (WHO) acknowledges that the effective use of partograph helps prevent maternal and neonatal deaths, identify abnormalities, and inform appropriate labour management. In Tanzania, the national Emergency Obstetric Neonatal Care (EmoNC) assessment has consistently reported low utilisation of partographs. However, little is known about the local factors hindering partograph use. Therefore, this study assessed factors affecting the utilisation of partographs among healthcare workers in Health facilities in Bukoba DC in the Kagera region. To address this, a quantitative descriptive cross-sectional design was adopted. The sample size for this study comprised 224 nurses and 79 clinicians recruited from Bukoba DC. Stratified random sampling was utilised to select study participants from the identified health facilities. Data were collected through structured questions, and data analysis was achieved through descriptive and multivariate analysis using the Statistical Package for Social Science (SPSS version 27). The study found that 80.8% of healthcare workers (HCW) used the partograph, while 19.2% did not. Its use was correlated with age and educational attainment. HCWs who were 27 years of age or older were 10% less likely than those under 26 to use the partograph (AOR = 0.904, CI 95% = 0.834-0.979, p = 0.013). Compared to those with less than two years of college education, HCWs with three years or more were 1.1 times more likely to do it (AOR = 1.141, CI 95% = 1.054-1.235, p = 0.001). HCWs who performed 6–10 deliveries in a 24-hour shift were also 9.6% less likely to use the partograph than those who performed 1–5 deliveries. Similarly, compared to those in the reproductive and child health (RCH) department, healthcare workers in the labour ward unit were 9.9% less likely to use the partograph (AOR = 0.901, CI 95% = 0.822-0.988, p = 0.027). The study shows that while most healthcare workers use partographs, there are gaps in knowledge and attitudes about their use, especially in reducing maternal and newborn deaths. To improve this, facilities should prioritise resources, implement continuous training, and ensure regular availability of partograph forms and monitoring equipment.
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