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Completion of the modified World Health Organization (WHO) partograph during labour in public health institutions of Addis Ababa, Ethiopia.
Reproductive Health. 2013; 10:23.BACKGROUND: The World Health Organization (WHO) recommends using the partograph to follow labour and delivery, with the objective to improve health care and reduce maternal and foetal morbidity and death. The partograph consists of a graphic representation of labour and is an excellent visual resource to analyze cervix, uterine contraction and foetal presentation in relation to time. However, poor utilization of the partograph was found in the public health institutions which reflect poor monitoring of mothers in labour and/or poor pregnancy outcome. METHODS: A retrospective document review was undertaken to assess the completion of the modified WHO partograph during labour in public health institutions of Addis Ababa, Ethiopia. A total of 420 of the modified WHO partographs used to monitor mothers in labour from five public health institutions that provide maternity care were reviewed. A structured checklist was used to gather the required data. The collected data were analyzed using SPSS version 16.0. Frequency distributions, cross-tabulations and a graph were used to describe the results of the study. RESULTS: All facilities were using the modified WHO partograph. The correct completion of the partograph was very low. From 420 partographs reviewed across all the five health facilities, foetal heart rate was recorded into the recommended standard in 129(30.7%) of the partographs, while 138 (32.9%) of cervical dilatation and 87 (20.70%) of uterine contractions were recorded to the recommended standard. The study did not document descent of the presenting part in 353 (84%). Moulding in 364 (86.7%) of the partographs reviewed was not recorded. Documentation of state of the liquor was 113(26.9%), while the maternal blood pressure was recorded to standard only in 78(18.6%) of the partographs reviewed. CONCLUSIONS: This study showed a poor completion of the modified WHO partographs during labour in public health institutions of Addis Ababa, Ethiopia. The findings may reflect poor management of labour or simply inappropriate completion of the instrument and indicate the need for pre-service and periodic on-job training of health workers on the proper completion of the partograph. Regular supportive supervision, provision of guidelines and mandatory health facility policy are also needed in support of a collaborative effort to reduce maternal and perinatal deaths.
PEOPLE. 1987; 14(2):33.3 agencies in Turkey are placing family planning centers in factory settings: the Family Planning Association of Turkey (FPAT), the Confederation of Trade Unions (TURK-IS), and the Family Health and Planning Foundation, a consortium of industrialists. The FPAT started with 27 factories 7 years ago, educating and serving 35,000 workers. The 1st work with management, then train health professionals in family planning, immunization, infant and child care, maternal health, education, motivation techniques, record-keeping and follow-up. Worker education is then begun in groups of 50. New sites are covered on a 1st-come-1st-served basis. This program is expected to be successful because newcomers to city jobs are beginning to see the need for smaller families, and accept family planning. TURK-IS has conducted seminars for trade union leaders and workers' representatives and provided contraceptives in 4 family planning clinics and in 20 hospitals run by Social Security, a workers' health organization. They have distributed condoms in factories and trained nurses to insert IUDs in factory units. The businessmen have opened family planning services in 15 factories, with support from the Pathfinder Fund, and hope to make the project self-supporting.