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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.
International Migration/Migrations Internationales/Migraciones Internacionales. 1988 Jun; 26(2):133-46.International labor standards take the form of Conventions and Recommendations that embody the agreements reached by a 2/3 majority of the representatives of Governments, Employers, and Workers of International Labour Office (ILO) member states. Originally designed to guard against the danger that 1 country or other would keep down wages and working conditions to gain competitive advantage and thereby undermine advances elsewhere, international labor standards have also been inspired by humanitarian concerns--the visible plight of workers and the physical dangers of industrialization and by the notion of social justice, which embraces wellbeing and dignity, security, and equality as well as a measure of participation in economic and social matters. ILO standards apply to workers generally and therefore also to migrant workers, irrespective of the fact that the general standards are complemented by standards especially for migrant workers. The social security protection of migrant workers has been dealt with in ILO instruments primarily from the angle of equality of treatment but also from that of the maintenance of acquired rights and rights in course of acquisition, including the payment of benefits to entitled persons resident abroad. The ILO Conventions on migrant workers and the Recommendations which supplement them deal with practically all aspects of the work and life of non-nationals such as recruitment matters, information to be made available, contract conditions, medical examination and attention, customs, exemption for personal effects, assistance in settling into their new environment, vocational training, promotion at work, job security and alternative employment, liberty of movement, participation in the cultural life of the state as well as maintenance of their own culture, transfer of earnings and savings, family reunification and visits, appeal against unjustified termination of employment or expulsion, and return assistance. ILO's supervisory mechanism consists basically of a dialogue between the ILO and the Government that is responsible for a law, regulation, or practice alleged to be in contravention of principles it voluntarily accepted. The control machinery is often set in motion by workers' organizations. The UN General Assembly is currently elaborating a new instrument designed to cover both regular and irregular migrant workers and their families.