Abdoulie Gassama

Title: Partograph knowledge and utilization for preventing labour complications among obstetric care providers in gambian hospitals

Abstract

This presentation details the findings of a cross-sectional study investigating the knowledge and utilization of the partograph, a vital labour monitoring tool, among doctors, nurses, and midwives across six major hospitals in The Gambia. Despite the World Health Organization's recommendation for its universal use to prevent prolonged and obstructed labour, maternal mortality remains high in the region. The study, involving 252 obstetric care providers, combined interviewer-administered questionnaires with retrospective reviews of filled partographs. Key findings indicate a critical gap between knowledge and practice. While 68% of respondents demonstrated "very good" knowledge of the partograph, its overall utilization was alarmingly low at only 27%. Significant disparities were observed across professional cadres and healthcare facilities. Nurses showed the highest utilization rate (67%), compared to midwives (26%) and medical doctors (24%). Furthermore, utilization was substantially higher in specialized facilities like the Bundung Maternal and Child Health Hospital (44%) compared to the Edward Francis Small Teaching Hospital (11%). Multivariable regression identified professional qualification, healthcare setting, and knowledge of partograph indications as the most significant predictors of utilization. A counter-intuitive finding revealed that providers with lower knowledge scores had higher odds of using the tool, suggesting complexity in the relationship between knowledge and application. The presentation will conclude with evidence-based recommendations for policy, practice, and further research to bridge this gap and improve maternal health outcomes.

The audience take away from presentation:

Identification of Systemic and Individual Barriers: Attendees will gain a clear understanding of the key factors hindering partograph use in low-resource settings, including professional cadre disparities, institutional resource allocation, and the complex relationship between theoretical knowledge and practical application.

A Model for Multi-faceted Intervention: The findings provide a framework for developing targeted interventions. Audience members will learn why a one-size-fits-all approach is insufficient and how strategies must be tailored to specific professional groups (nurses vs. doctors) and hospital environments (specialized vs. tertiary teaching hospitals).

Methodology for Assessing Clinical Tool Adoption: Researchers and public health practitioners will be able to adapt the study's robust methodology, which combined self-reported data with objective record reviews and used hierarchical regression models, to evaluate the adoption of other clinical guidelines or tools in their own contexts.

Actionable Recommendations for Improving Compliance: The presentation will offer concrete, practical recommendations. These include the need for regular, hands-on in-service training combined with supportive supervision, the integration of partograph use into official labour management protocols, and the potential for peer-led learning from high-performing facilities.

Direction for Future Research: The findings highlight the need for qualitative research to explore the "why" behind the quantitative data and for intervention studies to test solutions like digital partographs or audit and feedback systems, providing a roadmap for future academic inquiry.