Evaluation report
Midwives in the Cape Coast Metropolis of Ghana are enhancing the effectiveness of labour monitoring by utilising partographs
Kofitse SK, Adong JW ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined how midwives in Cape Coast, Ghana use partographs—tools for monitoring labour during childbirth. Researchers surveyed 67 midwives and reviewed 285 partographs from six health facilities. While documentation completeness reached 75%, this fell short of the 90% standard, and midwives' knowledge of how to interpret partograph findings was particularly weak at 27%. The authors recommend better training and supervision to improve how these essential labour monitoring tools are used.
Key points
- Overall partograph documentation completeness was 75%, below the anticipated 90% standard
- Labour progression factors were the most completely documented (91%), while maternal pre-risk factors were the least (53%)
- Client age was the least documented variable (2%), while gravida was fully documented (100%)
- Average midwife knowledge score on partograph application was 73%, with interpretation of observations being the weakest domain at 27%
- The study recommends structured mentorship, routine in-service training, and supervisory support to improve midwife skills
Limitations
The study was cross-sectional and descriptive, so it cannot establish causation or identify the specific reasons for gaps in documentation and knowledge. It does not evaluate the impact of improved partograph use on maternal or newborn health outcomes.
Abstract
Abstract Background The partograph is an essential maternal tool for monitoring labour progression in child birth, significantly lowering maternal and newborn complications. However, some clinics in Ghana often fail to apply it appropriately, during childbirth. We assessed partograph utilisation and documentation completeness among midwives in selected health facilities in the Cape Coast Metropolitan Area. Methods A cross-sectional study was employed. Questionnaires were administered to 67 consenting midwives working in six selected facilities, which collectively accounted for 96% of deliveries in the metropolis. A retrospective record review was conducted on 285 partographs. Descriptive statistics were computed and the Chi-square (χ²) test was used to determine associations between selected variables and partograph utilisation, Results Overall partograph documentation completeness was 75%. Labour progression factors had the highest section-level completeness (91%), while maternal pre-risk factors had the lowest section completeness (53%). Among individual variables, the age of the client was the least documented (2%), whereas gravida was fully documented (100%). The average knowledge score on partograph application was 73% across 10 assessed components. The lowest knowledge domain was the interpretation of partograph observations (27%). Conclusions Partograph documentation and midwife knowledge in the Cape Coast Metropolis fell short of the anticipated 90% standard. There is a need for structured mentorship, routine in-service training, and supervisory support, for midwives to enhance skills, completeness and interpretation of the partograph.