Assessment of partogram use during labour in Rujumbura Health Sub District, Rukungiri District, Uganda.

BACKGROUND A partogram is a universal tool for monitoring labour. It is used for labour management in Rujumbura HSD, Rukungiri District. However, the District Health Officer reported only 30% use of a partogram. The study intended to find out why the low use, and suggest strategies in scaling up. OBJECTIVES To establish extent of use of a partogram, health facility and health workers' factors that affected its use during labour plus the relationship between foetal Apgar score and its use. MATERIALS AND METHODS A cross-sectional study involving observations, record reviews and interviewing of staff in 8 health facilities (4 Public and 4 Private Not For Profit) in Rujumbura HSD in Rukungiri district was conducted from May 23(rd) to 27(th) June 2008. It employed both qualitative and quantitative methods of data collection. RESULTS The partogram was used in 69.9% of deliveries. The partographs that fulfilled the standard monitoring of foetal heart rate were only 2%. There were few trained health workers and lack of guidelines on partogram use. A good Apgar score was associated with standard foetal monitoring and was statistically significant (P < 0.001). CONCLUSIONS AND RECOMMENDATIONS There was poor use of partograms during labour mainly affected by health input factors. We recommended training of health workers on partogram use, provision of guidelines and adequate resources.