Feasibility of using partograph by practitioners of Indian system of medicine (AYUSH): An exploratory observation

被引:4
作者
Chandhiok, Nomita [1 ]
Shrotri, Aparna
Joglekar, Neelam Sanjay
Chaudhury, Nayanjeet [2 ]
Choudhury, Panna
Singh, Shalini [1 ]
机构
[1] Indian Council Med Res, New Delhi 110029, India
[2] Populat Serv Int, New Delhi 110019, India
关键词
Partograph; Skilled birth attendant; Labour; Task shifting; PUBLIC-HEALTH INSTITUTIONS; ADDIS-ABABA; LABOR; CERVICOGRAPHS; PRIMIGRAVIDAE; ORGANIZATION; MANAGEMENT; LINE;
D O I
10.1016/j.midw.2015.03.004
中图分类号
R47 [护理学];
学科分类号
1011 ;
摘要
Objective: to understand the use of the partograph by Skilled Birth Attendance/Basic Emergency Obstetric Care (SBA/BEmOC) trained practitioners from Indian systems of medicine called AYUSH practitioners (APs). Design: mixed method observational study, inducting an exploration of the views of APs, programme managers and SBA trainers on the necessity, feasibility and barriers to the use of partograph. Setting: primary and community health centres in two purposively selected districts in each of the three states (Rajasthan, Maharashtra and Odisha) in India where SBA/BEmOC trained APs are deployed to provide SBA services. In-depth interviews with state, district and block level programme managers were held at their respective headquarters. Participants: 83 APs plotted the simplified partograph based on a given labour case scenario. In-depth interviews were conducted with 36 programme managers and 37 APs (24 Ayurvedic and 13 Homoeopathic). Measurements and findings: the completed simplified partograph was analysed according to a previously devised scoring system with a score of 70% or more indicating competency. APs in Rajasthan and Maharashtra demonstrated good partograph plotting skills (72.1% and 82% respectively) obtaining a competency score of more than 70%. However, overall performance of APs in Odisha was poor (11.1%) and except correct recording of fetal condition, the APs did not score well in the plotting of the other partograph components. Errors occurred mainly in the recording of cervical dilatation and uterine contractions. The in-depth interviews revealed that most APs demonstrated a good understanding of the tool in the context of decision making regarding timely referral in case of prolonged labour or fetal distress. There was a high perception of the need for more hands-on training in the SBA training curriculum. The programme managers also expressed the need for appropriate training and supervision to ensure good plotting of parlograph. The barriers for partograph use included increased workload, insufficient training, unavailability of parlograph forms and its null utility for women coming late in labour. Key conclusions: knowledge of plotting and correct interpretation of partograph were generally good in two states but more practice is needed to improve providers' skills. Identified barriers could be addressed with further training and local managerial support. An analysis of the causes for the poor performance of APs in Odisha should be carried out. Pre-service and periodic in-service training of APs on the completion of the partograph, regular supportive supervision, implementation of programme guidelines on mandatory completion of partograph and an environment that supports its correct and consistent use are recommended. Implications for practice: with appropriate training, it is feasible for AYUSH practitioners to use partograph for monitoring progress of labour. (C) 2015 Elsevier Ltd. All rights resented.
引用
收藏
页码:702 / 707
页数:6
相关论文
共 18 条
  • [1] [Anonymous], 2006, PREGN CHILDB POSTP N
  • [2] [Anonymous], 2010, SBA TRAINERS GUIDEFO
  • [3] [Anonymous], INT J CLIN CASES INV
  • [4] Chandhiok N., 2014, INT HLTH
  • [5] Fawole A O, 2008, Afr J Reprod Health, V12, P22
  • [6] PRIMIGRAVID LABOR - A GRAPHICOSTATISTICAL ANALYSIS
    FRIEDMAN, EA
    [J]. OBSTETRICS AND GYNECOLOGY, 1955, 6 (06) : 567 - 589
  • [7] THE PARTOGRAPH: AN ESSENTIAL YET UNDERUTILIZED TOOL
    Kushwah, Beenu
    Singh, Alok Pratap
    Singh, Shipra
    [J]. JOURNAL OF EVOLUTION OF MEDICAL AND DENTAL SCIENCES-JEMDS, 2013, 2 (24): : 4373 - 4379
  • [8] KWAST BE, 1994, LANCET, V343, P1399
  • [9] Comparison of two World Health Organization partographs
    Mathews, J. E.
    Rajaratnam, A.
    George, A.
    Mathai, M.
    [J]. INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS, 2007, 96 (02) : 147 - 150
  • [10] Medical Manpower-Department of AYUSH. Ministry of Health and Family Welfare Government of India, 2010, MED MANP