Number of facility-based deliveries monitored with a partogram; evi­dence of correct use of the partogram; number of de­liveries at the facility during the reference period (e.g., 3 months, 12 months)

Data Source(s):

Review of medical records; direct observation by su­pervisor or external evaluator (regarding correct use); and review of the partogram

Purpose:

In a pictorial overview, the partogram graphically displays the dynamics of labor during the first stage of delivery. It records fetal condition, la­bor progress, and maternal condition with the aim of alerting health professionals to any problems with the mother or baby. In this way, the partogram acts as an “early warning sys­tem” that detects insufficient uterine action and/or cephalopelvic disproportion leading to obstructed la­bor (WHO, 1991a).

Issue(s):

There is no one partogram template; different health facilities may use different versions, with varying degrees of usefulness and simplicity.  The WHO still recommends partograms as a method of diagnosing obstructed labor, with the focus being on low-resource settings.  However, a systematic Cochrane review concluded, “On the basis of the findings of this review, we cannot recommend routine use of the partogram as part of standard labour management and care. Given the fact that the partogram is currently in widespread use and generally accepted, it appears reasonable, until stronger evidence is available, that partogram use should be locally determined. Further trial evidence is required to establish the efficacy of partogram use” (Lavender et al., 2012).

References:

Schwarcz R., A. Diaz, and F. Nieto. 1990. “Guía para la vigilancia del parto. Partograma con curvas de alerta.” Montevideo, Uruguay: Centro Latinoamericano de Perinatología.