A study to assess the perceived barriers in utilization of partograph

Shivani Sharma, Saroj Parwez, Kiran Batra


Background: Though maternal mortality can visualize the decreasing trends in India, but still we need to work hard for attaining sustainable development goals. As per the WHO, partograph must be used to monitor labor of all intra-natal mothers, but its implementation is limited due to various barriers experienced by health workers. The aim of the study was to assess the barriers which are experienced by the health care providers in actual utilization of the existing partograph.

Methods:Qualitative research approach was adopted to understand the views related to the partograph. Interview techniques was adopted to collect data. Various focus group discussions were conducted from November 2018 to March 2019 to gather data related to barriers experienced by the partograph users in the hospital setting. The participants were from the health centres and educational institutions of Mohali and Patiala districts of Punjab.

Results: Certain factors were highlighted in the discussion which needs to be addressed if we want that partograph should be used to its maximum potential. It brought to light various themes and factors which lead to underutilization of the existing partograph. The results highlighted the factors related to the partograph utilization, factors related to health centre, factors related to components of the partograph and enhancement of utilization of the partograph.

Conclusions:It can be concluded that in developing countries like India, where we are still struggling with the maternal and child health issues, attention should be drawn to the actual problems faced by the health care providers so that maternal and perinatal outcomes can be improved. 


Barriers, Utilization, Partograph

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UNICEF. Maternal mortality, 2019. Available at: Accessed on 18 November 2021.

WHO, UNFPA, World Bank Group, United Nations Population Division. Trends in Maternal Mortality: 2000 to 2017. Geneva: WHO; 2019.

Alkema L, Chou D, Hogan D, Zhang S, Moller AB, Gemmill A, et al. Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the un maternal mortality estimation Inter-Agency group. Lancet. 2016;387:462-74.

Mathai M. The partograph for the prevention of obstructed labor. Clin Obstet Gynecol. 2009;52(2):256-69.

Lavender T, Hart A, Smyth RM. Effect of partogram use on outcomes for women in spontaneous labour at term. Cochrane Database Syst Rev. 2013;(7):CD005461.

May C, Finch T, Mair F, Ballini L, Dowrick C, Eccles M, et al. Understanding the implementation of complex interventions in health care: the normalization process model. BMC Health Serv Res. 2007;7:148.

Bulatao RA, Ross JA. Rating maternal and neonatal health services in developing countries. Bull World Health Organ. 2002;80(9):721-7.

WHO. Preventing Prolonged Labour. A Practical Guide: The Partogram Part 1: Principle and Strategy. Geneva: WHO; 1993.

Colaizzi PF. Psychological research as the phenomenologist views it. In: Valle RS, King M, eds. Existential phenomenological alternatives for psychology. USA: Oxford University Press; 1978: 48-71.

Zelellw D, Tegegne T. The Use and Perceived Barriers of the Partograph at Public Health Institutions in East Gojjam Zone, Northwest Ethiopia. Ann Glob Health. 2018;84(1):198-203.

Hagos AA, Teka EC, Degu G. Utilization of Partograph and its associated factors among midwives working in public health institutions, Addis Ababa City Administration, Ethiopia, 2017. BMC Pregnancy Childbirth. 2020;20(1):49.

Haile Y, Tafese F, Weldemarium TD, Rad MH. Partograph Utilization and Associated Factors among Obstetric Care Providers at Public Health Facilities in Hadiya Zone, Southern Ethiopia. J Pregnancy. 2020;2020:3943498.

Neke JM, Lebeko FL, Motupa B. The partograph: a labour management tool or a midwifery record?. Int J Nurs Midwif. 2013;5(8).

Yisma E, Dessalegn B, Astatkie A, Fesseha N. Completion of the modified World Health Organization (WHO) partograph during labour in public health institutions of Addis Ababa, Ethiopia. Reprod Health. 2013;10:23.

Melese KG, Weji BG, Berheto TM, Bekru ET. Utilization of partograph during labour: A case of Wolaita Zone, Southern Ethiopia. Heliyon. 2020;6(12):05633.

Asibong U, Okokon IB, Agan TU, Oku A, Opiah M, Essien EJ, et al. The use of the partograph in labor monitoring: a cross-sectional study among obstetric caregivers in General Hospital, Calabar, Cross River State, Nigeria. Int J Womens Health. 2014;6:873-80.

Magon N. Partograph Revisited. Int J Clin Cas Investig. 2011;3:1-6.