QI Story: Enhancing Partograph Utilization at Madede Health Centre, Malawi

AUTHORS: Kuyokwa, M., Gondwe, S.C., Mwale, S., Chiumia, ANyirenda, W., &Mkandawire, E

Presenter Kuyokwa Moses, Mid-Wife Madede Health Centre Malawi, MZIMBA SOUTH DISTRICT HOSPITAL, MALAWI

The study at Madede Health Centre in Malawi aimed to increase the use of partographs during labor and delivery from 9% to 40% within six months. Three strategies were employed: midwives committing to use partographs, setting reminders, and enacting bylaws to reduce late arrivals.

Using a time series quasi-experimental design, the study observed significant improvements. Warnings to midwives increased partograph use by 54%, reminders from guardians by 58%, and enacting bylaws led to a 75% increase. The changes were non-random, indicating the effectiveness of the strategies. The study highlights the importance of partographs in early complication detection and intervention. Recommendations include complementing partographs with ultrasound scanning and addressing complications with improved ambulance access and obstetric protocols.

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