Assessment of the use of partographs in the region of Analamanga

Background: Maternal mortality is associated with an ever-worrying trend in Madagascar. The partograph, set up by the WHO, is topical when it comes to maternal and child mortality-reducing strategies, especially in developing countries. This study assesses the effect of partograph use on maternal and neonatal mortality in maternity wards of ten basic health centres (BHC) and three hospitals located in the districts of Avaradrano, Atsimondrano, Ambohidratrimo, including the district hospital (DH) of Ambohidroa. Methods: Across-sectional survey was conducted in selected districts, using parturients’ medical records during year 2010. Data were derived from the partographs of women meeting the following criteria: a spontaneous onset of labour, an uniparous pregnancy, a term birth, a foetal cephalic presentation, with no extra complication. Results: Neither maternal nor neonatal death was found where a partograph has been used. Partograph use rate is 64.8%. The main reasons for not using partographs include absence of training and lack of skilled health personnel. 128 abnormalities were identified with a correct management rate of 60.9%. Conclusions: Although implementation of the partograph appears to be easy and inexpensive, its use still collides with huge difficulties. It requires a qualified aid and a suitable environment to have a positive and significant impact on maternal and perinatal mortalities related to birth. [Int J Reprod Contracept Obstet Gynecol 2013; 2(3.000): 257-262]