Knowledge, attitudes and practices of health care providers on the use of the partogram in the maternity ward of Ngaoundere Regional Hospital, Adamawa Region-Cameroon

Maternal and perinatal mortality is a worldwide public health problem, because no woman should die giving birth. The partogram is an indispensable tool in the daily practice of maternity staff, as it is the written reflection of the quality of maternal and fetal care during labor, delivery and the post-partum period. The aim of this study was to
evaluate the knowledge, attitudes and practices of healthcare providers on the use of the partogram in the maternity ward of Ngaoundere Regional Hospital. We conducted a descriptive cross-sectional study over the period from July 28 to August 29, 2024. We identified a total of 35 healthcare staff using the partogram in the maternity ward, thus
constituting our exhaustive sample. A questionnaire was designed, pre-tested and administered face-to-face to participants. Data analysis was performed using Sphinx software and Microsoft Excel_2016 spreadsheet. The results show that 18 (51.4%) personnel who used the partogram were care assistants. Half of the participants had between 2 and 5 years’ professional experience. Only 7 (20%) of the department’s staff were permanent and 26 (71.4%) were trainees. A total of 25 (71.4%) providers received partogram training in a classroom workshop, and 18 (51.4%) were trained in the task by peers. Almost all the providers surveyed were familiar with all the elements of maternal and fetal monitoring, but some elements were still neglected, such as urination 4(11.4%) for the mother and active fetal movements 2(5.7%), head shaping 5(14.3%) for the fetus. Concerning attitudes, 33 (94.3%) providers identified a history of caesarean section as a risk factor during labour, while 29 (82.9%) identified high blood pressure. The danger signs most identified by providers during parturient labor were variable dilatation and eclampsia (71.4%), followed by hemorrhage (62.9%). On the other hand, the danger signs least identified by them were rupture syndrome (37.1%) and foetal distress (45.7%). In terms of providers’ practices in the face of risk, 32 (91.4%) claim to call the gynecologist, versus 3 (8.6%) who take action (cupping, administration of antispasmodics or oxytocin). Also, 7 (20.0%) providers claim to have often forgotten to use the partogram. Observation of completed partograms showed that of the 181 deliveries requiring the use of a  artogram, 13 (7.2%) were not completed, and 27 (14.9%) were incomplete or incorrectly completed. We recommend that healthcare providers knowledge and awareness of the
effective and systematic use of the partogram be reinforced to ensure the survival of parturients.

Keyword: Partogram, Knowledge, Attitudes, Practices.