title: The use of the partograph in labor monitoring: a cross-sectional study among obstetric caregivers in General Hospital, Calabar, Cross River State, Nigeria.
abstract: BACKGROUND
  Prolonged and obstructed labor is a significant cause of maternal morbidity and mortality in Nigeria, one of the six countries contributing significantly to the global maternal mortality crisis. The use of the partograph would engender a remarkable reduction in the number of these deaths since abnormal markers in the progress of labor would be identified early on.
  
  
  OBJECTIVE
  This study aimed to evaluate the non-physician obstetric caregivers' (OCGs) knowledge of partograph use, assess the extent of its use, determine the factors that impede its usage, and unravel the relationship between years of experience and partograph use among the respondents (OCGs) in General Hospital, Calabar, Nigeria.
  
  
  METHODS
  Using a self-administered semi-structured questionnaire, a cross-sectional descriptive study was conducted among 130 purposely selected and consenting OCGs working in the General Hospital, Calabar, Nigeria.
  
  
  RESULTS
  The majority of the respondents (70.8%) had good general knowledge of the partograph but lacked detailed and in-depth knowledge of the component parts of the partograph. Knowledge of partograph (χ(2) =12.05, P=0.0001) and partograph availability (χ(2) =56.5, P=0.0001) had a significant relationship with its utilization. Previous training (χ(2) =9.43, P=0.002) was significantly related to knowledge of partograph. Factors affecting utilization were: little or no knowledge of the partograph (85.4%), nonavailability (70%), shortage of staff (61.5%), and the fact that it is time-consuming to use (30%).
  
  
  CONCLUSIONS
  Lack of detailed knowledge of the partograph, nonavailability of the partograph, poor staff numbers, and inadequate training are factors that work against the effective utilization of the partograph in the study facility. Usage of this tool for labor monitoring can be enhanced by periodic training, making partographs available in labor wards, provision of reasonable staff numbers, and mandatory institutional policy.
authors.affiliation: Department of Family Medicine, College of Medical Sciences, University of Calabar and University of Calabar Teaching Hospital, Calabar, Nigeria.
authors.forename: Udeme
authors.initials: U
authors.lastname: Asibong
authors.affiliation: Department of Family Medicine, College of Medical Sciences, University of Calabar and University of Calabar Teaching Hospital, Calabar, Nigeria.
authors.forename: Ita B
authors.initials: IB
authors.lastname: Okokon
authors.affiliation: Department of Obstetrics and Gynecology, College of Medical Sciences, University of Calabar and University of Calabar Teaching Hospital, Calabar, Nigeria.
authors.forename: Thomas U
authors.initials: TU
authors.lastname: Agan
authors.affiliation: Department of Community Medicine, College of Medical Sciences, University of Calabar and University of Calabar Teaching Hospital, Calabar, Nigeria.
authors.forename: Affiong
authors.initials: A
authors.lastname: Oku
authors.affiliation: Department of Maternal and Child Health, Faculty of Nursing, Niger Delta University, Wilberforce Island, Bayelsa State, Nigeria.
authors.forename: Margaret
authors.initials: M
authors.lastname: Opiah
authors.affiliation: Institute of Community Health, University of Houston, Texas Medical Center, Houston, TX, USA.
authors.forename: E James
authors.initials: EJ
authors.lastname: Essien
authors.affiliation: Department of Family Medicine, College of Medical Sciences, University of Calabar and University of Calabar Teaching Hospital, Calabar, Nigeria ; Institute of Community Health, University of Houston, Texas Medical Center, Houston, TX, USA.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Monjok
keywords: Nigeria; knowledge; labor monitoring; obstetric caregivers; partograph; utilization