In Labour, but Not Watched: A Retrospective Chart Review of Partograph Use at a Tertiary Facility in Northern Uganda

Background High maternal and perinatal mortality in Uganda is linked to inadequate and inconsistent labor monitoring, leading to undetected prolonged and obstructed labor, key factors in poor intrapartum outcomes. We aimed to evaluate the completeness and consistency of partograph use for intrapatum monitoring in a major public hospital in northern Uganda. Methods Between April and June 2023, we conducted a retrospective chart review of archived files (clinical notes and partographs) of mothers who gave birth between December 2022 and February 2023. A structured checklist was used to extract data on the completion of the partograph. Results Of the 958 partographs reviewed, 3.2% (n = 31) were completed to standard, and only 23.6% (n = 226) of the records had patient names indicated. Similarly, information on gravidity/parity (22.6%, n = 216), patient identification number (18.4%, n = 176), and date/time of admission (22.3%, n = 214) was absent in a substantial proportion of cases. With respect to maternal vital signs, blood pressure (13.9%, n = 134) and pulse rate (13.8%, n = 132) were documented. Furthermore, only 4.1% (n = 39) of charts had actions documented after the alert line, and 2.7% (n = 26) had actions recorded after the action line. Conclusions. Overall, there is a low partograph completion level. These findings underscore the pressing need for improved partograph utilization and documentation practices in maternal healthcare. The partograph is a vital tool for safeguarding maternal and fetal health during labor. Healthcare institutions must prioritize comprehensive training for healthcare providers on the correct use of partographs and emphasize the importance of meticulous record-keeping.