Partograph utilization as a decision making tool and associated factors among obstetric care providers in Ethiopia: A systematic review and Meta-analysis

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Abstract Background: Globally, a total of 13.6 million women have died due to maternal causes from 1990 to 2015. Majority of these deaths occurred in resource-limited countries. Among the causes of these deaths obstructed and prolonged labour covers the highest percentage which could be prevented by cost-effective and affordable health interventions like partograph utilization. Therefore, this systematic review and meta-analysis aimed to assess the level of partograph utilization among obstetric care providers and its associated factors in Ethiopia. Method: For this study systematic review and meta-analysis guideline was followed. Different online databases were used for the review: PubMed, Google scholar, Cochrane Library, HINARI, and African Online Journals. Based on the adapted PICO principles different searching terms were applied to achieve and access all the essential articles. Microsoft Excel was used for data entrance and Stata 11 soft ware for data analysis.Result: Nineteen studies were included in this systematic review and meta-analysis with a total of 6237 obstetric care providers. The overall pooled prevalence of partograph utilization was 59.9% (95%CI:46.8,73). Being midwifery profession (AOR=4,95% CI:2.6,6), female health care providers (AOR=3.2,95%CI:2.2,4.7), Emergency Obstetric and Newborn Care training (AOR =2.9,95%CI:2.2,3.8), Knowledge of partograph (AO =2.5,95%CI:1.6,3.9), short term training on partograph(AOR=5.7,95%CI:2.5,12.9), favorable attitude (AOR=2.3,95%CI:1.5,3), and working at health center(AOR=3.5,95%CI:2.5,4.9).Conclusion: The overall pooled prevalence of partograph utilization among obstetric care providers was lower than the World Health Organization recommendation. Midwifery profession, female obstetric care provider, Emergency Obstetric and Newborn Care training, knowledge of partograph, short term training on partograph, favorable attitude towards partograph, and working at the health center were factors associated with partograph utilization. This finding is important to design strategic policies, to prevent obstetric complications, and maternal mortality resulted from preventable maternal deaths.

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