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| ORIGINAL ARTICLE |
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| Year : 2020 |
Volume
: 45 | Issue : 4 | Page
: 487-491 |
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Strengthening the use of partograph in high caseload public health facilities in India through an integrated quality improvement approach
Devina Bajpayee1, Enisha Sarin2, Saumyadripta Chaudhuri3, Sourav Ghosh Dastidar4, Anil Gupta5, Nitin Bisht6, Anurag Joshi7, Asif Jeelani8, Chitra Rathi9, Rakesh Parashar10, Geeta Verma11, Kaveri Haldar12, VS Sridhar13, Sachin Gupta14, Gunjan Taneja15, Rajeev Gera16
1 Senior Advisor-Maternal and Newborn Health, USAID-VRIDDHI/IPE Global, New Delhi, India
2 Senior Advisor-Monitoring Evaluation and Learning, USAID-VRIDDHI/IPE Global, New Delhi, India
3 Ex-Senior Technical Officer-Health Systems, USAID-VRIDDHI/IPE Global, New Delhi, India
4 State Technical Officer-Jharkhand, USAID-VRIDDHI/IPE Global, Ranchi, Jharkhand, India
5 State Technical Advisor-Himachal Pradesh, USAID-VRIDDHI/IPE Global, Shimla, India
6 State Technical Advisor-Uttarakhand, USAID-VRIDDHI/IPE Global, Dehradun, Uttarakhand, India
7 Ex- State Technical Advisor-Punjab, USAID-VRIDDHI/IPE Global, Chandigarh, Punjab, India
8 Ex- State technical Officer-Haryana, USAID-VRIDDHI/IPE Global, Chandigarh, Haryana, India
9 Ex-State Team Lead-Delhi, USAID-VRIDDHI/IPE Global, Delhi, India
10 Ex-Senior Advisor, Health Systems, USAID-VRIDDHI/IPE Global, New Delhi, India
11 Ex-National Program Manager, USAID-VRIDDHI/IPE Global, New Delhi, India
12 Ex-Technical Officer, USAID-VRIDDHI/IPE Global, New Delhi, India
13 Ex-Lead, Monitoring and Evaluation, USAID-VRIDDHI/IPE Global, New Delhi, India
14 Advisor – Maternal and Child Health, USAID - India, New Delhi, India
15 Ex-National Technical Lead, USAID-VRIDDHI/IPE Global, New Delhi, India
16 Ex-Project Director, USAID-VRIDDHI/IPE Global, New Delhi, India
Correspondence Address:
Dr. Enisha Sarin
IPE Global House, B – 84, Defence Colony, New Delhi - 110 024
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/ijcm.IJCM_530_19
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Background: The effective implementation of evidence-based practices including the use of partograph to improve maternal and newborn outcomes is critical on account of increased institutional delivery. However, despite clear guidelines, partograph use in India is not widely practiced. Materials and Methods: Quality improvement (QI) efforts along with training and mentoring were operationalized in a total of 141 facilities across 26 high priority districts of India. Assessments were conducted across baseline, intervention period, and end line. These included reviewing the availability of partograph and staff competency in filling them at baseline and end line, as well as reviewing monthly data for use and completeness of filling. The monthly data were tabulated quarter wise to study trends. Competency scores were tabulated to show the difference across assessments. Results: An overall upward trend from 29% to 61% was seen in the practice of partograph use. Simultaneously, completeness in filling up the partograph increased from 32% to 81%. Staff competency in filling partograph improved considerably: proportion of staff scoring low decreased over the intervention period from 63% to 2.5% (P < 0.0001), and the proportion scoring high increased from 13% to 72% (P < 0.0001) from baseline to end line. Conclusion: The integrated approach of training, mentoring, and QI can be used in similar settings to strengthen partograph use.
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