The Partograph: An interview with a local Doctor

What is the Partograph?

Infante Sano has worked hard to increase the frequency of use of the partograph by doctors at the NSR hospital in Bani. The partograph is a simple yet critical tool for labor and delivery. It enables the monitoring of active labor using only a stethoscope, sphigmometer and gloves. The partograph is literally a paper form designed to facilitate recording and interpreting of signs of maternal and fetal well being.

Why is the Partograph Important?

The partograph has been proven to reduce both maternal and infant morbidity and mortality. The partograph saves lives by allowing doctors to monitor labor and intervene appropriately when necessary. The World Health Organization promotes it around the world and is endorsed by USAID as a basic, high impact intervention for low-resource settings. In addition, it can be used by all medical professionals; nurses, general physicians and obstetricians, midwives and community health workers (where applicable).

 

How are we implementing the Partograph effectively?

Infante Sano introduced the partograph to medical professionals at the hospital in August of 2006 and established a partograph committee to continue spreading and teaching partograph use. Thanks largely to the efforts of Nika Lorraine Seidman, the committee has collected staff questionnaires to better understand barriers to partograph use, developed training materials, lead trainings, and monitored partograph use in the hospital.

 

The following is an interview with Dr Zapata, a general medical doctor who works in the Labor and Delivery ward in the NSR Hospital in Bani and who was appointed to the partograph committee.

A local perspective: Interview with a doctor in the Bani Hospital

 

Name: Dr. Nemia Zapata

 

Born: in a small rural area outside Bani

 

Lives: in Bani with husband and 2 children

 

Time at NSR Hospital in Bani: 15 years

 

Infante Sano Trainings Completed: COEm, Quality Improvement Training, Partograph Trainings

 

Participation in Infante Sano activities: member of partograph committee

 

Why did you get involved with Infante Sano?

“I am a worker. I am a doer. I don’t like to sit and talk without action. I was worried that Infante Sano would be about sitting and talking. But with the Infante Sano trainings come follow-up and action. After COEm (training in emergency obstetric care), I didn’t know how to use the partograph. Now, with follow-up, with practice exercises, with working together in labor and delivery on real partographs, I know the partograph.”

Have you seen any changes in labor and delivery?

“Before Infante Sano came to NSR, we were machines, we worked like machines. We did our jobs without knowing the “why” behind our work. With COEm, with the Infante Sano trainings and in working on partograph implentation, we learned about the “why,” and we learned to ask, “why.” When I know the “why” behind my job, I love my work. For example, before, nurses and doctors knew how to catch a baby when it was born. But with the “why,” we know how to deliver babies.”

 

How did you feel about organizing a partograph training, and teaching the partograph to your co-workers?

“I am a very happy person. The only thing I suffer from is being shy. Even though I am in the partograph committee and helped organize the partograph training for maternity staff, I told the group I would not speak in the training. But then at the training, I saw all my co-workers, and I saw an opportunity to teach them the “why”--to help them work, not like machines, but like doctors and nurses. Then I got my courage and I taught the whole partograph. And I have a lot more left to say!”

Why is using the partograph important?

“The partograph improves the care of the mother and the child. The mom is more healthy, and the baby is more healthy if we use the partograph. The partograph improves the quailty of care of the patient. It helps us monitor labor in a consistent way. More than that, patients are leaving happy becasue they know we are taking good care of them.”

“When I first saw the partograph, I was scared to use it. It looked complicated, and I did not think it was worth the effort. Now, I may not be perfect at the partograph, but I complete my partograph on every patient. And at the end of a delivery, I sign my partograph with my signature to let everyone know that I filled it out. If we all do this, we each accept responsiblity for the care of our patients.”

Anything else you’d like to add?

“There is a lot of work to do. But now I know that there is hope. I have hope. We have to keep working, and keep providing follow-up. Only with follow-up can we make change and keep those changes."

 

The image “http://infantesano.org/images/v2/partograph1.jpg” cannot be displayed, because it contains errors.

Dra. Zapata teaching the partograph to maternity staff, using the wall mural developed by the partograph committee.

 

http://infantesano.org/images/v2/partograph2.jpg

Two obstetricians listen attentively to Dra. Zapata’s explanation of the partograph.

*Special thanks again to Nika for all her fantastic and critical work with the partograph!