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Partograph Utilization During Labor Monitoring in Sub-Saharan Africa: A Systematic Review and Meta-Analysis
*Corresponding author: Armand Duclaire Kemo Djimeli, Department of Public Health, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon. armanddjimeli39@gmail.com
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Received: ,
Accepted: ,
How to cite this article: Djimeli AKD, Ateudjieu J, Kenfack B. Partograph utilization during labor monitoring in sub-Saharan Africa: A systematic review and meta-analysis. Int J MCH AIDS. 2025;14:e018. doi: 10.25259/IJMA_1_2025
Abstract
Background and Objective:
Prolonged and obstructed labor is a leading cause of maternal death, preventable through effective and inexpensive health interventions such as the correct and systematic use of the partograph. The objective of this review was to determine the prevalence of partograph use in Sub-Saharan Africa.
Methods:
We used the standard Preferred Reporting Items for Systematic Reviews and Meta-analyses checklist. Three online databases were used: PubMed, Google Scholar, and African Index Medicus. We included observational studies reporting the prevalence of partograph utilization, conducted in Sub-Saharan African countries, and published in English or French. Extracted data were entered into an Excel spreadsheet and then exported to R version 4.3.3 for analysis.
Results:
Of the 1,159 records identified in this review, 41 studies were included in this systematic review and meta-analysis. The overall pooled prevalence of partograph utilization was 51.17% (95% confidence interval: 43.05– 59.29). The study country and Sub-Saharan African region were sources of heterogeneity (p < 0.0001 for both), while the year of publication was not (p = 0.2385). The funnel plot and Egger’s test (p = 0.7072) demonstrated the absence of potential publication bias.
Conclusion and Global Health Implications:
This study showed that the overall pooled prevalence of partograph use in Sub-Saharan African countries was low. Therefore, effective intervention strategies are strongly recommended to increase partograph utilization.
Keywords
Labor Monitoring
Meta-Analysis
Partograph Utilization
Sub-Saharan Africa
Systematic Review
INTRODUCTION
In 2020, approximately 287,000 women lost their lives during pregnancy or childbirth; the majority of these deaths, 95% were related to preventable causes and occurred in low- and middle-income countries.[1] The maternal mortality rate in developed countries was 12/100,000 live births compared to 430/100,000 live births in low- and middle-income countries.[1] Several interventions can prevent maternal deaths: Contraception, Emergency obstetric and neonatal care, antenatal consultations, and deliveries assisted by skilled personnel using the partograph.[1,2] The partograph is an instrument that allows the recording of the identification parameters of the parturient, the progress of labor, as well as the main parameters of maternal and fetal monitoring against time in hours.[3] A study conducted by the World Health Organization (WHO) in South East Asia revealed that the use of the partograph reduced the proportion of prolonged labor (from 6.4% to 3.4%), the frequency of labor requiring an increase in uterine contractions (from 20.7% to 9.1%), emergency cesareans (from 9.9% to 8.3%), and stillbirths (from 0.5% to 0.3%).[4] Thus, the WHO recommends the routine use of the partograph for the monitoring of all women during labor.[4]
Although it is a simple, inexpensive, and effective tool, studies have shown significant variability in its frequency of use across countries in Sub-Saharan Africa: 41% in Ethiopia;[5] 38.7% in Tanzania;[6] 29.1% in Uganda;[7] 87% in Ghana;[8] 59.1% in Nigeria;[9] and 79.3% in Cameroon.[10] However, we did not find a study that reported the overall prevalence of partograph use in sub-Saharan Africa. To assess the gaps that need to be addressed to achieve the level of routine partograph use recommended by the WHO, we conducted this systematic review with meta-analysis to determine the overall prevalence of partograph use in sub-Saharan Africa.
METHODS
Search Strategy
First, we conducted a search in PROSPERO to ensure that a similar research project was not underway. The various stages of this review were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. We conducted the literature search in three databases: PubMed, Google Scholar, and African Index Medicus. Several expressions were combined using the Boolean operators “AND” and “OR” to conduct the literature search: “Partograph utilization,” “Partogram utilization,” “Partograph use,” “Use of partograph,” “Utilization of Partograph,” “Use of partogram,” “Partogram use,” “Utilization of partogram,” “Knowledge of partogram,” “partogram Knowledge,” “Knowledge of partograph,” “partograph Knowledge,” and “sub-Saharan Africa.”
Eligibility Criteria
This review included studies reporting the prevalence of partograph use in sub-Saharan Africa, published in French or English, up to October 12, 2024, in a peer-reviewed journal. We excluded studies available only in abstract form, without primary data, conducted before 2019, and systematic reviews.
Data Extraction and Quality Assessment
The results obtained from the database searches were exported to Zotero, where studies were selected by title, abstract, and full-text review. Data were collected using an Excel spreadsheet, including the first author’s name, year of publication, country of study, study design, and prevalence of partograph use. Two authors independently performed data extraction, and any disagreements were resolved by consensus. The methodological quality of the selected studies was assessed using the Newcastle–Ottawa scale.
Data Analysis
The extracted data were exported to R version 4.3.3 for meta-analysis. The random effect meta-analysis model was used to determine the overall prevalence of partograph utilization with a 95% confidence interval (CI). Publication bias was investigated using a funnel plot and Egger’s test. Subgroup analyses were conducted according to region, country of study, and year of publication.
RESULTS
Identification and Characteristics of Included Studies
A total of 1,159 results were obtained from the search strategy, including 980 articles from Google Scholar, 171 articles from PubMed, and 8 articles from African Index Medicus. Of all the results obtained, 143 were identified as duplicates and removed, and 891 were eliminated by reading the title and abstract. Finally, of the 125 eligible articles, 41 were included in the systematic review with meta-analysis [Figure 1].
- Flow diagram of studies selection for systematic review and meta-analysis of partograph utilization in Sub-Saharan Africa.
All included studies were cross-sectional. Regarding the distribution of studies in sub-Saharan Africa, 23 studies were conducted in East Africa,[5-7,11-30] 15 in West Africa,[8,9,31-43] one in Central Africa,[10] and two in Southern Africa.[44,45] Almost all studies (97.6%) were at low risk of bias [Table 1].
| No | First author and colleagues, year of publication | Country | Region | Study design | Prevalence | Risk of bias |
|---|---|---|---|---|---|---|
| 1 | Ayele et al., 2023[11] | Ethiopia | Eastern Africa | Cross-sectional | 55.1% | Low |
| 2 | Tesfaye et al., 2024[12] | Ethiopia | Eastern Africa | Cross-sectional | 32.8% | Low |
| 3 | Bahizi et al., 2022[13] | Uganda | Eastern Africa | Cross-sectional | 79.4% | Low |
| 4 | Mwari et al., 2021[14] | Kenya | Eastern Africa | Cross-sectional | 74% | Low |
| 5 | Negash, Alelgn, 2022[15] | Ethiopia | Eastern Africa | Cross-sectional | 58.4% | Low |
| 6 | Tilahun et al., 2021[16] | Ethiopia | Eastern Africa | Cross-sectional | 43% | Low |
| 7 | Haile et al., 2020[17] | Ethiopia | Eastern Africa | Cross-sectional | 54.4% | Low |
| 8 | Ayehubizu et al., 2022[5] | Ethiopia | Eastern Africa | Cross-sectional | 41% | Low |
| 9 | Hagos et al., 2020[18] | Ethiopia | Eastern Africa | Cross-sectional | 69% | Low |
| 10 | Gebreslassie et al., 2019[19] | Ethiopia | Eastern Africa | Cross-sectional | 83% | Low |
| 11 | Kidest et al., 2020[20] | Ethiopia | Eastern Africa | Cross-sectional | 73.6% | Low |
| 12 | Bedada et al., 2020[21] | Ethiopia | Eastern Africa | Cross-sectional | 31.1% | Low |
| 13 | Markos et al., 2020[22] | Ethiopia | Eastern Africa | Cross-sectional | 71.7% | Low |
| 14 | Peter et al., 2022[6] | Tanzania | Eastern Africa | Cross-sectional | 38.7% | Low |
| 15 | Abate et al., 2023[23] | Ethiopia | Eastern Africa | Cross-sectional | 28.8% | Low |
| 16 | Kibiwott et al., 2021[24] | Kenya | Eastern Africa | Cross-sectional | 44% | Low |
| 17 | Archbald et al., 2022[25] | Uganda | Eastern Africa | Cross-sectional | 71.5% | Low |
| 18 | Lugobe et al., 2019[26] | Uganda | Eastern Africa | Cross-sectional | 4.2% | Low |
| 19 | Mukisa et al., 2019[27] | Uganda | Eastern Africa | Cross-sectional | 9% | Low |
| 20 | Nassaka et Udho, 2022[28] | Uganda | Eastern Africa | Cross-sectional | 5% | Low |
| No | First author and colleagues, year of publication | Country | Region | Study design | Prevalence | Risk of bias |
| 21 | Githae et Boraya, 2019[29] | Kenya | Eastern Africa | Cross-sectional | 55.5% | Low |
| 22 | Mutema et Mhlanga, 2024[30] | Zimbabwe | Eastern Africa | Cross-sectional | 2% | Low |
| 23 | Olebo et al., 2023[7] | Uganda | Eastern Africa | Cross-sectional | 29.1% | Low |
| 24 | Anokye et al., 2019 [8] | Ghana | Western Africa | Cross-sectional | 87% | Low |
| 25 | Arinola et al., 2021 [31] | Nigeria | Western Africa | Cross-sectional | 55.1% | Low |
| 26 | Assifuah et al., 2020[32] | Ghana | Western Africa | Cross-sectional | 93.3% | Low |
| 27 | Lami, 2020[33] | Nigeria | Western Africa | Cross-sectional | 72.2% | Low |
| 28 | Nasiru et al., 2021 [34] | Nigeria | Western Africa | Cross-sectional | 100% | Low |
| 29 | Nkamare et al., 2020[35] | Nigeria | Western Africa | Cross-sectional | 30% | Moderate |
| 30 | Ojong et al., 2021[36] | Nigeria | Western Africa | Cross-sectional | 84% | Low |
| 31 | Abdullahi et al., 2021[9] | Nigeria | Western Africa | Cross-sectional | 59.1% | Low |
| 32 | Olawale et al., 2024[37] | Nigeria | Western Africa | Cross-sectional | 47.8% | Low |
| 33 | Daughter et al., 2023[38] | Nigeria | Western Africa | Cross-sectional | 49.4% | Low |
| 34 | Sibeudu et al., 2024[39] | Nigeria | Western Africa | Cross-sectional | 30.2% | Low |
| 35 | Ango et al., 2019[40] | Nigeria | Western Africa | Cross-sectional | 22.2% | Low |
| 36 | Ugwu et al., 2021[41] | Nigeria | Western Africa | Cross-sectional | 25.2% | Low |
| 37 | Ottah et al., 2023[42] | Nigeria | Western Africa | Cross-sectional | 39.2% | Low |
| 38 | Oyerinde et al., 2024[43] | Nigeria | Western Africa | Cross-sectional | 93% | Low |
| 39 | Brits et al., 2020[44] | South Africa | Southern Africa | Cross-sectional | 57.2% | Low |
| 40 | Mabasa et al. 2024[45] | South Africa | Southern Africa | Cross-sectional | 20% | Low |
| 41 | Ako et al., 2022[10] | Cameroon | Central Africa | Cross-sectional | 79.3% | Low |
Prevalence of Partograph Use in Sub-Saharan Africa
The prevalence of partograph use ranged from 2% in Zimbabwe[26] to 100% in Nigeria.[32] The overall prevalence of partograph use in sub-Saharan Africa was 51.17% (95% CI: 43.05–59.29) [Figure 2].
- Forest plot of the prevalence of partograph use among obstetric care providers in Sub-Saharan Africa.
Heterogeneity and Subgroup Analysis
The Cochrane I2 statistic was 100%, p ≤ 0.001, indicating the presence of statistically significant heterogeneity. Therefore, a subgroup analysis was performed. Regarding the country, the prevalence of partograph use was highest at 90.3% (95% CI: 84.1–96.5) in Ghana and lowest at 2% (95% CI: 0.0–5.9) in Zimbabwe, with p < 0.0001. In addition, the prevalence of use was highest at 79.3% (95% CI: 75.6–82.9) in Central Africa and lowest at 38.5% (95% CI: 2.1–74.9) in Southern Africa, with p < 0.0001. The prevalence of partograph use was highest at 55.7% (95% CI: 44.3–67.1) for studies published between 2019 and 2021 and lowest at 46% (95% CI: 34.6–57.4) for studies published between 2022 and 2024; however, the p-value was 0.2385 [Table 2].
| Moderator variables | Category | Number of studies | Prevalence %(95% CI) | I2(%) | P-value |
|---|---|---|---|---|---|
| Country | Ethiopia | 12 | 53.5 (43.2-63.9) | 98.3% | < 0.0001 |
| Nigeria | 13 | 54.6 (40.3-68.8) | 99.5% | ||
| Cameroon | 1 | 79.3 (75.6-82.9) | -- | ||
| Uganda | 6 | 33.0 (5.6-60.3) | 99.7% | ||
| Ghana | 2 | 90.3 (84.1-96.5) | 75.6% | ||
| South Africa | 2 | 38.5 (2.1-74.9) | 98.5% | ||
| Kenya | 3 | 57.1 (40.8-73.3) | 86.1% | ||
| Tanzania | 1 | 38.7 (30.9-46.5) | -- | ||
| Zimbabwe | 1 | 2.0 (0.0-5.9) | -- | ||
| Region | Eastern Africa | 23 | 45.7 (35.3-56.1) | 99.5% | < 0.0001 |
| Western Africa | 15 | 59.4 (45.5-73.2) | 99.4% | ||
| Central Africa | 1 | 79.3 (75.6-82.9) | -- | ||
| Southern Africa | 2 | 38.5 (2.1-74.9) | 98.5% | ||
| Year of publication | 2019-2021 | 22 | 55.7 (44.3-67.1) | 99.7% | 0.2385 |
| 2022-2024 | 19 | 46.0 (34.6-57.4) | 99.6% |
I2: Heterogeneity, p value: Significance test of subgroup differences.
Publication Bias
The distribution of studies on the funnel plot was symmetrical [Figure 3], and the Egger regression test found a p = 0.7072, indicating the absence of potential publication bias.
- Funnel plot of the pooled prevalence of partograph use among obstetric care providers in Sub-Saharan Africa.
DISCUSSION
This review revealed that the overall prevalence of partograph use in sub-Saharan Africa is 51.17% (95% CI: 43.05–59.29). The use of the partograph for monitoring all women during labor is recommended by the WHO; it allows for the detection of abnormal labor progression, abnormal maternal well-being, or fetal distress. The correct use of the partograph during labor allows for decision-making regarding intervention, such as referring the woman to a higher level of care, reinforcing labor with oxytocic agents, or the need for an emergency cesarean section. Therefore, the use of partographs in this study was low. This result is similar to that obtained in Ethiopia, where the authors reported an overall prevalence of partograph use of 59.95% (95% CI: 46.8–73.09) in 19 studies.[3] In terms of subgroup analysis, according to the country of study, Ghana had the highest prevalence of partograph use at 90.3%, while the lowest rate was recorded in Zimbabwe at 2%; this variability in the frequency of partograph use could be explained by the differences in obstetric care providers’ knowledge levels about the partograph and by the different strategies implemented regarding the partograph, as the majority of care providers in Ghana have received refresher training on the use of the partograph.[32]
Furthermore, the low prevalence of partograph use reported by several studies included in this review may be related to the fact that healthcare workers tend to document the progress of labor inside the patient’s files but omit to plot it in the partogram, which is not favorable for prompt detection of abnormal labor progression. Subgroup analysis by study region revealed that partograph use was highest in Central Africa at 79.3% and lowest in Southern Africa at 38.5%; this result should be interpreted with caution, as only one study was conducted in Central Africa. Nevertheless, all regions of sub-Saharan Africa should develop strategies to increase partograph use. Partograph use was highest at 55.7% in studies published between 2019 and 2021, but this difference was not statistically significant.
Less than half of the sub-Saharan African countries were included in this review, which may make it difficult to generalize the results to all sub-Saharan African countries. This review was conducted in sub-Saharan Africa; therefore, it does not provide information on the prevalence of partograph use across all low- and middle-income countries. The review period was limited to approximately 6 years, resulting in a small number of studies conducted in some countries. However, it highlights the gap that needs to be filled and the need for interventions that will help achieve the optimal level of use recommended by the WHO.
CONCLUSION AND GLOBAL HEALTH IMPLICATIONS
The overall combined prevalence of partograph use among obstetric care providers in sub-Saharan Africa was low. Variability in the prevalence of partograph use was observed depending on the country and region of study. The results indicated the need to implement effective strategies to increase the use of partograph in sub-Saharan Africa.
Key Messages
1) This review revealed a low prevalence of partograph use in sub-Saharan Africa for labor monitoring (51.17%). 2) Partograph use in different regions of sub-Saharan Africa was below the World Health Organization recommendations; therefore, all regions should implement strategies to increase its use. 3) Partograph use has not increased over time, highlighting the importance of conducting periodic interventions regarding the use of this essential tool.
Acknowledgments:
None.
COMPLIANCE WITH ETHICAL STANDARDS
Conflicts of Interest: The authors declare no competing interests. Financial Disclosure: Nothing to declare. Funding/Support: There was no funding for this study. Ethics Approval: Not applicable. Declaration of Patient Consent: Patient’s consent not required, as there are no patients in this study. Use of Artificial Intelligence (AI)-Assisted Technology for Manuscript Preparation: The authors confirm that there was no use of artificial intelligence (AI)-assisted technology for assisting in the writing or editing of the manuscript, and no images were manipulated using AI. Disclaimer: None.
References
- Maternal Mortality. [cited 2025 Apr 02]. Available from: https://www.who.int/news-room/fact-sheets/detail/maternal-mortality
- [Google Scholar]
- National guidelines for the maintaining of reproductive, maternal, newborn, child, adolescent, elderly and Nutrition care services in the context of COVID-19 in Cameroon. [cited 2025 Apr 02]. Available from: https://afrolib.afro.who.int
- [Google Scholar]
- Partograph utilization as a decision-making tool and associated factors among obstetric care providers in Ethiopia: A systematic review and meta-analysis. Syst Rev. 2020;9(1):251.
- [CrossRef] [PubMed] [Google Scholar]
- World Health Organization Maternal Health and Safe Motherhood Programme. Lancet. 1994;343(8910):1399-404.
- [CrossRef] [Google Scholar]
- Partograph utilization and associated factors among obstetric care givers in governmental health institutions of Jigjiga and Degehabur towns, Somali region, Ethiopia: A cross-sectional study. PLoS One. 2022;17(3):e0264373.
- [CrossRef] [PubMed] [Google Scholar]
- Levels of practices and influencing factors on the use of partograph on provision of health care among nurses in Singida Municipality, Tanzania. Int J Innov Sci Res Technol. 2022;7(4):1541-8.
- [Google Scholar]
- Assessing partograph quality and its impact on neonatal outcomes: a study at fort portal regional referral hospital Uganda. J Biomed Adv Clin Res. 2023;2(1):1-14.
- [Google Scholar]
- Use and completion of partograph during labour is associated with a reduced incidence of birth asphyxia: a retrospective study at a peri-urban setting in Ghana. J Health Popul Nutr. 2019;38(1):12.
- [CrossRef] [PubMed] [Google Scholar]
- Factors affecting utilization of partograph among obstetric care providers in public health care facilities in Kaduna Metropolis, Kaduna State, Nigeria. J Med Bas Sci Res. 2021;2(2):21-9.
- [Google Scholar]
- Attitudes, practices and factors affecting the use of the partogram by professionals attending to women in labour and delivery in the Bafut Health District. Open J Obst Gynecol. 2022;12:863-86.
- [CrossRef] [Google Scholar]
- The extent of partograph use and associated factors among obstetric care providers in government hospitals in Southern Ethiopia: a cross sectional study. E-Health Telecomm Syst Netw. 2023;12:1-13.
- [CrossRef] [Google Scholar]
- Partograph utilization is associated with educational status of obstetrics care givers in Ilu Ababor Zone, Ethiopia: a cross-sectional study. Ethiopian J Reprod Health. 2024;16(1):24-33.
- [CrossRef] [Google Scholar]
- Assessment of partograph utilization and its association with pregnancy outcomes in Uganda: a case of kamwenge district. Br J Healthcare Med Res. 2022;9(3):87-106.
- [CrossRef] [Google Scholar]
- Assessment of the midwives knowledge on utilization of partograph in management of labour in public health facilities in Tharaka Nithi County. Int J Health Sci Res. 2021;11(12):167-175.
- [CrossRef] [Google Scholar]
- Proper partograph utilization among skilled birth attendants in hawassa city public health facilities, Sidama Region, Ethiopia, in 2021. BMC Women's Health. 2022;22(1):539.
- [CrossRef] [PubMed] [Google Scholar]
- Utilization of partograph and its associated factors among obstetric caregivers in public health institutions of Southwest Ethiopia. BMC Pregnancy Childbirth. 2021;21(1):404.
- [CrossRef] [PubMed] [Google Scholar]
- Partograph utilization and associated factors among obstetric care providers at public health facilities in Hadiya Zone, Southern Ethiopia. J Pregnancy. 2020;2020:3943498.
- [CrossRef] [PubMed] [Google Scholar]
- Utilization of Partograph and its associated factors among midwives working in public health institutions, Addis Ababa City Administration, Ethiopia 2017. BMC Pregnancy Childbirth. 2020;20:49.
- [CrossRef] [PubMed] [Google Scholar]
- Utilization of the partograph and its associated factors among obstetric care providers in the eastern zone of Tigray, Northern Ethiopia, 2017: A Cross-Sectional Study. Pan Afr Med J. 2019;34:181.
- [CrossRef] [PubMed] [Google Scholar]
- Utilization of partograph during labour: a case of Wolaita Zone, Southern Ethiopia. Heliyon. 2020;6:e05633.
- [CrossRef] [PubMed] [Google Scholar]
- Low utilization of partograph and its associated factors among obstetric care providers in governmental health facilities at West Shoa Zone, Central Ethiopia. Int J Reprod Med. 2020;2020:3738673.
- [CrossRef] [PubMed] [Google Scholar]
- Partograph utilization and associated factors among obstetric care providers working in public health facilities of Wolaita Zone, 2017. J Pregnancy. 2020;2020:3631808.
- [CrossRef] [PubMed] [Google Scholar]
- Parthograph utilization and its determinant factors among health care workers in public health facilities, Dessie Town, North East Ethiopia. J Midwifery Reprod Health. 2023;11(3):3839-3847.
- [Google Scholar]
- Partograph use among skilled birth attendants in selected counties, western Kenya. Int J Nurs Midwifery. 2021;13(3):1925.
- [CrossRef] [Google Scholar]
- The correctness and completeness of documentation of parameters on the partographs used by midwives in primary healthcare facilities in midwestern Uganda. Nurs Open. 2022;10:1350-55.
- [CrossRef] [PubMed] [Google Scholar]
- Older age and higher parity are associated with nonuse of the partograph at Mbarara Regional Referral Hospital, Uganda. Int J Gynecol Obste. 2019;146(3):3215.
- [CrossRef] [PubMed] [Google Scholar]
- Level of partograph completion and healthcare workers' perspectives on its use in Mulago National Referral and Teaching Hospital, Kampala, Uganda. BMC Health Serv Res. 2019;19(1):107.
- [CrossRef] [PubMed] [Google Scholar]
- Low Partograph completion in a public health facility in Northern Uganda: a retrospective review of maternity records. Afr J Midwifery Women's Health. 2022;16:1-14.
- [CrossRef] [Google Scholar]
- Utilization of partograph in the management of women in labor among nurses working in Embu County, Kenya. Nurs Health Care Int J. 2019;3(2):000181.
- [CrossRef] [Google Scholar]
- Midwives' knowledge, perceptions and practices on utilization of the partograph at Mbuya Nehanda Maternity Hospital. Frontiers. 2024;4(3):74-90.
- [CrossRef] [Google Scholar]
- Knowledge and utilization levels of partograph in management of labour amongst midwives in selected health facilities in Akure, Ondo State. Afr J Health Nurs Midwifery. 2021;4(6):101-18.
- [CrossRef] [Google Scholar]
- Knowledge and challenges of partograph utilisation among midwives in the central region of Ghana. EC Nurs Healthcare. 2020;25:1-9.
- [Google Scholar]
- Midwives Knowledge of partograph towards prevention of maternal and neonatal mortality in Specialist Hospital Gombe. Asian J Res Nurs Health. 2022;5(2):50-78.
- [Google Scholar]
- The utilization of partograph in monitoring the progress of labour among nurses and midwives at Usmanu Danfodiyo University Teaching Hospital Sokoto, Nigeria. Int J Adv Eng Manag (IJAEM). 2021;3(1):897-904.
- [Google Scholar]
- Availability and utilization of partograph among health workers in selected primary health care centres in Yenagoa Metropolis, South-South Nigeria. IOSR J Nurs Health Sci. 2020;9:29-33.
- [Google Scholar]
- Knowledge and utilization of partograph in labor monitoring among nurses and midwives in a tertiary health facility in South-South Nigeria. Afr J Biomed Res. 2021;24:59-64.
- [Google Scholar]
- Assessment of knowledge and associated factors of pathograph utilization among healthcare providers in selected primary healthcare centres in Osun State. Bayero J Nurs Health Care. 2024;6(1):1228-36.
- [Google Scholar]
- Perception and utilization of partograph among midwives across selected health care facilities in Abuja Metropolis, Abuja: a comparative study. . 2023;6:01A208292.
- [CrossRef] [Google Scholar]
- Knowledge and utilization of partograph among midwives in selected health facilities in Anambra State. J Biomed Invest. 2024;12(2):34-45.
- [Google Scholar]
- Knowledge and utilization of partograph among primary healthcare workers in Sokoto Metropolis, Nigeria. Int Arch Med Health Res. 2019;1:70-4.
- [Google Scholar]
- Determinants of use of partograph among primary healthcare workers in enugu state, South-East Nigeria. Int J Med Health Dev. 2021;26:190-7.
- [CrossRef] [Google Scholar]
- Use of the partograph among obstetric care providers in government healthcare facilities in Uyo Senatorial District, Akwa Ibom State, Nigeria. Afr J Medical Health Sci. 2023;23(3):34-42.
- [Google Scholar]
- Utilization of partograph in the management of labour by health care providers in primary health care centers in Osun State, Nigeria. Adeleke Univ J Health Sci Biomed Res. 2024;2(1):1-8.
- [Google Scholar]
- The completion of partograms: knowledge, attitudes and practices of midwives in a public health obstetric unit in Bloemfontein, South Africa. Pan Afr Med J. 2020;36:301.
- [CrossRef] [PubMed] [Google Scholar]
- Utilisation of partogram at a district in the north west province, South Africa. Health SA. 2024;29:2175.
- [CrossRef] [PubMed] [Google Scholar]