Korle-Bu Modified WHO Partograph Aims to Enhance Labor Monitoring and Maternal-Neonatal Outcomes

The partograph is a critical graphical tool for monitoring the well-being of both mother and fetus during the first stage of labour. Despite its importance, studies consistently show alarmingly low completion rates, often below 5%, and frequent post-delivery completion, rendering it a record-keeping tool rather than an active monitoring instrument. This underutilization stems from its labour-intensive nature, even for skilled attendants, particularly in high-volume maternity settings. The current standard-of-care often falls short in providing consistent, real-time labour progression insights, leading to potential delays in intervention and suboptimal maternal and neonatal outcomes.

This randomized study will enroll 1000 women with uncomplicated pregnancies presenting in labour at Korle-Bu Teaching and La General hospitals in Accra. Participants will be allocated to one of two arms: 500 women monitored with the traditional WHO partograph and 500 women monitored with the Korle-Bu modified WHO partograph. Computer generated cluster randomization with concealment will ensure unbiased patient selection. Research assistants (Residents and Nurses) will receive standardized training to adhere to patient-specific protocols for labour monitoring. Data collection will include sociodemographic and obstetric information, duration of labour, any interventions performed, and key neonatal and maternal outcomes.

This study aims to determine if the Korle-Bu modified WHO partograph will achieve similar or improved 'patronization' and lead to more consistent monitoring of first-stage labour, ultimately resulting in better maternal and neonatal outcomes compared to the traditional WHO partograph. The core hypothesis is centered on user experience and adherence. The researchers anticipate that the modified partograph will address current usability challenges, thereby increasing its consistent application by healthcare providers. This enhanced adherence is expected to translate into more timely identification of labour complications and appropriate interventions. Specifically, the study expects to see improvements in metrics such as the duration of labour, rates of necessary interventions, and a reduction in adverse neonatal and maternal outcomes. The primary anticipated benefit is improved practical utility in busy clinical settings.

It is expected that the Korle-Bu Teaching Hospital (KBTH) modified WHO partograph will be more user-friendly, fostering greater adoption and consistent use.