CHAPTER II

REVIEW OF LITERATURE

Conducting a literature review will persist as a challenging and enlightening endeavor.

Researchers will undertake the process of reviewing literature by identifying, selecting,

analysing, and reporting existing information on the topic of interest. Through this review,

they will gain a comprehensive understanding of what is known about a particular situation,

while also identifying the knowledge gap that exists between the problem statement and the

research subject. This review will lay the foundation for their future research plan.

In the upcoming study, the investigator intends to conduct an extensive literature review

on child birth preparation, incorporating both research and non-research articles. The primary

goal of this review will be to gather a comprehensive knowledge and attitude of first-time

mothers. By exploring various sources, such as empirical studies, expert opinions, and

relevant articles, the researcher aims to contribute to the evolving understanding of this

critical aspect of maternal healthcare.

The review of literature for this study is organized under the following sections;

 Studies related to utilization of partograph

 Studies related to effectiveness of partograph

STUDIES RELATED TO UTILIZATION OF PARTOGRAPH

Sarika Chaturvedi, Sourab, Joanna (2020), conducted a study on implementation of the

partograph in India’s JSYcash transfer programme for facility births; a mixed methods study

in Madhya Pradesh province. It results that the partograph was used in 6% of the 1466

records reviewed. The staff obtained median score 1.08 (maximum of 10) at competence in

plotting a partograph. Three themes emerged from qualitative data: 1) partographs are used

rarely and retrospectively, 2) training does not support correct use of the partograph and 3)

partographs can be useful but are not feasible. The study shows that implementation fidelity

of partograph use in the JSY programme is low. Successful implementation of partograph can

result in improved quality of care in the JSY programme only if potential moderators to its

adherence, such as training, supervision, staff ‘buy in’ and practice environment are

addressed so that staff find a conductive practice environment in which to use the partograph

and women find it beneficial to present early in labor.

Gutema Chemrda, Kassa Daka (2019) conducted a cross-sectional study on Partograph

Utilization and Factors associated with poor perinatal outcomes in wolaita sodo university

referral Hospital, Southern Ethiopia. It results that out of 309 total of charts reviewed, only

for 58%, 3.2% and 2% of mothers monitoring of fetal heart rate, liquor status, and molding

was done respectively. Labor parameters (cervical dilation, station and uterine contractions)

were monitored to standard in 155(50%,12(3.9%) and 170(55%) respectively. There was

significant association between perinatal outcomes and factors like neonatal resuscitation,

Apgar score at 1st minute and liquor quality. This study showed poor quality of partograph

utilizations; despite good perinatal and immediate maternal outcomes.

Githae, Boraya (2019) a study to assess the utilization of partograph in the management of

women in labor among nurses working in Embu county, Kenya. The study revealed that,
nurses related factors influencing utilization of the partograph included negative attitude and

lack of training on partograph use. Majority of nurses working in labor ward felt that

partograph use is time consuming and needed supervision on partograph use. In addition,

majority of the nurses were not trained on partograph from the time they graduated from

college. The study recommends policy makers and nursing administrators to ensure that all

qualified nurses use the partograph in the care of women in labor

Oliva BAZIRETTE (2014), conducted a cross sectional study to assess the utilization of

partogram among nurses and midwives in selected health facilities in the eastern province of

Rwanda. The result reveals that 36.6% of nurses and midwives did not receive any in-service

training on how to manage women in labor. Despite the fair partogram knowledge of nurses

and midwives in this study, only 41,22% of respondents were reported not to properly used it.

Nurses and midwives’ years of professional experience as well as having received training in

managing pregnant mothers in labor, were found to be both predictors for the likelihood for

the proper use of partograph. In service training of obstetrical care givers in the Eastern

provinces is recommended to improve the utilization of partogram while managing pregnant

mothers in labor.

Ogunfowokan, Irinoye (2014), conducted a study to assess partograph utilization at three

levels of health care delivery services in Ile-Ife, Nigeria. The results showed that the

partograph charts were not being used at the primary and secondary health care maternity

units. Absence of partograph charts, and inadequate knowledge of obstetric staff were

reported as factors militating against the use of the partograph. The use of the partograph by

obstetric staff is still at a low ebb in primary, secondary and tertiary health care institutions.
 Abebe, Birhanu (2013), conducted a study to assess the knowledge and utilization of teg

partograph among health professionals in Amhara region, Ethiopia. In this study, the level of

knowledge of obstetric care was found to be poor. The significant number of study

participants reported that the partograph is useful to monitor lor and make timely decision,

their level of knowledge of the partograph and its components was generally poor. Presence

of participants’ sex and profession were the variables that had influenced the level of

knowledge of the partograph and obstetric care. Regular supportive supervision is also

needed to motivate staffs to utilize the partograph and help them become dedicated to record

and document their finidings.

Fawole, Adekanle (2010), conducted a study to utilize the partograph in primary health

care facilities in southwestern Nigeria. This study results that the knowledge about

assessment of labour was also poor; less than 50%o of all respondents knew the normal

duration of labour and just about 50 %FF understood assessment for progress of labour. The

partograph is not utilized for labour management in Nigeria. Effective interventions to

improve labor supervision skills and partograph utilization are urgently required.

STUDIES RELATED TO EFFECTIVENESS OF PARTOGRAPH

Mamths sonare (2022), conducted a study to assess the effectiveness of information

booklet regarding use of partograph among midwives working in labor room of selected

Hospital of Bhopal (M.P). This revealed that overall pretest and posttest mean knowledge

score of midwives regarding partograph. The mean posttest score 17.42 more than mean

pretest score 12.37 and SD pretest is 3.24. This study concluded that there is significant

difference and effectiveness of information booklet, in increasing the knowledge of midwives

regarding partograph.
 Kaur Mandeep, Chaudhary Priyanka (2022), conducted a study to assess the effectiveness

of computer assisted teaching on knowledge and practices regarding partograph among

nursing students of selected nursing colleges of Ludhiana, Punjab. This study results that

there was positive correlation between pretest knowledge and post test practices scores i.e.

0.199. There was also positive correlation between post test knowledge and post test practices

scores i.e. 0.170. Thus it was surmised that variations in knowledge of nursing students

regarding partograph has an imp-act on practices.

Munirathnamma K (2018), conducted a study to assess the effectiveness of an educational

intervention on knowledge regarding partograph among student nurses in selected nursing

institutions at Mysuru. This study results that an educational intervention on partograph was

effective in increasing the knowledge of student nurses regarding partograph as evidenced by

computed paired ‘t’ test which was statistically significant at 0.05 level of significance (t (29)

=2.05, P<0.05). it was concluded that educational intervention was effective in increasing the

knowledge of student nurses regarding partograph. Study finding also emphasizes the role of

educational strategies to improve the knowledge of health personnel’s regarding partograph.

Neemat Jumaah, Kafi Mohammed (2016), conducted a study to assess the effectiveness of

educational program on nurses knowledge regarding partograph in AL-Najaf city. The results

show that the educational program was effective on nurses’ knowledge regarding partograph.

It also shows that there is good improvement with highly significant differences I study group

between pre and post-test, in over all items. The study concludes that partograph educational

program is the effective and appropriate method to increase nurse’s knowledge.

Teena Yohannan, Sijo Koshy (2015), conducted a study to assess the effectiveness of

structured teaching programme on knowledge regarding plotting of partograph among the

nursing students in selected nursing colleges of Vadodara in Gujarat. Computed t test

revealed that mean post test knowledge score regarding plotting of partograph was

significantly higher than mean pretest knowledge score at p<0.05 level. The ‘t’ value was at

p<0.05 level indicating the structured teaching programme plotting partograph was effective.

The study findings revealed that structured teaching programme was highly effective in

improving knowledge of plotting of partograph among nursing students.

Manohari R (2010), conducted a study to evaluate the effectiveness of self-instructional

module on partograph in terms of knowledge among the staff nurses working in selected

maternity hospitals at Erode. This study results that the staff nurses with bachelor degree in

nursing had more knowledge on partograph when compared to other cadre nurses and those

with experience more than 15 years had more knowledge on partograph when compared to

nurses with experience less than 15 years. This study is based on the fact that improving the

professional competencies of the staff nurses by educating them about the current innovation

is very essential. This study could be considered as a part of continuing professional

development of the staff nurses. Self-instructional module on partograph served that purpose

and was effective in increasing the knowledge of staff nurses.

Arez Saviola, Raddi Sudha (2009), conducted a study to assess effectiveness of planned

teaching program on knowledge and skill in the use of partograph among nurses working in

maternity unit in selected hospitals at Karnataka. The results show that the overall pre-test

mean skill scores was 5.57, where post-test mean skill scores was 12.63. the range between

highest scores and lowest scores I the pre-test was 9 which was decrease to 7 after

administration of planned teaching program in the post-test. Thus it was inferred that the

planned teaching program was effective and while the gain in knowledge and skill score is

commendable, there is still room for improvement.