Evidence map›Paper›PMID 29743032›Full record

ArticleBMC pregnancy and childbirth2018

Use of an electronic Partograph: feasibility and acceptability study in Zanzibar, Tanzania.

Lindsay Elizabeth Litwin, Christina Maly, Asma Ramadan Khamis, Cyndi Hiner, Jérémie Zoungrana, Khadija Mohamed, Mary Drake, Michael Machaku, Mustafa Njozi, Salhiya Ali Muhsin and 2 more

Registry-linked trialAbstract readEvaluation StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC pregnancy and childbirth, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03757598 (ePartogram Effectiveness Study), which is not on this map. Cited by 16 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03757598 nacompletednot on this map

ePartogram Effectiveness Study: A Mixed Methods Quasi-experimental Study in Kisumu and Meru, Kenya.

TypeinterventionalSponsorJhpiegoRan2016 to 2017Enrolled113ConditionsObstetric Complication, Obstetric Labor Complications, Newborn MorbidityArmsePartogram use
3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Lindsay Elizabeth LitwinJhpiego, an affiliate of Johns Hopkins University, 1615 Thames Street, Baltimore, MD, 21231, USA. lindsay.litwin@jhpiego.org.
Christina MalyJhpiego, an affiliate of Johns Hopkins University, 1615 Thames Street, Baltimore, MD, 21231, USA.
Asma Ramadan KhamisJhpiego, an affiliate of Johns Hopkins University, Plot 72, Block 45B, Victoria Area, New Bagamoyo Rd, PO Box 9170, Dar es Salaam, Tanzania.
Cyndi HinerJhpiego, an affiliate of Johns Hopkins University, 1615 Thames Street, Baltimore, MD, 21231, USA.
Jérémie ZoungranaJhpiego, an affiliate of Johns Hopkins University, Plot 72, Block 45B, Victoria Area, New Bagamoyo Rd, PO Box 9170, Dar es Salaam, Tanzania.
Khadija MohamedMinistry of Health Zanzibar, Box 236, Stone Town, Zanzibar, Tanzania.
Mary DrakeJhpiego, an affiliate of Johns Hopkins University, Plot 72, Block 45B, Victoria Area, New Bagamoyo Rd, PO Box 9170, Dar es Salaam, Tanzania.
Michael MachakuJhpiego, an affiliate of Johns Hopkins University, Plot 72, Block 45B, Victoria Area, New Bagamoyo Rd, PO Box 9170, Dar es Salaam, Tanzania.
Mustafa NjoziJhpiego, an affiliate of Johns Hopkins University, Plot 72, Block 45B, Victoria Area, New Bagamoyo Rd, PO Box 9170, Dar es Salaam, Tanzania.
Salhiya Ali MuhsinMinistry of Health Zanzibar, Box 236, Stone Town, Zanzibar, Tanzania.
Yusuph K KulindwaJhpiego, an affiliate of Johns Hopkins University, Plot 72, Block 45B, Victoria Area, New Bagamoyo Rd, PO Box 9170, Dar es Salaam, Tanzania.
Patricia P GomezJhpiego, an affiliate of Johns Hopkins University, 1615 Thames Street, Baltimore, MD, 21231, USA.

Funding

GE Foundation 116659
6 · The paper itself

Abstract

backgroundThe ePartogram is a tablet-based application developed to improve care for women in labor by addressing documented challenges in partograph use. The application is designed to provide real-time decision support, improve data entry, and increase access to information for appropriate labor management. This study's primary objective was to evaluate the feasibility and acceptability of ePartogram use in resource-constrained clinical settings.

methodsThe ePartogram was introduced at three facilities in Zanzibar, Tanzania. Following 3 days of training, skilled birth attendants (SBAs) were observed for 2 weeks using the ePartogram to monitor laboring women. During each observed shift, data collectors used a structured observation form to document SBA comfort, confidence, and ability to use the ePartogram. Results were analyzed by shift. Short interviews, conducted with SBAs (n = 82) after each of their first five ePartogram-monitored labors, detected differences over time. After the observation period, in-depth interviews were conducted (n = 15). A thematic analysis of interview transcripts was completed.

resultsObservations of 23 SBAs using the ePartogram to monitor 103 women over 84 shifts showed that the majority of SBAs (87-91%) completed each of four fundamental ePartogram tasks-registering a client, entering first and subsequent measurements, and navigating between screens-with ease or increasing ease on their first shift; this increased to 100% by the fifth shift. Nearly all SBAs (93%) demonstrated confidence and all SBAs demonstrated comfort in using the ePartogram by the fifth shift. SBAs expressed positive impressions of the ePartogram and found it efficient and easy to use, beginning with first client use. SBAs noted the helpfulness of auditory reminders (indicating that measurements were due) and visual alerts (signaling abnormal measurements). SBAs expressed confidence in their ability to interpret and act on these reminders and alerts.

conclusionsIt is feasible and acceptable for SBAs to use the ePartogram to support labor management and care. With structured training and support during initial use, SBAs quickly became competent and confident in ePartogram use. Qualitative findings revealed that SBAs felt the ePartogram improved timeliness of care and supported decision-making. These findings point to the ePartogram's potential to improve quality of care in resource-constrained labor and delivery settings.

Indexed as

Decision Support TechniquesAdultDelivery, ObstetricFeasibility StudiesFemaleFetal MonitoringHumansLabor, ObstetricMaternal Health ServicesMidwiferyPatient Acceptance of Health CarePregnancyQualitative ResearchTanzaniaClinical decision supportLabor and deliveryMaternal and newborn healthMobile data collectionPartogramPartographQuality of careReal-time monitoringZanzibar

Identifiers

PMID29743032
PMCPMC5944152

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.