Estimating partograph utilization and associated factors among health care professionals in Ethiopia: a systematic review and Meta-analysis

Background: Partograph is the prestigious obstetric tool used to monitor labour, predict and follow the progress of labor, maternal and fetal conditions. It allows the health care professionals to increase the frequency of follow up and to prevent prolonged labour, uterine rupture, postpartum hemorrhage, puerperal sepsis, stillbirths, birth asphyxia, and neonatal sepsis. There are various studies on partograph utilization and associated factors in different regions of Ethiopia, they present inconsistent findings and no study was conducted which shows the national estimate of partograph utilization in Ethiopia. Thus, this review was conducted to estimate the national pooled prevalence of partograph utilization and associated factors in Ethiopia. Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed for this systematic review and meta-analysis. The databases used were; PUBMED, Cochrane Library, Google Scholar, EMBASE, African Journals Online Google scholar, maternity and infant care database and online repositories. A combination of search items: “partograph utilization”, “knowledge and utilization of partograph”, “documentation of partograph”, “partograph and health professionals”, “intrapartum monitoring using partograph” and/or “Ethiopia” were used. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for critical appraisal of studies. Descriptive information of studies was presented in narrative form and quantitative results were presented in forest plots. The Cochran Q test and I2 test statistics were used to test heterogeneity across studies. The meta-analysis was conducted using STATA 11 software. The pooled Meta logistic regression was computed to present the pooled prevalence and relative risks (RRs) of the determinate factors with 95% confidence interval (CI). Result: A total of 15 studies were included in this meta-analysis with a sample size of 4,553. The national pooled prevalence of partograph utilization was 57.1 %. In subgroup analysis, the highest prevalence of partograph utilization was observed in Oromia (66.10% ) and the lowest in Tigray (50.66% ), increased utilization of partograph was observed after 2016 (62.75% ). Statistically, a significant association was observed between partograph utilization and midwifery profession female health care profession, having short in-service Emergency Obstetric and Newborn Care training, Knowledge of partograph, short Training on partograph. Conclusion: The pooled prevalence of partograph utilization during labour was low. There was a statistically significant association was between partograph utilization and midwifery profession, female health care profession, having short in-service Emergency Obstetric and Newborn Care training, Knowledge of partograph, short Training on partograph. The concerned body should intervene on the identified factors to increase the utilization of partograph during labour and delivery