Clinical audit of intra-partum care at secondary health facilities in Nigeria.

Niger J Clin Pract

Department of Community Medicine, College of Medicine, University College Hospital, Ibadan, Nigeria.

Published: June 2010

Objective: Intra-partum care has a significant influence on birth outcomes. Gap however exists between evidence and practice. This study documented pattern of intra-partum monitoring among birth attendants in public secondary healthcare facilities and related findings to quality of care provided.

Method: Intra-partum monitoring records of vaginal examination, fetal heart and blood pressure were reviewed. Research assistants extracted information and documented same in appropriate section of Safe Motherhood Needs Assessment forms. Monitoring records were categorized into optimal and sub-optimal care. Proportions were calculated for parturients who received either optimal or sub-optimal care. Chi-square test of statistics was used to explore differences. Level of significance was p < 0.05.

Result: Areview of 349 records of paturients was carried out. Their mean age was 23.4 +/- 3.3 years. Pregnancy outcome was a live-birth in 329 (97.3%). Optimal care of vaginal examination, fetal heart monitoring and blood pressure measurement was provided in 243 (71.9%), 73 (21.6%) and 52 (15.4%) parturients respectively and diminished significantly as labour progressed.

Conclusion: Intra-partum care provided by birth attendants was generally sub-optimal and use of the monitoring records to influence birth outcome is doubtful. Improvement in record keeping practices and skills in intra-partum monitoring for decision making, are suggested.

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