Barriers to and incentives for achieving partograph use in obstetric practice in low- and middle-income countries: a systematic review
Open accessAbstract
BACKGROUND: The partograph is a graphic display of the progress of labour, recommended by the World Health Organization, but often underused in practice in low- and middle-income countries. We were interested in going beyond demonstration of potential efficacy - on which the existing literature concentrates - through a systematic review to identify barriers to and incentives for achieving partograph use. METHODS: We searched Ovid MEDLINE, Ovid Maternity and Infant Care, POPLINE, Web of Science, and Scopus, from 1st January 1994 to 30th September 2013, using the term 'partogra*' to include 'partograph', 'partogram', or 'partogramme'. The selection criteria were for primary or secondary research describing barriers to and incentives for partograph use in low- and middle-income countries, in English, reported in peer-reviewed publications since 1994. Thematic analysis of text on partograph use was applied to a commonly used framework for change in clinical practice, with levels describing the innovation, the individual professional, the woman, and social, organisational, economic and political contexts. RESULTS: Reported barriers to and incentives for partograph use related to the partograph itself, professional skills and practice, clinical leadership and quality assurance, and the organisational environment within the wider provision of obstetric care. Neither the evidence base for its effectiveness, nor its credibility, was reported as a barrier to use. CONCLUSION: Identifying and addressing local barriers and incentives in low- and middle-income countries, based on those in published research, could inform strategies to improve partograph use. Emerging technologies could be used to address some barriers. The thresholds for essential maternity care at which the partograph adds value should be further evaluated.
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Barriers to partograph use have been observed in low and in low−/middle-income countries.
“Barriers to partograph use have been observed in low and in low−/middle‐income countries. 24”
From Review of maternal death audits in refugee camps in <scp>UNHCR</scp> East and Horn of Africa and Great Lakes Region, 2017–2019 (2023) · cites this paper as [24]
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“Systematic reviews of barriers to implementation of clinical guidelines [33], and partograph use [34] have indicated similar structural and individual level constraints that interfere with health workers’ adherence to these standards.”
BackgroundSouza, J. P., Oladapo, O. T., Fawole, B., Mugerwa, K. Y., Reis, R., Barbosa-Júnior, F., Oliveira-Ciabati, L., Alves, D., & Gülmezoglu, A. M. (2018) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.15205 · Cited by 47 · see citing works
Nababan, H. Y., Islam, R., Mostari, S., Tariqujjaman, M., Sarker, M., Islam, M. T., & Moucheraud, C. (2017) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-017-1588-x · Cited by 43 · see citing works
“Consequently, although it was made available for this study and training was provided to the nurse-midwives, a lack of experience and/or low confidence may have limited its uptake [29].”
BackgroundInfluentialKananura, R. M., Kiwanuka, S. N., Kiracho, E. E., & Waiswa, P. (2017) · Reproductive Health · doi:10.1186/s12978-017-0402-6 · Cited by 39 · see citing works
“Additionally, the use of partograph helps the health care providers to make timely decisions [35].”
BackgroundAmare, D., & Tegegne, T. K. (2018) · PLoS ONE · doi:10.1371/journal.pone.0200479 · Cited by 38 · see citing works
Vogel, J. P., Pujar, Y. V., Vernekar, S. S., Armari, E., Pingray, V., Althabe, F., Gibbons, L., Berrueta, M. B., Somannavar, M. S., Ciganda, Á., et al. (2024) · Nature Medicine · doi:10.1038/s41591-023-02751-4 · Cited by 34 · see citing works
Use of an electronic Partograph: feasibility and acceptability study in Zanzibar, Tanzania
Litwin, L., Maly, C., Khamis, A. R., Hiner, C., Zoungrana, J., Mohamed, K., Drake, M., Machaku, M. D., Njozi, M., Muhsin, S. A., et al. (2018) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-018-1760-y · Cited by 33 · see citing works
Sanghvi, H., Mohan, D., Litwin, L., Bazant, E., Gomez, P. P., MacDowell, T., Onsase, L., Wabwile, V., Waka, C., Qureshi, Z. P., et al. (2019) · Global Health Science and Practice · doi:10.9745/ghsp-d-19-00195 · Cited by 30 · see citing works
Sousa, K. D. M., Pimenta, I. D. S. F., Elorriaga, M. F., Saturno-Hernández, P. J., Rosendo, T. M. S. D. S., de Freitas, M. R., Medeiros, W. R., Martins, Q. C. S., & Gama, Z. A. D. S. (2019) · BMJ Open · doi:10.1136/bmjopen-2019-030944 · Cited by 29 · see citing works
Use of the partograph - Current thinking
Lavender, T., & Bernitz, S. (2020) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2020.03.010 · Cited by 29 · see citing works
Quality of care during childbirth in Tanzania: identification of areas that need improvement
Miltenburg, A. S., Kiritta, R. F., Meguid, T., & Sundby, J. (2018) · Reproductive Health · doi:10.1186/s12978-018-0463-1 · Cited by 27 · see citing works
“However, when birth is in transition to deviate from what is accepted as the norm, care provision can become highly unpredictable as a result of ineffective referral systems, unavailable supervision staff and lack of timely available necessary supplies and materials [4, 30, 34, 35].”
BackgroundEscobar, M. F., Benitez-Díaz, N., Blanco-Londoño, I., Cerón-Garcés, C., Peña-Zárate, E. E., Guevara-Calderón, L. A., Libreros‐Peña, L., & Galindo-Sánchez, J. S. (2024) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-024-06796-2 · Cited by 25 · see citing works
“Challenges persist even with essential commodities available [46] due to insufficiently trained providers and the absence of evidence-based care guidelines [47, 48].”
BackgroundHaile, Y., Tafese, F., Weldemarium, T. D., & Rad, M. H. (2020) · Journal of Pregnancy · doi:10.1155/2020/3943498 · Cited by 25 · see citing works
Advancement in Partograph: WHO’s Labor Care Guide
Ghulaxe, Y., Tayade, S. A., Huse, S., & Chavada, J. (2022) · Cureus · doi:10.7759/cureus.30238 · Cited by 21 · see citing works
“A 2014 deliberate survey on partograph use in low-pay and center-pay nations found that while the partograph was largely seen as a valuable device for observing work, its utilization was frequently seen as tedious [30].”
Biswas, T. K., Sujon, H., Rahman, M. H., Perry, H. B., & Chowdhury, M. E. (2019) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-019-2656-1 · Cited by 21 · see citing works
Litorp, H., Gurung, R., Målqvist, M., & Ashish, K. C. (2020) · Reproductive Health · doi:10.1186/s12978-020-01039-x · Cited by 19 · see citing works
Zelellw, D., & Tegegne, T. K. (2018) · Annals of Global Health · doi:10.29024/aogh.23 · Cited by 18 · see citing works
Lavender, T., Omoni, G. M., Laisser, R. M., McGowan, L., Wakasiaka, S., Maclean, G. D., & Chimwaza, A. F. (2019) · Sexual & Reproductive Healthcare · doi:10.1016/j.srhc.2019.03.001 · Cited by 16 · see citing works
Palo, S. K., Patel, K., Singh, S., Priyadarshini, S., & Pati, S. (2019) · Journal of Family Medicine and Primary Care · doi:10.4103/jfmpc.jfmpc_472_19 · Cited by 16 · see citing works
“[29,30] According to a systematic review findings, the barriers like professional skills and practice, clinical leadership, and quality assurance need to be addressed for the provision of better obstetric care.[31] A study from India had also suggested training the health staff to maximize partograph utilization,[32]…”
Geelhoed, D., de Deus, V., Sitoe, M., Matsinhe, O., Cardoso, M. I. L., Manjate, C. V., Matsena, P. I. P., & Mosse, C. D. D. (2018) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-018-1901-3 · Cited by 15 · see citing works
Baumgartner, J. N., Headley, J., Kirya, J., Guenther, J., Kaggwa, J., Kim, M. K., Aldridge, L. R., Weiland, S., & Egger, J. R. (2021) · Health Policy and Planning · doi:10.1093/heapol/czab072 · Cited by 14 · see citing works
“A review of barriers to real-time use of the partograph in low-resource settings revealed many reasons including lack of graphing skills, stockouts, an organizational acceptance of retrospective documentation, and providers not internalizing its function and value (Ollerhead and Osri, 2014).”
BackgroundJaribu, J., Penfold, S. C., Manzi, F., Schellenberg, J., & Pfeiffer, C. (2016) · BMJ Open · doi:10.1136/bmjopen-2015-010317 · Cited by 14 · see citing works
“A partograph is a graphic display of the progress of labour, which helps skilled birth attendants to recognise emerging difficulties and take action according to a clinical management protocol.(37) The overall health facility deliveries improved by 46% from a median of 110 to 161 deliveries per month in a collaborativ…”
Backgroundvan Boekholt, T. A., Moturi, E., Hölscher, H., Schulte‐Hillen, C., Tappis, H., & Burton, A. (2023) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.14504 · Cited by 12 · see citing works
Jain, S. M., Kumar, P., Jain, M., Bathla, M., Joshi, S. H., Srivastava, S., Singh, M., Sudke, A. K., Datta, V., & Shivkumar, P. (2021) · BMJ Open Quality · doi:10.1136/bmjoq-2021-001404 · Cited by 13 · see citing works
An exploration of midwives' views of the latest World Health Organization labour care guide
Laisser, R. M., Danna, V. A., Bonet, M., Oladapo, O. T., & Lavender, T. (2021) · African Journal of Midwifery and Women s Health · doi:10.12968/ajmw.2020.0043 · Cited by 12 · see citing works
Computerized Childbirth Monitoring Tools for Health Care Providers Managing Labor: A Scoping Review
Balikuddembe, M. S., Tumwesigye, N. M., Wakholi, P., & Tylleskär, T. (2017) · JMIR Medical Informatics · doi:10.2196/medinform.6959 · Cited by 11 · see citing works
“The obstructed labor complex directly contributes to 6-10% of the maternal deaths, in addition to contributing to other diseases for the mother and the baby [3,4].”
Mugyenyi, G. R., Tumuhimbise, W., Atukunda, E. C., Tibaijuka, L., Ngonzi, J. N. J., Kayondo, M., Kanyesigye, M., Musiimenta, A., Fajardo, Y., & Byamugisha, J. K. (2025) · International Journal of Women s Health · doi:10.2147/ijwh.s498903 · Cited by 8 · see citing works
Balikuddembe, M. S., Tumwesigye, N. M., Wakholi, P., & Tylleskär, T. (2019) · Reproductive Health · doi:10.1186/s12978-019-0786-6 · Cited by 7 · see citing works
prasavGraph: An Android-based e-Partograph
Singh, S., Khalid, A., Paul, K., Haider, Y., & Prasad, S. (2016) · International Conference on Systems in Medicine and Biology (ICSMB) · doi:10.1109/icsmb.2016.7915099 · Cited by 7 · see citing works
Improving Tanzanian childbirth service quality
Jaribu, J., Penfold, S. C., Green, C., Manzi, F., & Schellenberg, J. (2018) · International Journal of Health Care Quality Assurance · doi:10.1108/ijhcqa-10-2015-0122 · Cited by 7 · see citing works
“…deaths are preventable through implementing effective and affordable interventions (Bhutta et al. , 2012; Khan et al. , 2006), including birth preparedness, labour monitoring (partograph) and immediate care for every neonate (Bhutta et al. , 2014; Lassi et al. , 2016; Ollerhead and Osrin, 2014).”
BackgroundArchbald, B., Munguiko, C., & Masereka, E. M. (2022) · Nursing Open · doi:10.1002/nop2.1383 · Cited by 6 · see citing works
“…completeness, correctness, intrapartum, partograph Despite the ability to improve labour outcomes and prevent maternal and neonatal mortality, the partograph has not been widely and appropriately used especially in low and middle income countries (Chaturvedi et al., 2015; Ollerhead & Osrin, 2014).”
BackgroundGebrehiwot, S. W., Abrha, M. W., & Weldearegay, H. G. (2020) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-020-03344-6 · Cited by 6 · see citing works
Sarin, E., Bajpayee, D., Chaudhuri, S., Dastidar, S. G., Gupta, A. K., Bisht, N., Joshi, A., Jeelani, A., Rathi, C., Parashar, R., et al. (2020) · Indian Journal of Community Medicine · doi:10.4103/ijcm.ijcm_530_19 · Cited by 6 · see citing works
“The current intervention brought forward multiple challenges to partograph usage including limited organizational commitment, lack of guidance at facility level, limited availability, limited knowledge, and competency of service providers.[18-22] The QI teams that were formed in the facilities identified targets for e…”
Lumadi, T. G. (2017) · Curationis · doi:10.4102/curationis.v40i1.1770 · Cited by 4 · see citing works
“Challenges on the use of the partogram as a clinical practice guideline to improve intrapartum care in developing countries including South Africa were documented by many researchers (Markos & Bogale 2015:1; Ollerhead & Osrin 2014:1; Opoku & Nguah 2015:1).”
MethodRecording Data Labour With Documentation Midwifery Based On Word Electric Browser (WEB)
Juwita, J., Ahmad, M., Syarif, S., Mappaware, N. A., Prihantono, P., & Bahar, B. (2019) · Global Journal of Health Science · doi:10.5539/gjhs.v11n5p149 · Cited by 4 · see citing works
“…with limited human resources so that it has an impact on the completeness of partograph filling, reducing the error rate (Qureshi, Sekadde-Kigondu, & Mutiso, 2010; Pirie, 2011; Ontario, 2013; Maureen D, et al., 2015; Muslihatun et al., 2013; Ollerhead & Osrin, 2014; Sharma, Deka, & Das, 2015).”
BackgroundArchbald, B. (2022) · British journal of healthcare and medical research · doi:10.14738/jbemi.93.11837 · Cited by 4 · see citing works
Gupta, M. K., Raghav, P. R., Gautam, V., Bhardwaj, P., Rustagi, N., Naveen, K. H., & Gothwal, M. (2020) · Journal of Family Medicine and Primary Care · doi:10.4103/jfmpc.jfmpc_345_20 · Cited by 4 · see citing works
“[18,23,24] Low utilization of partograph in low‐ and middle‐income countries has also reported by Ollerhead and Osrin (2014).[26] A higher level of utilization has also been reported by many authors.”
BackgroundLee, N., Flynn, J. M., Gao, Y., & Kildea, S. V. (2022) · Women and Birth · doi:10.1016/j.wombi.2022.04.004 · Cited by 4 · see citing works
Use of the partogram in a private hospital in South Africa
Yazbek, M., & Jomeen, J. (2018) · Midwifery · doi:10.1016/j.midw.2018.11.009 · Cited by 3 · see citing works
“Identifying the latent phase of labour seems to be a common problem (Ollerhead and Osrin, 2014).”
BackgroundOrhue, A. A. E., Iribhogbe, O. I., Aziken, M. E., & Ande, B. (2020) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.13144 · Cited by 3 · see citing works
Development and Heuristic-based Usability Evaluation of an e-partograph
Kebebaw, T., Alemneh, E., Azage, M., Misgan, E., Nigatu, D., & Abate, E. (2021) · International Conference on Information and Communication Technology for Development for Africa (ICT4DA) · doi:10.1109/ict4da53266.2021.9672245 · Cited by 3 · see citing works
“Use of emerging technologies with clinical prompts and remote decision support tool to support electronic recording and provision of appropriate care packages can alleviate the barriers of paper based partograph use [10].”
Backgroundde Oliveira, D. C. C., Gomes, M. L., Nakano, A. R., Soares, T., Nicida, L. R. D. A., Torres, J. A., & Engstrom, E. M. (2024) · Reproductive Health · doi:10.1186/s12978-024-01772-7 · Cited by 3 · see citing works
“In a review on the use of partography during work, the lack of training of professionals to use the instrument, the lack of time to execute it properly, as well as the lack of institutional protocols to guide the conduct on the results of the partography were highlighted [30].”
BackgroundMugyenyi, G. R., Tumuhimbise, W., Ntayi, J. M., Byamugisha, J. K., Musimenta, A., Kayondo, M., Ngonzi, J. N. J., Tornes, Y., & Atukunda, E. C. (2025) · Cureus · doi:10.7759/cureus.82295 · Cited by 3 · see citing works
“Although two reviews [14,15] have documented the challenges of utilizing the partograph and factors contributing to the successes or failures of the partograph in labor monitoring in low-and middle-income countries, there has not been any review specific to Sub-Saharan Africa, where the burden of…”
Mugyenyi, R. G., Tumuhimbise, W., Ntayi, J., Yarine, T., Byamugisha, J. K., & Atukunda, E. (2023) · Research Square · doi:10.21203/rs.3.rs-3372438/v1 · Cited by 3 · see citing works
Armari, E., Vernekar, S. S., Pujar, Y. V., Pingray, V., Althabe, F., Gibbons, L., Berrueta, M. B., Ciganda, Á., Rodríguez, R., Kumar, J. A., et al. (2025) · Birth · doi:10.1111/birt.70004 · Cited by 2 · see citing works
“High patient loads, inadequate provider training, and ambiguous policy guidance are common barriers [9, 11, 12].”
Hasan, M. J. (2017) · IOSR Journal of Mobile Computing & Application · doi:10.9790/0050-04015561 · Cited by 2 · see citing works
Chimala, E. B., Kafulafula, U. K., Kadango, A., Tang, J. H., & Chodzaza, E. (2020) · African Journal of Midwifery and Women s Health · doi:10.12968/ajmw.2019.0032 · Cited by 2 · see citing works
Management of Normal and Abnormal Labour
Badejoko, O. O., & Onwudiegwu, U. (2021) · Springer eBooks · doi:10.1007/978-3-030-75385-6_12 · Cited by 2 · see citing works
Singh, R., Agarwal, M., Sinha, S., Sinha, H. H., & Anant, M. (2022) · Cureus · doi:10.7759/cureus.30851 · Cited by 2 · see citing works
Litorp, H., Målqvist, M., Sunny, A. K., Gurung, A., Gurung, R., & Ashish, K. C. (2023) · Birth · doi:10.1111/birt.12709 · Cited by 2 · see citing works
“1,13 Developing and implementing low-cost technologies to enhance monitoring, unburden midwives, improve detection of abnormal fetal heart rates, and increase the well-being of mothers 34– 38 might be one way to tackle this problem in low-resource settings.”
Barriers and incentives influencing the use of partograph in Nigeria: A comprehensive review
Elendu, C., Davidson, G., Wali, J. N., Sampson, G. U., Eneyo, U. S., Ebosie, P. E., Opara, P. C., Davidson, P. N., Davidson, D. U., & Davidson, J. (2024) · Medicine · doi:10.1097/md.0000000000038389 · Cited by 2 · see citing works
Tesfaye, G. A., Chanie, F. T., & Negera, E. (2023) · medRxiv · doi:10.1101/2023.01.20.23284834 · Cited by 2 · see citing works
Sospeter, P., Al‐beity, F. M. A., Kidanto, H. L., Said, A., Kikula, A. I., & Godfrey, S. (2023) · Research Square · doi:10.21203/rs.3.rs-2603863/v1 · Cited by 2 · see citing works
Kaunda, P., Leshabari, S., & Mwale, C. M. (2021) · African Journal of Midwifery and Women s Health · doi:10.12968/ajmw.2020.0037 · Cited by 1 · see citing works
Pasquale, J., Gialdini, C., Chamillard, M., Díaz, V., Rijken, M. J., Browne, J. L., Seto, M. T. Y., Cheung, K. W., Bonet, M., & WHO Intrapartum Care Algorithms Working Group (2024) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.17895 · Cited by 1 · see citing works
Midwives practices and mothers’ experiences during intrapartum midwifery care: a qualitative study
Katushabe, E., Musa-Maliki, A. U., & Steen, M. (2026) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-025-08624-7 · Cited by 1 · see citing works
“This issue is analogous to earlier studies conducted in Ethiopia and South Asia that documented both retrospective completion and formality of labour monitoring instrument completion [52, 53].”
Stern, C., Valenzuela, C., Whitehorn, A. S., Pollock, D., Minooee, S., Gohil, D. A., Zhu, Z., Kirkpatrick, P., Loureiro, R., Davies, E. L., et al. (2026) · JBI Evidence Synthesis · doi:10.11124/jbies-25-00265 · Cited by 3 · see citing works
Effectiveness Of Partograph Based On Computer System With Clinical Decision Making In Labor Process
(2018) · International Journal of ChemTech Research · doi:10.20902/ijctr.2018.110541 · Cited by 1 · see citing works
Okoroafor Nkiru, L., Esievo, N. J., Ijeoma, M., & Ijeoma, O. (2022) · African Journal of Health Nursing and Midwifery · doi:10.52589/ajhnm-td5iri1o · Cited by 1 · see citing works
The Impact of the Use of e-Partogram on Maternal and Perinatal Outcomes: A Scoping Review
Singh, P., & Bhalerao, A. V. (2024) · Cureus · doi:10.7759/cureus.62295 · Cited by 2 · see citing works
“The WHO states that receiving care from a trained birth attendant before, during, and after childbirth is one of the most important requirements for the prevention of maternal and perinatal deaths [7].”
BackgroundPartograph: A Tool yet to be utilized Properly
Halder, M., Ghosh, R. M., & Goswami, S. (2016) · Journal of South Asian Federation of Obstetrics and Gynaecology · doi:10.5005/jp-journals-10006-1383 · Cited by 1 · see citing works
Web-Based Partograph on Early Detection of Emergency Cases and Referral Processes
Tandiallo, D., Ahmad, M., Syarif, S., Mappaware, N. A., Prihantono, P., & Bahar, B. (2019) · Global Journal of Health Science · doi:10.5539/gjhs.v11n6p79 · Cited by 1 · see citing works
“Moreover, World Health Organization (WHO) launched partograph which is used to monitoring cervical dilatation, fetal head loss, uterine contractions, and fetal heart rate (Yisma, Dessalegn, Astatkie, & Fesseha, 2013a; Mathibe Neke & Matupa, 2013; Asibong et al., 2014; Ollerhead & Osrin, 2014).”
MethodBalikuddembe, M. S., Wakholi, P., Tumwesigye, N. M., & Tylleskär, T. (2020) · JMIR Medical Informatics · doi:10.2196/17056 · Cited by 1 · see citing works
“Among the problems with the WHO partograph was a large number of variables to register and it was regarded as labor intensive and unpractical for low-resource settings [4,15].”
BackgroundDebdas, A., Mitra, J. R., & Singh, R. (2021) · Journal of South Asian Federation of Obstetrics and Gynaecology · doi:10.5005/jp-journals-10006-1837 · Cited by 1 · see citing works
Mugyenyi, G. R., Wilson, T., Atukunda, E. C., Tibaijuka, L., Ngonzi, J. N. J., Kayondo, M., Kanyesigye, M., Musiimenta, A., Fajardo, Y. T., & Byamugisha, J. K. (2024) · medRxiv · doi:10.1101/2024.09.04.24313073 · Cited by 1 · see citing works
CHALLENGES EXPERIENCED BY MIDWIVES ON THE USE OF PARTOGRAM AT LIMPOPO PROVINCE OF SOUTH AFRICA
Lumadi, T. G., Moleki, M. M., & Modiba, L. M. (2015) · Africa Journal of Nursing and Midwifery · doi:10.25159/2520-5293/224
Lumadi, T. G. (2017) · Africa Journal of Nursing and Midwifery · doi:10.25159/2520-5293/1271
Pratiwi, V., Rantalaen, L., & Rosiyana, N. M. (2020) · Jurnal Bidan Cerdas · doi:10.33860/jbc.v1i3.226
A Tablet-Based Tool for Care During Labor+Attention to System Requirements
Hodgins, S. (2019) · Global Health Science and Practice · doi:10.9745/ghsp-d-19-00384
“Even if they are used for decision making, there has tended to be excessive emphasis on rate of cervical dilatation.(6,7)”
BackgroundThe use of educational games in midwifery: an overview
Maclean, G. D., & Laisser, R. M. (2020) · African Journal of Midwifery and Women s Health · doi:10.12968/ajmw.2019.0003
Strategies to improve maternal and new-born care referral systems
Desta, B. F. (2019) · Unisa Institutional Repository (University of South Africa)
Risk factors for stillbirth in Freetown, Sierra Leone – The StillFree studyPreprint
Sala, A., Orsi, M., Parisi, F., Kargbo, H., Turay, M., Bah, A. K., Kanu, S., Tiru, N. A., Driul, L., Pisani, L., et al. (2025) · Research Square · doi:10.21203/rs.3.rs-7889661/v1
Litorp, H., Gurung, R., Målqvist, M., & Kc, A. (2020) · Figshare · doi:10.6084/m9.figshare.13466747
Grewal, A. K. (2025) · Lecture notes in networks and systems · doi:10.1007/978-981-97-7190-5_24
Katushabe, E., Steen, M., & Musa-Maliki, A. U. (2026) · Research Square · doi:10.21203/rs.3.rs-10296307/v1
Comparative analysis of WHO labour care guide versus WHO modified partogram on labour outcomes
Awasthi, R., Gupta, R., Gupta, N., Aggarwal, S., Gupta, G., Midha, T., & Trivedi, P. (2026) · International Journal of Reproduction Contraception Obstetrics and Gynecology · doi:10.18203/2320-1770.ijrcog20263041
- Authors
- Ollerhead, E., & Osrin, D.
- Affiliations
- University College London (GB)
- Corresponding author
- Ollerhead, Elizabeth
- ORCID
- Osrin, David
- Venue
- BMC Pregnancy and Childbirth
- Published
- 2014-08-16
- Volume
- 14
- Issue
- 1
- Pages
- 281-281
- ISSN
- 1471-2393 (ISSN-L)
- PMC
- PMC4147181
- OpenAlex
- W2165324237
- Cited by
- 83
- References
- 69
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 7 · 2023: 5 · 2022: 7 · 2021: 7 · 2020: 14 · 2019: 11 · 2018: 10 · 2017: 7 · 2016: 5 · 2015: 1
- FWCI
- 0.64
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Pregnancy and Childbirth (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- Wellcome Trust (091561/Z/10/Z, 091561)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Keywords
- partograph, obstetric practice, low- and middle-income countries, clinical leadership, quality assurance, organizational context, professional skills
- MeSH terms
- Attitude of Health Personnel, Clinical Competence, Decision Support Techniques, Developing Countries, Dystocia, Female, Humans, Labor, Obstetric, Leadership, Pregnancy, Organizational Culture, Delivery, Obstetric
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