Assessment of Partograph Utilization and Its Determinants Among Obstetric Care Providers in Selected Public Hospitals of Addis Ababa, Ethiopia: A Multi-Center Cross-Sectional Study, 2024

Assessment of Partograph Utilization and Its Determinants Among Obstetric Care Providers in Selected Public Hospitals of Addis Ababa, Ethiopia: A Multi-Center Cross-Sectional Study, 2024 | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Assessment of Partograph Utilization and Its Determinants Among Obstetric Care Providers in Selected Public Hospitals of Addis Ababa, Ethiopia: A Multi-Center Cross-Sectional Study, 2024 Abdurehman Seid Mohammed¹, Mustofa Hassen Yesuf², Getachew Mekete Diress³ This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7293323/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background The partograph is a simple, low-cost tool recommended by the World Health Organization (WHO) to track labor progress and prevent complications like prolonged and obstructed labor—key contributors to maternal and neonatal mortality. Despite its proven benefits, consistent utilization remains limited in many low-resource settings. This study aimed to assess partograph utilization and identify its key determinants among obstetric care providers in selected public hospitals in Addis Ababa, Ethiopia. Methods A cross-sectional study was carried out from January to March 2024 in four major public hospitals in Addis Ababa. A total of 482 obstetric care providers were included using a census approach. Data were collected through structured, pretested questionnaires and analyzed using SPSS version 26. Logistic regression was used to identify factors associated with partograph use. Variables with a p-value < 0.05 in the multivariable model were considered significant. Results Out of the total participants, 91.1% reported using the partograph, and 88.8% said they used it routinely. Midwives were more than twice as likely to use the partograph effectively compared to other providers (AOR = 2.24, 95% CI: 1.05–4.79). Providers who had received on-the-job training (AOR = 6.73, 95% CI: 2.19–13.49), had good knowledge (AOR = 4.90, 95% CI: 2.03–11.79), worked in facilities with supportive policies (AOR = 2.74, 95% CI: 1.31–5.71), received regular supervision (AOR = 2.08, 95% CI: 1.06–4.09), and experienced strong team collaboration (AOR = 2.31, 95% CI: 1.17–4.57) were significantly more likely to use the partograph properly. Interestingly, those with over 10 years of service were less likely to demonstrate good practice compared to providers with 5–10 years of experience (AOR = 0.09, 95% CI: 0.01–0.82). Conclusion While partograph use in Addis Ababa’s public hospitals is relatively high, gaps remain in consistency and quality. Strengthening hands-on training, institutional policies, regular supervision, and team collaboration can make a meaningful difference. Efforts to integrate partograph use into everyday clinical routines—supported by leadership and infrastructure—are essential for improving labor outcomes for mothers and babies alike. Partograph Labor monitoring Obstetric care providers Ethiopia Figures Figure 1 Figure 2 Figure 3 Figure 4 Introduction Maternal and neonatal morbidity and mortality remain persistent public health challenges in many low- and middle-income countries (LMICs), particularly in sub-Saharan Africa. A key contributor to these adverse outcomes is suboptimal intrapartum care, especially the failure to detect and manage prolonged or obstructed labor in a timely manner. Globally, obstructed labor complicates approximately 5% of all deliveries and contributes to around 8% of maternal deaths. In Ethiopia, the burden is more severe, with obstructed labor accounting for nearly 47% of labor complications and contributing to about 9% of maternal deaths annually ( 1 , 2 ). The partograph, a simple yet powerful graphical tool, has been endorsed by the World Health Organization (WHO) as a gold standard for monitoring the progress of labor and ensuring timely interventions. It serves as a visual representation of key labor indicators, including cervical dilatation, fetal descent, uterine contractions, and maternal and fetal well-being. When used correctly, the partograph enables healthcare providers to identify deviations from normal labor patterns early, take appropriate clinical actions, and prevent complications such as obstructed labor, uterine rupture, sepsis, and stillbirth ( 7 ). Historically, Friedman first introduced the concept of charting labor progress in 1954, emphasizing that cervical dilatation should progress at a minimum rate of 1.2–1.5 cm per hour during the active phase of labor. This led to the development of the original partograph, which incorporated alert and action lines to prompt timely decision-making. Later, WHO modified the tool by removing the latent phase and standardizing its use across resource-limited settings. The modified partograph now focuses exclusively on the active phase, starting at 4 cm dilatation, where the risk of labor complications becomes clinically significant ( 7 ). Despite its clinical utility, evidence suggests that partograph use remains inconsistent and suboptimal in many low-resource settings. Challenges range from limited provider training and knowledge gaps to institutional constraints such as lack of supervision and unclear policies and limited resources( 3 – 6 , 8 , 9 , 14 – 15 ). In Ethiopia, although the Federal Ministry of Health recommends routine use of the partograph in all laboring mothers, utilization rates vary widely across regions and facilities, and many providers fail to complete it accurately or use it consistently ( 10 ). A systematic review and meta-analysis revealed that national-level partograph utilization in Ethiopia remains below optimal, despite its proven potential to reduce maternal and neonatal mortality when applied properly ( 4 ). Therefore, understanding the contextual factors that influence its use at the facility level is essential. Given the partograph’s potential to reduce maternal and neonatal mortality when effectively implemented, it is critical to understand the factors influencing its use at the facility level. This study aimed to assess the level of partograph utilization and identify its determinants among obstetric care providers in selected public hospitals of Addis Ababa, Ethiopia. Findings from this study will provide critical insights for healthcare administrators, educators, and policymakers to improve intrapartum care practices and enhance maternal and newborn health outcomes across the country. Methods and Materials Study area and period This study was conducted in four prominent public hospitals in Addis Ababa, the vibrant capital of Ethiopia: Saint Peter Specialized Hospital, Ras Desta Damtew Memorial General Hospital, St. Paul’s Hospital Millennium Medical College, and Minilik II Referral and Teaching Hospital. These institutions are central pillars in the city’s healthcare system, particularly in the delivery of maternal and obstetric care. Saint Peter Specialized Hospital, a federal referral center, is widely recognized for its specialized services in tuberculosis and chronic diseases. In recent years, it has also expanded its role in providing maternal and child health services. With an estimated 250 inpatient beds, it serves a diverse and growing urban population. Ras Desta Damtew Memorial General Hospital, located in the heart of Addis Ababa, offers essential general medical services, with a strong focus on obstetric and gynecological care. The hospital has an approximate capacity of 200 beds and plays a critical role in meeting the city’s maternal health needs. St. Paul’s Hospital Millennium Medical College (SPHMMC) stands as one of the nation’s leading teaching and referral institutions. With approximately 750 inpatient beds, the hospital delivers high-quality obstetric and neonatal services while simultaneously serving as a hub for training the next generation of healthcare professionals. Minilik II Referral and Teaching Hospital, one of the oldest and most historic hospitals in the country, is located in the Arada Sub-City of Addis Ababa. With a bed capacity of around 300, the hospital offers comprehensive tertiary-level obstetric care and serves as a key clinical training site for health science students. Together, these hospitals represent the cornerstone of obstetric service delivery in Addis Ababa. The study was carried out across these facilities during the year 2024, with the aim of assessing partograph utilization and its associated factors among obstetric healthcare providers. Study design and Study period A multi-center, institution-based cross-sectional study was conducted from January to March 2024 to assess partograph utilization and associated factors among obstetric healthcare providers in Addis Ababa, Ethiopia. Study Setting The study was carried out at four major public hospitals in Addis Ababa: Saint Peter Specialized Hospital, Ras Desta Damtew Memorial General Hospital, St. Paul’s Hospital Millennium Medical College, and Minilik II Referral and Teaching Hospital. These institutions play a central role in maternal healthcare service delivery and clinical training within the city. Saint Peter Specialized Hospital is a federal tertiary care center known for its specialized services, including maternal and child health. It has an estimated 400 inpatient beds and provides a range of obstetric services. Ras Desta Damtew Memorial General Hospital, located in the Kirkos Sub-City, offers general and specialized maternal health services, with a bed capacity of approximately 200. St. Paul’s Hospital Millennium Medical College (SPHMMC) is one of the largest referral and teaching hospitals in the country, affiliated with a leading medical college. It provides comprehensive maternity care and hosts around 750 inpatient beds. Minilik II Referral and Teaching Hospital, situated in Arada Sub-City, is one of Ethiopia’s oldest hospitals, delivering tertiary-level obstetric care with an estimated 300 inpatient beds. Together, these hospitals serve a high patient load and represent diverse healthcare settings within the capital. Source and Study Population The source population included all obstetric healthcare providers (midwives, nurses, general practitioners, and obstetricians) working in the maternity and labor wards of the selected hospitals from July 1, 2023, to August 30, 2023. The study population consisted of obstetric care providers who were present and actively working during the data collection period from January to March 2024. Inclusion and Exclusion Criteria All obstetric care providers who were actively working in the labor and delivery units of the selected hospitals during the study period were included. However, those who were on sick leave, annual leave, or maternity leave at the time of data collection were excluded from the study. Sample size determination The sample size for this study was calculated using the single population proportion formula, based on the following assumptions: a 5% margin of error, a 95% confidence interval (Z = 1.96), and a proportion (p) of 73.3%(2) representing good partograph utilization practice among obstetric care providers in Addis Ababa. The initial sample size was computed as follows: The sample size (n) for the study was determined by using single population proportion formula, and calculated by taking the following statistical assumptions. = (1.96) 2 ×0.73(1-0.73) = 302 (0.05) (0.05) To account for the study design, a design effect of 1.5 was applied. Additionally, to compensate for potential non-response, 10% was added to the sample size. Thus, the final sample size was determined to be 499 participants. 1.1 Sampling Procedure and Technique This study employed a census sampling method by including all obstetric healthcare providers working at Saint Peter Specialized Hospital, Ras Desta Damtew General Hospital, Saint Paul Millennium Medical College, and Menelik Referral and Teaching Hospital in Addis Ababa. Given the relatively small number of eligible staff that matched the calculated sample size, this approach ensured comprehensive coverage without the need for further sampling. Study Variables Dependent Variable : Partograph utilization practice, categorized as good versus poor practice. Independent Variables: Socio-demographic Factors: Sex, age, years of service, workplace, profession, and level of education. Obstetric Care Provider Factors: Knowledge of partograph use, on-the-job training, and department of work. Health Facility Factors: Workload, availability of supportive supervision, presence of pre-printed partograph forms, and equipment availability for monitoring vital signs Operational Definitions Good Partograph Utilization: Refers to obstetric care providers who routinely and correctly use the partograph to monitor labor during the intrapartum period, in line with WHO guidelines and national standards (14,15). Poor Partograph Utilization: Refers to obstetric care providers who either do not use the partograph at all or use it inconsistently or incompletely in monitoring labor (14,15). Obstetric Caregivers : Healthcare professionals involved in labor and delivery services, including medical doctors, obstetricians/gynecologists, residents, interns, health officers, midwives, and nurses. Good Knowledge: Defined as scoring 50% or higher on a standardized set of eight questions assessing knowledge about the components, interpretation, and use of the partograph (3). Poor Knowledge: Defined as scoring less than 50% on the same knowledge assessment questions related to partograph utilization (3). Data collection procedures and quality assurance Data were collected using a structured, interviewer-administered questionnaire. The tool was adapted from previously validated instruments and relevant literature, with contextual modifications made to align with the objectives and setting of the study. To ensure consistency and methodological rigor, all data collectors received comprehensive training prior to the commencement of data collection. The training addressed the purpose of the study, the structure and flow of the questionnaire, interviewing techniques, and key ethical considerations, including obtaining informed consent and maintaining confidentiality. A pretest was conducted on 5% of the total sample size at Zewditu Memorial Hospital, one week before the actual data collection. Based on the results of the pretest, necessary adjustments were made to improve the clarity and relevance of the questionnaire. Throughout the data collection period, completed questionnaires were collected by the principal investigator and trained data collectors. Daily reviews, supervision, and consistency checks were conducted to ensure the completeness, accuracy, and overall quality of the data. Data management and data analysis The collected data were checked for completeness and consistency before being cleaned and entered into Epi Info version 7.2.5.0. The dataset was then exported to SPSS version 26 for statistical analysis. Descriptive statistics were summarized using frequency tables, graphs, and charts to present the distribution of key variables. Univariable binary logistic regression analysis was performed to examine the association between each independent variable—including socio-demographic characteristics, obstetric care provider factors, and health facility factors—and the outcome variable: partograph utilization practice (good vs. poor). Crude odds ratios (COR) with 95% confidence intervals were calculated, and variables with a p-value less than 0.25 were considered candidates for multivariable analysis. Multivariable binary logistic regression was conducted to control for potential confounders and to identify independent predictors of good partograph utilization. Adjusted odds ratios (AORs) with corresponding 95% confidence intervals and p-values were used to interpret the strength and significance of associations. Variables with a p-value ≤ 0.05 were considered statistically significant. Multicollinearity among independent variables was assessed using the Variance Inflation Factor (VIF), and model fitness was evaluated using the Hosmer–Lemeshow goodness-of-fit test, with a p-value > 0.05 indicating an adequate model fit. Ethical consideration Ethical approval was obtained from the Institutional Review Committee of Saint Peter Specialized Hospital. Formal letters of permission were submitted to Ras Desta Damtew General Hospital, Saint Paul Millennium Medical College, and Menelik II Referral and Teaching Hospital to initiate data collection. Before data collection, the objectives and significance of the study were clearly explained to all participants. Written informed consent was obtained from each participant. Confidentiality of the information was strictly maintained, and participant privacy was respected throughout the study. Results Out of the 499 questionnaires distributed to obstetric care providers in selected public hospitals of Addis Ababa, 482 were fully completed and valid for analysis, resulting in a high response rate of 96.4%. Seventeen questionnaires were excluded due to incomplete or incorrect responses. This robust participation reflects strong engagement and provides a reliable foundation for assessing partograph utilization and its determinants. Socio-demographic characteristics of study participants Among the participants, 57.7% were male and 42.3% female. Nearly half (49.8%) were aged between 25 and 29 years, while 74.0% were single. The majority (90.2%) held a degree or higher qualification, reflecting a well-educated healthcare workforce (Table 1 ). Table 1 Socio-demographic characteristic of obstetric care givers at in selected public hospitals of Addis Ababa, 2024 (n = 482). Variables Frequency Percent Sex Female 278 42.3% Male 204 57.7% Age 35 58 12.0% Marital status Single 295 74.0% Married 172 24.9% Divorced 15 1.2% Educational level Diploma 47 9.8% Degree and above 435 90.2% Professional characteristics of obstetric care givers Midwives (37.3%) and nurses (22.8%) constituted the majority of providers, followed by medical doctors (31.1%) and others (8.7%). Most were from Saint Peter Specialized Hospital (34.2%) and SPHMMC (28.6%), with the rest from Ras Desta (16.6%) and Minilik II Hospital (20.6%). Nearly half worked in delivery rooms (40.5%), and 57.7% had fewer than five years of service. Overall, 62.2% had received obstetric care training—mainly in labor and delivery (24.9%), BEMONC (18.7%), CEMONC (16.6%), and newborn care (13.5%). Notably, 89.2% were trained in partograph use. ( Table 2 ). Table 2 Professional characteristics of obstetric care providers in selected public hospitals of Addis Ababa, 2024 (n = 482). Variables Frequency Percent Profession Midwife 150 37.3% Medical practitioner 110 31.1% Nurse 180 22.8% Others (Specialist, Health offier,IESo) 42 8.7% Work place SPSH 165 34.2% RDGH 80 16.6% SPHMMC 167 28.6% MRH 70 20.6 Regular working department ANC 90 18.7% Delivery room 195 40.5% Family planning 20 4.1% PNC 100 20.7% OPD (adult & under five) 60 12.5% Others 17 3.5% Years of hospital service 10 years 47 9.8% Received training on obstetric caregivers Yes 300 62.2% No 182 37.8% Type of training Labor and delivery ward 120 24.9% Newborn care 65 13.5% BEMONC 90 18.7% CEMONC 80 16.6% Others 30 6.2% Training on partograph Yes 430 89.2% No 52 10.8% Knowledge of obstetric care givers about partograph All participants had heard of the partograph, while only 376 (78.0%) correctly identified its definition. A total of 411 (85.3%) accurately reported the correct time to begin plotting, and 462 (95.9%) were aware of its main components ( Table 3 ) . Among the 458 providers who reported using the partograph in clinical practice (95.0%), only 426(88.4%) demonstrated good knowledge of its appropriate use ( Fig. 1 ). Table 3 Knowledge related responses of obstetric care givers about partograph utilization at in selected public hospitals of Addis Ababa,Ethiopia 2024 Variables Frequency Percent Defined partograph correctly Yes 426 88.4% No 56 11.6% Listed all the components of partograph Yes 437 90.7% No 45 9.3% Use of partograph Routine monitoring of labor 52 10.8% To helps the health care givers in identifying slow progress in labor 59 12.2% To prevent prolonged labor and obstructed labor 51 10.6% All list 275 57.1% None available 41 3.8% Others 4 0.8% Defined alert line correctly Early warning if labor 214 44.4% Transfer the women from health center to hospital 50 10.4% Reaching the action line 63 13.1% All of the above 124 25.7% None available 31 6.4% Defined action line correctly Conduct full medical assessment 73 15.1% Consider intravenous infusion/ bladder 67 13.9% The action line drawn 4 hours to the right of the alert line and parallel 185 38.4% All of the above 115 23.9% None available 22 4.6% Others 0 0.0% Knowledge about the start time of plotting paragraph Active first stage (5cm or above) 309 64.1% Cervical dilation, descent of the fetal head 33 6.8% Uterine contractions are used in assessing the progress of labor 26 5.4% All of the above 76 15.8% None available 38 7.9% Defined satisfactory labour progress correctly A rate of dilation of the cervix that keeps it on or to the left of the alert line 132 27.4% Evidence of fetal descent coinciding with cervival dilation 98 20.3% Contractions which show a steady increase in duration and the number in 10 min 82 17.0% All of the above 130 27.0% None available 40 8.3% Defined importance of partograph correctly A single sheet of paper can provide details of necessary information at a glance 104 21.6% No need to record labour events repeatedly 29 6.0% Gives clear picture of normality and abnormality in labours 167 34.6% All the above 138 28.6% None available 44 6.2% Others 0 0.0% Utilization of partograph Out of the 482 obstetric care providers who reported using the partograph, 428 (88.8%) used it routinely, 54 (11.2%) used it sometimes, and 0 (0.0%) used it occasionally (Table 4 ). Table 4 Utilization of partograph by obstetric care givers in selected public hospitals of Addis Ababa,Ethiopia 2024 Variables Frequency Percent Partograph use currently Yes 439 91.1% No 43 8.9% Frequency of partograph utilization Routinely 428 88.8% Sometimes 54 11.2% Occasionally 0 0.0% Plot fetal heart rate correctly Yes 439 91.1% No 43 8.9% Plot cervical dilation 4 hourlies Yes 439 91.1% No 43 8.9% Plot descent correctly Yes 439 91.1% No 43 8.9% Plot uterine contraction correctly Yes 439 91.1% No 43 8.9% Record membrane rupture or intact Yes 439 91.1% No 43 8.9% Record color of liquor correctly Yes 439 91.1% No 43 8.9% Monitor maternal B/P at least 4 hourlies Yes 439 91.1% No 43 8.9% Monitor maternal pulse at least every 30 minute Yes 439 91.1% No 43 8.9% Plot correctly across alert line Yes 439 91.1% No 43 14.8% Plot correctly across action line Yes 439 91.1% No 43 8.9% Distribution of Reported Reasons for Non-Utilization of the Partograph Among Obstetric Care Providers (n = 43, 8.9%) The pie chart illustrates ( Fig. 3 ) , the distribution of self-reported reasons why 43 obstetric care providers (8.9% of the total sample) did not currently use the partograph. The most commonly cited barriers were inadequate training or knowledge (26%), followed by high workload and staff shortages (22%), and lack of essential tools or printed partograph charts (18%). Other contributors included absence of supervision or enforcement (14%), negative attitudes toward the tool (12%), and cases of rapid labor or emergencies where usage was deemed impractical (8%). These findings reflect both system-level and individual-level challenges to effective partograph implementation. Institutional and organizational factors the institutional and organizational characteristics of obstetric care providers included in the study. A majority of participants (64.3%) reported that their facilities have clear institutional policies supporting the use of the partograph. More than half of the respondents (58.1%) indicated that they receive supportive supervision, which is vital for maintaining quality labor monitoring practices. Additionally, strong team collaboration was reported by 61.2% of providers, reflecting a collaborative work environment that can facilitate consistent and effective partograph utilization. Table 5 Institutional and Organizational Characteristics of Respondents (N = 482) Variables Frequency Percent Institutional Policy Yes 310 64.3% No 172 35.7% Supportive SupervisionYes280 Yes 280 58.1% N o 202 41.9% Team Collaboration Yes 295 61.2% No 187 38.8% Factors associated with utilization of partograph Table 6 presents the results of both bivariate and multivariable logistic regression analyses conducted to identify factors independently associated with good partograph utilization among obstetric care providers in selected public hospitals of Addis Ababa, Ethiopia. In the bivariate analysis, variables such as age, profession, workplace, years of hospital service, training on obstetric care, on-the-job training, knowledge about the partograph, institutional policy support, supportive supervision, and team collaboration were found to be associated with good partograph utilization. In the multivariable analysis, the following factors remained significantly associated with good practice: Profession: Midwives were over 2 times more likely to use the partograph appropriately compared to other professionals (AOR = 2.24, 95% CI: 1.05–4.79). Years of Hospital Service: Caregivers with 5–10 years of service had significantly higher odds of good practice compared to those with more than 10 years of experience (AOR = 0.09, 95% CI: 0.01–0.82), suggesting peak efficiency with intermediate experience. On-the-Job Training: Providers who received on-the-job training were more than 6 times more likely to utilize the partograph properly (AOR = 6.73, 95% CI: 2.19–13.49), highlighting the value of continuous practical training. Knowledge About the Partograph: Those with good knowledge were nearly 5 times more likely to practice appropriate use (AOR = 4.90, 95% CI: 2.03–11.79). Institutional Policy Support: Facilities with clear institutional policies on partograph use had more than 2.7 times higher odds of good utilization (AOR = 2.74, 95% CI: 1.31–5.71). Supportive Supervision: Providers who received regular supervision were twice as likely to demonstrate good practice (AOR = 2.08, 95% CI: 1.06–4.09). Team Collaboration: A collaborative work environment also significantly enhanced partograph utilization (AOR = 2.31, 95% CI: 1.17–4.57) ( Tabe 6). Table 6 Factors associated with good partograph utilization practice among obstetric caregivers in selected public hospitals of Addis Ababa, Ethiopia 2024 Variables Category Partograph use Odds ratio (OR) at 95% CI Good practice Poor practice Crude OR Adjusted OR Sex Male 190(43.3%) 30(69.8%) 0.52(0.59–1.39) 0.79(0.41–1.53) Female 249(56.9%) 13(30.2%) 1 1 Age 35 50(86.2%) 8(13.8%) 1 1 Educational level Diploma 17(3.9%) 5(3.5%) 2.56(0.92–6.12) 1.09(0.56–3.68) Degree and above 423(87.3%) 12(2.5%) 1 1 Profession Midwives 130(86.7%) 20(13.3%) 2.02(1.01–4.48) 2.24(1.05–4.79) Nurses 128(71.1%) 52(28.9%) 0.85(0.41–1.79) 0.96(0.44–2.09) Medical Doctors 85(77.3%) 25(22.7%) 1.10(0.02–2.32) 1.29(0.59–2.81) Others (Specialist, Health officer. IEso.) 32(5.6%) 10(23.8%) 1 1 Regular working department ANC 71(78.9%) 19(21.1%) 0.23(0.03–2.14) 0.25(0.02–3.19) Delivery 187(95.9%) 8(4.1%) 1.45(0.45–1.92) 1.49(0.14–16.39) Family planning 16(80.0%) 4(20.0%) 0.26(0.03–2.14) 0.29(0.03–3.34) PNC 91(91.0%) 9(9.0%) 0.63(0.30–12.2) 0.70(0.06–8.52) OPD(adult & under five) 58(96.7%) 2(3.3%) 1.84(0.20–17.20) 1.68(0.15–18.56) Others 16(94.1%) 1(5.9%) 1 1 Years of hospital service 10 years 52(98.1%) 1(1.9%) 1 1 Received training on obstetric cares Yes 276(92.0%) 24(8.0%) 1.34(0.73–2.45) 1.21(0.62–2.36) No 163(89.6%) 19(10.4%) 1 1 Type of training Labor and delivery ward 109(90.8%) 11(9.2%) 2.29(0.74–7.04) 1.34(0.33–5.49) Newborn care 59(90.8%) 6(9.2%) 2.29(0.63–8.35) 1.90(0.43–8.34) BEMONC 84(93.3%) 6(22.5%) 3.20(0.90-11.38) 1.18(0.26–5.38) CEMONC 72(90.0%) 8(10.0%) 1.89(0.54–6.58) 0.96(0.22–4.20) Others 25(83.3%) 5(16.7%) 1 1 On-the-job training Yes 418(95.0%) 12(89.4%) 4.25(2.43–10.03) 6.73(2.19–13.49) No 21(40.4%) 31(59.6%) 1 1 Knowledge about partograph Good knowledge 340(55.3%) 10(23.3.%) 6.85(3.34–8.44) 4.90(2.034–11.79) Poor knowledge 99(22.6%) 33(76.7%) 1 1 Institution policy Yes 310(70.6%) 18(41.9%) 2.21(1.22-4.00) 2.74(1.31–5.71) no 129(29.4%) 25(58.1) 1 1 Supportive supervision yes 280(63.8%) 12(27.9) 2.10(1.13–3.88) 2.08(1.06–4.09) no 159(36.2%) 31(72.1%) 1 1 Team collaboration yes 295(67.2%) 14(32.8% 2.39(1.32–4.35) 2.31(1.17–4.57) no 144(32.8%) 29(67.4%) 1 1 NB- Adjusted Odds Ratio written in bold indicates statistical significance or P-value < 0.05 Discussion This This study assessed the level of partograph utilization and its associated factors among obstetric care providers in selected public hospitals of Addis Ababa, Ethiopia. The overall partograph utilization rate was 91.1%, with 88.8% of respondents reporting routine use. This level of utilization is relatively high compared to findings from other regions in Ethiopia and internationally. In Ethiopia, studies from the Somali Region (58.2%), Wolaita Zone (73.3%), and Hadiya Zone (70.8%) reported significantly lower utilization rates( 2 , 9 ). These discrepancies may reflect the impact of urbanization, resource availability, and institutional policies that favor better implementation in Addis Ababa. Similarly, in Nigeria, utilization varied between 40% and 60% depending on institutional type and provider cadre( 11 ). In Rwanda, Bazirete et al. found a utilization rate of 67%( 3 ), while in Cameroon it was as low as 45.5%( 12 ). These findings demonstrate a general trend of suboptimal partograph use across sub-Saharan Africa, often due to inadequate training, insufficient supervision, and infrastructural limitations( 4 ). In Asia, the partograph remains underutilized despite WHO recommendations. In India, utilization rates range from 38–54%, often limited by workload and lack of awareness( 5 ). In Bhutan and Nepal, usage depends on the integration of partographs into routine hospital protocols and the presence of trained staff( 6 ). Comparatively, in Europe, partograph or similar labor monitoring tools are routinely used. In the UK and Sweden, electronic versions of the partograph are embedded in maternity care systems, supported by strong institutional monitoring, standardized guidelines, and regular audits( 7 ). The difference in utilization between European and African/Asian countries highlights the importance of systemic factors in facilitating consistent and high-quality intrapartum monitoring. This study identified several factors significantly associated with good partograph utilization. Professionally, midwives were more than twice as likely to use the partograph appropriately compared to other healthcare providers (AOR = 2.24). This aligns with studies from Tigray, Nigeria, and Cameroon, highlighting midwives' critical role in maternal health care due to their specialized training and consistent exposure to labor cases(8,11,12]. On-the-job training emerged as a powerful predictor of good practice (AOR = 6.73), consistent with findings from Hadiya Zone, Rwanda, and India( 9 ). This underscores the importance of continuous, practice-based education( 9 ) in reinforcing proper partograph use. Similarly, knowledge about the partograph was significantly associated with its utilization (AOR = 4.90), echoing results from Uganda, Nigeria, and other Ethiopian regions where informed providers were more likely to document labor effectively( 10 ). Institutional and system-level factors also played a substantial role. Facilities with clear institutional policies (AOR = 2.74), supportive supervision (AOR = 2.08), and strong team collaboration (AOR = 2.31) were significantly more likely to demonstrate good utilization(11,12]. These findings are supported by literature from Tigray, Rwanda, and systematic reviews that emphasize the enabling role of supportive infrastructure and leadership in promoting evidence-based practices( 4 , 12 ). Interestingly, years of hospital service influenced utilization patterns. Providers with 5–10 years of experience were more likely to demonstrate good practice compared to those with more than 10 years (AOR = 0.09). This may reflect a peak period of professional motivation and familiarity with current guidelines among mid-career providers( 13 ) Strengths and limitations of the study Strengths of the study This study demonstrates several methodological strengths, including a multi-center design that enhances the generalizability of its findings across urban Ethiopia. Additionally, the high response rate of 96.4% minimizes the risk of non-response bias, ensuring more reliable and representative results. Furthermore, the research employed rigorous statistical analyses, such as multivariable regression and robust confounding control, strengthening the validity and accuracy of the conclusions drawn. These strengths collectively enhance the study's credibility and applicability to public health interventions in similar settings. Limitations of the study The study has several limitations, including its cross-sectional design, which prevents causal inference, and the reliance on self-reported utilization data, which may be subject to recall or social desirability bias. Additionally, the study was limited to urban public hospitals, so the findings may not reflect the practices or experiences of rural or private healthcare facilities. Conclusions While partograph utilization among obstetric caregivers in Addis Ababa was encouraging, ensuring quality and consistency remains a challenge. The study identified profession, experience, knowledge, on-the-job training, supportive supervision, institutional policy, and team collaboration as critical determinants. These factors must be addressed through structured policy, education, and supervision frameworks to ensure optimal use of the partograph and improve maternal and neonatal outcomes. Recommendations The recommendations are to improve obstetric care, such as institutionalizing regular on-the-job training for all providers with a focus on practical demonstrations, strengthening policies to mandate and audit routine partograph use, and enhancing supportive supervision to ensure compliance and accountability. Additionally, the study advocates for a collaborative, multidisciplinary approach to intrapartum care, extending research and training initiatives to all healthcare settings to promote widespread implementation. Furthermore, it highlights the potential integration of partograph monitoring into electronic health record systems, drawing inspiration from successful European models, to enhance efficiency and accuracy in maternal healthcare delivery. Abbreviations ANC: Antenatal Care ,AOR: Adjusted Odd Ratio, ,BEMONC: Basic Emergency Obstetrics and Newborn Care, ,BSc: Bachelor of Science,CEMONC: Compressive Emergency Obstetrics and Newborn Care ,CI: Confidence Interval,EDHS: Ethiopian Demographic and Health Survey, IESo;integrated Eemergency surgical officers, M.Sc.: Master of Science,MMR: Maternal Mortality Ratio,MOH: Minister of Health,OCG: Obstetric Care Givers,SPSS: Statistical Package for Social Sciences,VIF: Variance Inflation Factor,WHO: World Health Organization. Declarations Authors' Contributions All authors have contributed to the preparation of a proposal, development of a questionnaire study designing, conceptualization, supervising data collection, data entry, data analysis, and data interpretation. Availability of data and material The data of this study will be available from the corresponding author upon reasonable request. Consent for publication Not Aplicable. Declaration of conflicting interests The authors declare that there is no conflict of interest. Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Provenance and peer review: Not commissioned, externally peer-reviewed. References World Health Organization. Trends in maternal mortality: 2000 to 2020: estimates by WHO, UNICEF, UNFPA, World Bank Group and UN DESA/Population Division. Geneva: WHO; 2023. Central Statistical Agency (CSA) [Ethiopia] and ICF. Ethiopia Demographic and Health Survey 2016. Addis Ababa, Ethiopia, and Rockville, Maryland, USA: CSA and ICF; 2016. Bahizi A, Lwanga D, Victor T. Assessment of partograph utilization and its association with pregnancy outcomes in Uganda: A case of Kamwenge District. J Biomed Eng Med. 2022;9(3):1–21. Ayenew A, Zewdu BF. Partograph utilization as a decision-making tool and associated factors among obstetric care providers in Ethiopia: A systematic review and meta-analysis. Syst Rev. 2020;9:345. Bhatt MJ, Kadikar GK, Kanani M, Shah S. Comparison of normal and abnormal labour by using modified WHO partograph. Int J Reprod Contracept Obstet Gynecol. 2018;7(4):1451–6. Kuenzang, Pokhrel HP, Dorji K, Rinzin D. Knowledge of partograph recording and interpretation and its documentation status in Samdrup Jongkhar District, Bhutan. Int J Innov Res Med Sci. 2018;3(12):2400–6. World Health Organization. WHO recommendations: Intrapartum care for a positive childbirth experience. Geneva: WHO. 2018. Available from: https://www.who.int/publications/i/item/9789241550217 Hailu T, Nigus K, Gidey G, Hailu B, Moges Y. Assessment of partograph utilization and associated factors among obstetric care givers at public health institutions in central zone, Tigray, Ethiopia. BMC Res Notes. 2018;11(1):710. Haile Y, Tafese F, Weldemarium TD, Rad MH. Partograph utilization and associated factors among obstetric care providers in Hadiya Zone, Southern Ethiopia. J Pregnancy. 2020;2020:1–8. Godie Y, Getu M, Sebsibie G, Tadesse A, Mihretu E, Birhanu D. Partograph utilization and associated factors among obstetric care providers in public hospitals, Addis Ababa, Ethiopia. Gynecol Obstet Res Open J. 2023;10(1):1–9. Agan TU, Akpan U, Okokon IB, Oku AO, Asibong UE, Opiah MM, et al. Assessment of the knowledge and utilization of the partograph among non-physician obstetric care givers in the University of Calabar Teaching Hospital, Calabar, Nigeria. Br J Med Med Res. 2014;4(35):5610–21. Maphasha OM, Govender I, Motloba DP, Barua C. Use of the partogram by doctors and midwives at Odi District Hospital, Gauteng, South Africa. S Afr Fam Pract. 2017;59(3):122–6. Arinola AP, Teresa O, Babafemi AA. Knowledge and utilization levels of partograph in management of labour amongst midwives in selected health facilities in Akure, Ondo State. Afr J Health Nurs Midwifery. 2021;4(6):101–18. Markos D, Bogale D. Documentation status of the modified World Health Organization partograph in public health institutions of Bale zone. Ethiopia Reprod Health. 2015;12(1):1–6. Markos M, Arba A, Paulos K. Partograph utilization and associated factors among obstetric care providers in public health facilities of Wolaita Zone, Southern Ethiopia. Hindawi. 2020;2020:1–8. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7293323","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":497522117,"identity":"f6f0aa0d-c367-4010-aa74-05667e40e5bb","order_by":0,"name":"Abdurehman Seid Mohammed¹","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA+klEQVRIiWNgGAWjYDACCQYDEMnYxt58wOADkMnGTqyWfp5jCYUzQFqYidPCwDhzRo7BZx4Qk5AW/tnN2yR/VFjIbjhzwHCzza9t8nzMDIwfPubgseTOsTJpnjMSxhuONyQb5/bdNmxjZmCWnLkNjzU3csykGdskEoG2HDPO7bnNCNTCxsyLR4s8UIvkz39ALTcS239b9ty2J6jFAKhFgrdBInHmjGQGY4YftxMJajG8c6zYmueYhDEwkBkMextuJ7cxMzbj9Yvc7eaNN3/U1Mm2sfd/MPjx57bt/Pbmgx8+4vM+CmBsA5MNxKoHgT+kKB4Fo2AUjIKRAgCPWlYLvYz7kgAAAABJRU5ErkJggg==","orcid":"","institution":"¹Department of Public Health, Saint peter Specialized Hospital","correspondingAuthor":true,"prefix":"","firstName":"Abdurehman","middleName":"Seid","lastName":"Mohammed¹","suffix":""},{"id":497522118,"identity":"592e2efc-e0ee-47a8-be97-0844d0c23833","order_by":1,"name":"Mustofa Hassen Yesuf²","email":"","orcid":"","institution":"¹Department of Public Health, Saint peter Specialized Hospital","correspondingAuthor":false,"prefix":"","firstName":"Mustofa","middleName":"Hassen","lastName":"Yesuf²","suffix":""},{"id":497522119,"identity":"9e82618d-ea6b-484e-a3f3-11531f2bd987","order_by":2,"name":"Getachew Mekete Diress³","email":"","orcid":"","institution":"¹Department of Public Health, Saint peter Specialized Hospital","correspondingAuthor":false,"prefix":"","firstName":"Getachew","middleName":"Mekete","lastName":"Diress³","suffix":""}],"badges":[],"createdAt":"2025-08-04 16:53:19","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7293323/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7293323/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":89994786,"identity":"0c0d84dd-befd-4c13-870b-b049806e8a12","added_by":"auto","created_at":"2025-08-27 07:52:21","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":413478,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eData flow diagram on Questionnaire Distribution and Response Flow in Public Hospitals of Addis Abab\u003c/strong\u003ea\u003c/p\u003e","description":"","filename":"image2.png","url":"https://assets-eu.researchsquare.com/files/rs-7293323/v1/a0677c2f9b2b8101c0a3b651.png"},{"id":89994777,"identity":"64950cb0-6719-492d-b588-f71db2c9289b","added_by":"auto","created_at":"2025-08-27 07:52:21","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":255457,"visible":true,"origin":"","legend":"\u003cp\u003eKnowledge level of obstetric care about partograph utilization in selected public hospitals of Addis Ababa Ethiopia 2024\u003c/p\u003e","description":"","filename":"image3.png","url":"https://assets-eu.researchsquare.com/files/rs-7293323/v1/0a700385e423373767788f96.png"},{"id":89994781,"identity":"6e4f82fb-69c1-4319-8d48-7e2f6d4a038d","added_by":"auto","created_at":"2025-08-27 07:52:21","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":188234,"visible":true,"origin":"","legend":"\u003cp\u003ePractice of partograph utilization by obstetric care givers in selected public hospitals of Addis Ababa Ethiopia 2024\u003c/p\u003e","description":"","filename":"image4.png","url":"https://assets-eu.researchsquare.com/files/rs-7293323/v1/a505cd136a0362afd136f419.png"},{"id":89994782,"identity":"3a16b178-3637-42db-972c-439c7ffeb4b8","added_by":"auto","created_at":"2025-08-27 07:52:21","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":232262,"visible":true,"origin":"","legend":"\u003cp\u003eReasons for not using partograph by obstetric caregivers in selected public hospitals of Addis Ababa, Ethiopia 2024\u003c/p\u003e","description":"","filename":"image5.png","url":"https://assets-eu.researchsquare.com/files/rs-7293323/v1/c00d7a6ae23935c5bd84dd85.png"},{"id":89998324,"identity":"2dcaab56-4eaa-4c4d-a5ab-8fe2d0620d83","added_by":"auto","created_at":"2025-08-27 08:24:22","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2816034,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7293323/v1/61710a5e-1714-46c6-b84f-4023e40b94c2.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Assessment of Partograph Utilization and Its Determinants Among Obstetric Care Providers in Selected Public Hospitals of Addis Ababa, Ethiopia: A Multi-Center Cross-Sectional Study, 2024","fulltext":[{"header":"Introduction","content":"\u003cp\u003eMaternal and neonatal morbidity and mortality remain persistent public health challenges in many low- and middle-income countries (LMICs), particularly in sub-Saharan Africa. A key contributor to these adverse outcomes is suboptimal intrapartum care, especially the failure to detect and manage prolonged or obstructed labor in a timely manner. Globally, obstructed labor complicates approximately 5% of all deliveries and contributes to around 8% of maternal deaths. In Ethiopia, the burden is more severe, with obstructed labor accounting for nearly 47% of labor complications and contributing to about 9% of maternal deaths annually (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe partograph, a simple yet powerful graphical tool, has been endorsed by the World Health Organization (WHO) as a gold standard for monitoring the progress of labor and ensuring timely interventions. It serves as a visual representation of key labor indicators, including cervical dilatation, fetal descent, uterine contractions, and maternal and fetal well-being. When used correctly, the partograph enables healthcare providers to identify deviations from normal labor patterns early, take appropriate clinical actions, and prevent complications such as obstructed labor, uterine rupture, sepsis, and stillbirth (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eHistorically, Friedman first introduced the concept of charting labor progress in 1954, emphasizing that cervical dilatation should progress at a minimum rate of 1.2\u0026ndash;1.5 cm per hour during the active phase of labor. This led to the development of the original partograph, which incorporated alert and action lines to prompt timely decision-making. Later, WHO modified the tool by removing the latent phase and standardizing its use across resource-limited settings. The modified partograph now focuses exclusively on the active phase, starting at 4 cm dilatation, where the risk of labor complications becomes clinically significant (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eDespite its clinical utility, evidence suggests that partograph use remains inconsistent and suboptimal in many low-resource settings. Challenges range from limited provider training and knowledge gaps to institutional constraints such as lack of supervision and unclear policies and limited resources(\u003cspan additionalcitationids=\"CR4 CR5\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). In Ethiopia, although the Federal Ministry of Health recommends routine use of the partograph in all laboring mothers, utilization rates vary widely across regions and facilities, and many providers fail to complete it accurately or use it consistently (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). A systematic review and meta-analysis revealed that national-level partograph utilization in Ethiopia remains below optimal, despite its proven potential to reduce maternal and neonatal mortality when applied properly (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Therefore, understanding the contextual factors that influence its use at the facility level is essential.\u003c/p\u003e\u003cp\u003eGiven the partograph\u0026rsquo;s potential to reduce maternal and neonatal mortality when effectively implemented, it is critical to understand the factors influencing its use at the facility level. This study aimed to assess the level of partograph utilization and identify its determinants among obstetric care providers in selected public hospitals of Addis Ababa, Ethiopia. Findings from this study will provide critical insights for healthcare administrators, educators, and policymakers to improve intrapartum care practices and enhance maternal and newborn health outcomes across the country.\u003c/p\u003e"},{"header":"Methods and Materials","content":"\u003ch2\u003eStudy area and period\u003c/h2\u003e\n\u003cp\u003eThis study was conducted in four prominent public hospitals in Addis Ababa, the vibrant capital of Ethiopia: Saint Peter Specialized Hospital, Ras Desta Damtew Memorial General Hospital, St. Paul\u0026rsquo;s Hospital Millennium Medical College, and Minilik II Referral and Teaching Hospital. These institutions are central pillars in the city\u0026rsquo;s healthcare system, particularly in the delivery of maternal and obstetric care.\u003c/p\u003e\n\u003cp\u003eSaint Peter Specialized Hospital, a federal referral center, is widely recognized for its specialized services in tuberculosis and chronic diseases. In recent years, it has also expanded its role in providing maternal and child health services. With an estimated 250 inpatient beds, it serves a diverse and growing urban population.\u003c/p\u003e\n\u003cp\u003eRas Desta Damtew Memorial General Hospital, located in the heart of Addis Ababa, offers essential general medical services, with a strong focus on obstetric and gynecological care. The hospital has an approximate capacity of 200 beds and plays a critical role in meeting the city\u0026rsquo;s maternal health needs.\u003c/p\u003e\n\u003cp\u003eSt. Paul\u0026rsquo;s Hospital Millennium Medical College (SPHMMC) stands as one of the nation\u0026rsquo;s leading teaching and referral institutions. With approximately 750 inpatient beds, the hospital delivers high-quality obstetric and neonatal services while simultaneously serving as a hub for training the next generation of healthcare professionals.\u003c/p\u003e\n\u003cp\u003eMinilik II Referral and Teaching Hospital, one of the oldest and most historic hospitals in the country, is located in the Arada Sub-City of Addis Ababa. With a bed capacity of around 300, the hospital offers comprehensive tertiary-level obstetric care and serves as a key clinical training site for health science students.\u003c/p\u003e\n\u003cp\u003eTogether, these hospitals represent the cornerstone of obstetric service delivery in Addis Ababa. The study was carried out across these facilities during the year 2024, with the aim of assessing partograph utilization and its associated factors among obstetric healthcare providers.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy design and Study period\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp id=\"_Toc155515896\"\u003eA multi-center, institution-based cross-sectional study was conducted from January to March 2024 to assess partograph utilization and associated factors among obstetric healthcare providers in Addis Ababa, Ethiopia.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy Setting\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was carried out at four major public hospitals in Addis Ababa: Saint Peter Specialized Hospital, Ras Desta Damtew Memorial General Hospital, St. Paul\u0026rsquo;s Hospital Millennium Medical College, and Minilik II Referral and Teaching Hospital. These institutions play a central role in maternal healthcare service delivery and clinical training within the city.\u003c/p\u003e\n\u003cp\u003eSaint Peter Specialized Hospital is a federal tertiary care center known for its specialized services, including maternal and child health. It has an estimated 400 inpatient beds and provides a range of obstetric services.\u003c/p\u003e\n\u003cp\u003eRas Desta Damtew Memorial General Hospital, located in the Kirkos Sub-City, offers general and specialized maternal health services, with a bed capacity of approximately 200.\u003c/p\u003e\n\u003cp\u003eSt. Paul\u0026rsquo;s Hospital Millennium Medical College (SPHMMC) is one of the largest referral and teaching hospitals in the country, affiliated with a leading medical college. It provides comprehensive maternity care and hosts around 750 inpatient beds.\u003c/p\u003e\n\u003cp\u003eMinilik II Referral and Teaching Hospital, situated in Arada Sub-City, is one of Ethiopia\u0026rsquo;s oldest hospitals, delivering tertiary-level obstetric care with an estimated 300 inpatient beds.\u003c/p\u003e\n\u003cp\u003eTogether, these hospitals serve a high patient load and represent diverse healthcare settings within the capital.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSource and Study Population\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe source population included all obstetric healthcare providers (midwives, nurses, general practitioners, and obstetricians) working in the maternity and labor wards of the selected hospitals from July 1, 2023, to August 30, 2023.\u003c/p\u003e\n\u003cp\u003eThe study population consisted of obstetric care providers who were present and actively working during the data collection period from January to March 2024.\u003c/p\u003e\n\u003ch2\u003eInclusion and Exclusion Criteria\u003c/h2\u003e\n\u003cp\u003eAll obstetric care providers who were actively working in the labor and delivery units of the selected hospitals during the study period were included.\u003c/p\u003e\n\u003ch2\u003eHowever, those who were on sick leave, annual leave, or maternity leave at the time of data collection were excluded from the study.\u003c/h2\u003e\n\u003ch2\u003eSample size determination\u0026nbsp;\u003c/h2\u003e\n\u003cp\u003eThe sample size for this study was calculated using the single population proportion formula, based on the following assumptions: a 5% margin of error, a 95% confidence interval (Z = 1.96), and a proportion (p) of 73.3%(2) representing good partograph utilization practice among obstetric care providers in Addis Ababa. The initial sample size was computed as follows:\u003c/p\u003e\n\u003cp\u003eThe sample size (n) for the study was determined by using single population proportion formula, and calculated by taking the following statistical assumptions.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003cimg 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\" alt=\"image\" width=\"461\" height=\"167\"\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; =\u0026nbsp;\u003cstrong\u003e\u003cu\u003e(1.96)\u003csup\u003e2\u003c/sup\u003e\u0026times;0.73(1-0.73)\u003c/u\u003e = 302 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;(0.05) (0.05)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTo account for the study design, a design effect of 1.5 was applied. Additionally, to compensate for potential non-response, 10% was added to the sample size. Thus, the final sample size was determined to be 499 participants.\u003c/p\u003e\n\u003ch2 id=\"_Toc155515902\"\u003e1.1 Sampling Procedure and Technique\u003c/h2\u003e\n\u003cp\u003eThis study employed a census sampling method by including all obstetric healthcare providers working at Saint Peter Specialized Hospital, Ras Desta Damtew General Hospital, Saint Paul Millennium Medical College, and Menelik Referral and Teaching Hospital in Addis Ababa. Given the relatively small number of eligible staff that matched the calculated sample size, this approach ensured comprehensive coverage without the need for further sampling.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy Variables\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDependent Variable\u003c/strong\u003e: Partograph utilization practice, categorized as good versus poor practice.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eIndependent Variables:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSocio-demographic Factors: Sex, age, years of service, workplace, profession, and level of education.\u003c/p\u003e\n\u003cp\u003eObstetric Care Provider Factors: Knowledge of partograph use, on-the-job training, and department of work.\u003c/p\u003e\n\u003cp\u003eHealth Facility Factors: Workload, availability of supportive supervision, presence of pre-printed partograph forms, and equipment availability for monitoring vital signs\u003c/p\u003e\n\u003cp id=\"_Toc155515903\"\u003eOperational Definitions\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eGood Partograph\u003c/strong\u003e Utilization: Refers to obstetric care providers who routinely and correctly use the partograph to monitor labor during the intrapartum period, in line with WHO guidelines and national standards (14,15).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePoor Partograph\u003c/strong\u003e Utilization: Refers to obstetric care providers who either do not use the partograph at all or use it inconsistently or incompletely in monitoring labor (14,15).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObstetric Caregivers\u003c/strong\u003e: Healthcare professionals involved in labor and delivery services, including medical doctors, obstetricians/gynecologists, residents, interns, health officers, midwives, and nurses.\u003c/p\u003e\n\u003cp\u003eGood Knowledge: Defined as scoring 50% or higher on a standardized set of eight questions assessing knowledge about the components, interpretation, and use of the partograph (3).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePoor Knowledge:\u0026nbsp;\u003c/strong\u003eDefined as scoring less than 50% on the same knowledge assessment questions related to partograph utilization (3).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData collection procedures and quality assurance\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData were collected using a structured, interviewer-administered questionnaire. The tool was adapted from previously validated instruments and relevant literature, with contextual modifications made to align with the objectives and setting of the study.\u003c/p\u003e\n\u003cp\u003eTo ensure consistency and methodological rigor, all data collectors received comprehensive training prior to the commencement of data collection. The training addressed the purpose of the study, the structure and flow of the questionnaire, interviewing techniques, and key ethical considerations, including obtaining informed consent and maintaining confidentiality.\u003c/p\u003e\n\u003cp\u003eA pretest was conducted on 5% of the total sample size at Zewditu Memorial Hospital, one week before the actual data collection. Based on the results of the pretest, necessary adjustments were made to improve the clarity and relevance of the questionnaire.\u003c/p\u003e\n\u003cp id=\"_Toc155515904\"\u003eThroughout the data collection period, completed questionnaires were collected by the principal investigator and trained data collectors. Daily reviews, supervision, and consistency checks were conducted to ensure the completeness, accuracy, and overall quality of the data.\u003c/p\u003e\n\u003cp\u003eData management and data analysis\u003c/p\u003e\n\u003cp id=\"_Toc155515905\"\u003eThe collected data were checked for completeness and consistency before being cleaned and entered into Epi Info version 7.2.5.0. The dataset was then exported to SPSS version 26 for statistical analysis. Descriptive statistics were summarized using frequency tables, graphs, and charts to present the distribution of key variables.\u003c/p\u003e\n\u003cp\u003eUnivariable binary logistic regression analysis was performed to examine the association between each independent variable\u0026mdash;including socio-demographic characteristics, obstetric care provider factors, and health facility factors\u0026mdash;and the outcome variable: partograph utilization practice (good vs. poor). Crude odds ratios (COR) with 95% confidence intervals were calculated, and variables with a p-value less than 0.25 were considered candidates for multivariable analysis.\u003c/p\u003e\n\u003cp\u003eMultivariable binary logistic regression was conducted to control for potential confounders and to identify independent predictors of good partograph utilization. Adjusted odds ratios (AORs) with corresponding 95% confidence intervals and p-values were used to interpret the strength and significance of associations. Variables with a p-value \u0026le; 0.05 were considered statistically significant.\u003c/p\u003e\n\u003cp\u003eMulticollinearity among independent variables was assessed using the Variance Inflation Factor (VIF), and model fitness was evaluated using the Hosmer\u0026ndash;Lemeshow goodness-of-fit test, with a p-value \u0026gt; 0.05 indicating an adequate model fit.\u003c/p\u003e\n\u003ch2\u003eEthical consideration\u003c/h2\u003e\n\u003cp\u003eEthical approval was obtained from the Institutional Review Committee of Saint Peter Specialized Hospital. Formal letters of permission were submitted to Ras Desta Damtew General Hospital, Saint Paul Millennium Medical College, and Menelik II Referral and Teaching Hospital to initiate data collection.\u003c/p\u003e\n\u003cp\u003eBefore data collection, the objectives and significance of the study were clearly explained to all participants. Written informed consent was obtained from each participant. Confidentiality of the information was strictly maintained, and participant privacy was respected throughout the study.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eOut of the 499 questionnaires distributed to obstetric care providers in selected public hospitals of Addis Ababa, 482 were fully completed and valid for analysis, resulting in a high response rate of 96.4%. Seventeen questionnaires were excluded due to incomplete or incorrect responses. This robust participation reflects strong engagement and provides a reliable foundation for assessing partograph utilization and its determinants.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cb\u003eSocio-demographic characteristics of study participants\u003c/b\u003e\u003c/p\u003e\u003cp\u003eAmong the participants, 57.7% were male and 42.3% female. Nearly half (49.8%) were aged between 25 and 29 years, while 74.0% were single. The majority (90.2%) held a degree or higher qualification, reflecting a well-educated healthcare workforce (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eSocio-demographic characteristic of obstetric care givers at in selected public hospitals of Addis Ababa, 2024 (n\u0026thinsp;=\u0026thinsp;482).\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFrequency\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePercent\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSex\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e278\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e42.3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e204\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e57.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e15.8%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e25\u0026ndash;29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e240\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e49.8%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e30\u0026ndash;34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e108\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e22.4%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e12.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarital status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSingle\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e295\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e74.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e172\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e24.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDivorced\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.2%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEducational level\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDiploma\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e9.8%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDegree and above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e435\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e90.2%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eProfessional characteristics of obstetric care givers\u003c/b\u003e\u003c/p\u003e\u003cp\u003eMidwives (37.3%) and nurses (22.8%) constituted the majority of providers, followed by medical doctors (31.1%) and others (8.7%). Most were from Saint Peter Specialized Hospital (34.2%) and SPHMMC (28.6%), with the rest from Ras Desta (16.6%) and Minilik II Hospital (20.6%). Nearly half worked in delivery rooms (40.5%), and 57.7% had fewer than five years of service. Overall, 62.2% had received obstetric care training\u0026mdash;mainly in labor and delivery (24.9%), BEMONC (18.7%), CEMONC (16.6%), and newborn care (13.5%). Notably, 89.2% were trained in partograph use. \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e\u003cb\u003e).\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eProfessional characteristics of obstetric care providers in selected public hospitals of Addis Ababa, 2024 (n\u0026thinsp;=\u0026thinsp;482).\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFrequency\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePercent\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eProfession\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMidwife\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e150\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e37.3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMedical practitioner\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e110\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e31.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNurse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e180\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e22.8%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOthers (Specialist, Health offier,IESo)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e42\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWork place\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSPSH\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e165\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e34.2%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRDGH\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e16.6%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSPHMMC\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e167\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e28.6%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMRH\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e20.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRegular working department\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eANC\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e18.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDelivery room\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e195\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e40.5%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFamily planning\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePNC\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e100\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e20.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOPD (adult \u0026amp; under five)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e12.5%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOthers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3.5%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYears of hospital service\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;5 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e257\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e57.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5\u0026ndash;10 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e160\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e33.2%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;10 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e9.8%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eReceived training on obstetric caregivers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e300\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e62.2%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e182\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e37.8%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eType of training\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLabor and delivery ward\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e120\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e24.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNewborn care\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e13.5%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBEMONC\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e18.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCEMONC\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e16.6%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOthers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6.2%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTraining on partograph\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e430\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e89.2%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e10.8%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eKnowledge of obstetric care givers about partograph\u003c/b\u003e\u003c/p\u003e\u003cp\u003eAll participants had heard of the partograph, while only 376 (78.0%) correctly identified its definition. A total of 411 (85.3%) accurately reported the correct time to begin plotting, and 462 (95.9%) were aware of its main components ( Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e. Among the 458 providers who reported using the partograph in clinical practice (95.0%), only 426(88.4%) demonstrated good knowledge of its appropriate use ( Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u003cb\u003e).\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eKnowledge related responses of obstetric care givers about partograph utilization at in selected public hospitals of Addis Ababa,Ethiopia 2024\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFrequency\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePercent\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDefined partograph correctly\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e426\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e88.4%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e11.6%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eListed all the components of partograph\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e437\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e90.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e9.3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUse of partograph\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRoutine monitoring of labor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e10.8%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTo helps the health care givers in identifying slow progress in labor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e12.2%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTo prevent prolonged labor and obstructed labor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e10.6%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAll list\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e275\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e57.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNone available\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3.8%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOthers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.8%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDefined alert line correctly\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEarly warning if labor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e214\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e44.4%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTransfer the women from health center to hospital\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e10.4%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eReaching the action line\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e13.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAll of the above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e124\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e25.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNone available\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6.4%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDefined action line correctly\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eConduct full medical assessment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e15.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eConsider intravenous infusion/ bladder\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e13.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eThe action line drawn 4 hours to the right of the alert line and parallel\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e185\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e38.4%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAll of the above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e115\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e23.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNone available\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4.6%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOthers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eKnowledge about the start time of plotting paragraph\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eActive first stage (5cm or above)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e309\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e64.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCervical dilation, descent of the fetal head\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6.8%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUterine contractions are used in assessing the progress of labor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e5.4%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAll of the above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e15.8%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNone available\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e7.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDefined satisfactory labour progress correctly\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eA rate of dilation of the cervix that keeps it on or to the left of the alert line\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e132\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e27.4%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEvidence of fetal descent coinciding with cervival dilation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e98\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e20.3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eContractions which show a steady increase in\u003c/p\u003e\u003cp\u003eduration and the number in 10 min\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e82\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e17.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAll of the above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e130\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e27.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNone available\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8.3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDefined importance of partograph correctly\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eA single sheet of paper can provide details of necessary information at a glance\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e104\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e21.6%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo need to record labour events repeatedly\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGives clear picture of normality and abnormality in labours\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e167\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e34.6%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAll the above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e138\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e28.6%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNone available\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6.2%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOthers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eUtilization of partograph\u003c/b\u003e\u003c/p\u003e\u003cp\u003eOut of the 482 obstetric care providers who reported using the partograph, 428 (88.8%) used it routinely, 54 (11.2%) used it sometimes, and 0 (0.0%) used it occasionally (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e\u003cb\u003e).\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eUtilization of partograph by obstetric care givers in selected public hospitals of Addis Ababa,Ethiopia 2024\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFrequency\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePercent\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePartograph use currently\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e439\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e91.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFrequency of partograph utilization\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRoutinely\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e428\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e88.8%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSometimes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e11.2%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOccasionally\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePlot fetal heart rate correctly\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e439\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e91.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePlot cervical dilation 4 hourlies\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e439\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e91.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePlot descent correctly\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e439\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e91.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePlot uterine contraction correctly\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e439\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e91.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRecord membrane rupture or intact\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e439\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e91.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRecord color of liquor correctly\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e439\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e91.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMonitor maternal B/P at least 4 hourlies\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e439\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e91.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMonitor maternal pulse at least every 30 minute\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e439\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e91.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePlot correctly across alert line\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e439\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e91.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e14.8%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePlot correctly across action line\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e439\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e91.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eDistribution of Reported Reasons for Non-Utilization of the Partograph Among Obstetric Care Providers (n\u0026thinsp;=\u0026thinsp;43, 8.9%)\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe pie chart illustrates \u003cb\u003e(\u003c/b\u003eFig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e, the distribution of self-reported reasons why 43 obstetric care providers (8.9% of the total sample) did not currently use the partograph. The most commonly cited barriers were inadequate training or knowledge (26%), followed by high workload and staff shortages (22%), and lack of essential tools or printed partograph charts (18%). Other contributors included absence of supervision or enforcement (14%), negative attitudes toward the tool (12%), and cases of rapid labor or emergencies where usage was deemed impractical (8%). These findings reflect both system-level and individual-level challenges to effective partograph implementation.\u003c/p\u003e\u003cp\u003e\u003cb\u003eInstitutional and organizational factors\u003c/b\u003e\u003c/p\u003e\u003cp\u003ethe institutional and organizational characteristics of obstetric care providers included in the study. A majority of participants (64.3%) reported that their facilities have clear institutional policies supporting the use of the partograph. More than half of the respondents (58.1%) indicated that they receive supportive supervision, which is vital for maintaining quality labor monitoring practices. Additionally, strong team collaboration was reported by 61.2% of providers, reflecting a collaborative work environment that can facilitate consistent and effective partograph utilization.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eInstitutional and Organizational Characteristics of Respondents (N\u0026thinsp;=\u0026thinsp;482)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFrequency\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePercent\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eInstitutional Policy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e310\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e64.3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e172\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e35.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSupportive SupervisionYes280\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e280\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e58.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eN o\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e202\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e41.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTeam Collaboration\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e295\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e61.2%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e187\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e38.8%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eFactors associated with utilization of partograph\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e presents the results of both bivariate and multivariable logistic regression analyses conducted to identify factors independently associated with good partograph utilization among obstetric care providers in selected public hospitals of Addis Ababa, Ethiopia. In the bivariate analysis, variables such as age, profession, workplace, years of hospital service, training on obstetric care, on-the-job training, knowledge about the partograph, institutional policy support, supportive supervision, and team collaboration were found to be associated with good partograph utilization.\u003c/p\u003e\u003cp\u003eIn the multivariable analysis, the following factors remained significantly associated with good practice:\u003c/p\u003e\u003cp\u003eProfession: Midwives were over 2 times more likely to use the partograph appropriately compared to other professionals (AOR\u0026thinsp;=\u0026thinsp;2.24, 95% CI: 1.05\u0026ndash;4.79).\u003c/p\u003e\u003cp\u003eYears of Hospital Service: Caregivers with 5\u0026ndash;10 years of service had significantly higher odds of good practice compared to those with more than 10 years of experience (AOR\u0026thinsp;=\u0026thinsp;0.09, 95% CI: 0.01\u0026ndash;0.82), suggesting peak efficiency with intermediate experience.\u003c/p\u003e\u003cp\u003eOn-the-Job Training: Providers who received on-the-job training were more than 6 times more likely to utilize the partograph properly (AOR\u0026thinsp;=\u0026thinsp;6.73, 95% CI: 2.19\u0026ndash;13.49), highlighting the value of continuous practical training.\u003c/p\u003e\u003cp\u003eKnowledge About the Partograph: Those with good knowledge were nearly 5 times more likely to practice appropriate use (AOR\u0026thinsp;=\u0026thinsp;4.90, 95% CI: 2.03\u0026ndash;11.79).\u003c/p\u003e\u003cp\u003eInstitutional Policy Support: Facilities with clear institutional policies on partograph use had more than 2.7 times higher odds of good utilization (AOR\u0026thinsp;=\u0026thinsp;2.74, 95% CI: 1.31\u0026ndash;5.71).\u003c/p\u003e\u003cp\u003eSupportive Supervision: Providers who received regular supervision were twice as likely to demonstrate good practice (AOR\u0026thinsp;=\u0026thinsp;2.08, 95% CI: 1.06\u0026ndash;4.09).\u003c/p\u003e\u003cp\u003eTeam Collaboration: A collaborative work environment also significantly enhanced partograph utilization (AOR\u0026thinsp;=\u0026thinsp;2.31, 95% CI: 1.17\u0026ndash;4.57) (\u003cb\u003eTabe 6).\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eFactors associated with good partograph utilization practice among obstetric caregivers in selected public hospitals of Addis Ababa, Ethiopia 2024\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eCategory\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003ePartograph use\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003eOdds ratio (OR) at 95% CI\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eGood practice\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePoor practice\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eCrude OR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eAdjusted OR\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e190(43.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e30(69.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.52(0.59\u0026ndash;1.39)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.79(0.41\u0026ndash;1.53)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e249(56.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e13(30.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e59(77.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e17(22.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e2.19(1.01\u0026ndash;4.77)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.91(0.31\u0026ndash;2.65)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e25\u0026ndash;29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e184(76.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e56(23.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e2.14(1.11\u0026ndash;4.49)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.05(0.51\u0026ndash;2.19)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e30\u0026ndash;34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e89(82.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e19(17.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e2.83(1.32\u0026ndash;6.06)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.64(0.67\u0026ndash;4.13)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e50(86.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8(13.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eEducational level\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDiploma\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e17(3.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5(3.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2.56(0.92\u0026ndash;6.12)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.09(0.56\u0026ndash;3.68)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDegree and above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e423(87.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e12(2.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e\u003cb\u003eProfession\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMidwives\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e130(86.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e20(13.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e2.02(1.01\u0026ndash;4.48)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e2.24(1.05\u0026ndash;4.79)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNurses\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e128(71.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e52(28.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.85(0.41\u0026ndash;1.79)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.96(0.44\u0026ndash;2.09)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMedical Doctors\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e85(77.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e25(22.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.10(0.02\u0026ndash;2.32)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.29(0.59\u0026ndash;2.81)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOthers (Specialist, Health officer. IEso.)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e32(5.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10(23.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e\u003cp\u003e\u003cb\u003eRegular working department\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eANC\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e71(78.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e19(21.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.23(0.03\u0026ndash;2.14)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.25(0.02\u0026ndash;3.19)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDelivery\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e187(95.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8(4.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.45(0.45\u0026ndash;1.92)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.49(0.14\u0026ndash;16.39)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFamily planning\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16(80.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4(20.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.26(0.03\u0026ndash;2.14)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.29(0.03\u0026ndash;3.34)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePNC\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e91(91.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e9(9.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.63(0.30\u0026ndash;12.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.70(0.06\u0026ndash;8.52)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOPD(adult \u0026amp; under five)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e58(96.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2(3.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.84(0.20\u0026ndash;17.20)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.68(0.15\u0026ndash;18.56)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOthers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16(94.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1(5.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eYears of hospital service\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;5 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e229(89.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e28(10.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.21(0.02\u0026ndash;1.92)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.34(0.03\u0026ndash;3.74)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5\u0026ndash;10 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e158(98.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2(1.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.05(0.01\u0026ndash;0.50)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.09(0.01\u0026ndash;0.82)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;10 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e52(98.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1(1.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eReceived training on obstetric cares\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e276(92.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e24(8.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e1.34(0.73\u0026ndash;2.45)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.21(0.62\u0026ndash;2.36)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e163(89.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e19(10.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003e\u003cb\u003eType of training\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLabor and delivery ward\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e109(90.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e11(9.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2.29(0.74\u0026ndash;7.04)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.34(0.33\u0026ndash;5.49)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNewborn care\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e59(90.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6(9.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2.29(0.63\u0026ndash;8.35)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.90(0.43\u0026ndash;8.34)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBEMONC\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e84(93.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6(22.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.20(0.90-11.38)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.18(0.26\u0026ndash;5.38)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCEMONC\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e72(90.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8(10.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.89(0.54\u0026ndash;6.58)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.96(0.22\u0026ndash;4.20)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOthers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e25(83.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5(16.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eOn-the-job training\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e418(95.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e12(89.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e4.25(2.43\u0026ndash;10.03)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e6.73(2.19\u0026ndash;13.49)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e21(40.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e31(59.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eKnowledge about partograph\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGood knowledge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e340(55.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10(23.3.%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e6.85(3.34\u0026ndash;8.44)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e4.90(2.034\u0026ndash;11.79)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePoor knowledge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e99(22.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e33(76.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eInstitution \u003cb\u003epolicy\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e310(70.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e18(41.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e2.21(1.22-4.00)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e2.74(1.31\u0026ndash;5.71)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eno\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e129(29.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e25(58.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eSupportive supervision\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eyes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e280(63.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e12(27.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e2.10(1.13\u0026ndash;3.88)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e2.08(1.06\u0026ndash;4.09)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eno\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e159(36.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e31(72.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eTeam collaboration\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eyes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e295(67.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e14(32.8%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e2.39(1.32\u0026ndash;4.35)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e2.31(1.17\u0026ndash;4.57)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eno\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e144(32.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e29(67.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eNB-\u003c/b\u003e Adjusted Odds Ratio written in bold indicates statistical significance or P-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003e This This study assessed the level of partograph utilization and its associated factors among obstetric care providers in selected public hospitals of Addis Ababa, Ethiopia. The overall partograph utilization rate was 91.1%, with 88.8% of respondents reporting routine use. This level of utilization is relatively high compared to findings from other regions in Ethiopia and internationally. In Ethiopia, studies from the Somali Region (58.2%), Wolaita Zone (73.3%), and Hadiya Zone (70.8%) reported significantly lower utilization rates(\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). These discrepancies may reflect the impact of urbanization, resource availability, and institutional policies that favor better implementation in Addis Ababa. Similarly, in Nigeria, utilization varied between 40% and 60% depending on institutional type and provider cadre(\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). In Rwanda, Bazirete et al. found a utilization rate of 67%(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e), while in Cameroon it was as low as 45.5%(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). These findings demonstrate a general trend of suboptimal partograph use across sub-Saharan Africa, often due to inadequate training, insufficient supervision, and infrastructural limitations(\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn Asia, the partograph remains underutilized despite WHO recommendations. In India, utilization rates range from 38\u0026ndash;54%, often limited by workload and lack of awareness(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). In Bhutan and Nepal, usage depends on the integration of partographs into routine hospital protocols and the presence of trained staff(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Comparatively, in Europe, partograph or similar labor monitoring tools are routinely used. In the UK and Sweden, electronic versions of the partograph are embedded in maternity care systems, supported by strong institutional monitoring, standardized guidelines, and regular audits(\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). The difference in utilization between European and African/Asian countries highlights the importance of systemic factors in facilitating consistent and high-quality intrapartum monitoring.\u003c/p\u003e\u003cp\u003eThis study identified several factors significantly associated with good partograph utilization. Professionally, midwives were more than twice as likely to use the partograph appropriately compared to other healthcare providers (AOR\u0026thinsp;=\u0026thinsp;2.24). This aligns with studies from Tigray, Nigeria, and Cameroon, highlighting midwives' critical role in maternal health care due to their specialized training and consistent exposure to labor cases(8,11,12]. On-the-job training emerged as a powerful predictor of good practice (AOR\u0026thinsp;=\u0026thinsp;6.73), consistent with findings from Hadiya Zone, Rwanda, and India(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). This underscores the importance of continuous, practice-based education(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e) in reinforcing proper partograph use. Similarly, knowledge about the partograph was significantly associated with its utilization (AOR\u0026thinsp;=\u0026thinsp;4.90), echoing results from Uganda, Nigeria, and other Ethiopian regions where informed providers were more likely to document labor effectively(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eInstitutional and system-level factors also played a substantial role. Facilities with clear institutional policies (AOR\u0026thinsp;=\u0026thinsp;2.74), supportive supervision (AOR\u0026thinsp;=\u0026thinsp;2.08), and strong team collaboration (AOR\u0026thinsp;=\u0026thinsp;2.31) were significantly more likely to demonstrate good utilization(11,12]. These findings are supported by literature from Tigray, Rwanda, and systematic reviews that emphasize the enabling role of supportive infrastructure and leadership in promoting evidence-based practices(\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Interestingly, years of hospital service influenced utilization patterns. Providers with 5\u0026ndash;10 years of experience were more likely to demonstrate good practice compared to those with more than 10 years (AOR\u0026thinsp;=\u0026thinsp;0.09). This may reflect a peak period of professional motivation and familiarity with current guidelines among mid-career providers(\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e)\u003c/p\u003e\u003cp\u003e\u003cb\u003eStrengths and limitations of the study\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eStrengths of the study\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis study demonstrates several methodological strengths, including a multi-center design that enhances the generalizability of its findings across urban Ethiopia. Additionally, the high response rate of 96.4% minimizes the risk of non-response bias, ensuring more reliable and representative results. Furthermore, the research employed rigorous statistical analyses, such as multivariable regression and robust confounding control, strengthening the validity and accuracy of the conclusions drawn. These strengths collectively enhance the study's credibility and applicability to public health interventions in similar settings.\u003c/p\u003e\u003cp\u003e\u003cb\u003eLimitations of the study\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe study has several limitations, including its cross-sectional design, which prevents causal inference, and the reliance on self-reported utilization data, which may be subject to recall or social desirability bias. Additionally, the study was limited to urban public hospitals, so the findings may not reflect the practices or experiences of rural or private healthcare facilities.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eWhile partograph utilization among obstetric caregivers in Addis Ababa was encouraging, ensuring quality and consistency remains a challenge. The study identified profession, experience, knowledge, on-the-job training, supportive supervision, institutional policy, and team collaboration as critical determinants. These factors must be addressed through structured policy, education, and supervision frameworks to ensure optimal use of the partograph and improve maternal and neonatal outcomes.\u003c/p\u003e\u003cp\u003e\u003cb\u003eRecommendations\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe recommendations are to improve obstetric care, such as institutionalizing regular on-the-job training for all providers with a focus on practical demonstrations, strengthening policies to mandate and audit routine partograph use, and enhancing supportive supervision to ensure compliance and accountability. Additionally, the study advocates for a collaborative, multidisciplinary approach to intrapartum care, extending research and training initiatives to all healthcare settings to promote widespread implementation. Furthermore, it highlights the potential integration of partograph monitoring into electronic health record systems, drawing inspiration from successful European models, to enhance efficiency and accuracy in maternal healthcare delivery.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eANC: Antenatal Care ,AOR: Adjusted Odd Ratio, ,BEMONC: Basic Emergency Obstetrics and Newborn Care, ,BSc: Bachelor of Science,CEMONC: Compressive Emergency Obstetrics and Newborn Care ,CI: Confidence Interval,EDHS: Ethiopian Demographic and Health Survey, IESo;integrated Eemergency surgical officers, M.Sc.: Master of Science,MMR: Maternal Mortality Ratio,MOH: Minister of Health,OCG: Obstetric Care Givers,SPSS: Statistical Package for Social Sciences,VIF: Variance Inflation Factor,WHO: World Health Organization.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAll authors\u003c/strong\u003e have contributed to the preparation of a proposal, development of a questionnaire study designing, conceptualization, supervising data collection, data entry, data analysis, and data interpretation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and material\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data of this study will be available from the corresponding author upon reasonable request.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot Aplicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDeclaration of conflicting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that there is no conflict of interest. \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eProvenance and peer review:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNot\u003c/strong\u003e commissioned, externally peer-reviewed.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eWorld Health Organization. Trends in maternal mortality: 2000 to 2020: estimates by WHO, UNICEF, UNFPA, World Bank Group and UN DESA/Population Division. Geneva: WHO; 2023.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCentral Statistical Agency (CSA) [Ethiopia] and ICF. Ethiopia Demographic and Health Survey 2016. Addis Ababa, Ethiopia, and Rockville, Maryland, USA: CSA and ICF; 2016.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBahizi A, Lwanga D, Victor T. Assessment of partograph utilization and its association with pregnancy outcomes in Uganda: A case of Kamwenge District. J Biomed Eng Med. 2022;9(3):1\u0026ndash;21.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAyenew A, Zewdu BF. Partograph utilization as a decision-making tool and associated factors among obstetric care providers in Ethiopia: A systematic review and meta-analysis. Syst Rev. 2020;9:345.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBhatt MJ, Kadikar GK, Kanani M, Shah S. Comparison of normal and abnormal labour by using modified WHO partograph. Int J Reprod Contracept Obstet Gynecol. 2018;7(4):1451\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKuenzang, Pokhrel HP, Dorji K, Rinzin D. Knowledge of partograph recording and interpretation and its documentation status in Samdrup Jongkhar District, Bhutan. Int J Innov Res Med Sci. 2018;3(12):2400\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWorld Health Organization. WHO recommendations: Intrapartum care for a positive childbirth experience. Geneva: WHO. 2018. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.who.int/publications/i/item/9789241550217\u003c/span\u003e\u003cspan address=\"https://www.who.int/publications/i/item/9789241550217\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHailu T, Nigus K, Gidey G, Hailu B, Moges Y. Assessment of partograph utilization and associated factors among obstetric care givers at public health institutions in central zone, Tigray, Ethiopia. BMC Res Notes. 2018;11(1):710.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHaile Y, Tafese F, Weldemarium TD, Rad MH. Partograph utilization and associated factors among obstetric care providers in Hadiya Zone, Southern Ethiopia. J Pregnancy. 2020;2020:1\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGodie Y, Getu M, Sebsibie G, Tadesse A, Mihretu E, Birhanu D. Partograph utilization and associated factors among obstetric care providers in public hospitals, Addis Ababa, Ethiopia. Gynecol Obstet Res Open J. 2023;10(1):1\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAgan TU, Akpan U, Okokon IB, Oku AO, Asibong UE, Opiah MM, et al. Assessment of the knowledge and utilization of the partograph among non-physician obstetric care givers in the University of Calabar Teaching Hospital, Calabar, Nigeria. Br J Med Med Res. 2014;4(35):5610\u0026ndash;21.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMaphasha OM, Govender I, Motloba DP, Barua C. Use of the partogram by doctors and midwives at Odi District Hospital, Gauteng, South Africa. S Afr Fam Pract. 2017;59(3):122\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eArinola AP, Teresa O, Babafemi AA. Knowledge and utilization levels of partograph in management of labour amongst midwives in selected health facilities in Akure, Ondo State. Afr J Health Nurs Midwifery. 2021;4(6):101\u0026ndash;18.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMarkos D, Bogale D. Documentation status of the modified World Health Organization partograph in public health institutions of Bale zone. Ethiopia Reprod Health. 2015;12(1):1\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMarkos M, Arba A, Paulos K. Partograph utilization and associated factors among obstetric care providers in public health facilities of Wolaita Zone, Southern Ethiopia. Hindawi. 2020;2020:1\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Partograph, Labor monitoring, Obstetric care providers, Ethiopia","lastPublishedDoi":"10.21203/rs.3.rs-7293323/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7293323/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eThe partograph is a simple, low-cost tool recommended by the World Health Organization (WHO) to track labor progress and prevent complications like prolonged and obstructed labor\u0026mdash;key contributors to maternal and neonatal mortality. Despite its proven benefits, consistent utilization remains limited in many low-resource settings. This study aimed to assess partograph utilization and identify its key determinants among obstetric care providers in selected public hospitals in Addis Ababa, Ethiopia.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eA cross-sectional study was carried out from January to March 2024 in four major public hospitals in Addis Ababa. A total of 482 obstetric care providers were included using a census approach. Data were collected through structured, pretested questionnaires and analyzed using SPSS version 26. Logistic regression was used to identify factors associated with partograph use. Variables with a p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 in the multivariable model were considered significant.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eOut of the total participants, 91.1% reported using the partograph, and 88.8% said they used it routinely. Midwives were more than twice as likely to use the partograph effectively compared to other providers (AOR\u0026thinsp;=\u0026thinsp;2.24, 95% CI: 1.05\u0026ndash;4.79). Providers who had received on-the-job training (AOR\u0026thinsp;=\u0026thinsp;6.73, 95% CI: 2.19\u0026ndash;13.49), had good knowledge (AOR\u0026thinsp;=\u0026thinsp;4.90, 95% CI: 2.03\u0026ndash;11.79), worked in facilities with supportive policies (AOR\u0026thinsp;=\u0026thinsp;2.74, 95% CI: 1.31\u0026ndash;5.71), received regular supervision (AOR\u0026thinsp;=\u0026thinsp;2.08, 95% CI: 1.06\u0026ndash;4.09), and experienced strong team collaboration (AOR\u0026thinsp;=\u0026thinsp;2.31, 95% CI: 1.17\u0026ndash;4.57) were significantly more likely to use the partograph properly. Interestingly, those with over 10 years of service were less likely to demonstrate good practice compared to providers with 5\u0026ndash;10 years of experience (AOR\u0026thinsp;=\u0026thinsp;0.09, 95% CI: 0.01\u0026ndash;0.82).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eWhile partograph use in Addis Ababa\u0026rsquo;s public hospitals is relatively high, gaps remain in consistency and quality. Strengthening hands-on training, institutional policies, regular supervision, and team collaboration can make a meaningful difference. Efforts to integrate partograph use into everyday clinical routines\u0026mdash;supported by leadership and infrastructure\u0026mdash;are essential for improving labor outcomes for mothers and babies alike.\u003c/p\u003e","manuscriptTitle":"Assessment of Partograph Utilization and Its Determinants Among Obstetric Care Providers in Selected Public Hospitals of Addis Ababa, Ethiopia: A Multi-Center Cross-Sectional Study, 2024","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-08-27 07:52:16","doi":"10.21203/rs.3.rs-7293323/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"51ae8298-33ae-4f82-bb8f-00b1e6cf8a6f","owner":[],"postedDate":"August 27th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-08-27T07:52:17+00:00","versionOfRecord":[],"versionCreatedAt":"2025-08-27 07:52:16","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7293323","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7293323","identity":"rs-7293323","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}