Introduction: In low resource setting, the completion rate of partograph is low despite heavy investment in training of healthcare workers on Basic Emergency Obstetric and Neonatal Care (BEmONC), which promotes the use of partographs to monitor the progress of labour. In Kenya, the rate of caesarean section, instrumental delivery and APGAR score less than 7 at one minute has increased. Therefore, this study determined the extent of use of partographas a tool for monitoring the progress of the mother and the foetus during labour in selectedWestern counties in Kenya.

Methods: This was a cross-sectional study conducted in Kisumu and Vihiga counties inwestern Kenya between May and June 2019. Validated self-administered questionnaires andchecklists were used to collect data from participants while randomly chosen participant-filledpartograph were evaluated. Sample characteristic and extent of use of partograph weredescribed using frequencies and percentages while factors associated with partograph usewere assessed using multivariable logistic regression. Statistical significance was set at p<0.05.

Results: Out of 149 participants, 104 (69.8%) were female, 144 (96.6%) were nurses, 52%worked in health centres, 37% had worked for seven or more years and trained on BEmONCwithin 1–2 years. The mean age of the participants was 35.3 (standard deviation: 7.1) years. Demographics (98%), foetal heart rate (80.5%), TPR (74.5%) and maternal blood pressure(73.2%) section of the partograph were the most charted. The least charted sections werefoetal descent (19.5%), cervical dilatation (21.5%) and uterine contractions (24.8%). Use of partograph was associated with the female gender with a 58% (aOR: 0.42. 95%CI: 0.19–0.91) lower odds compared to male nurses.

Conclusion: Our findings highlight a persistent gap in the use of partograph in Kenya despitethe recent countrywide BEmONC training. There is a need for enhanced on-job training for nurses-midwives on the use of partograph but also a need to explore the possibility of usingthe electronic partograph that are effective in reducing adverse foetal outcomes and improveadherence to labour care and strengthen routine support supervision to reviewnurses- midwives in the use of partograph.

Keywords: Partogrph, Labour, Antenatal care, Skilled birth attendance, Kenya