Evaluation of an adapted model of the World Health Organization partographused by Angolan midwives in a peripheral delivery unit

Objective: to study the impact of an educational intervention of midwives' use of the Angolan model of the World Health Organization's (WHO) partograp h. Setting: a peripheral delivery unit with approximately 1500 deliveries per year, run by eleven midwives in Luanda, Angola. Design: the quasi-experimental, One-Group Pre-test - Post-test design was u sed in this study. Fifty partographs plotted with an initial dilatation <8 cm were randomly selected from the first period of six month to form sample I, and another fifty from the second six-months period to form sample II. Intervention: in-service education (theory and practice) performed by a tea m of midwives and an obstetrician. Measurements and findings: when comparing sample II with sample I, statisti cally significant improvements were found in seven of 10 measured variables . This indicates a positive effect of the educational intervention on a pro per use of the partograph, Due to the small sample size, however, this stud y cannot evaluate action taken in relation to prolonged labour. Implications for practice: the in-service educational programme may be of u se when introducing the WHO partograph in similar settings, and the finding s of this study may indicate which parts of the programme need more emphasi s. Conclusions: the midwives improved in general their documentation of the pa rtograph. However, they tended to exceed established criteria for responsib ilities at the peripheral delivery unit, a fact supported by an increased n umber of missed transfers. The study did not, however answer the question w hy the midwives acted as they did in the referred cases. (C) 2000 Harcourt Publishers Ltd.