[Assessment of partogram utilisation in Benin]

A safe motherhood program was launched in Benin in 1989. One of the methods used to decrease maternal mortality and morbidity was the partogram. We recently conducted a survey in maternity facilities in urban and rural Benin to assess its utilisation rate and the quality of its use. In this cross-sectional survey, all facilities were asked to respond to a questionnaire. In addition, we retrospectively studied files in half the facilities, based on a stratified randomisation. Partograms were used in 98% of all cases; in 13.3% of files (all in rural areas), partogram completion stopped before delivery. Overall completion was less good: of the 984 partograms examined, administrative data were complete on only 20% and medical delivery data on 50%. Action taken before the alert line was crossed was incorrect in 48% of cases (particularly oxytocin use). The alert line was crossed in 13.5% of the cases, but correct action always followed (artificial rupture of membranes, oxytocin administration). The patient transfer rate was 13% and the cesarean rate 5.2%. This alert line was crossed only once. These results thus show very high coverage of partogram use, but inadequate quality and thus demonstrate the need for refresher training for maternity staff about partogram use.