Partograph Utilization During Labor Monitoring in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

Background and Objective: Prolonged and obstructed labor is a leading cause of maternal death, preventable through effective and inexpensive health interventions such as the correct and systematic use of the partograph. The objective of this review was to determine the prevalence of partograph use in Sub-Saharan Africa. Methods: We used the standard Preferred Reporting Items for Systematic Reviews and Meta-analyses checklist. Three online databases were used: PubMed, Google Scholar, and African Index Medicus. We included observational studies reporting the prevalence of partograph utilization, conducted in Sub-Saharan African countries, and published in English or French. Extracted data were entered into an Excel spreadsheet and then exported to R version 4.3.3 for analysis. Results: Of the 1,159 records identified in this review, 41 studies were included in this systematic review and meta-analysis. The overall pooled prevalence of partograph utilization was 51.17% (95% confidence interval: 43.05– 59.29). The study country and Sub-Saharan African region were sources of heterogeneity (p < 0.0001 for both), while the year of publication was not (p = 0.2385). The funnel plot and Egger’s test (p = 0.7072) demonstrated the absence of potential publication bias. Conclusion and Global Health Implications: This study showed that the overall pooled prevalence of partograph use in Sub-Saharan African countries was low. Therefore, effective intervention strategies are strongly recommended to increase partograph utilization.