|Question||No of studies||Evidence synthesis||Quality|
|What is health workers knowledge of assessment using the partograph?||n = 10||
Knowledge of assessment using the partograph is generally poor, particularly when to start the partograph, the plotting of normal labour and the function of the action and alert lines.|
Knowledge is better in health workers with professional qualifications and those in tertiary settings.
There is a little available evidence of health workers’ understanding of the partograph as a tool to aid decision making.
**Low [33, 36, 41, 43, 48]|
*V low [26, 30, 32, 42, 71]
|Do education, training and experience impact on knowledge of the partograph?||n = 5||
Professional education and/or training in partograph use improve knowledge of the partograph.|
There does not appear to be a link between length of experience in using the partograph and knowledge of the partograph.
**Low [41, 43, 48]|
*V low [30, 32]
|What is the level of competence in partograph completion?||n = 11||
The overall standard of partograph recording is poor and frequently not in accordance with WHO or other guidance.|
Particular aspects of the partograph are more likely to be completed; these are cervical dilatation, fetal heart rate, and condition of the neonate. Maternal observations are least likely to be completed well.
**Low [25, 33, 36]|
*V low [24, 26–31, 66]
|Do training interventions increase knowledge and use of the partograph?||n = 8||
Training interventions do appear to improve knowledge and use of the partograph.|
Individualised training sessions and self-directed training (e.g., CD-ROM or maternal care manual) are most effective in increasing knowledge (in the included studies).
Health workers desire training in partograph use, even if they have already received training.
*V low [34, 35, 37, 53, 72]