Daksh: Digital partograph and intrapartum monitoring mobile application

This is a cross-sectional study which reports the development and pilot of a digital mobile partograph application in 5 primary healthcare centers of North Karnataka, India.

The DAKSH is a tablet-based application designed to improve care for women in the intrapartum period by addressing the issue related to paper partograph usage. Application is designed to provide real-time labor monitoring, basic decision making support by alerts and better record-keeping. The primary objective of the study was to evaluate the feasibility and acceptability of mobile partograph in low resource primary healthcare centers.

The digital partograph was introduced at 5 primary healthcare centers in North Karnataka, India. Following 2 days of training, remote monitoring was done through a dashboard and a bi-monthly evaluation visit was conducted. Results were analyzed in terms of quantitative-analysis (data filled into the application was compared against hospital records) and qualitative analysis (during each bi-monthly visit staff nurses were interviewed).

A total of 10 staff nurses from these healthcare centers used the application to monitor 424 pregnancies for a period of 10-months. During this period the hospital observed around 463 childbirths and out of which 91.56% (n=424) were recorded into the application.

This shows good acceptability of application among staff nurses. Plotting of partograph, auditory reminders to monitor labour vitals were helpful.