Integrated Innovation to Improve Maternal, Newborn and Child Health (MNCH): the Graphless Partograph

Globally, 289,000 maternal deaths occur each year; 9% are due to obstructed labour (OL). OL also contributes to 2.6 million annual stillbirths and 2.7 million newborn deaths. Improved intrapartum care with use of the partograph, a graph based tool to prevent OL, could avert these outcomes. Yet globally it remains underutilized. Contributing factors include: limited graphing skills and lack of an organizational culture that supports its use. To address this gap, we will develop and implement a novel graphless partograph with onsite mentoring, delivered in partnership with local government at facilities in Taita and Taveta County, Kenya. As one of the country’s 15 counties where 99% of MNCH mortality is concentrated, MNCH is a health priority. Our innovation addresses all 3 domains of science (evidence based, low cost, simple tool promotes uptake of knowledge/ skills to strengthen health provider labour management), social (mentoring by local quality improvement teams identify and address cultural/organizational factors that impede implementation and uptake) and business innovation (insertion within local health systems and alignment with county/country priorities promotes sustainability and transition to scale). Applied successfully this approach could be scaled up across county and national platforms, with real ability to address inequity and transform the lives of women and newborns through improved access to and quality of essential MNCH services in Kenya and beyond.