Developing and Testing A Synchronized E-Partograph to Improve Management of Intra-Partum Care and Support the Referral System for Emergency Obstetric Care Among Refugee Hosting Communities in Adjumani District, Uganda

Develop a portable electronic partograph (e-partograph) based at a PHC centre synchronised with a hospital-based monitor. The e-partograph will be plotted to monitor foetal heart rate, cervical dilation, descent of the presenting part, contractions and blood pressure. Deviant trends will be flagged with an alarm system with a link to algorithms for alternative actions accessible to the health worker. For example, if contractions are weak and the cervix is fully dilated but the descent is slow in a multiparous woman the action would be to set up intravenous line, and give 5% dextrose and alert the emergency team. The PHC centre will be enhanced with internet link to the referral hospital through which the two screens will be synchronized. Within the same connectivity, health worker at the PHC centre and the medical officer at the hospital can further discuss a patient and together agree on the course of action. A systematic review of the evidence, will guide development of the algorithms for action. The e-partograph will be developed and piloted in a busy rural health centre hosting both refugees and host communities before future scale up to other rural PHC centres. Health centres will be equipped with solar panels to ensure regular supply of electricity and promote the use of renewable energy. Internet connectivity will be provided by one of the telecom companies available in Uganda based on a public-private-partnership arrangement.