Congo is intensifying efforts to reduce maternal mortality by introducing innovative tools, including the labour monitoring guide. Also known as the partogram, this is used to monitor the well-being of both mother and baby during active labour.
In use in the Republic of the Congo since 1993, the partogram supports decision-making in the event of complications and helps reduce avoidable risks and deaths. In 2022, a simplified version was rolled out to 12 health districts, making it more accessible and easier for maternity staff to use.
In Brazzaville, the Mère-Enfant Blanche Gomes Hospital has been using the updated tool since 2023. “Previously, the partogram was a complicated chart to complete, which led to low uptake and errors in labour monitoring,” explains Dr Frédine Mahoungou, an obstetrician-gynaecologist at Blanche Gomes. “This sometimes resulted in rushed deliveries and overuse of oxytocin, which increases the uterine contractions. The risk of tearing and haemorrhage was high, creating a stressful situation for both staff and the woman in labour.”
To support effective uptake of the new tool, World Health Organisation (WHO), with the support of the Swedish government, helped train 235 health professionals, including midwives and gynaecologists. The revised partogram allows for visual tracking of key indicators such as cervical dilation, contraction frequency, and vital signs of both mother and baby.
“This training has brought more calm and clarity to labour monitoring,” says Minerve Nsouka, a midwife at the hospital. “With the old partogram, we were very stressed because we didn’t know how to use it efficiently. The new version is much easier and helps us better follow the progress of labour.”
In 2023, the so-called “fill rate” for the new partogram was 99%, up from 74% in 2022. The Caesarean section rate also dropped from 32% to 21%, while the rate of stillbirths decreased from 2% to 1%.
“Now, if we detect an abnormality, we immediately call the doctor,” adds midwife Nsouka. “I can better support women during labour, guiding their breathing, encouraging hydration, and offering reassurance and care.”
Better care before, during and after childbirth is critical to reducing maternal mortality. According to WHO estimates, the maternal mortality ratio in Congo dropped to 241 maternal deaths per 100 000 live births in 2023 – down from 710 in 2005. While this marks significant progress, it remains above the global average of 211 deaths per 100 000 live births, and far from the target of 70 by 2030.
To bolster national efforts, WHO supported a strategy in 2022 focused on promoting family planning and emergency obstetric care. The strategy also highlights the use of improved antenatal and delivery monitoring tools to enhance the safety and quality of maternal care.
By identifying risks early and responding quickly to complications, trained health workers are helping improve both clinical outcomes and the overall childbirth experience.
“When I had my first child in 2016, it was very different. This time, the midwives were holding me, we even danced – I could feel the difference,” explains Ghislaine, a mother of three who recently gave birth to a baby boy. “I felt safe and fully supported throughout the delivery.”
In the WHO African Region, the new partogram, combined with other health initiatives, is helping reduce maternal mortality. Between 2000 and 2023, the region recorded a nearly 40% decline, from 727 to 442 deaths per 100,000 live births.
In Congo, maternal mortality dropped by over 50% between 2005 and 2023. “WHO continues to support maternal and neonatal health initiatives to ensure that every pregnancy and birth occurs in conditions of safety and well-being,” says Dr Vincent Dossou Sodjinou, Acting WHO Representative in Congo. “All women must be able to give birth with the support of qualified staff who know how to use these tools.”
The Congolese health authorities are ramping up efforts to improve maternal health. “Thanks to the new partogram, we are now better equipped to provide optimal conditions so that childbirth can be a satisfactory experience for mothers and the wider community,” concludes Dr Mahoungou. “It is essential that women leave the maternity unit safe, well, and feeling cared for.”
Distributed by APO Group on behalf of World Health Organization (WHO) – Republic of the Congo.
