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.