The WHO safe childbirth checklist program implementation challenges and successful strategies for improving maternal and newborn quality of care and birth outcomes: a comprehensive review article
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20251409Keywords:
Child birth practices, Safe childbirth checklist implementation challenges, WHO safe childbirth checklistAbstract
The implementation of the World Health Organization Safe Childbirth Checklist (SCC) bundle, a novel childbirth safety program for institutional births, would increase the quality of essential childbirth practices linked with improved maternal and perinatal health outcomes. The ob
The implementation of the World Health Organization Safe Childbirth Checklist (SCC) bundle, a novel childbirth safety program for institutional births, would increase the quality of essential childbirth practices linked with improved maternal and perinatal health outcomes. The objective of using SCC bundle is to improve quality of care during the delivery, immediate postpartum care, and pregnancy outcome and to enhance the satisfaction of beneficiaries visiting the health facilities and providing respectful maternity care to all pregnant women attending the public health facilities. A search of PubMed, Scopus, Embase, Science Direct, and MEDLINE databases revealed articles concerning safe childbirth checklist, quality improvement of labor room practice, maternal and newborn outcomes, and barriers and facilitators for its implementation. The research studies considered were reviews, systematic reviews, meta-analyses, randomized controlled trials and observational studies. The data was sought from 2013 to 2023. The SCC is a facility-based reminder tool aimed to assist healthcare workers in improving maternal and newborn care practices before, during, and after delivery, thereby expected to impact on perinatal mortality. The checklist also addresses intrapartum-related stillbirths resulting from inadequate care during labor and delivery and neonatal deaths arising from birth asphyxia, complications related to prematurity, and infections. The purpose of this review is to find the successful strategies to overcome the SCC implementation challenges so that it can be used as a standard tool by the health care workers in all health care settings to enhance the quality of childbirth practice and prevent the unwanted death, labor, and delivery complications.
jective is to improve quality of care during the delivery, immediate postpartum care, and pregnancy outcome. In addition to enhancing the satisfaction of beneficiaries visiting the health facilities and providing respectful maternity care to all pregnant women attending the public health facility. A search of PubMed, Scopus, Embase, Science Direct, and MEDLINE databases revealed articles concerning safe childbirth checklist, quality improvement of labour room practice, maternal and newborn outcomes, and barriers and facilitators for its implementation. The research studies considered were reviews, systematic reviews, meta-analyses, randomized controlled trials and observational studies. The data was sought from 2013 to 2023. The SCC is a facility-based reminder tool aimed to assist healthcare workers in improving maternal and newborn care practices before, during, and after delivery, thereby expected to impact on perinatal mortality. The checklist also addresses intrapartum-related stillbirths resulting from inadequate care during labour and delivery and neonatal deaths arising from birth asphyxia, complications related to prematurity, and infections. The purpose of this review is to find the successful strategies to overcome the SCC implementation challenges so that it can be used as a standard tool by the health care workers in all health care settings to enhance the quality of childbirth practice and prevent the unwanted death, labor, and delivery complications.
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References
Hug L, Sharrow D, Zhong K, You D, Ho J, Retno Mahanani W. Levels & trends in child mortality. New York, USA: United Nations Children’s Fund. 2017: 1-40.
Alkema L, Chou D, Hogan D. United Nations maternal mortality estimation inter-agency group collaborators and technical advisory group. Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN maternal mortality estimation inter-agency group. Lancet. 2016;387(10017):462-74. DOI: https://doi.org/10.1016/S0140-6736(15)00838-7
Requejo JH, Bryce J, Barros AJ. Countdown to 2015 and beyond: fulfilling the health agenda for women and children. Lancet. 2015;385(9966):466-76. DOI: https://doi.org/10.1016/S0140-6736(14)60925-9
Lawn JE, Lee ACC, Kinney M. Two million intrapartum-related stillbirths and neonatal deaths: where, why, and what can be done. Int J Gynaecol Obstet. 2009;107(1):18-9. DOI: https://doi.org/10.1016/j.ijgo.2009.07.016
Kruk ME, Gage AD, Arsenault C. High-quality health systems in the Sustainable Development Goals era: time for a revolution. Lancet Glob Health. 2018;6(11):1196-252. DOI: https://doi.org/10.1016/S2214-109X(18)30386-3
UN inter-agency group for child mortality estimation. Levels and trends in child mortality: report 2015. UNICEF, WHO, World Bank Group, United Nations 2015. Avaialble at: http://www.who.int/maternal. Accessed on 20th November 2024.
Lancet Ending Preventable Stillbirths study group. Ending preventable stillbirths. The Lancet. 2016;15:45-8.
Blencowe H, Cousens S, Jassir FB, Say L, Chou D, Mathers C, et al. National, regional, and worldwide estimates of stillbirth rates in 2015, with trends from 2000: a systematic analysis. Lancet Glob Health. 2016;4(2):98–108. DOI: https://doi.org/10.1016/S2214-109X(15)00275-2
Ogu RN, Agholor KN, Okonofua FE. Engendering the attainment of the SDG-3 in Africa: Overcoming the socio-cultural factors contributing to maternal mortality. African J Reprod Health. 2016;20(3):62-74. DOI: https://doi.org/10.29063/ajrh2016/v20i3.11
Safe childbirth checklist programme, An overview. 2013. Available at: http:// www.who.int/patientsafety. Accessed on 11 Nov 2024.
WHO. WHO safe childbirth checklist implementation guide: improving the quality of facility-based delivery for mothers and newborns. 2015. Available at: http://www.who.int. Accessed on 21 January 2025.
World Health Organisation. WHO recommendations on of the mother and newborn: highlights from the world health organization 2013 guidelines. Geneva: World Health Organization. 2015.
Dohbit J, Agala V, Chinwa-Banda P, Anane-Fenin B, Maduka O, et al. Improving maternal health: the safe childbirth checklist as a tool for reducing maternal mortality and morbidity. Selected Topics in Midwif Care. 2019;5:3407-8.
Dohbit J, Agala V, Chinwa-Banda P, Anane-Fenin B, Maduka O, Edewor U, et al. Improving maternal health: the safe childbirth checklist as a tool for reducing maternal mortality and morbidity. Mivšek AP, editor. 2019: 87-110. DOI: https://doi.org/10.5772/intechopen.82616
WHO Recommendations on Interventions to Improve Preterm Birth Outcomes. France: World Health Organization. 2015.
Spector JM, Lashoher A, Agrawal P. Designing the WHO Safe Childbirth Checklist program to improve quality of care at childbirth. Int J Gynaecol Obstet. 2013;122(2):164-8. DOI: https://doi.org/10.1016/j.ijgo.2013.03.022
Tolu LB, Jeldu WG, Feyissa GT. Effectiveness of utilizing the WHO safe childbirth checklist on improving essential childbirth practices and maternal and perinatal outcome: a systematic review and meta-analysis. PLoS One. 2020;15(6):234320. DOI: https://doi.org/10.1371/journal.pone.0234320
Hirschhorn LR, Semrau K, Kodkany B. Learning before leaping: integration of an adaptive study design process prior to initiation of Better Birth, a large-scale randomized controlled trial in Uttar Pradesh, India. Implement Sci. 2015;10(7):117. DOI: https://doi.org/10.1186/s13012-015-0309-y
Deshmukh VL, Chahande PD, Shirale T, Yeilka KY. WHO Childbirth Checklist 2012: impact on maternal and newborn care evaluation. Int J Res Anal. 2016;4(1):113-29.
Nababan HY, Islam R, Mostari S. Improving quality of care for maternal and newborn health: a pre-post evaluation of the Safe Childbirth Checklist at a hospital in Bangladesh. BMC Pregnancy Childbirth. 2017;17(1):402. DOI: https://doi.org/10.1186/s12884-017-1588-x
Kabongo L, Gass J, Kivondo B, Kara N, Semrau K, Hirschhorn LR. Implementing the WHO Safe Childbirth Checklist: lessons learnt on a quality improvement initiative to improve mother and newborn care at Gobabis District Hospital, Namibia. BMJ Open Qual. 2017;6(2):145. DOI: https://doi.org/10.1136/bmjoq-2017-000145
Patabendige M, Senanayake H. Implementation of the WHO Safe Childbirth Checklist program at a tertiary care setting in Sri Lanka: a developing country experience. BMC Pregnancy Childbirth. 2015;15(2):12. DOI: https://doi.org/10.1186/s12884-015-0436-0
Molina R, Villar de Onis J, Reyes A. Implementation of an adapted Safe Childbirth Checklist in rural Chiapas, Mexico: an evaluation study. Lancet Glob Health. 2017;5(l1):26. DOI: https://doi.org/10.1016/S2214-109X(17)30133-X
Kara N, Firestone R, Kalita T. Better Birth Trial Group. The Better Birth program: pursuing effective adoption and sustained use of the WHO Safe Childbirth Checklist through coaching-based implementation in Uttar Pradesh, India. Glob Health Sci Pract. 2017;5(2):232-43. DOI: https://doi.org/10.9745/GHSP-D-16-00411
Semrau KE, Hirschhorn LR, Kodkany B. Effectiveness of the WHO Safe Childbirth Checklist program in reducing severe maternal, fetal, and newborn harm in Uttar Pradesh, India: study protocol for a matched-pair, cluster-randomized controlled trial. Trials. 2016;17(1):576. DOI: https://doi.org/10.1186/s13063-016-1673-x
Semrau KEA, Hirschhorn LR, Marx Delaney M. Better birth trial group. outcomes of a coaching-based who safe childbirth checklist program in India. N Engl J Med. 2017;377(24):2313-24. DOI: https://doi.org/10.1056/NEJMoa1701075
Varghese B, Copas A, Kumari S, et al. Does the Safe Childbirth Checklist (SCC) program save newborn lives? evidence from a realistic quasi-experimental study, Rajasthan, India. Matern Health Neonatol Perinatol. 2019;5(1):3. DOI: https://doi.org/10.1186/s40748-019-0098-4
Walker D, Otieno P, Butrick E, Namazzi G, Achola K, Merai R, et al. Effect of a quality improvement package for intrapartum and immediate newborn care on fresh stillbirth and neonatal mortality among preterm and low-birthweight babies in Kenya and Uganda: a cluster-randomised facility-based trial. The Lancet Global Health. 2020;8(8):1061-70. DOI: https://doi.org/10.1016/S2214-109X(20)30232-1
Kaplan LC, Ichsan I, Diba F, Marthoenis M, Muhsin M, Samadi S, et al. Effects of the world health organization safe childbirth checklist on quality of care and birth outcomes in ACEH, Indonesia: a cluster-randomized clinical trial. JAMA network open. 2021;4(12):2137168. DOI: https://doi.org/10.1001/jamanetworkopen.2021.37168
Kaplan L, Kuhnt J, Richert K, Vollmer S. How to increase the uptake of development interventions considering the theory of planned behaviour. Deutsches Institut für Entwicklungspolitik discussion paper 10. 2019. Accessed on 12 December 2024
Kumar S, Yadav V, Balasubramaniam S, Jain Y, Joshi CS. Effectiveness of the WHO SCC on improving adherence to essential practices during childbirth, in resource constrained settings. BMC pregnancy and childbirth. 2016;16:12-6. DOI: https://doi.org/10.1186/s12884-016-1139-x
Tuyishime E, Park PH, Rouleau D, Livingston P, Banguti PR, Wong R. Implementing the World Health Organization safe childbirth checklist in a district Hospital in Rwanda: a pre-and post-intervention study. Matern Health Neonatol Perinatol. 2018;4:1-6. DOI: https://doi.org/10.1186/s40748-018-0075-3
Bitewulign B, Abdissa D. Using the WHO safe childbirth checklist to improve essential care delivery as part of the district-wide maternal and newborn health quality improvement initiative, a time series study. BMC Health Services Res. 2021;21(1):1-13. DOI: https://doi.org/10.1186/s12913-021-06781-x
Marx Delaney M, Maji P, Kalita T, Kara N, Rana D, Kumar K, et al. Improving adherence to essential birth practices using the WHO safe childbirth checklist with peer coaching: experience from 60 public health facilities in Uttar Pradesh. India Global Health Sci Prac. 2017;5(2):217–31. DOI: https://doi.org/10.9745/GHSP-D-16-00410
Molina RL, Benski AC, Bobanski L, Tuller DE, Semrau KE. Adaptation and implementation of the WHO Safe Childbirth Checklist around the world. Implementation science communications. 2021;2:1-10. DOI: https://doi.org/10.1186/s43058-021-00176-z
Ogu RN, Ntoimo LF, Okonofua FE. Perceptions of women on workloads in health facilities and its effect on maternal health care: A multi-site qualitative study in Nigeria. Midwifery. 2017;55(12):1-6. DOI: https://doi.org/10.1016/j.midw.2017.08.008
Kanduma EL, Pérez-Escamilla R. Barriers and facilitators for implementing the who safe childbirth checklist (SCC) in mozambique: a qualitative study using the consolidated framework for implementation research (CFIR). PLOS Global Public Health. 2024;4(9):3174. DOI: https://doi.org/10.1371/journal.pgph.0003174
Maternal Health Division Ministry of Health and Family Welfare Government of India. Dakshata, Empowering providers for improved MNH care during institutional deliveries. Operational guidelines. 2015. Available at: nrhm.gov.in/images/pdf. Accessed on 5th January 2024.
Molina RL, Bobanski L, Dhingra-Kumar N, Moran AC, Taha A, Kumar S, et al. The WHO safe childbirth checklist after 5 years: future directions for improving outcomes. The Lancet Global Health. 2022;10(3):324-5. DOI: https://doi.org/10.1016/S2214-109X(21)00556-8