Experiences with the WHO Safe Childbirth Checklist from around the world

28 January 2016
The WHO Safe Childbirth Checklist, released in December 2015, is a tool to support the performance of essential best practices around the time of childbirth. In order to gain a better understanding of how to implement the Checklist in different settings, WHO established the WHO Safe Childbirth Checklist Collaboration during the pilot phase. A number of countries and facilities joined the Collaboration from November 2012 through March 2015 to explore the use and implementation of the Checklist. 

 

Bangladesh: Safe Childbirth Checklist

The WHO Safe Childbirth Checklist has been implemented in two tertiary public health facilities in Dhaka, Bangladesh. One facility is using an electronic version of the Checklist while the other is using the paper version. The objective is to compare the usability and costs of the different methods and to find out which one is more interesting for the facilities in Bangladesh. The Checklist was modified to be more specific to the local context and health professionals were trained in the use of the Checklist.

Mexico: Safe Childbirth Checklist

In Mexico, the WHO Safe Childbirth Checklist was modified by adding items in order to adapt it to the context as well as to ensure its accordance with clinical practice and national standards in Mexico. Three different booklets of the Checklist  were produced: one for the mother, one for the baby and one for both. The project is being lead by the National Institute of Public Health.

 

Mexico 2: Safe Childbirth Checklist

After adaptation of the Checklist in Mexico, it was tested during simulations of childbirth. The Checklist has then been implemented by working closely with experts from the birthing centres as well as the staff participating in childbirth.

 

Nigeria: Safe Childbirth Checklist

At Model Primary Health Centre Mgbundukwu, one of the facilities participating in the pilot phase in Rivers State, Nigeria, the project champion suggested to put the WHO Safe Childbirth Checklist inside the partograph as the nurses and midwives were already trained to use the partograph for every woman that presented in labor. This made it much easier for the staff to use the Checklist as they did not need to search for it separately. With this method the Checklist was used in 100% of births.

Nigeria 2: Safe Childbirth Checklist

At health care facilities in Port Harcourt, Nigeria, the WHO Safe Childbirth Checklist is put together with the partograph, investigation request forms, and other documents needed at the point of service delivery. This ensures it is consistently used for every childbirth.

 

Nigeria 3: Safe Childbirth Checklist

Labour ward staff with the Checklist at the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria, together with the Principal Investigator of the implementation project.

Sri Lanka: Safe Childbirth Checklist

In Sri Lanka, after the first experience of implementing the WHO Safe Childbirth Checklist at the De Soysa Maternity Hospital in Colombo, the Checklist was modified to fit into national obstetric practice. Since then the Checklist has been made part of the clinical case notes of the Mother in this hospital. It is planned to use the Checklist in combination with the WHO Surgical Safety Checklist in Cesarean sections.

 

India: Safe Childbirth Checklist

In Rajasthan, India, parts of the Checklist were enlarged into posters that were hung on the wall in the labour ward. Staff at Bharatiya hospital in Churu have noted that timely detection of complications saves a lot of trouble for the mother and baby and her family and reduces the burden on the healthcare system.

India 2: Safe Childbirth Checklist

Staff using the Checklist at the Community Health Center (CHC) in Behror, Rajasthan, India, feel that their referral rate has come down. They say they examine patients in a more systematic way compared to before and that they are able to identify complications earlier.

Ethiopia: Safe Childbirth Checklist

In Ethiopia, the University of Aberdeen supported the implementation of the Checklist in the Felege Hiwot Referral Hospital in Bahir Dar. The Checklist was introduced through a group of interns who received on-site orientation. Following a trial period, feedback was obtained from users and adaptations were made to make the Checklist more appropriate for the setting. After 3 months from introduction, the majority of staff were familiar with the modified Checklist and it was being used in about 65% of cases. By 1 year, the final checklist was being used in 77% cases.

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