Feasibility study on the adoption of the WHO safe childbirth checklist by front-line healthcare providers and managers in Burkina Faso and Côte d’Ivoire

Abstract

Background The World Health Organization Safe Childbirth Checklist tool was specifically designed for developing countries such as sub-Saharan African countries, to ensure safety and security of the couple mother and newborn around the time of childbirth. However, the implementation of the Safe Childbirth Checklist tool requires a good knowledge of the context setting to face challenges. Our study objectives were (1) to assess the acceptability of the WHO SCC tool and (2) to identify conditions and strategies for a better introduction and use of the WHO SSC tool. Methods This was a pilot multi-country study conducted from January to March 2019 in Burkina Faso and Côte d’Ivoire, respectively, in the health regions of central-North and Agnéby-Tiassa-Mé. In each health region, 5 health facilities of different levels within the health system pyramid were selected through a purposive sampling. The study was conducted in 2 phases: 38 healthcare providers and 15 managers were first trained to use the Safe Childbirth Checklist tool; secondly, the trained providers were allowed to use the tool in real-life conditions for 2 weeks. Then, semi-structured interviews were conducted among healthcare providers and managers. The topics covered by the interview guides were acceptability of the tool, barriers and facilitators to its use, as well as strategies for better introduction and use within the healthcare system. Analysis was carried out using the Nvivo 12 software. Results Respondents reported an overall good acceptance of using the tool. However, they suggested minor content adaptation. The design of the tool and increased workload were the main barriers to its use. Potential facilitators to its introduction were managers’ commitment, healthcare providers’ motivation, and the availability of supplies. The best strategies for optimal use were its attachment to existing tool such as partograph or/and its display in the maternity ward. Conclusions The findings showed that the implementation of the Safe Childbirth Checklist tool is acceptable in Burkina Faso and Côte d’Ivoire. These findings are important and will help to design a trial aiming at assessing the effectiveness of the tool WHO SCC tool in these two countries.

Implementing the WHO Safe Childbirth Checklist modified for preterm birth: lessons learned and experiences from Kenya and Uganda

“…However, providers often perceived it as a burden at first and if they lack the time, training and support to master its use, they may never get beyond the point of thinking it adds to their workload. Workload, particularly with high patient volume, has been previously observed in studies in Burkina Faso, Cote d’Ivoire and Sri Lanka [ 22 , 23 ]. Low rates of completion at the PTBi EA referral hospitals, which had the highest delivery volumes, underscores this critical implementation barrier.…”

Factors Contributing to Rapidly Increasing Rates of Caesarean Section in Andhra Pradesh, India: A Case-Control Study

“…In addition to CS audits, there have been other initiatives in India aimed at reducing the rate of unnecessary CS, such as the 'Birth Checklist' programme, which is being implemented in select states. This programme provides a checklist of evidence-based practises for safe and effective childbirth, including the appropriate use of CS, and is designed to improve the quality of maternal and newborn care [ 26 ].…”

Adaptation and implementation of the WHO Safe Childbirth Checklist around the world

“…[Participant from multi-national organization] Promising practices around SCC adaptation include identifying the purpose of the SCC (e.g., quality improvement tool through team communication and shared accountability) as well as the desired outcomes. Adaptations to the SCC content and structure should be made in a planned, systematic way with an inclusive group of stakeholders based on the stated purpose and in accordance with local guidelines and contextual factors, such as language and respectful maternity care practices [13,14]. Design thinking-defined as "a systematic innovation process that prioritizes deep empathy for end-user desires, needs and challenges to fully understand a problem in hopes of developing more comprehensive and effective solutions" [15]-may be particularly helpful in adapting the SCC to account for local contextual factors through ideation, prototyping, and field testing.…”