Implementing a modified World Health Organization safe childbirth checklist in health centers of Ethiopia: a pre and post intervention study

Abstract

Background Childbirth is a complex process, and checklists are useful tools to remember steps of such complex processes. The World Health Organization safe childbirth checklist is a tool used to improve the quality of care provided to women giving birth. The checklist was modified by Ministry of Health and was introduced to health centers in Ethiopia by the USAID Transform: Primary Health Care Activity. Methods A pre and post intervention study design with prospective data collection was employed. The availability of essential childbirth supplies and adherence of health care providers to essential birth practices were compared for the pre and post intervention periods. Results The pre and post intervention assessments were conducted in 247 and 187 health centers respectively. A statistically significant improvement from 63.6% pre intervention to 83.5% post intervention was observed in the availability of essential childbirth supplies, t (389.7) = − 7.1, p = 0.000. Improvements in adherence of health care providers to essential birth practices were observed with the highest being at pause point three (26.2%, t (306.3) = − 10.6, p = 0.000) followed by pause point four (21.1%, t (282.5) = − 8.0, p = 0.000), and pause point two (18.2%, t (310.8) = − 9.7, p = 0.000). The least and statistically non-significant improvement was observed at pause point one (3.3%, t (432.0) = − 1.5, p = 0.131). Conclusion Improvement in availability of essential childbirth supplies and adherence of health care providers towards essential birth practices was observed after introduction of a modified World Health Organization safe childbirth checklist. Scale up of the use of the checklist is recommended.

Impact of the implementation of the WHO Safe Childbirth Checklist on essential birth practices and adverse events in two Brazilian hospitals: a before and after study

“…Similarly, a pre and postintervention study conducted in Ethiopia on SCC implementation found a 26.2% improvement in EBPs at this pause point. 38 Thus, this positive impact of the checklist on neonatal care denotes the importance of this tool for reducing early neonatal mortality, 11 17 18 which showed the slowest improvement during the era of the Millennium Development Goals. 39 …”

Impact of the WHO Safe Childbirth Checklist on safety culture among health workers: A randomized controlled trial in Aceh, Indonesia

“…In other SCC evaluations, compliance was measured either in terms of completing single checklist items, certain bundles (e.g., before/after birth) or the full checklists over the total number of checklists provided [17][18][19], over the total number of live births [20], or over mothers admitted [15]. Other studies simply asked health care providers whether they carried out essential birth practices outlined in the SCC [21] (Abawollo et al 2021).…”

Application of the PDCA cycle for implementing the WHO Safe Childbirth Checklist in women with vaginal deliveries

“…[2] Since then, the SCC has been implemented in many countries and regions, but with inconsistent results. [3][4][5][6] In 2018, our hospital took the lead in introducing and applying the SCC in China based on our experience, and the National Health Commission of China promoted the SCC nationwide. As in some other countries, [6][7][8] we found that providing the checklist only to health care workers or requiring health systems to use the safe delivery checklist does not lead to widespread and sustained use of the checklist, nor does it improve the quality of patient safety.…”