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Implementing the WHO Safe Childbirth Checklist: lessons from a global collaboration
  1. WRG Perry1,
  2. S Bagheri Nejad1,
  3. K Tuomisto1,
  4. N Kara2,
  5. N Roos3,
  6. TR Dilip3,
  7. LR Hirschhorn4,
  8. I Larizgoitia5,
  9. K Semrau2,6,7,
  10. M Mathai3,8,
  11. N Dhingra-Kumar1
  1. 1Department of Service Delivery and Safety, World Health Organization, Geneva, Switzerland
  2. 2Ariadne Labs at Brigham and Women's Hospital and the Harvard T H Chan School of Public Health, Boston, Massachusetts, USA
  3. 3Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland
  4. 4Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
  5. 5Evaluation Office, World Health Organization, Geneva, Switzerland
  6. 6Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
  7. 7Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA
  8. 8Centre for Maternal and Newborn Health, Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
  1. Correspondence to Dr S Bagheri Nejad; bagherinejads{at}who.int

Abstract

The WHO Safe Childbirth Checklist (SCC) was developed to ensure the delivery of essential maternal and perinatal care practices around the time of childbirth. A research collaboration was subsequently established to explore factors that influence use of the Checklist in a range of settings around the world. This analysis article presents an overview of the WHO SCC Collaboration and the lessons garnered from implementing the Checklist across a diverse range of settings. Project leads from each collaboration site were asked to distribute two surveys. The first was given to end users, and the second to implementation teams to describe their respective experiences using the Checklist. A total of 134 end users and 38 implementation teams responded to the surveys, from 19 countries across all levels of income. End users were willing to adopt the SCC and found it easy to use. Training and the provision of supervision while using the Checklist, alongside leadership engagement and local ownership, were important factors which helped facilitate initial implementation and successful uptake of the Checklist. Teams identified several challenges, but more importantly successfully implemented the WHO SCC. A critical step in all settings was the adaptation of the Checklist to reflect local context and national protocols and standards. These findings were invaluable in developing the final version of the WHO SCC and its associated implementation guide. Our experience will provide useful insights for any institution wishing to implement the Checklist.

  • child health
  • health policy
  • maternal health
  • obstetrics
  • prevention strategies

© World Health Organization [2017]. Licensee BMJ. This is an open access article distributed under the terms of the Creative Commons Attribution N-Noncommercial IGO License (CC BY 3.0 IGO), which permits use, distribution, and reproduction for non-commercial purposes in any medium, provided the original work is properly cited. In any reproduction of this article there should not be any suggestion that WHO or this article endorse any specific organization or products. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL.

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Footnotes

  • PWRG and BNS are joint first authors.

  • Contributors WRGP and SBN are joint first authors. All authors contributed to the writing and editing of the manuscript. WRGP, SBN and IL were responsible for the conception of the WHO Safe Childbirth Checklist Collaboration, which was subsequently run by SBN and WRGP with oversight of KT, NDK, NR, NK, LRH, KS and MM. All authors contributed to the design of the survey and subsequent analysis. TRD undertook statistical analysis.

  • Disclaimer The author(s) is(are) staff member(s) of the World Health Organization. The author(s) alone is(are) responsible for the views expressed in this publication and they do not necessarily represent the views, decisions or policies of the World Health Organization.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Data sharing statement WHO Safe Childbirth Checklist is available online at .