Background Safe childbirth remains a daunting challenge, particularly in low-middle income countries, where most pregnancy-related deaths occur. Cameroon’s maternal mortality rate, estimated at 529 per 100,000 live births in 2017, is significantly high. The WHO Safe Childbirth Checklist (SCC) was designed to improve the quality of care provided to pregnant women during childbirth. The SCC was implemented at the Yaoundé Gynaeco-Obstetric and Paediatric Hospital to improve the quality of care during childbirth. Methods This study was a retrospective study to determine the adoption rate of the SCC and its association with maternal (eclampsia, perineal tears, and postpartum haemorrhage) and neonatal (stillbirth, neonatal asphyxia and neonatal death) complications. Data were collected 6 months after the introduction of the SCC. Multivariate binary logistic regression was used to analyse the association between the use of the SCC and maternofoetal complications. Results Out of 1611 deliveries conducted, 1001 records were found, giving a retrieval rate of 62%. Twenty-five records were excluded. During the study period, the checklists were used in 828 of 976 clinical notes, with an adoption rate of 84.8% and a utilization rate of 93.9% at 6 months. Severe preeclampsia/eclampsia was associated with the non-use of the SCC (2.1 vs 5.4%, p = 0.041). Stillbirth, neonatal asphyxia, and neonatal death rates were not significantly different between the checklist and non-checklist groups. However, for all neonatal outcomes, the proportion of complications was lower when the checklist was used. Conclusion The use of the SCC was associated with significantly reduced pregnancy complications, especially for reducing the rates of severe pre-eclampsia/eclampsia. The use of the SCC increased to 93.9% of all deliveries within 6 months. We advocate for the use of the WHO Safe Childbirth Checklist in maternity units.
Background: Safe childbirth remains a daunting challenge, particularly in low middle-income countries, where most pregnancy-related deaths occur. Cameroon's maternal mortality rate, estimated at 529 per 100,000 live births in 2017 is significantly high. The WHO Safe Childbirth Checklist (SCC) was designed to improve the quality of care provided to pregnant women during childbirth. It was implemented at the Yaoundé Gynaeco-Obstetric and Paediatric Hospital to improve the quality of care during childbirth. Methods: A retrospective study to determine the adoption rate of the SCC and its association with maternal (eclampsia, perineal tears, post-partum haemorrhage) and neonatal (foetal death, neonatal asphyxia and neonatal death) complications. Data was collected six months after the introduction of the SCC at the maternity. The Chi-square test was used to compare categorical variables, while the student's T-test was used to compare continuous variables. Results: Out of 1611 deliveries conducted, 1001 records were found, giving a retrieval rate of 62%. Twenty-five records were excluded. During the study period, checklists were used in 828 of 976 clinical notes, giving a mean adoption rate of 84.8% and utilization rate of 93.9% at six months. Severe pre-eclampsia/eclampsia were associated with the non-use of SCC (2.1% Vs 5.4%, p = 0.017). Stillbirth, neonatal asphyxia, and neonatal death rates were not statistically different between checklist and non-checklist groups. However, in all neonatal outcomes, the proportion of complications was less when the checklist was used.Conclusion: The use of the safe childbirth checklist was associated with significantly reduced pregnancy complications, especially reducing severe pre-eclampsia/ and eclampsia. The use of the safe childbirth checklist increased to 93.9% of all deliveries within six months. We advocate for the use of the WHO Safe Childbirth Checklist in maternity units.
Background: Safe childbirth remains a daunting challenge, particularly in low middle income countries, where most pregnancy-related deaths occur. Cameroon’s maternal mortality rate, estimated at 529 per 100,000 live births in 2017 is significantly high. Adherence to essential birth practices by birth attendants is key to improving pregnancy outcomes. The WHO Safe Childbirth Checklist (SCC) was designed as a tool to improve the quality of care provided to women giving birth. It was implemented at the Yaounde Gynaeco-Obsteric and Paediatric Hospital in order to improve quality of care. The purpose of this study was to determine the adoption rate of the SCC and its association with maternal (eclampsia, perineal tears, post-partum haemorrhage) and neonatal (foetal death, neonatal asphyxia and neonatal death) complications, six months after introduction at the maternity. Methods: A retrospective study was conducted from January – June 2018. Six months was chosen because research conducted on the SCC in India showed that adherence to essential birth practices was optimal within this period. Data collection sheets were used to document information from delivery records. The Chi square test was used to compare categorical variables, while the student’s T test was used to compare continuous variables. Results: Out of 1611 deliveries conducted, only 1001 records could be traced, giving 38% of missing data. Twenty-five records were excluded. During the study period, checklists were used in 828 clinical notes, giving an adoption rate of 84.8%. Fewer cases of severe pre-ecclampsia/eclampsia were associated with the use of SCC (2·1% Vs 5·4%, p = 0·017). The difference in the proportion of perineal tears, post-partum haemorrhage, stillbirths, neonatal asphyxia and neonatal deaths observed between the checklist and non-checklist groups was not statistically significant. Conclusion: Our results suggest that the SCC program is a cost effective intervention that could potentially reduce maternal mortality and morbidity, most of reduction coming from prevention of severe pre-eclampsia, eclampsia in low-middle income countries.
Background: Safe childbirth remains a daunting challenge, particularly in low-resource settings where most pregnancy-related deaths occur. Cameroon’s maternal mortality rate, estimated at 782 per 100,000 live births in 2011 is significantly high. Adherence to good practice standards by birth attendants is key to improving pregnancy outcomes. The WHO Safe Childbirth checklist was designed as a tool to improve the quality of care provided to women giving birth. This checklist was implemented at the Yaounde Gyneco-Obsteric and Pediatric Hospital. Quantitative and qualitative assessment of its utilization is essential to secure a change in attitudes and practice and engender improvement in maternal health. Objective: Evaluate the change in attitudes and practice of nurses and compare outcomes in cases where it was and was not used, 6 months after introduction of the safe childbirth checklist in a maternity setting. Methods: A cross sectional and retrospective study was conducted over a 6 month period (January – June 2018). Predesigned questionnaires were used to collect qualitative data from personnel of the Gynecology and Obstetrics unit who used the safe childbirth checklist and quantitative data from patient delivery records. Data analysis was done using SPSS version 23.0. Chi square test was used to compare categorical variables, while the student test was used to compare continuous variables. Results: Of the 1001 files retrieved from the archives, 25 were excluded. The checklist was used in 828/976 (84.8%) files. We observed an increasing trend in the usage rate, with a peak at 93.9% recorded during the last 2 months. Pages 2 and 3 were least completed, in <10% of cases during the first 5 months. A significant reduction in the onset of pre-eclampsia and eclampsia was noted with the use of the checklist (2·1% Vs 5·4%, p = 0·017). Fifty percent of the staff reported that the checklist increased workload while 37.5% mentioned laziness and absence of checklists in some files as a hindrance to its proper use. Conclusion: The use of the safe childbirth checklist improved progressively with a simultaneous reduction in obstetrical and neonatal complications overtime. Keywords: Checklist, childbirth, Obstetrical complications
Background: Safe childbirth remains a daunting challenge, particularly in low-resource settings where most pregnancy-related deaths occur. Cameroon’s maternal mortality rate, estimated at 782 per 100,000 live births in 2011 is significantly high. Adherence to good practice standards by birth attendants is key to improving pregnancy outcomes. The WHO Safe Childbirth checklist was designed as a tool to improve the quality of care provided to women giving birth. This checklist was implemented at the Yaounde Gyneco-Obsteric and Pediatric Hospital. Quantitative and qualitative assessment of its utilization is essential to secure a change in attitudes and practice and determine improvement in maternal health. Objective: Evaluate a change in attitudes and practice and determine improvement in outcomes 6 months after initiation of the safe childbirth checklist use. Methods: A cross sectional and retrospective study was conducted over a 6 month period (January – June 2018). Predesigned questionnaires were used to collect qualitative data from personnel of the Gynecology and Obstetrics unit and quantitative data from patient delivery records. Data analysis was done using SPSS version 23.0. Chi square test was used to compare categorical variables, while the student test was used to compare continuous variables. P -values below 5% were considered statistically significant. Results: Of the 1001 files retrieved from the archives, 25 were excluded. The checklist was used in 828/976 (84.8%) files. We observed an increasing trend in the usage rate, with a peak at 93.9% during the last 2 months. Pages 2 and 3 were least completed, in <10% of cases during the first 5 months. A significant reduction in the onset of pre-eclampsia and eclampsia was noted with the use of the checklist (2·1% Vs 5·4%, p = 0·017). The proportion of neonatal deaths recorded amongst cases with a used checklist was smaller compared to cases without checklists (0·2% Vs 0·7%, p = 0·380). Fifty percent of the staff reported that the checklist increased workload while 37.5% mentioned laziness and absence of checklists in some files as a hindrance to its proper use. Conclusion: The use of the checklist improved progressively with a simultaneous reduction in obstetrical and neonatal complications.
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