Implementing the WHO Safe Childbirth Checklist: lessons from a global collaboration

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.

Quality of the Clinical Maternal and Neonatal Healthcare Assessment in a Tertiary Public Maternity Hospital in R. Macedonia

“…According to WHO, childbirth is a complex process, and it is essential to remember to provide everything that is needed to ensure that both the mother and the newborn child receive the safest care possible. Checklists are useful tools to organize such complex and important processes -they have long been used to prompt users to remember essential tasks to deliver better and safer care in a variety of settings [11,12].…”

Feasibility and Acceptability of a Checklist and Learning Collaborative to Promote Quality and Safety in the Perinatal Care of Women with Opioid Use Disorders

“…A popular example of a health care provider prompt is the use of checklists to help clinicians deliver key elements of care for complex health conditions or procedures . This approach is widely used in surgical specialties, and the World Health Organization's Safe Childbirth Checklist, defined as a “list of essential evidence based practices drawn from existing [World Health Organization] guidelines [that] should be performed at every birth to ensure the best outcome,” 25 (p.1) has been disseminated extensively after testing by 38 implementation teams. Checklists enhance safety because they remind clinicians engaged in multiple tasks about essential details that might otherwise be omitted, and they can facilitate team communication .…”

“…This approach is widely used in surgical specialties, and the World Health Organization's Safe Childbirth Checklist, defined as a “list of essential evidence based practices drawn from existing [World Health Organization] guidelines [that] should be performed at every birth to ensure the best outcome,” 25 (p.1) has been disseminated extensively after testing by 38 implementation teams. Checklists enhance safety because they remind clinicians engaged in multiple tasks about essential details that might otherwise be omitted, and they can facilitate team communication . However, the effectiveness of checklists depends upon whether they are clinically relevant, not burdensome, and perceived as capable of improving care .…”

“…Checklists enhance safety because they remind clinicians engaged in multiple tasks about essential details that might otherwise be omitted, and they can facilitate team communication . However, the effectiveness of checklists depends upon whether they are clinically relevant, not burdensome, and perceived as capable of improving care . Sustainability depends on easy integration into daily routines .…”

“…However, the effectiveness of checklists depends upon whether they are clinically relevant, not burdensome, and perceived as capable of improving care . Sustainability depends on easy integration into daily routines . Therefore, any approach taken to implementation should ensure alignment with the local context …”