Patient safety

WHO Safe Childbirth Checklist

Of the more than 130 million births occurring each year, an estimated 303 000 result in the mother’s death, 2.6 million in stillbirth, and another 2.7 million in a newborn death within the first 28 days of birth. The majority of these deaths occur in low-resource settings and most could be prevented.

In response to this unacceptable situation, the WHO Safe Childbirth Checklist has been developed to support the delivery of essential maternal and perinatal care practices. The Checklist addresses the major causes of maternal death (haemorrhage, infection, obstructed labour and hypertensive disorders), intrapartum-related stillbirths (inadequate intrapartum care), and neonatal deaths (birth asphyxia, infection and complications related to prematurity). It was developed following a rigorous methodology and tested for usability in ten countries across Africa and Asia.

An implementation guide for health facilities has been developed to help birth attendants and health-care leaders successfully launch and sustain use of the WHO Safe Childbirth Checklist.

WHO Safe Childbirth Checklist Collaboration

A collaborative field-testing exercise was established in 2012 to explore implementation and usability of the Checklist in diverse settings around the world. Participants were invited to use the Checklist with the aim of exploring facilitating factors and barriers to effective implementation and use of the Checklist. A total of 34 implementation projects across 29 countries and over 230 pilot sites joined the Collaboration. Feedback was systematically collected from the collaboration participants in the form of progress reports and a survey on the experiences of using and implementing the Checklist.

BetterBirth study

Since 2012, WHO has been supporting a multi-centred randomized controlled trial in more than 100 hospitals in Uttar Pradesh, India, to test whether adoption of the Checklist improves health outcomes for mothers and newborns. The trial is being conducted by the Ariadne Labs, a joint centre of Boston’s Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health, with support from the Bill & Melinda Gates Foundation.

The Safe Childbirth Checklist programme represents a joint effort by WHO, acting through the Department of Service Delivery and Safety, the Department of Maternal, Newborn, Child and Adolescent Health, and the Department of Reproductive Health and Research, the Harvard T.H. Chan School of Public Health and many individual experts from around the world.