Patient safety

Safe Childbirth Checklist: a tool to help achieve MDGs

Applying knowledge to practice

Globally, nearly half a million mothers are still dying in childbirth, almost 4 million newborns die in the neonatal period, and 1 million stillbirths occur each year despite the fact that most maternal and newborn deaths and a large percentage of stillbirths, are avoidable. These figures indicate that a majority of high-risk countries have achieved insufficient progress towards MDG 4 (reducing child mortality rates) and 5 (reducing the maternal mortality ratio), according to a recently released report on progress towards achieving the Millennium Development Goals.

Gaps in maternal and perinatal care practices at birthing sites worldwide are well-recognized and documented, yet there are no universally applied practice tools which clearly define minimum care standards and support their effective delivery. Proven interventions are relatively inexpensive and easy to perform but the unfortunate disparity between knowledge and practice has constituted a major barrier to improving outcomes associated with childbirth in parts of the world where mortality rates are highest.

Closing the gap: The Safe Childbirth Checklist

To address this, WHO Patient Safety has, over the past two years, worked with a broad network of stakeholders and international experts in maternal-newborn health to develop a transformative checklist tool that defines facility-based standards of care at the time of childbirth and supports their effective delivery. The Safe Childbirth Checklist Programme aims to help frontline health workers prevent avoidable childbirth-related mortality and morbidity.

This programme contains two main components:

  • Safe Childbirth Checklist with essential aspects of safe maternal and perinatal care, based on current guidelines published by WHO and others, data-driven literature and expert consensus; and
  • quality improvement programme, with the Safe Childbirth Checklist at its core, designed to maximize the likelihood of successful checklist implementation.

Results from pilot testing

The Safe Childbirth Checklist Programme is currently being pilot tested in a large community health centre in Karnataka, India, to assess how health-care workers adhere to critical safety practices and to see which factors influence the implementation of the checklist in this particular setting. Preliminary analyses suggest that health-care workers are more likely to successfully complete essential clinical care practices if they use the Safe Childbirth Checklist. WHO Patient Safety is exploring options for a larger trial to evaluate the impact of the Safe Childbirth Checklist on maternal and perinatal survival in high-risk settings.

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