Abstract
BackgroundThe World Health Organization Safe Childbirth Checklist tool was specifically designed for developing countries such as sub-Saharan African countries, to ensure safety and security of the couple mother and newborn around the time of childbirth. However, the implementation of the Safe Childbirth Checklist tool requires a good knowledge of the context setting to face challenges. Our study objectives were (1) to assess the acceptability of the WHO SCC tool and (2) to identify conditions and strategies for a better introduction and use of the WHO SSC tool.MethodsThis was a pilot multi-country study conducted from January to March 2019 in Burkina Faso and Côte d’Ivoire, respectively, in the health regions of central-North and Agnéby-Tiassa-Mé. In each health region, 5 health facilities of different levels within the health system pyramid were selected through a purposive sampling. The study was conducted in 2 phases: 38 healthcare providers and 15 managers were first trained to use the Safe Childbirth Checklist tool; secondly, the trained providers were allowed to use the tool in real-life conditions for 2 weeks. Then, semi-structured interviews were conducted among healthcare providers and managers. The topics covered by the interview guides were acceptability of the tool, barriers and facilitators to its use, as well as strategies for better introduction and use within the healthcare system. Analysis was carried out using the Nvivo 12 software.ResultsRespondents reported an overall good acceptance of using the tool. However, they suggested minor content adaptation. The design of the tool and increased workload were the main barriers to its use. Potential facilitators to its introduction were managers’ commitment, healthcare providers’ motivation, and the availability of supplies. The best strategies for optimal use were its attachment to existing tool such as partograph or/and its display in the maternity ward.ConclusionsThe findings showed that the implementation of the Safe Childbirth Checklist tool is acceptable in Burkina Faso and Côte d’Ivoire. These findings are important and will help to design a trial aiming at assessing the effectiveness of the tool WHO SCC tool in these two countries.
Highlights
The World Health Organization Safe Childbirth Checklist tool was designed for developing countries such as sub-Saharan African countries, to ensure safety and security of the couple mother and newborn around the time of childbirth
The findings showed that the implementation of the Safe Childbirth Checklist tool is acceptable in Burkina Faso and Côte d’Ivoire
The key findings are a positive attitude toward the WHO World Health Organization Safe Childbirth Checklist (SCC) tool and an overall good acceptance, and barriers and facilitators to its use are best known as well as effective strategies for its introduction and optimal use within the healthcare system
Summary
The World Health Organization Safe Childbirth Checklist tool was designed for developing countries such as sub-Saharan African countries, to ensure safety and security of the couple mother and newborn around the time of childbirth. The WHO Safe Childbirth Checklist (WHO SCC) tool was designed for these developing countries such as sub-Saharan African (SSA) countries, where resources are often limited for the successful implementation of heavy interventions. Poor quality of care at the time of delivery and in the immediate postpartum can be explained by the overload of work, lack of human resources, inadequate training, and motivation of healthcare providers All these factors lead to the development of more routine practices than systematized care made of good practices recognized as effective for both mother and newborn during childbirth and immediate postpartum period
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