Abstract
BackgroundChildbirth is a complex process, and checklists are useful tools to remember steps of such complex processes. The World Health Organization safe childbirth checklist is a tool used to improve the quality of care provided to women giving birth. The checklist was modified by Ministry of Health and was introduced to health centers in Ethiopia by the USAID Transform: Primary Health Care Activity.MethodsA pre and post intervention study design with prospective data collection was employed. The availability of essential childbirth supplies and adherence of health care providers to essential birth practices were compared for the pre and post intervention periods.ResultsThe pre and post intervention assessments were conducted in 247 and 187 health centers respectively. A statistically significant improvement from 63.6% pre intervention to 83.5% post intervention was observed in the availability of essential childbirth supplies, t (389.7) = − 7.1, p = 0.000. Improvements in adherence of health care providers to essential birth practices were observed with the highest being at pause point three (26.2%, t (306.3) = − 10.6, p = 0.000) followed by pause point four (21.1%, t (282.5) = − 8.0, p = 0.000), and pause point two (18.2%, t (310.8) = − 9.7, p = 0.000). The least and statistically non-significant improvement was observed at pause point one (3.3%, t (432.0) = − 1.5, p = 0.131).ConclusionImprovement in availability of essential childbirth supplies and adherence of health care providers towards essential birth practices was observed after introduction of a modified World Health Organization safe childbirth checklist. Scale up of the use of the checklist is recommended.
Highlights
Childbirth is a complex process, and checklists are useful tools to remember steps of such complex processes
Levene’s test for equality of variances assessment revealed that homogeneity of variances was violated for all the variables except for pause point one, quick checks for danger signs performed before referral or admission of mothers, partograph use for all laboring mothers at the facility, and Human Immune Virus (HIV) testing and treatment services for both the mother and baby during antenatal care (ANC)
A statistically significant improvement from a pre intervention score of 63.6 to 83.5% post-intervention was observed in the availability of essential childbirth supplies in selected health centers of Ethiopia one year after the introduction of the modified World Health Organization (WHO) safe childbirth checklist (SCC), t (389.7) = − 7.1, p = 0.000, (Table 2)
Summary
Childbirth is a complex process, and checklists are useful tools to remember steps of such complex processes. The World Health Organization safe childbirth checklist is a tool used to improve the quality of care provided to women giving birth. Since 1990 many sub-Saharan African countries have been successful in reducing their rates of maternal mortality. Sustainable Development Goal 3 includes a target that aims to reduce the global maternal mortality ratio to less than 70 per 100,000 live births, with no country having a maternal mortality rate of more than twice the global average [2, 3]. Around 75% of all maternal deaths are due to severe bleeding, infections, high blood pressure during pregnancy, complications from delivery, and unsafe abortions [4]. It is of paramount importance that all births are attended by skilled health professionals, as timely management can make the difference in the lives of both the mother and the baby [5, 6]
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