Abstract
BackgroundIn an effort to mitigate missed opportunities to provide high-quality care, the World Health Organization (WHO) has developed the Safe Childbirth Checklist (SCC) to support health providers perform essential tasks. Our qualitative study is a baseline assessment of quality of care (QoC) perceived by mothers who gave birth at health facilities aiming to highlight areas where implementing the SCC can potentially improve the QoC as well as areas that are not part of the SCC yet require improvement.MethodsAssessing the overall experience of care, our qualitative study focuses on 8 out of 29 items in the checklist that are related to the personal interactions between healthcare provider and mothers. Using a set of semi-structured questions, we interviewed 26 new mothers who gave institutional births in Aceh province in Indonesia.ResultsOur findings revealed some gaps where implementing the SCC can potentially improve safety and QoC. They include communicating danger signs at critical points during birth and after discharge, encouraging breastfeeding, and providing mothers with information on family planning. Moreover, taking a qualitative approach allowed us to identify additional aspects such as need for clarity at the point of admission, maintaining dignity, and protecting mothers’ rights in the decision-making process to be also essential for better QoC.ConclusionsOur study highlights the need to actively listen to and engage with the experiences of women in the adaptation and implementation of the checklist. While our findings indicate that implementing the SCC has the potential to improve the quality of maternal care and overall birth experience, a more holistic understanding of the lived experiences of women and the dynamics of their interactions with health facilities, care providers, and their birth companions can complement the implementation of the checklist.
Highlights
In an effort to mitigate missed opportunities to provide high-quality care, the World Health Organization (WHO) has developed the Safe Childbirth Checklist (SCC) to support health providers perform essential tasks
While some evidence suggests that implementing the SCC can save newborn lives [8] and improve quality of care (QoC) when appropriately adapted [9], the implementation of the checklist has yet to correlate with significant improvements in maternal and neonatal mortality and patient care [10,11,12,13]
The framework contains 8 domains of quality of care to assist in translating it into practice, and it is accompanied by statements to aid practitioners in delivering measurable outcomes [2]
Summary
In an effort to mitigate missed opportunities to provide high-quality care, the World Health Organization (WHO) has developed the Safe Childbirth Checklist (SCC) to support health providers perform essential tasks. While some evidence suggests that implementing the SCC can save newborn lives [8] and improve QoC when appropriately adapted [9], the implementation of the checklist has yet to correlate with significant improvements in maternal and neonatal mortality and patient care [10,11,12,13]. The SCC preceded the development of the WHO’s framework [16] and standards for improving quality of maternal and newborn care in health facilities. This framework includes both provisions of and experiences of care that aims to achieve the coverage of key practices in addition to people-centered outcomes, recognizing that poor quality of care contributes to morbidity and mortality. The structured order of the SCC and the availability of the implementation guidance can help healthcare providers to use it as a tool to assess and improve QoC [5]
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