Maternal, newborn, child and adolescent health

Launch of the WHO Safe Childbirth Checklist Collaboration

Following the success of the Surgical Safety Checklist in 2008, the World Health Organization (WHO) is pleased to announce the launch of the Safe Childbirth Checklist Collaboration with an invitation to organizations working in maternal and child health to work with WHO to study the implementation and usefulness of the Checklist in diverse health-care settings. The launch of the Collaboration follows completion of the Pilot Edition of the Safe Childbirth Checklist and Manual.

As part of this launch, WHO invites any health-care, research or academic institution, nongovernmental organization or other agency, especially in low- and middle-income countries, to join the collaborative field-testing exercise in order to help WHO ensure the viability and practical use of the Checklist in multiple settings, and to identify barriers and successes in its use. To learn more and participate in the Collaboration, please follow the link to the right of this page.

In a launch event today at WHO Headquarters in Geneva, members of various WHO Departments involved in this project presented the Safe Childbirth Checklist and shared information about the pilot testing of it and the start of the Collaboration.

Speaking at the launch Sir Liam Donaldson, WHO Envoy for Patient Safety said, “The Safe Childbirth Checklist is an excellent example of how safety improvement methods developed in other areas of health care and by other industries, for example aviation, can be applied to today’s global health challenges”.

In 2010, 287 000 women died during pregnancy and childbirth, some 2.6 million stillbirths occurred worldwide, and nearly 3 million newborns died within their first month of life. The majority of these deaths occurred in low-resource settings and most could have been prevented with simple, cost-effective interventions.

Marleen Temmerman, WHO Director of Reproductive Health and Research, stated, "The majority of maternal and newborn deaths are preventable, as the main conditions leading to these deaths can be avoided and managed adequately through the use of effective interventions, as recommended within the WHO clinical guidelines. The Safe Childbirth Checklist provides an easy-to-use tool to facilitate the use of these recommended practices, synthesized on the basis of the latest research evidence."

According to Dr Edward Kelley, Coordinator of the Patient Safety Programme in the Health Systems and Innovation (HIS) Cluster at WHO Headquarters, “This Checklist is similar to the style of the Surgical Safety Checklist which was introduced in 2008 by the World Health Organization. Since then, it has changed medical practice in developed as well as developing countries and has become the one of the most downloaded documents from the WHO website”.

The Safe Childbirth Checklist has been developed in collaboration with the Harvard School of Public Health (HSPH). The Checklist is an easy-to-read list to remind health-care workers of essential maternal and prenatal care practices to allow for a healthier delivery. It contains 29 items addressing the major causes of maternal death, including haemorrhage, infection, obstructed labour, and neonatal deaths. “The programme aims to transform behavioral patterns at the bedside – at times when the successful delivery of essential practices is crucial in order to reduce harm. Widely accepted protocols and guidelines have been distilled into a simple, user-friendly checklist programme for frontline workers. It is introduced through initial safety training and reinforced through periodic coaching”, emphasized Jonathan Spector, Research Scientist, HSPH.

The experience so far has demonstrated that the checklist has great potential to improve health care around childbirth, and therefore to save lives. During its initial test phase in India, its use increased the use of essential childbirth-related care practices by almost 50%. “The checklist programme actively prompts health-care workers to remember to complete proven practices such as handwashing, infection management, postpartum bleeding assessment, and breastfeeding within an hour after birth”, said Bhala Kodkany, Professor of Obstetrics and Gynecology and Director of JNMC Women’s and Children’s Health Research Unit, Karnataka, India

WHO is currently providing strategic oversight to a multi-centered randomized-controlled trial in over 100 hospitals in India, to test the effectiveness of the Checklist in improving health outcomes for mothers and neonates. The trial is being conducted by the Harvard School of Public Health. It is estimated that the study will be completed in 2015.

To reduce the chance that a mother or her baby dies during childbirth or shortly after, WHO has developed the Pilot Edition of the Safe Childbirth Checklist and is currently collaborating with possible users to field-test its effectiveness. “The hope is that use of this simple, low-cost tool can help birth attendants better adhere to universally accepted standards in childbirth care", stated Atul Gawande, Professor in Health Policy and Management at the HSPH and one of the leads of the trial.

The Safe Childbirth Checklist Programme represents a joint effort between the WHO Patient Safety Programme (PSP) and the Departments of Maternal, Newborn, Child and Adolescent Health (MCA) and Reproductive Health Research (RHR) in collaboration with the Harvard School of Public Health.

WHO looks forward to your participation in the Collaboration!