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BMC Public Health
Published in: BMC Public Health 1/2018

Open Access 01-12-2018 | Study protocol

Impact of the Safe Childbirth Checklist on health worker childbirth practices in Luapula province of Zambia: a pre-post study

Authors: Sandra Mudhune, Sydney Chauwa Phiri, Marta R. Prescott, Elizabeth A. McCarthy, Aaron Banda, Prudence Haimbe, Francis Dien Mwansa, Angel Mwiche, Francis Bwalya, Micheck Kabamba, Hilda Shakwelele, Margaret L. Prust

Published in: BMC Public Health | Issue 1/2018

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Abstract

Background

A strong evidence base exists regarding routine and emergency services that can effectively prevent or reduce maternal and new-born mortality. However, even when skilled providers care for women in labour, many of the recommended services are not provided, despite being available. Barriers to the provision of appropriate childbirth services may include lack of availability of supplies, limited health worker knowledge and confidence, or inadequate time. The WHO Safe Childbirth Checklist (SCC) includes reminders for evidenced-based practices at specific points in the childbirth process. Zambia is currently considering nation-wide adoption of the SCC, but there is a need for context-specific evidence. Beginning in September 2017, a program is being implemented in Nchelenge District to pilot use of the SCC, along with coaching that focuses on strengthening the systems that allow the essential practices in childbirth to be performed.

Methods

This study will use a pre-post study design to measure health worker adherence to the essential practices for delivery care outlined in the SCC. Data will be collected through observations of health workers as they care for mothers during childbirth at four facilities. Data collection will take place before the start of the intervention, at 3 months, and at 6 months post-intervention. The primary outcome interest is the change in the average proportion of essential childbirth practices completed. A health worker questionnaire will be administered at the time that the SCC is introduced and 6 months later to gather their perspectives on incorporating the SCC into clinical practice in Zambia.

Discussion

Findings are expected to inform plans for introducing the SCC in Zambia. This evaluation will aim to understand uptake and impact of the SCC and associated coaching in the context of a basic level of mentorship that the government could feasibly provide at a national scale.

Trial registration

Clinical Trials.gov (NCT03263182) Registered August 28, 2017.
Literature
1.
Central Statistical Office (CSO), Ministry of Health (MOH), Tropical Diseases Research Centre (TDRC), University of Zambia, Macro International Inc. Zambia Demographic and Health Survey 2014. Calverton: CSO and Macro International Inc; 2014.
2.
3.
Paxton A, Maine D, Freedman L, Fry D, Lobis S. The evidence for emergency obstetric care. Int J Gynaecol Obstet. 2005;88:181–93.CrossRefPubMed
4.
WHO. Making pregnancy safer the critical role of the skilled attendant: a joint statement by WHO, ICM and FIGO. Geneva: World health organization (WHO), Department of Reproductive Health and Research (RHR); 2004.
5.
Ministry of Health. Human resources for Health Planning & Development Strategy Framework. Lusaka: MOH, Zambia; 2017.
6.
Campbell J, Buchan J, Cometto G, David B, Dussault G, Fogstad H, Fronteira I, Lozano R, Nyonator F, Pablos-Méndez A, Quain EE, Starrs A, Tangcharoensathien V. Human resources for health and universal health coverage: fostering equity and effective coverage. Bull World Health Organ. 2013;91(11):853–63.CrossRefPubMedPubMedCentral
7.
Haynes AB, Weiser TG, Berry WR, Lipsitz SR, Breizat AH, Dellinger EP, Herbosa T, Joseph S, Kibatala PL, Lapitan MC, Merry AF, Moorthy K, Reznick RK, Taylor B, Gawande AA. Safe surgery saves lives study group: a surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med. 2009;360(5):491–9.CrossRefPubMed
8.
Hirschhorn LR, Semrau K, et al. Learning before leaping: integration of an adaptive study design process prior to initiation of BetterBirth, a large-scale randomized controlled trial in Uttar Pradesh, India. Implement Sci. 2015;10:117.CrossRefPubMedPubMedCentral
9.
Kumar S, Yadav V, et al. Effectiveness of the WHO SCC on improving adherence to essential *practices during childbirth, in resource constrained settings. BMC Pregnancy Childbirth. 2016;16(1):345.CrossRefPubMedPubMedCentral
10.
Spector JM, Agrawal P, et al. Improving quality of care for maternal and newborn health: prospective pilot study of the WHO safe childbirth checklist program. PLoS One. 2012;7(5):e35151.CrossRefPubMedPubMedCentral
11.
Kumari S, Panicker R, et al. Evaluation of the Safe Childbirth Checklist program in Rajasthan, India: the how and what of the evaluation efforts. J Public Health Dev Countries. 2016;2(2):212–22.
12.
Marx Delaney M, et al. Improving adherence to essential birth practices using the WHO Safe Childbirth Checklist with peer coaching: experience from 60 public health facilities in Uttar Pradesh, India. Glob Health Sci Pract. 2017;5(2):217–31.CrossRefPubMedPubMedCentral
13.
Kara N, et al. The BetterBirth program: pursuing effective adoption and sustained use of the WHO Safe Childbirth Checklist through coaching-based implementation in Uttar Pradesh, India. Glob Health Sci Pract. 2017;5(2):232–43.CrossRefPubMedPubMedCentral
14.
Patabendige M, Senanayake H. Implementation of the WHO safe childbirth checklist program at a tertiary care setting in Sri Lanka: a developing country experience. BMC Pregnancy Childbirth. 2015;15:12.CrossRefPubMedPubMedCentral
15.
Albolinoa S, Daglianaa G, et al. Safety and quality of maternal and neonatal pathway: a pilot study on the childbirth checklist in 9 Italian hospitals. Procedia Manuf. 2015;3:242–9.CrossRef
16.
Davoodi R, Soltanifar A, et al. Efficacy of evidence based care on care quality of mother and infant in 3 teaching hospitals: a protocol. Patient Saf Qual Improv J. 2013;2(2):97–100.
17.
Ariadne Labs. Implementing Checklists for  Quality Improvement: The Namibian Experience using the WHO Safe Childbirth Checklist. [Webinar]. 2015.
18.
Kabongo L, et al. Implementing the WHO Safe Childbirth Checklist: lessons learnt on a quality improvement initiative to improve mother and newborn care at Gobabis District hospital, Namibia. BMJ Open Qual. 2017;6(2):e000145.CrossRefPubMedPubMedCentral
19.
Kumar V, Kabongo L, Semrau K, Saurastri R. Plenary 4: The Ariadne Labs BetterBirth Panel. Panel presentation at; 2017; World Congress of the Royal College of Obstetricians and Gynaecologists, Cape Town South Africa.
20.
The Nambia Ministry of Health and Social Services (MoHSS), ICF International. The Namibia Demographic and Health Survey 2013. Windhoek and Rockville: MoHSS and ICF International; 2014.
21.
Uganda Bureau of Statistics, UBOS and ICF. Uganda Demographic and Health Survey 2016: Key Indicators Report. Rockville and Kampala: UBOS, UBOS and ICF; 2017.
22.
Hayes RJ, Bennett S. Simple sample size calculation for cluster-randomized trials. Int J Epidemiol. 1999;28(2):319–26.CrossRefPubMed
23.
Prust ML, et al. Multi-month prescriptions, fast-track refills, and community ART groups: results from a process evaluation in Malawi on using differentiated models of care to achieve national HIV treatment goals. J Int AIDS Soc. 2017;20(Suppl 4):21650.CrossRefPubMedPubMedCentral
24.
McCarthy EA, et al. Quality improvement intervention to increase adherence to ART prescription policy at HIV treatment clinics in Lusaka, Zambia: a cluster randomized trial. PLoS One. 2017;12(4):e0175534.CrossRefPubMedPubMedCentral
25.
Wang PC, et al. A cluster randomised trial on the impact of integrating early infant HIV diagnosis with the expanded Programme on immunization on immunization and HIV testing rates in rural health facilities in southern Zambia. PLoS One. 2015;10(10):e0141455.CrossRefPubMedPubMedCentral
26.
Wang P, et al. Measuring the impact of non-monetary incentives on facility delivery in rural Zambia: a clustered randomised controlled trial. Tropical Med Int Health. 2016;21(4):515–24.CrossRef
27.
Wang P, et al. Community point distribution of insecticide-treated bed nets and community health worker hang-up visits in rural Zambia: a decision-focused evaluation. Malar J. 2016;15:140.CrossRefPubMedPubMedCentral
Metadata
Title
Impact of the Safe Childbirth Checklist on health worker childbirth practices in Luapula province of Zambia: a pre-post study
Authors
Sandra Mudhune
Sydney Chauwa Phiri
Marta R. Prescott
Elizabeth A. McCarthy
Aaron Banda
Prudence Haimbe
Francis Dien Mwansa
Angel Mwiche
Francis Bwalya
Micheck Kabamba
Hilda Shakwelele
Margaret L. Prust
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2018
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-018-5813-y

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