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Safe birth matters: facilitators and barriers to uptake of the WHO safe childbirth checklist tool in a Tanzania Regional Hospital
Thomas, Joycelyn; Voss, Joachim & Tarimo, Edith
Abstract
Background: The World Health Organization (WHO) developed the Safe Birth Checklist (SCC) to facilitate best practices
in safe birthing practices. The SCC is utilizing existing evidence-based WHO guidelines and recommendations which has
combined those into a single and practical bedside tool. The SCC is the first checklist-based intervention to target the prevention
of maternal and neonatal deaths.
Objective: The objective of this project was to pilot-test the World Health Organization Safe Childbirth Checklist with
Maternity Regional Hospital in, Tanzania.
Study Design and Methods: Retrospective analysis on 35 charts were completed to identify presence or absence of documentation
aligned with evidenced based checklist items. Staff training, end user observations and focus group discussions
were utilized to elicit feedback about the tool and the process. Descriptive statistics and manual content analysis were used to
analyze the rate of uptake and ownership over the checklist. The Checklist is broken down into four sections or time points
(that are considered natural pause points in the care of laboring women). The four different pause points are admission,
delivery, post-partum, and discharge
Results: We trained 26 participants out of 32 staff how to use the SCC. Delivery time point had the lowest at SCC completion
rate at 39% compared to discharge having the highest completion rate at 93%. There was variation in completion rate
of the checklist items at each time point. Checklist items at the beginning of each time point were completed between 94%
and 100% of the time with the latter checklist list items completed between 29% and 57% of the time
Conclusion: This project was able to identify facilitators and potential barriers to the successful uptake of the Safe Childbirth
Checklist in Shinyanga Regional Hospital. Based on these findings, the MOH have opportunities to utilize those findings
in the scale-up of the implementation of the checklist and future evaluation activities.
Keywords
Safe birth matters; WHO safe childbirth checklist tool; Tanzania Regional Hospital.
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