Can a Simple Checklist Help Save the Lives of Women and Newborns?

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According to a new study published in PLoS One by researchers from Harvard School of Public Health (HSPH) and the World Health Organization (WHO), a simple and low-cost checklist has the potential to dramatically improve practices of health workers during childbirth.

From our colleagues at Harvard School of Public Health:

The researchers conducted the study at a hospital in Karnataka, India. As part of the checklist-based program, local staff reviewed deficiencies in their current practices and undertook training on using the WHO Safe Childbirth Checklist. The 29 items on the checklist address the major causes of maternal deaths (e.g. hemorrhage, infection, obstructed labor, and hypertensive disease), intrapartum-related stillbirths, and neonatal deaths (e.g. complications of premature birth, infection, and birth asphyxia).

Researchers observed the childbirth practices of health care workers during 499 birth events—the period from admission to discharge—prior to introducing the checklist to establish a baseline, and then compared the results with 795 birth events after implementing the checklist.

The results reveal that the number of essential practices performed by the hospital workers increased from an average of 10 of 29 at baseline to 25 of 29 after implementing the checklist. “The checklist program actively prompted 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 Dr. Bhala Kodkany, professor of obstetrics and gynecology and director of JNMC Women’s and Children’s Health Research Unit in Karnataka, India, and a co-investigator.

Read the full press release here.

Read the full study here.

This study examined the impact of the checklist on health worker practices during childbirth–but did not measure the impact of the checklist on health outcomes of women and newborns. The  researchers are now working on a large-scale trial in more than 100 hospitals in northern India to take a closer look at the link between using the checklist and improved health outcomes among women and newborns.

Follow the conversation on Twitter! Stay tuned to Dr. Priya Agrawal (one of the authors of the study) at @priya__agrawal, Harvard School of Public Health at @HarvardHSPH, and the World Health Organization at @WHO.