ArticleBMJ open2022
Impact of the implementation of the WHO Safe Childbirth Checklist on essential birth practices and adverse events in two Brazilian hospitals: a before and after study.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Impact of the WHO safe childbirth checklist on birth attendant behavior and maternal-newborn outcomes: A systematic review and meta-analysis.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Pooled it
- Article
- Construction and content validation of a checklist for effective communication of nursing care to newborns.Revista brasileira de enfermagem · 2026Article
- Article
- Article
- Barriers to implementing the WHO Safe Childbirth Checklist in maternity hospitals, Brazil.Revista de saude publica · 2025Article
- Manual for nursing consultation with people living with Diabetes Mellitus: implementation science.Revista brasileira de enfermagem · 2025Article
- The relationship between delivery fear and childbirth experience with the level of adherence to the WHO recommendations for a positive childbirth experience in Iranian women: a cross-sectional study.Reproductive health · 2024Article
- Article
- Impact of the WHO Safe Childbirth Checklist on safety culture among health workers: A randomized controlled trial in Aceh, Indonesia.PLOS global public health · 2023Article
- Elaboration and implementation of a protocol for the Golden Hour of premature newborns using an Implementation Science lens.Revista latino-americana de enfermagem · 2023Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe WHO Safe Childbirth Checklist (SCC) is a promising initiative for safety in childbirth care, but the evidence about its impact on clinical outcomes is limited. This study analysed the impact of SCC on essential birth practices (EBPs), obstetric complications and adverse events (AEs) in hospitals of different profiles.
designQuasi-experimental, time-series study and pre/post intervention.
settingTwo hospitals in North-East Brazil, one at a tertiary level (H1) and another at a secondary level (H2).
participants1440 women and their newborns, excluding those with congenital malformations.
interventionsThe implementation of the SCC involved its cross-cultural adaptation, raising awareness with videos and posters, learning sessions about the SCC and auditing and feedback on adherence indicators. PRIMARY AND SECONDARY OUTCOME MEASURES: Simple and composite indicators related to seven EBPs, 3 complications and 10 AEs were monitored for 1 year, every 2 weeks, totalling 1440 observed deliveries.
resultsThe checklist was adopted in 83.3% (n=300) of deliveries in H1 and in 33.6% (n=121) in H2. The hospital with the highest adoption rate for SCC (H1) showed greater adherence to EBPs (improvement of 50.9%;p<0.001) and greater reduction in clinical outcome indicators compared with its baseline: percentage of deliveries with severe complications (reduction of 30.8%;p=0.005); Adverse Outcome Index (reduction of 25.6%;p=0.049); Weighted Adverse Outcome Score (reduction of 39.5%;p<0.001); Severity Index (reduction of 18.4%;p<0.001). In H2, whose adherence to the SCC was lower, there was an improvement of 24.7% compared with before SCC implementation in the composite indicator of EBPs (p=0.002) and a reduction of 49.2% in severe complications (p=0.027), but there was no significant reduction in AEs.
conclusionsA multifaceted SCC-based intervention can be effective in improving adherence to EBPs and clinical outcomes in childbirth. The context and adherence to the SCC seem to modulate its impact, working better in a hospital of higher complexity.
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