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Implementation of the WHO safe childbirth checklist program at a tertiary care setting in Sri Lanka: a developing country experience.
BMC Pregnancy and Childbirth. 2015; 15:12.BACKGROUND: To study institutionalization of the World Health Organization's Safe Childbirth Checklist (SCC) in a tertiary care center in Sri Lanka. METHOD: A hospital-based, prospective observational study was conducted in the De Soysa Hospital for Women, Colombo, Sri Lanka. Healthcare workers were educated regarding the SCC, which was to be used for each woman admitted to the labor room during the study period. A qualitatively pretested, self-administered questionnaire was given to all nursing and midwifery staff to assess knowledge and attitudes towards the checklist. Each item of the SCC was reviewed for adherence. RESULTS: A total of 824 births in which the checklist used were studied. There were a total of births 1800 during the period, giving an adoption rate of 45.8%. Out of the 170 health workers in the hospital (nurses, midwives and nurse midwives) 98 answered the questionnaire (response rate = 57.6%). The average number of childbirth practices checked in the checklist was 21 out of 29 (95% CI 20.2, 21.3). Educating the mother to seek help during labor, after delivery and after discharge from hospital, seeking an assistant during labor, early breast-feeding, maternal HIV infection and discussing contraceptive options were checked least often. The mean level of knowledge on the checklist among health workers was 60.1% (95% CI 57.2, 63.1). Attitudes for acceptance of using the checklist were satisfactory. Average adherence to checklist practices was 71.3%. Sixty eight (69.4%) agreed that the Checklist stimulates inter-personal communication and teamwork. Increased workload, poor enthusiasm of health workers towards new additions to their routine schedule and level of user-friendliness of Checklist were limitations to its greater use. CONCLUSIONS: Amongst users, the attitude towards the checklist was satisfactory. Adoption rate amongst all workers was 45.8% and knowledge regarding the checklist was 60.1%. These two factors are probably linked. Therefore prior to introducing it to a facility awareness about the value and correct use of the SCC needs to be increased, while giving attention to satisfactory staffing levels.
New York, New York, United Nations, 1989. , vii, 397 p. (ST/CSDHA/6)This is the 1st update of the World Survey on the Role of Women in Development published by WHO. 11 chapters consider such topics as the overall theme, debt and policy adjustment, food and agriculture, industrial development, service industries, informal sector, policy response, technology, women's participation in the economy and statistics. The thesis of the document is that while isolated improvements in women's condition can be found, the economic deterioration in most developing countries has struck women hardest, causing a "feminization of poverty." Yet because of their potential and their central role in food production, processing, textile manufacture, and services among others, short and long term policy adjustments and structural transformation will tap women's potential for full participation. Women;s issues in agriculture include their own nutritional status, credit, land use, appropriate technology, extension services, intrahousehold economics and forestry. For their part in industrial development, women need training and/or re-training, affirmative action, social support, and better working conditions to enable them to participate fully. In the service industries the 2-tier system of low and high-paid jobs must be dismantled to allow women upward mobility. Regardless of the type of work being discussed, agricultural, industrial, primary or service, formal or informal, family roles need to be equalized so that women do not continue to bear the triple burden of work, housework and reproduction.