The effect of the WHO Safe Childbirth Checklist on essential delivery practices and birth outcomes: Evidence from a pair-wise matched randomized controlled trial in Pakistan

Jana Kuhnt; Ashfa Hashmi; Sebastian Vollmer

doi:10.1016/j.ssmph.2023.101495

The effect of the WHO Safe Childbirth Checklist on essential delivery practices and birth outcomes: Evidence from a pair-wise matched randomized controlled trial in Pakistan

SSM Popul Health. 2023 Aug 23:24:101495. doi: 10.1016/j.ssmph.2023.101495. eCollection 2023 Dec.

Authors

Jana Kuhnt¹, Ashfa Hashmi², Sebastian Vollmer³

Affiliations

¹ German Institute of Development and Sustainability (IDOS), Tulpenfel 6, 53113, Bonn, Germany.
² GIZ (Deutsche Gesellschaft für Internationale Zusammenarbeit), University of Göttingen, Germany.
³ University of Goettingen, Center for Modern Indian Studies, Waldweg 26, 37073 Göttingen, Germany.

Abstract

We study the effect of the Safe Childbirth Checklist (SCC) - a tool developed by the WHO to improve the quality of delivery care - on a range of provider- and patient-level outcomes. We conducted a clustered pair-wise matched randomized controlled trial among 166 health providers in two districts of Pakistan. This included primary and secondary health facilities as well as non-facility based rural health workers. We do not find positive effects on health outcomes, but on the adherence to some essential delivery practices, mostly to those conducted during the patient's admission to the delivery ward. We also find increased rates of referrals to higher-level facilities.

Keywords: Clustered pair-wise matched randomized controlled trial; Maternal and newborn health; Pakistan; Safe Childbirth Checklist (SSC).