[ Fall 2011 ]
Of the estimated 130 million births each year around the world, 4 million babies die in the first 28 days of life. Nearly 350,000 of those births result in the mother’s death, 99 percent of them in developing countries. An innovative childbirth safety checklist–a single sheet providing core guidelines to improve safety and health care quality around the time of birth–could have a dramatic impact on making birth safer for mothers and children around the world.
Thanks to a $14.1 million, four-year grant from the Bill & Melinda Gates Foundation, HSPH researchers will test the effectiveness of the World Health Organization (WHO) Safe Childbirth Checklist in reducing deaths and improving outcomes for mothers and infants in 120 hospitals in northern India.
A team led by Atul Gawande, associate professor of health policy and management at HSPH and a surgeon at Brigham and Women’s Hospital, and co-principal investigator Jonathan Spector, research associate in health policy and management at HSPH and a neonatologist at Massachusetts General Hospital, worked between 2008 and 2010 with the WHO Departments of Patient Safety, Reproductive Health and Research, and Maternal, Newborn, Child and Adolescent Health to develop the checklist. The list is expected to be released later this year. The same team will now conduct a clinical trial in areas of extreme poverty in northern India to evaluate the checklist’s impact. Based on a review of existing protocols and produced in consultation with frontline health workers and policymakers around the globe, the list focuses on the biggest killers of mothers and newborns, such as bleeding, infection, high blood pressure, and asphyxia.
The childbirth checklist program is modeled after a similar safe-surgery program pioneered by Gawande that reduced safe-surgery program pioneered by Gawande that reduced surgery-related deaths and complications by more than one-third at eight pilot sites worldwide. “Checklists can be an important tool for health workers, because the documents help organize both the time and resources needed to save the lives of women and newborns during birth,” says France Donnay. Senior Program Officer for Maternal Health at the Gates Foundation. “The Bill & Melinda Gates Foundation is pleased to be part of this effort.”