<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03263182</url>
  </required_header>
  <id_info>
    <org_study_id>3DE SCC</org_study_id>
    <nct_id>NCT03263182</nct_id>
  </id_info>
  <brief_title>Impact of the Safe Childbirth Checklist in Luapula Province of Zambia Province of Zambia</brief_title>
  <official_title>Impact of the Safe Childbirth Checklist on Health Worker Childbirth Practices in Luapula Province of Zambia</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Clinton Health Access Initiative Inc.</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
    <collaborator>
      <agency>Department for International Development, United Kingdom</agency>
      <agency_class>Other</agency_class>
    </collaborator>
    <collaborator>
      <agency>Ministry of Health, Zambia</agency>
      <agency_class>Other</agency_class>
    </collaborator>
  </sponsors>
  <source>Clinton Health Access Initiative Inc.</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      This study would like to determine if the introduction of the Safe Childbirth Checklist and&#xD;
      associated mentorship can improve the adherence of skilled birth attendants (SBAs) to the&#xD;
      essential practices of childbirth delivery.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      This study will use a pre-post study design to measure health worker adherence to the&#xD;
      essential practices for delivery care outlined in the Safe Childbirth Checklist (SCC). The&#xD;
      intervention, including the introduction of the SCC and mentorship visits to support uptake,&#xD;
      will be tested in four purposively selected health facilities in Nchelenge District, Luapula&#xD;
      Province of Zambia. Since the essential delivery care practices outlined in the SCC are&#xD;
      evidence-based practices broadly accepted to support positive clinical outcomes for mothers&#xD;
      and infants, this evaluation will focus on adherence to the checklist rather than on patient&#xD;
      outcomes. Data will be collected through observations of skilled birth attendants assisting&#xD;
      with childbirth delivery before the start of the intervention and again at 3 months and 6&#xD;
      months post-intervention. A health worker questionnaire will be administered at the time that&#xD;
      the SCC is introduced and six months later to gather their perspectives on incorporating the&#xD;
      SCC into clinical practice in Zambia.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Completed</overall_status>
  <start_date type="Actual">September 4, 2017</start_date>
  <completion_date type="Actual">May 4, 2018</completion_date>
  <primary_completion_date type="Actual">May 4, 2018</primary_completion_date>
  <study_type>Observational</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <observational_model>Cohort</observational_model>
    <time_perspective>Prospective</time_perspective>
  </study_design_info>
  <primary_outcome>
    <measure>Change in the average proportion of observed, SCC tasks completed per birth from selected task list</measure>
    <time_frame>Through study completion, an average of 6 months</time_frame>
    <description>Numerator: Count of SCC tasks observed and completed for each delivery, according to the specifications for data collection outlined in the data collection procedures Denominator: Count of potential SCC items observed</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Characteristics of health workers participating in facility-level SCC training</measure>
    <time_frame>Baseline</time_frame>
    <description>Questionnaire to understand Health worker cadre and training</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Feedback of health workers participating in facility-level SCC training</measure>
    <time_frame>Baseline</time_frame>
    <description>Proportion of health workers agreeing with statements on the clarity of the training and their confidence in using the SCC after the training</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Feedback of health workers in participating facilities on SCC implementation</measure>
    <time_frame>6 months</time_frame>
    <description>Questionnaire to understand Health worker cadre and training</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Feedback of health workers in participating facilities on SCC implementation</measure>
    <time_frame>6 months</time_frame>
    <description>Proportion of health workers agreeing with on ease of using the SCC and challenges faced in implementation</description>
  </secondary_outcome>
  <number_of_groups>1</number_of_groups>
  <enrollment type="Actual">159</enrollment>
  <condition>Maternal Death</condition>
  <condition>Newborn Death</condition>
  <arm_group>
    <arm_group_label>Nchelenge Facilities</arm_group_label>
    <description>Purposively selected health facilities based on criteria including: high demand for services, perceived need for support for quality improvement, and presence of a SBA to mentor.</description>
  </arm_group>
  <intervention>
    <intervention_type>Behavioral</intervention_type>
    <intervention_name>Introduction of the Safe Childbirth Checklist</intervention_name>
    <description>Adaptation of the SCC tool to Zambia: In order to produce a tool that is fully relevant to the Zambian context, a team of clinical experts from the MOH adapted the language of the SCC.&#xD;
Training of trainers on the SCC by international experts: Ariadne Labs has designed a training-of-trainers (TOT) for coach training to support quality improvement initiatives, including the implementation of the WHO SCC. Members of the district mentorship team for Nchelenge District will receive this type of TOT training.&#xD;
Following the TOT session, the district mentorship team will conduct facility-level training for health workers on using the SCC. Within target facilities, all public sector health workers will be invited to participate in the training.&#xD;
Mentorship and support to facility-level health workers on using the SCC: The district mentorship team will carry out coaching and support visits to health facilities following the initial SCC training.</description>
    <arm_group_label>Nchelenge Facilities</arm_group_label>
  </intervention>
  <eligibility>
    <study_pop>
      <textblock>
        All births will be observed at any time of the day (with two data collectors taking 12-hour&#xD;
        shifts). Observations will be conducted for a minimum of three days in all four facilities,&#xD;
        or as long as required to observe at least 7 births. It may not be possible for the&#xD;
        observer to observe every delivery process at all times, particularly if multiple&#xD;
        observations are taking place at one time, so observations will relate to activities at&#xD;
        four specific periods (pause points): on admission, when the mother starts pushing, through&#xD;
        the delivery to one hour after delivery, and before discharge.&#xD;
      </textblock>
    </study_pop>
    <sampling_method>Non-Probability Sample</sampling_method>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  For facility observations, all consecutive deliveries will be observed. If a pregnant&#xD;
             woman or health worker declines to participate in the consent process, no observations&#xD;
             will be recorded.&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
        -&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>N/A</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>Accepts Healthy Volunteers</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Sandra Mudhune</last_name>
    <role>Principal Investigator</role>
    <affiliation>Clinton Health Access Initiative, Nigeria</affiliation>
  </overall_official>
  <overall_official>
    <last_name>Francis Bwalya</last_name>
    <role>Principal Investigator</role>
    <affiliation>Ministry of Health, Zambia</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>Kabuta Rural Health Centre</name>
      <address>
        <city>Nchelenge</city>
        <zip>0</zip>
        <country>Zambia</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Kambwali Rural Health Center</name>
      <address>
        <city>Nchelenge</city>
        <zip>0</zip>
        <country>Zambia</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Kashikishi Rural Health Centre</name>
      <address>
        <city>Nchelenge</city>
        <zip>0</zip>
        <country>Zambia</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>St Paul's Mission Hospital</name>
      <address>
        <city>Nchelenge</city>
        <zip>0</zip>
        <country>Zambia</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>Zambia</country>
  </location_countries>
  <link>
    <url>http://www.who.int/mediacentre/factsheets/fs348/en/.</url>
    <description>Maternal mortality factsheet. Updated November 2016</description>
  </link>
  <reference>
    <citation>Albolinoa S, Daglianaa G, et al. Safety and quality of maternal and neonatal pathway: A pilot study on the childbirth checklist in 9 Italian hospitals. Procedia Manufacturing. 2015; (3):242-249.</citation>
  </reference>
  <reference>
    <citation>Ariadne Labs. Implementing Checklists for Quality Improvement: The Namibian Experience using the WHO Safe Childbirth Checklist.</citation>
  </reference>
  <reference>
    <citation>Central Statistical Office (CSO), Ministry of Health (MOH), Tropical Diseases Research Centre (TDRC), University of Zambia, and Macro International Inc. (2014). Zambia Demographic and Health Survey 2014. Calverton, Maryland, USA: CSO and Macro International Inc.</citation>
  </reference>
  <reference>
    <citation>Davoodi R, Soltanifar A, et al. Efficacy of Evidence Based Care on Care Quality of Mother and Infant in 3 Teaching Hospitals: A Protocol. Patient Safety and Quality Improvement Journal. 2013 Dec 14; 2(2):97-100.</citation>
  </reference>
  <reference>
    <citation>Hayes RJ, Bennett S. Simple sample size calculation for cluster-randomized trials. Int J Epidemiol. 1999 Apr;28(2):319-26. doi: 10.1093/ije/28.2.319.</citation>
    <PMID>10342698</PMID>
  </reference>
  <reference>
    <citation>Haynes AB, Weiser TG, Berry WR, Lipsitz SR, Breizat AH, Dellinger EP, Herbosa T, Joseph S, Kibatala PL, Lapitan MC, Merry AF, Moorthy K, Reznick RK, Taylor B, Gawande AA; Safe Surgery Saves Lives Study Group. A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med. 2009 Jan 29;360(5):491-9. doi: 10.1056/NEJMsa0810119. Epub 2009 Jan 14.</citation>
    <PMID>19144931</PMID>
  </reference>
  <reference>
    <citation>Hirschhorn LR, Semrau K, Kodkany B, Churchill R, Kapoor A, Spector J, Ringer S, Firestone R, Kumar V, Gawande A. Learning before leaping: integration of an adaptive study design process prior to initiation of BetterBirth, a large-scale randomized controlled trial in Uttar Pradesh, India. Implement Sci. 2015 Aug 14;10:117. doi: 10.1186/s13012-015-0309-y.</citation>
    <PMID>26271331</PMID>
  </reference>
  <reference>
    <citation>Kumar S, Yadav V, Balasubramaniam S, Jain Y, Joshi CS, Saran K, Sood B. Effectiveness of the WHO SCC on improving adherence to essential practices during childbirth, in resource constrained settings. BMC Pregnancy Childbirth. 2016 Nov 8;16(1):345. doi: 10.1186/s12884-016-1139-x.</citation>
    <PMID>27825321</PMID>
  </reference>
  <reference>
    <citation>Kumari S, Panicker R, et al. Evaluation of the Safe Childbirth Checklist Program in Rajasthan, India: The How and What of the Evaluation Efforts. Journal of Public Health in Developing Countries. 2016 Aug 11;2(2);212-222.</citation>
  </reference>
  <reference>
    <citation>McCambridge J, Witton J, Elbourne DR. Systematic review of the Hawthorne effect: new concepts are needed to study research participation effects. J Clin Epidemiol. 2014 Mar;67(3):267-77. doi: 10.1016/j.jclinepi.2013.08.015. Epub 2013 Nov 22.</citation>
    <PMID>24275499</PMID>
  </reference>
  <reference>
    <citation>Moyer CA, Mustafa A. Drivers and deterrents of facility delivery in sub-Saharan Africa: a systematic review. Reprod Health. 2013 Aug 20;10:40. doi: 10.1186/1742-4755-10-40.</citation>
    <PMID>23962135</PMID>
  </reference>
  <reference>
    <citation>Ministry of Health [Zambia]. Health Sector Payroll Data. January 2014.</citation>
  </reference>
  <reference>
    <citation>Ministry of Health [Zambia]. Emergency Obstetric and Newborn Care (EmONC) Training Process Evaluation Report. February 2017.</citation>
  </reference>
  <reference>
    <citation>Ministry of Health [Zambia]. Zambia National Emergency Obstetric and Newborn Care (EmONC) Needs Assessment 2014-5. January 2017.</citation>
  </reference>
  <reference>
    <citation>Patabendige M, Senanayake H. Implementation of the WHO safe childbirth checklist program at a tertiary care setting in Sri Lanka: a developing country experience. BMC Pregnancy Childbirth. 2015 Feb 4;15:12. doi: 10.1186/s12884-015-0436-0.</citation>
    <PMID>25648543</PMID>
  </reference>
  <reference>
    <citation>Paxton A, Maine D, Freedman L, Fry D, Lobis S. The evidence for emergency obstetric care. Int J Gynaecol Obstet. 2005 Feb;88(2):181-93. doi: 10.1016/j.ijgo.2004.11.026. Epub 2005 Jan 8.</citation>
    <PMID>15694106</PMID>
  </reference>
  <reference>
    <citation>Spector JM, Agrawal P, Kodkany B, Lipsitz S, Lashoher A, Dziekan G, Bahl R, Merialdi M, Mathai M, Lemer C, Gawande A. Improving quality of care for maternal and newborn health: prospective pilot study of the WHO safe childbirth checklist program. PLoS One. 2012;7(5):e35151. doi: 10.1371/journal.pone.0035151. Epub 2012 May 16.</citation>
    <PMID>22615733</PMID>
  </reference>
  <reference>
    <citation>Spector JM, Lashoher A, Agrawal P, Lemer C, Dziekan G, Bahl R, Mathai M, Merialdi M, Berry W, Gawande AA. Designing the WHO Safe Childbirth Checklist program to improve quality of care at childbirth. Int J Gynaecol Obstet. 2013 Aug;122(2):164-8. doi: 10.1016/j.ijgo.2013.03.022. Epub 2013 Jun 3.</citation>
    <PMID>23742897</PMID>
  </reference>
  <reference>
    <citation>Wang P, Connor AL, Guo E, Nambao M, Chanda-Kapata P, Lambo N, Phiri C. Measuring the impact of non-monetary incentives on facility delivery in rural Zambia: a clustered randomised controlled trial. Trop Med Int Health. 2016 Apr;21(4):515-24. doi: 10.1111/tmi.12678.</citation>
    <PMID>26848937</PMID>
  </reference>
  <reference>
    <citation>WHO. Making pregnancy safer: the critical role of the skilled attendant. A joint statement by WHO, ICM, and FIGO. Geneva: Department of Reproductive Health and Research, World Health Organization. 2004.</citation>
  </reference>
  <reference>
    <citation>WHO. Making pregnancy safer the critical role of the skilled attendant: a joint statement by WHO, ICM and FIGO. Geneva: World health organization (WHO). Department of Reproductive Health and Research (RHR). 2004.</citation>
  </reference>
  <verification_date>July 2018</verification_date>
  <study_first_submitted>August 22, 2017</study_first_submitted>
  <study_first_submitted_qc>August 25, 2017</study_first_submitted_qc>
  <study_first_posted type="Actual">August 28, 2017</study_first_posted>
  <last_update_submitted>July 30, 2018</last_update_submitted>
  <last_update_submitted_qc>July 30, 2018</last_update_submitted_qc>
  <last_update_posted type="Actual">July 31, 2018</last_update_posted>
  <responsible_party>
    <responsible_party_type>Sponsor</responsible_party_type>
  </responsible_party>
  <keyword>childbirth</keyword>
  <keyword>delivery</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Maternal Death</mesh_term>
    <mesh_term>Death</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>Undecided</sharing_ipd>
    <ipd_description>This is yet to be finalized with the Ministry of Health, Zambia.</ipd_description>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03263182
org study id: 3DE SCC
nct id: NCT03263182
lead sponsor: 
collaborator: 
collaborator: 
has dmc: No
is fda regulated drug: No
is fda regulated device: No
This study would like to determine if the introduction of the Safe Childbirth Checklist and
      associated mentorship can improve the adherence of skilled birth attendants (SBAs) to the
      essential practices of childbirth delivery.
This study will use a pre-post study design to measure health worker adherence to the
      essential practices for delivery care outlined in the Safe Childbirth Checklist (SCC). The
      intervention, including the introduction of the SCC and mentorship visits to support uptake,
      will be tested in four purposively selected health facilities in Nchelenge District, Luapula
      Province of Zambia. Since the essential delivery care practices outlined in the SCC are
      evidence-based practices broadly accepted to support positive clinical outcomes for mothers
      and infants, this evaluation will focus on adherence to the checklist rather than on patient
      outcomes. Data will be collected through observations of skilled birth attendants assisting
      with childbirth delivery before the start of the intervention and again at 3 months and 6
      months post-intervention. A health worker questionnaire will be administered at the time that
      the SCC is introduced and six months later to gather their perspectives on incorporating the
      SCC into clinical practice in Zambia.
observational model: Cohort
time perspective: Prospective
measure: Change in the average proportion of observed, SCC tasks completed per birth from selected task list
time frame: Through study completion, an average of 6 months
description: Numerator: Count of SCC tasks observed and completed for each delivery, according to the specifications for data collection outlined in the data collection procedures Denominator: Count of potential SCC items observed
measure: Characteristics of health workers participating in facility-level SCC training
time frame: Baseline
description: Questionnaire to understand Health worker cadre and training
measure: Feedback of health workers participating in facility-level SCC training
time frame: Baseline
description: Proportion of health workers agreeing with statements on the clarity of the training and their confidence in using the SCC after the training
measure: Feedback of health workers in participating facilities on SCC implementation
time frame: 6 months
description: Questionnaire to understand Health worker cadre and training
measure: Feedback of health workers in participating facilities on SCC implementation
time frame: 6 months
description: Proportion of health workers agreeing with on ease of using the SCC and challenges faced in implementation
arm group label: Nchelenge Facilities
description: Purposively selected health facilities based on criteria including: high demand for services, perceived need for support for quality improvement, and presence of a SBA to mentor.
intervention type: Behavioral
intervention name: Introduction of the Safe Childbirth Checklist
description: Adaptation of the SCC tool to Zambia: In order to produce a tool that is fully relevant to the Zambian context, a team of clinical experts from the MOH adapted the language of the SCC.
Training of trainers on the SCC by international experts: Ariadne Labs has designed a training-of-trainers (TOT) for coach training to support quality improvement initiatives, including the implementation of the WHO SCC. Members of the district mentorship team for Nchelenge District will receive this type of TOT training.
Following the TOT session, the district mentorship team will conduct facility-level training for health workers on using the SCC. Within target facilities, all public sector health workers will be invited to participate in the training.
Mentorship and support to facility-level health workers on using the SCC: The district mentorship team will carry out coaching and support visits to health facilities following the initial SCC training.
arm group label: Nchelenge Facilities
study pop: 
sampling method: Non-Probability Sample
criteria: 
gender: All
minimum age: N/A
maximum age: N/A
healthy volunteers: Accepts Healthy Volunteers
last name: Sandra Mudhune
role: Principal Investigator
affiliation: Clinton Health Access Initiative, Nigeria
last name: Francis Bwalya
role: Principal Investigator
affiliation: Ministry of Health, Zambia
facility: 
facility: 
facility: 
facility: 
country: Zambia
url: http://www.who.int/mediacentre/factsheets/fs348/en/.
description: Maternal mortality factsheet. Updated November 2016
citation: Albolinoa S, Daglianaa G, et al. Safety and quality of maternal and neonatal pathway: A pilot study on the childbirth checklist in 9 Italian hospitals. Procedia Manufacturing. 2015; (3):242-249.
citation: Ariadne Labs. Implementing Checklists for Quality Improvement: The Namibian Experience using the WHO Safe Childbirth Checklist.
citation: Central Statistical Office (CSO), Ministry of Health (MOH), Tropical Diseases Research Centre (TDRC), University of Zambia, and Macro International Inc. (2014). Zambia Demographic and Health Survey 2014. Calverton, Maryland, USA: CSO and Macro International Inc.
citation: Davoodi R, Soltanifar A, et al. Efficacy of Evidence Based Care on Care Quality of Mother and Infant in 3 Teaching Hospitals: A Protocol. Patient Safety and Quality Improvement Journal. 2013 Dec 14; 2(2):97-100.
citation: Hayes RJ, Bennett S. Simple sample size calculation for cluster-randomized trials. Int J Epidemiol. 1999 Apr;28(2):319-26. doi: 10.1093/ije/28.2.319.
PMID: 10342698
citation: Haynes AB, Weiser TG, Berry WR, Lipsitz SR, Breizat AH, Dellinger EP, Herbosa T, Joseph S, Kibatala PL, Lapitan MC, Merry AF, Moorthy K, Reznick RK, Taylor B, Gawande AA; Safe Surgery Saves Lives Study Group. A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med. 2009 Jan 29;360(5):491-9. doi: 10.1056/NEJMsa0810119. Epub 2009 Jan 14.
PMID: 19144931
citation: Hirschhorn LR, Semrau K, Kodkany B, Churchill R, Kapoor A, Spector J, Ringer S, Firestone R, Kumar V, Gawande A. Learning before leaping: integration of an adaptive study design process prior to initiation of BetterBirth, a large-scale randomized controlled trial in Uttar Pradesh, India. Implement Sci. 2015 Aug 14;10:117. doi: 10.1186/s13012-015-0309-y.
PMID: 26271331
citation: Kumar S, Yadav V, Balasubramaniam S, Jain Y, Joshi CS, Saran K, Sood B. Effectiveness of the WHO SCC on improving adherence to essential practices during childbirth, in resource constrained settings. BMC Pregnancy Childbirth. 2016 Nov 8;16(1):345. doi: 10.1186/s12884-016-1139-x.
PMID: 27825321
citation: Kumari S, Panicker R, et al. Evaluation of the Safe Childbirth Checklist Program in Rajasthan, India: The How and What of the Evaluation Efforts. Journal of Public Health in Developing Countries. 2016 Aug 11;2(2);212-222.
citation: McCambridge J, Witton J, Elbourne DR. Systematic review of the Hawthorne effect: new concepts are needed to study research participation effects. J Clin Epidemiol. 2014 Mar;67(3):267-77. doi: 10.1016/j.jclinepi.2013.08.015. Epub 2013 Nov 22.
PMID: 24275499
citation: Moyer CA, Mustafa A. Drivers and deterrents of facility delivery in sub-Saharan Africa: a systematic review. Reprod Health. 2013 Aug 20;10:40. doi: 10.1186/1742-4755-10-40.
PMID: 23962135
citation: Ministry of Health [Zambia]. Health Sector Payroll Data. January 2014.
citation: Ministry of Health [Zambia]. Emergency Obstetric and Newborn Care (EmONC) Training Process Evaluation Report. February 2017.
citation: Ministry of Health [Zambia]. Zambia National Emergency Obstetric and Newborn Care (EmONC) Needs Assessment 2014-5. January 2017.
citation: Patabendige M, Senanayake H. Implementation of the WHO safe childbirth checklist program at a tertiary care setting in Sri Lanka: a developing country experience. BMC Pregnancy Childbirth. 2015 Feb 4;15:12. doi: 10.1186/s12884-015-0436-0.
PMID: 25648543
citation: Paxton A, Maine D, Freedman L, Fry D, Lobis S. The evidence for emergency obstetric care. Int J Gynaecol Obstet. 2005 Feb;88(2):181-93. doi: 10.1016/j.ijgo.2004.11.026. Epub 2005 Jan 8.
PMID: 15694106
citation: Spector JM, Agrawal P, Kodkany B, Lipsitz S, Lashoher A, Dziekan G, Bahl R, Merialdi M, Mathai M, Lemer C, Gawande A. Improving quality of care for maternal and newborn health: prospective pilot study of the WHO safe childbirth checklist program. PLoS One. 2012;7(5):e35151. doi: 10.1371/journal.pone.0035151. Epub 2012 May 16.
PMID: 22615733
citation: Spector JM, Lashoher A, Agrawal P, Lemer C, Dziekan G, Bahl R, Mathai M, Merialdi M, Berry W, Gawande AA. Designing the WHO Safe Childbirth Checklist program to improve quality of care at childbirth. Int J Gynaecol Obstet. 2013 Aug;122(2):164-8. doi: 10.1016/j.ijgo.2013.03.022. Epub 2013 Jun 3.
PMID: 23742897
citation: Wang P, Connor AL, Guo E, Nambao M, Chanda-Kapata P, Lambo N, Phiri C. Measuring the impact of non-monetary incentives on facility delivery in rural Zambia: a clustered randomised controlled trial. Trop Med Int Health. 2016 Apr;21(4):515-24. doi: 10.1111/tmi.12678.
PMID: 26848937
citation: WHO. Making pregnancy safer: the critical role of the skilled attendant. A joint statement by WHO, ICM, and FIGO. Geneva: Department of Reproductive Health and Research, World Health Organization. 2004.
citation: WHO. Making pregnancy safer the critical role of the skilled attendant: a joint statement by WHO, ICM and FIGO. Geneva: World health organization (WHO). Department of Reproductive Health and Research (RHR). 2004.
responsible party type: Sponsor
mesh term: Maternal Death
mesh term: Death
sharing ipd: Undecided
ipd description: This is yet to be finalized with the Ministry of Health, Zambia.