IMPACT OF UTILIZING THE WHO SAFE CHILDBIRTH CHECKLIST ON REDUCING MATERNAL AND PERINATAL DEATH: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

Abstract

Background

The World Health Organization (WHO) Safe Childbirth Checklist (SCC) is a 29-item checklist designed to address the primary cause of maternal death, intrapartum stillbirth, and early neonatal death. The objective of this review was to locate literature reporting on the effect of utilizing the WHO safe childbirth checklist on maternal and perinatal death.

Methods

We searched MEDLINE, google scholar, Cochrane Central Register of Controlled Trials (CENTRAL), met-Register of Controlled Trials (m-RCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/stop/search/en) to retrieve all available comparative studies published in English after 2008. Two reviewers did study selection, critical appraisal, and data extraction independently. We did a random or fixed-effect meta-analysis to pool studies together and effect estimates were expressed as an odds ratio. Quality of evidence for major outcomes was assessed using the Grading of Recommendations, Assessment, development, and evaluation (GRADE).

Results

We retained two cluster randomized trials and three pre-and-post intervention studies reporting on WHO SCC's. The WHO SCC utilization reduced still birth (OR =0.92[95% CI 0.87-0.96]). However, the utilization of the checklist had no impact on early neonatal death (OR=1.07[95%CI [1.01-1.13]) and maternal death (OR =1.06[95% CI 0.77-1.45]).

Conclusions

Moderate quality of evidence indicates that WHO SCC reduces stillbirth, whereas low and very low quality of evidence suggests that WHO SCC has no impact on maternal and early neonatal death, respectively. Therefore, it is imperative to use a structured checklist for intrapartum follow-up of labour and delivery.

Keywords: Maternal health, Newborn health, WHO Safe Childbirth Checklist, maternal mortality, perinatal mortality.