scholarly journals Effectiveness of the World Health Organization Safe Childbirth Checklist (WHO-SCC) in preventing poor childbirth outcomes: a study protocol for a matched-pair cluster randomized control trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tieba Millogo ◽  
Kadidiatou Raïssa Kourouma ◽  
Aïssatou Diallo ◽  
Marie Laurette Agbre-Yace ◽  
Mamadou Diouldé Baldé ◽  
...  
Keyword(s):  
Low Cost ◽  
Controlled Trial ◽  
Healthcare Providers ◽  
World Health ◽  
Matched Pair ◽  
Control Group ◽  
Safe Childbirth Checklist ◽  
Cluster Randomized ◽  
Health Organization ◽  
Safe Childbirth

Abstract Background Women delivering in health facilities in sub-Saharan Africa and their newborns do not always receive proven interventions needed to prevent and/or adequately manage severe complications. The gaps in quality of care are increasingly pointed out as major contributing factor to the high and slow declining perinatal mortality rates. The World Health Organization Safe Childbirth Checklist (WHO-SCC), as a quality improvement strategy, targets low cost and easy to perform interventions and suits well with the context of limited resource settings. In this matched-pair cluster randomized controlled trial, we assess the effectiveness of the WHO-SCC in improving healthcare providers’ adherence to best practices and ultimately improving childbirth outcomes. Methods This is a multi-country study. In each country we will carry out a matched-pair cluster randomized controlled trial whereby four pairs of regional hospitals will be randomized on a 1:1 basis to either the intervention or control group. A context specific WHO-SCC will be implemented in the intervention facilities along with trainings of healthcare providers on best childbirth practices and ongoing supportive supervisions. The standard of care will prevail in the control group. The primary outcome is a summary composite metric that combine the following poor childbirth outcomes: stillbirths, maternal deaths, early neonatal deaths, severe postpartum hemorrhage, maternal infections, early neonatal infections, prolonged obstructed labor, severe pre-eclampsia, uterine rupture in the health facility, eclampsia and maternal near miss. The occurrence of these outcomes will be ascertained in a sample of 2530 childbirth events in each country using data extraction. A secondary outcome of interest is the adherence of healthcare providers to evidence best practices. This will be measured through direct observations of a sample of 620 childbirth events in each country. Discussion Our study has the potential to provide strong evidence on the effectiveness of the WHO-SCC, a low cost and easy to implement intervention that can be easily scaled up if found effective. Trial registration The trial was registered in the Pan-African Clinical Trials Registry on 21st January 2020 under the following number: PACTR202001484669907. https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=9662

scholarly journals Adaptation and validation for Colombia of the WHO safe childbirth checklist

2018 ◽  
Vol 49 (3) ◽  
pp. 201-212
Author(s):  
Ana Carolina Amaya Arias ◽  
Óscar Zuluaga ◽  
Douglas Idárraga ◽  
Javier Hernando Eslava Schmalbach
Keyword(s):  
Low Income ◽  
Health Workers ◽  
Low Cost ◽  
Neonatal Morbidity ◽  
Neonatal Care ◽  
World Health ◽  
Low Income Countries ◽  
Safe Childbirth Checklist ◽  
Health Organization ◽  
Safe Childbirth

Introduction: Most maternal deaths that occur in developing countries are considered unfair and can be avoided. In 2008, The World Health Organization (WHO) proposed a checklist for childbirth care, in order to assess whether a simple, low-cost intervention had an impact on maternal and neonatal mortality in low-income countries. Objective: To translate, adapt and validate the content of the WHO Safe Childbirth Checklist (SCC) for its use in Colombia Methods: The checklist was translated and adapted to the Colombian context. It was subsequently validated by a panel of experts composed of 17 health workers with experience in maternal and neonatal care and safety. Reliability among judges was estimated (Rwg) and items were modified or added to each section of the list according to the results. Results: Modifications were made to 28 items, while 19 new items were added, and none was removed. The most important modifications were made to the management guidelines included in each item, and the items added refer to risks inherent to our environment. Conclusion: The Colombian version of the SCC will be a useful tool to improve maternal and neonatal care and thereby contribute to reducing maternal and neonatal morbidity and mortality in our country.

scholarly journals Azithromycin Reduction to Reach Elimination of Trachoma (ARRET): study protocol for a cluster randomized trial of stopping mass azithromycin distribution for trachoma

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Abdou Amza ◽  
Boubacar Kadri ◽  
Beido Nassirou ◽  
Ahmed M. Arzika ◽  
Ariana Austin ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Controlled Trial ◽  
Clinical Signs ◽  
Cluster Randomized Trial ◽  
World Health ◽  
Baseline Assessment ◽  
Randomized Controlled ◽  
Registration Number ◽  
Cluster Randomized ◽  
Health Organization

Abstract Background The World Health Organization (WHO) recommends annual mass azithromycin distribution until districts drop below 5% prevalence of trachomatous inflammation—follicular (TF). Districts with very low TF prevalence may have little or no transmission of the ocular strains of Chlamydia trachomatis that cause trachoma, and additional rounds of mass azithromycin distribution may not be useful. Here, we describe the protocol for a randomized controlled trial designed to evaluate whether mass azithromycin distribution can be stopped prior to the current WHO guidelines. Methods The Azithromycin Reduction to Reach Elimination of Trachoma (ARRET) study is a 1:1 community randomized non-inferiority trial designed to evaluate whether mass azithromycin distribution can be stopped in districts with baseline prevalence of TF under 20%. Communities in Maradi, Niger are randomized after baseline assessment either to continued annual mass azithromycin distribution or stopping annual azithromycin distribution over a 3-year period. We will compare the prevalence of ocular C. trachomatis (primary outcome), TF and other clinical signs of trachoma, and serologic markers of trachoma after 3 years. We hypothesize that stopping annual azithromycin distribution will be non-inferior to continued annual azithromycin distributions for all markers of trachoma prevalence and transmission. Discussion The results of this trial are anticipated to provide potentially guideline-changing evidence for when mass azithromycin distributions can be stopped in low TF prevalence areas. Trial registration number This study is registered at clinicaltrials.gov (NCT04185402). Registered December 4, 2019; prospectively registered pre-results.

scholarly journals Tianwang Buxin Granules Influence the Intestinal Flora in Perimenopausal Insomnia

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Xiqian Yang ◽  
Hesong Xiao ◽  
Yi Zeng ◽  
Liangliang Huang ◽  
Ke Ji ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Controlled Trial ◽  
Intestinal Flora ◽  
World Health ◽  
Control Group ◽  
Metagenomic Sequencing ◽  
Clinical Trial Registry ◽  
Clinical Trial Registration ◽  
Faecalibacterium Prausnitzii ◽  
Health Organization

Study Objectives. To study the relationship between perimenopausal insomnia (PI) and intestinal flora and the potential mechanism of Tianwang Buxin granules (TWBXG) in exerting its clinical efficacy. Methods. The subjects included 13 PI patients from the Hubei Provincial Hospital of TCM, Hubei University of TCM, and Wuhan Traditional Chinese Medicine Hospital, and the corresponding noninsomniac spouses of the patients were selected as controls. TWBXG was continuously administered for 4 weeks. The feces of PI patients and their noninsomniac spouses before and after treatment with TWBXG were collected. The intestinal flora composition of each group was detected by metagenomic sequencing, and the efficacy of TWBXG was evaluated by the PSQI scale. Results. Compared with the control group, the model group showed an increase in the abundance of Roseburia faecis, Ruminococcus, Prevotella copri, Fusicatenibacter saccharivorans, and Blautia obeum, while those of Bacteroides, fecal Bacteroidetes, and Faecalibacterium prausnitzii were decreased. Compared with pretreatment, the PSQI score was significantly reduced ( P < 0.05 ), the abundance of Bacteroides, fecal Bacteroidetes, and Faecalibacterium prausnitzii increased, and that of Roseburia faecis, Ruminococcus, Prevotella copri, Fusicatenibacter saccharivorans, and Blautia obeum decreased after treatment. However, there was still a certain gap in the abundance of related flora in the treatment group compared with the control. Conclusion. PI is associated with disturbances in the intestinal flora and is mainly related to the disorders of Roseburia faecis, Ruminococcus, Prevotella copri, Fusicatenibacter saccharivorans, Blautia obeum, Bacteroides, fecal Bacteroidetes, and Faecalibacterium prausnitzii. TWBXG can effectively treat PI, and its effect may be achieved by regulating the disordered intestinal flora. Clinical Trials. The study was registered in the Chinese clinical trial registry and approved by the World Health Organization clinical trial registration platform (Effects of the modified Tianwang Buxin granule and modified Tianwang Buxin decoction pieces on insomnia: a randomized, controlled trial, ChiCTR-IPR-17011549).

scholarly journals Safe birth matters: facilitators and barriers to uptake of the WHO safe childbirth checklist tool in a Tanzania Regional Hospital

2021 ◽  
Vol 21 (1) ◽  
pp. 44-50
Author(s):  
Joycelyn Thomas ◽  
Joachim Voss ◽  
Edith Tarimo
Keyword(s):  
World Health Organization ◽  
Scale Up ◽  
Regional Hospital ◽  
Completion Rate ◽  
World Health ◽  
Safe Childbirth Checklist ◽  
The World ◽  
Health Organization ◽  
Safe Childbirth ◽  
Time Point

Background: The World Health Organization (WHO) developed the Safe Birth Checklist (SCC) to facilitate best practices in safe birthing practices. The SCC is utilizing existing evidence-based WHO guidelines and recommendations which has combined those into a single and practical bedside tool. The SCC is the first checklist-based intervention to target the pre- vention of maternal and neonatal deaths. Objective: The objective of this project was to pilot-test the World Health Organization Safe Childbirth Checklist with Maternity Regional Hospital in, Tanzania. Study Design and Methods: Retrospective analysis on 35 charts were completed to identify presence or absence of docu- mentation aligned with evidenced based checklist items. Staff training, end user observations and focus group discussions were utilized to elicit feedback about the tool and the process. Descriptive statistics and manual content analysis were used to analyze the rate of uptake and ownership over the checklist. The Checklist is broken down into four sections or time points (that are considered natural pause points in the care of laboring women). The four different pause points are admission, delivery, post-partum, and discharge. Results: We trained 26 participants out of 32 staff how to use the SCC. Delivery time point had the lowest at SCC comple- tion rate at 39% compared to discharge having the highest completion rate at 93%. There was variation in completion rate of the checklist items at each time point. Checklist items at the beginning of each time point were completed between 94% and 100% of the time with the latter checklist list items completed between 29% and 57% of the time. Conclusion: This project was able to identify facilitators and potential barriers to the successful uptake of the Safe Child- birth Checklist in Shinyanga Regional Hospital. Based on these findings, the MOH have opportunities to utilize those find- ings in the scale-up of the implementation of the checklist and future evaluation activities. Keywords: Safe birth matters; WHO safe childbirth checklist tool; Tanzania Regional Hospital.

scholarly journals Effects of the World Health Organization Safe Childbirth Checklist on Quality of Care and Birth Outcomes in Aceh, Indonesia

2021 ◽  
Vol 4 (12) ◽  
pp. e2137168
Author(s):  
Lennart Christian Kaplan ◽  
Ichsan Ichsan ◽  
Farah Diba ◽  
Marthoenis Marthoenis ◽  
Muhsin Muhsin ◽  
...  
Keyword(s):  
Quality Of Care ◽  
World Health Organization ◽  
Birth Outcomes ◽  
World Health ◽  
Safe Childbirth Checklist ◽  
The World ◽  
Health Organization ◽  
Safe Childbirth

scholarly journals Safe birth matters: facilitators and barriers to uptake of the WHO safe childbirth checklist tool in a Tanzania Regional Hospital

2021 ◽  
Vol 21 ◽  
pp. 44-50
Author(s):  
Joycelyn Thomas ◽  
Joachim Voss ◽  
Edith Tarimo
Keyword(s):  
World Health Organization ◽  
Scale Up ◽  
Regional Hospital ◽  
Completion Rate ◽  
World Health ◽  
Safe Childbirth Checklist ◽  
The World ◽  
Health Organization ◽  
Safe Childbirth ◽  
Time Point

Background: The World Health Organization (WHO) developed the Safe Birth Checklist (SCC) to facilitate best practices in safe birthing practices. The SCC is utilizing existing evidence-based WHO guidelines and recommendations which has combined those into a single and practical bedside tool. The SCC is the first checklist-based intervention to target the pre- vention of maternal and neonatal deaths. Objective: The objective of this project was to pilot-test the World Health Organization Safe Childbirth Checklist with Maternity Regional Hospital in, Tanzania. Study Design and Methods: Retrospective analysis on 35 charts were completed to identify presence or absence of docu- mentation aligned with evidenced based checklist items. Staff training, end user observations and focus group discussions were utilized to elicit feedback about the tool and the process. Descriptive statistics and manual content analysis were used to analyze the rate of uptake and ownership over the checklist. The Checklist is broken down into four sections or time points (that are considered natural pause points in the care of laboring women). The four different pause points are admission, delivery, post-partum, and discharge. Results: We trained 26 participants out of 32 staff how to use the SCC. Delivery time point had the lowest at SCC comple- tion rate at 39% compared to discharge having the highest completion rate at 93%. There was variation in completion rate of the checklist items at each time point. Checklist items at the beginning of each time point were completed between 94% and 100% of the time with the latter checklist list items completed between 29% and 57% of the time. Conclusion: This project was able to identify facilitators and potential barriers to the successful uptake of the Safe Child- birth Checklist in Shinyanga Regional Hospital. Based on these findings, the MOH have opportunities to utilize those find- ings in the scale-up of the implementation of the checklist and future evaluation activities. Keywords: Safe birth matters; WHO safe childbirth checklist tool; Tanzania Regional Hospital.

Effectiveness and cost-effectiveness of brief Mindfulness-Based Cognitive Therapy for the improvement of productivity in the workplace: Study protocol for a randomized controlled trial (Preprint)

2021 ◽  
Author(s):  
Mitsuhiro Sado ◽  
Masashi Yamada ◽  
Akira Ninomiya ◽  
Maki Nagaoka ◽  
Naho Goto ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cognitive Therapy ◽  
Work Performance ◽  
Controlled Trial ◽  
Self Report ◽  
World Health ◽  
Control Group ◽  
Work Related ◽  
Health Organization ◽  
The Impact

BACKGROUND Numerous studies have demonstrated the effectiveness of Mindfulness Based Programs’ (MBPs) among both clinical and non-clinical populations. These data document positive impacts in the workplace, including reducing perceived stress and burnout and increasing wellbeing. However, the effectiveness for productivity, which is of most interest to managers and administrators, is still unclear. In addition, MBPs in the workplace tend to be modified by reducing the number of the program sessions or delivering content online to improve accessibility. To date, however, the impact on productivity of MBPs in the workplace that feature these modifications has not been investigated. OBJECTIVE The study aimed to investigate the effectiveness and cost-effectiveness of the online-delivered brief Mindfulness Based Cognitive Therapy (bMBCT) for improving productivity and other work related outcomes. METHODS We conduct a four-week RCT with a six-month follow-up. Employees are included in the study if they 1) are between the ages of 20-65 and 2) work longer than 30 hours weekly. Employees were randomly allocated to either the bMBCT group or wait-list control group. The primary outcome of the study is the mean difference of productivity measured by World Health Organization Health and Work Performance Questionnaire (WHO-HPQ) between the groups at 4, 16, 28 weeks. Secondary outcomes include several clinical outcomes and health economics evaluation. RESULTS Recruitment began in August 2021. 104 participants have been enrolled in the study as of October 2021. The intervention is ongoing and scheduled to be completed in December 2023. Data collection will be completed by March 2024. CONCLUSIONS The novelty of the study is that 1) it will investigate the bMBCTs’ effectiveness on productivity, which is still unclear, 2) samples are recruited from three companies in different industries, etc. The limitations of the study are 1) all measures assessed are self-report format, 2) we lack an active control group. This study has the potential to provide new data on the relationship between MBPs and occupational health and productivity. CLINICALTRIAL UMIN Clinical Trials Registry: UMIN000044721

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