Harvard School of Public Health (HSPH) has been awarded a $14.1 million, four-year grant from the Bill & Melinda Gates Foundation to test the effectiveness of an innovative checklist-based childbirth safety program in reducing deaths and improving outcomes of mothers and infants in 120 hospitals in India. The program was developed by the World Health Organization (WHO) and HSPH.

Atul Gawande, associate professor in health policy and management at HSPH and a surgeon at Brigham and Women’s Hospital, Boston, and co-principal investigator Jonathan Spector, research associate in health policy and management at HSPH and a neonatologist at Massachusetts General Hospital, Boston, are leading the BetterBirth clinical trial. The study will evaluate the impact of the WHO Safe Childbirth Checklist program at hospitals in Uttar Pradesh, India.

The HSPH team worked with the WHO Departments of Patient Safety, Reproductive Health and Research, and Maternal, Newborn, Child and Adolescent Health to develop the Safe Childbirth Checklist program, which is expected to be released later this year. The checklist program aims to improve the safety of the mother and infant from the moment the woman enters a hospital, through labor and delivery, to discharge home.

The one-page checklist features “pause points,” natural break points in the flow of clinical care when the  medical team  confirms that  essential tasks have been performed. The checklist program targets the major killers of mothers and babies worldwide. For mothers, those include bleeding, infection, elevated blood pressure, and prolonged or obstructed labor. For babies, it’s asphyxia, infection, and complications of prematurity.

 

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