Mothers' experiences of quality of care and potential benefits of implementing the WHO safe childbirth checklist: a case study of Aceh Indonesia

BMC Pregnancy Childbirth. 2019 Dec 3;19(1):461. doi: 10.1186/s12884-019-2625-8.

Abstract

Background: In an effort to mitigate missed opportunities to provide high-quality care, the World Health Organization (WHO) has developed the Safe Childbirth Checklist (SCC) to support health providers perform essential tasks. Our qualitative study is a baseline assessment of quality of care (QoC) perceived by mothers who gave birth at health facilities aiming to highlight areas where implementing the SCC can potentially improve the QoC as well as areas that are not part of the SCC yet require improvement.

Methods: Assessing the overall experience of care, our qualitative study focuses on 8 out of 29 items in the checklist that are related to the personal interactions between healthcare provider and mothers. Using a set of semi-structured questions, we interviewed 26 new mothers who gave institutional births in Aceh province in Indonesia.

Results: Our findings revealed some gaps where implementing the SCC can potentially improve safety and QoC. They include communicating danger signs at critical points during birth and after discharge, encouraging breastfeeding, and providing mothers with information on family planning. Moreover, taking a qualitative approach allowed us to identify additional aspects such as need for clarity at the point of admission, maintaining dignity, and protecting mothers' rights in the decision-making process to be also essential for better QoC.

Conclusions: Our study highlights the need to actively listen to and engage with the experiences of women in the adaptation and implementation of the checklist. While our findings indicate that implementing the SCC has the potential to improve the quality of maternal care and overall birth experience, a more holistic understanding of the lived experiences of women and the dynamics of their interactions with health facilities, care providers, and their birth companions can complement the implementation of the checklist.

Keywords: Aceh; Indonesia; Maternal health; Maternal rights; Safe childbirth checklist.

MeSH terms

  • Adult
  • Checklist
  • Delivery, Obstetric*
  • Female
  • Humans
  • Indonesia
  • Maternal Health Services*
  • Mothers / psychology*
  • Patient Satisfaction
  • Pregnancy
  • Qualitative Research
  • Quality of Health Care*
  • World Health Organization
  • Young Adult