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      Adaptation and validation of the World Health Organization’s on Safe Childbirth Checklist for the Brazilian context Translated title: Adaptação e validação da lista de verificação do parto seguro da Organização Mundial da Saúde para o contexto brasileiro

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          Abstract

          Abstract Objectives: to culturally adapt and validate the WHO Safe Childbirth Checklist (SCC) in Brazilian hospitals. Methods: a methodological study was carried out with consensus techniques and cross-cultural adaptation stages. The original SCC underwent three adaptation and validation stages: 1- nominal group with a panel of experts; 2- consensus conference at two maternity schools, in meetings with professionals who would use the list; 3- pre-test with a structured questionnaire for health professionals from both maternities (n=40) after 30 days of using the checklist. Validation criteria contemplated the content validity, adequated to Brazilian protocols, terminology and feasibility for local context. Results: the adapted SCC in Brazil was called the Lista de Verificação para o Parto Seguro - Brasil (LVPS-BR) (Checklist for Safe Childbirth -Brazil) and included 49 items. In the first stage, the 29 items of the original SCC were approved with some adaptations (e.g. CD4 was replaced by the Rapid HIV Test). In the second stage, some of the 29 items were adjusted and added 24 items more. In the third stage, three items were excluded, two were grouped and one more was added. Conclusions: the validation process provided a potentially useful LVPS for the Brazilian context, presenting validity and feasibility evidences for the Brazilian context.

          Translated abstract

          Resumo Objetivos: adaptar culturalmente e validar o Safe Childbirth Checklist (SCC) da OMS para os hospitais brasileiros. Métodos: realizou-se uma pesquisa metodológica com técnicas de consenso e etapas de adaptação transcultural. O SCC original passou por três etapas de adaptação e validação: 1- grupo nominal com painel de especialistas; 2- conferência de consenso em duas maternidades escolas, em reuniões com profissionais que utilizariam a lista; 3- pré-teste com questionário estruturado aos profissionais de saúde das duas maternidades (n=40) após 30 dias de sua utilização. Critérios de validação contemplaram as validades de face e conteúdo, adequação aos protocolos nacionais, terminologia e viabilidade no contexto local. Resultados: o SCC adaptado para o Brasil foi denominado Lista de Verificação para o Parto Seguro - Brasil (LVPS-BR), contendo 49 itens. Na primeira etapa, os 29 itens do SCC original foram aprovados com algumas adaptações (ex.: CD4 substituído por Teste Rápido para HIV). Na segunda etapa, ocorreram ajustes em alguns dos 29 itens e acrescentaram-se 24 itens. Na terceira etapa, excluíram-se três itens, agruparam-se dois e acrescentou-se um. Conclusões: o processo de validação disponibilizou uma LVPS potencialmente útil para o contexto brasileiro, apresentando indícios de validade e viabilidade para o contexto nacional.

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          Validade de conteúdo nos processos de construção e adaptação de instrumentos de medidas

          Este estudo teve por objetivo realizar uma revisão sobre validade de conteúdo, fase importante nos processos de construção e adaptação de instrumentos de medida. Foi realizada pesquisa bibliográfica definida como integrativa, por meio de pesquisa a bases de dados nacionais e internacionais. Iniciou-se a descrição das bases conceituais e os métodos de medidas usados em validade de conteúdo, com ênfase na área da saúde. Verificou-se que existem controvérsias na literatura sobre a terminologia e o conceito da validade de conteúdo. Foram descritos os procedimentos recomendados para realizar a validade de conteúdo durante os processos de construção e de adaptação de instrumentos, particularmente a avaliação por juízes, o que pode envolver procedimentos qualitativos e quantitativos. Descreveu-se número, seleção e qualificação desses juízes. Os diferentes métodos para quantificar o grau de concordância entre os especialistas foram analisados, principalmente o Índice de Validade de Conteúdo (IVC). Este estudo descreveu aspectos do processo de realização da validade de conteúdo, um dos procedimentos a serem considerados por pesquisadores e profissionais da área de saúde preocupados em utilizarem medidas e instrumentos confiáveis e apropriados para determinada população.
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            Quality of care for maternal and newborn health: the neglected agenda.

            The quality of care received by mothers and babies in developing countries is often reported as poor. Yet efforts to address this contributory factor to maternal and newborn mortality have received less attention compared with barriers of access to care. The current heightened concern to achieve Millennium Development Goals 4 & 5 has illuminated the neglected quality agenda. Whilst there is no universally-accepted definition of "quality care", it is widely acknowledged to embrace multiple levels--from patient to health system, and multiple dimensions, including safety as well as efficiency. Quality care should thus lie at the core of all strategies for accelerating progress towards MDG4 &5. Interventions to measure and improve quality need themselves to be evidence-based. Two promising approaches are maternal and perinatal death reviews and criterion-based audit. These and other quality improvement tools have a crucial role to play in the implementation of effective maternal and newborn care.
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              Improving Quality of Care for Maternal and Newborn Health: Prospective Pilot Study of the WHO Safe Childbirth Checklist Program

              Background Most maternal deaths, intrapartum-related stillbirths, and newborn deaths in low income countries are preventable but simple, effective methods for improving safety in institutional births have not been devised. Checklist-based interventions aid management of complex or neglected tasks and have been shown to reduce harm in healthcare. We hypothesized that implementation of the WHO Safe Childbirth Checklist program, a novel childbirth safety program for institutional births incorporating a 29-item checklist, would increase delivery of essential childbirth practices linked with improved maternal and perinatal health outcomes. Methods and Findings A pilot, pre-post-intervention study was conducted in a sub-district level birth center in Karnataka, India between July and December 2010. We prospectively observed health workers that attended to women and newborns during 499 consecutively enrolled birth events and compared these with observed practices during 795 consecutively enrolled birth events after the introduction of the WHO Safe Childbirth Checklist program. Twenty-nine essential practices that target the major causes of childbirth-related mortality, such as hand hygiene and uterotonic administration, were evaluated. The primary end point was the average rate of successful delivery of essential childbirth practices by health workers. Delivery of essential childbirth-related care practices at each birth event increased from an average of 10 of 29 practices at baseline (95%CI 9.4, 10.1) to an average of 25 of 29 practices afterwards (95%CI 24.6, 25.3; p<0.001). There was significant improvement in the delivery of 28 out of 29 individual practices. No adverse outcomes relating to the intervention occurred. Study limitations are the pre-post design, potential Hawthorne effect, and focus on processes of care versus health outcomes. Conclusions Introduction of the WHO Safe Childbirth Checklist program markedly improved delivery of essential safety practices by health workers. Future study will determine if this program can be implemented at scale and improve health outcomes.

                Author and article information

                Journal
                rbsmi
                Revista Brasileira de Saúde Materno Infantil
                Rev. Bras. Saude Mater. Infant.
                Instituto de Medicina Integral Prof. Fernando Figueira (Recife, PR, Brazil )
                1519-3829
                1806-9304
                June 2018
                : 18
                : 2
                : 401-418
                Affiliations
                [4] Natal RN orgnameMaternidade Escola Januário Cicco Brasil
                [1] Natal Rio Grande do Norte orgnameUniversidade Federal do Rio Grande do Norte orgdiv1Programa de Pós-graduação em Saúde Coletiva Brazil
                [5] Santa Cruz RN orgnameHospital Universitário Ana Bezerra Brasil
                [3] Natal Rio Grande do Norte orgnameUniversidade Federal do Rio Grande do Norte orgdiv1Departamento de Infectologia Brazil
                [2] Natal Rio Grande do Norte orgnameUniversidade Federal do Rio Grande do Norte orgdiv1Departamento de Saúde Coletiva Brazil zasgama@ 123456gmail.com
                [6] Natal Rio Grande do Norte orgnameUniversidade Federal do Rio Grande do Norte orgdiv1Curso de Gestão em Sistemas e Serviços de Saúde Brazil
                Article
                S1519-38292018000200401 S1519-3829(18)01800200401
                10.1590/1806-93042018000200009
                85924ced-94d8-40ff-8d3e-5e20fa0931e5

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 30 March 2018
                : 08 February 2017
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 29, Pages: 18
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                SciELO Brazil

                Categories
                Original Articles

                Serviços de saúde Materno-infantil,Healthcare quality,Patient’s safety,Maternal-child health services,Checklist,Qualidade dos cuidados de saúde,Segurança do paciente,Lista de verificação

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