Exploring barriers and drivers to a modified WHO safe childbirth checklist implementation in three West African countries: a qualitative study using the updated consolidated framework for implementation research

IntroductionSub-Saharan Africa faces the highest maternal and newborn mortality and morbidity rates globally. The World Health Organization Safe Childbirth Checklist (WHO SCC) was developed to address this issue by promoting evidence-based practices during childbirth. This study explored the barrier...

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Main Authors: Kadidiatou Raïssa Kourouma, Wambi Maurice Evariste Yaméogo, Daouda Doukouré, Alpha Oumar Sall, Marie Laurette Agbré Yacé, Tiéba Millogo, Mamadou Diouldé Baldé, Issaka Tiembré, Alexandre Delamou, Séni Kouanda
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Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Health Services
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Online Access:https://www.frontiersin.org/articles/10.3389/frhs.2025.1593083/full
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author Kadidiatou Raïssa Kourouma
Kadidiatou Raïssa Kourouma
Wambi Maurice Evariste Yaméogo
Wambi Maurice Evariste Yaméogo
Daouda Doukouré
Daouda Doukouré
Alpha Oumar Sall
Marie Laurette Agbré Yacé
Marie Laurette Agbré Yacé
Tiéba Millogo
Tiéba Millogo
Mamadou Diouldé Baldé
Issaka Tiembré
Alexandre Delamou
Séni Kouanda
Séni Kouanda
author_facet Kadidiatou Raïssa Kourouma
Kadidiatou Raïssa Kourouma
Wambi Maurice Evariste Yaméogo
Wambi Maurice Evariste Yaméogo
Daouda Doukouré
Daouda Doukouré
Alpha Oumar Sall
Marie Laurette Agbré Yacé
Marie Laurette Agbré Yacé
Tiéba Millogo
Tiéba Millogo
Mamadou Diouldé Baldé
Issaka Tiembré
Alexandre Delamou
Séni Kouanda
Séni Kouanda
author_sort Kadidiatou Raïssa Kourouma
collection DOAJ
description IntroductionSub-Saharan Africa faces the highest maternal and newborn mortality and morbidity rates globally. The World Health Organization Safe Childbirth Checklist (WHO SCC) was developed to address this issue by promoting evidence-based practices during childbirth. This study explored the barriers and drivers to implementing a modified WHO SCC (mSCC) in Burkina Faso, Cote d'Ivoire, and Guinea.MethodsA qualitative multiple case study design was conducted from May to June 2023, involving individual interviews with diverse stakeholders (n = 110) across four regional hospitals in each country. The mSCC was implemented in these hospitals along with training and coaching. Data was analyzed using thematic analysis, guided by the updated CFIR framework. Nvivo 14 was used for coding.ResultsThe study identified 17 drivers and 7 barriers. Key drivers included the mSCC's clarity, simplicity and alignment with national guidelines, training, coaching, and stakeholders’ engagement. in these 3 countries. Barriers were mainly related to resource constraints (medicines, supplies, staffing, and space), increased workload, and lack of incentives. Specific barriers for Burkina Faso and Cote d’Ivoire were the lack of incentives and the positioning of the Kakemono in confined space only in Cote d'Ivoire. Despite these challenges, the mSCC was generally well-received, with strong support from leadership and implementation facilitators contributing to its integration into routine care.ConclusionThis study highlighted the importance of addressing resource limitations, optimizing workload, and providing incentives to ensure successful mSCC implementation. Findings underscored the need for context-specific strategies and strong leadership support when introducing similar interventions in resource-constrained settings.
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spelling doaj-art-85fbeff42238427ba301e6496ce1ad872025-08-20T03:22:58ZengFrontiers Media S.A.Frontiers in Health Services2813-01462025-06-01510.3389/frhs.2025.15930831593083Exploring barriers and drivers to a modified WHO safe childbirth checklist implementation in three West African countries: a qualitative study using the updated consolidated framework for implementation researchKadidiatou Raïssa Kourouma0Kadidiatou Raïssa Kourouma1Wambi Maurice Evariste Yaméogo2Wambi Maurice Evariste Yaméogo3Daouda Doukouré4Daouda Doukouré5Alpha Oumar Sall6Marie Laurette Agbré Yacé7Marie Laurette Agbré Yacé8Tiéba Millogo9Tiéba Millogo10Mamadou Diouldé Baldé11Issaka Tiembré12Alexandre Delamou13Séni Kouanda14Séni Kouanda15National Institute of Public Health (INSP), Abidjan, Côte d'IvoireCentre for Reproductive Health Research of Côte D’Ivoire (CRESARCI), Abidjan, Côte D'IvoireAfrican Institute of Public Health, Ouagadougou, Burkina FasoResearch Institute for Health Sciences (IRSS), Ouagadougou, Burkina FasoNational Institute of Public Health (INSP), Abidjan, Côte d'IvoireCentre for Reproductive Health Research of Côte D’Ivoire (CRESARCI), Abidjan, Côte D'IvoireCentre for Reproductive Health Research of Guinea (CERREGUI), Conakry, GuineaNational Institute of Public Health (INSP), Abidjan, Côte d'IvoireCentre for Reproductive Health Research of Côte D’Ivoire (CRESARCI), Abidjan, Côte D'IvoireAfrican Institute of Public Health, Ouagadougou, Burkina FasoResearch Institute for Health Sciences (IRSS), Ouagadougou, Burkina FasoCentre for Reproductive Health Research of Guinea (CERREGUI), Conakry, GuineaDepartment of Biomedical and Public Health, Faculty of Medicine, University Félix Houphouët-Boigny, Abidjan, Côte D'IvoireDepartment of Public Health, African Center of Excellence for the Prevention and Control of Communicable Diseases (CEA-PCMT), Gamal Abdel Nasser University, Conakry, GuineaAfrican Institute of Public Health, Ouagadougou, Burkina FasoResearch Institute for Health Sciences (IRSS), Ouagadougou, Burkina FasoIntroductionSub-Saharan Africa faces the highest maternal and newborn mortality and morbidity rates globally. The World Health Organization Safe Childbirth Checklist (WHO SCC) was developed to address this issue by promoting evidence-based practices during childbirth. This study explored the barriers and drivers to implementing a modified WHO SCC (mSCC) in Burkina Faso, Cote d'Ivoire, and Guinea.MethodsA qualitative multiple case study design was conducted from May to June 2023, involving individual interviews with diverse stakeholders (n = 110) across four regional hospitals in each country. The mSCC was implemented in these hospitals along with training and coaching. Data was analyzed using thematic analysis, guided by the updated CFIR framework. Nvivo 14 was used for coding.ResultsThe study identified 17 drivers and 7 barriers. Key drivers included the mSCC's clarity, simplicity and alignment with national guidelines, training, coaching, and stakeholders’ engagement. in these 3 countries. Barriers were mainly related to resource constraints (medicines, supplies, staffing, and space), increased workload, and lack of incentives. Specific barriers for Burkina Faso and Cote d’Ivoire were the lack of incentives and the positioning of the Kakemono in confined space only in Cote d'Ivoire. Despite these challenges, the mSCC was generally well-received, with strong support from leadership and implementation facilitators contributing to its integration into routine care.ConclusionThis study highlighted the importance of addressing resource limitations, optimizing workload, and providing incentives to ensure successful mSCC implementation. Findings underscored the need for context-specific strategies and strong leadership support when introducing similar interventions in resource-constrained settings.https://www.frontiersin.org/articles/10.3389/frhs.2025.1593083/fullquality of caresafe childbirth checklistimplementation sciencebarriersdriversWest Africa
spellingShingle Kadidiatou Raïssa Kourouma
Kadidiatou Raïssa Kourouma
Wambi Maurice Evariste Yaméogo
Wambi Maurice Evariste Yaméogo
Daouda Doukouré
Daouda Doukouré
Alpha Oumar Sall
Marie Laurette Agbré Yacé
Marie Laurette Agbré Yacé
Tiéba Millogo
Tiéba Millogo
Mamadou Diouldé Baldé
Issaka Tiembré
Alexandre Delamou
Séni Kouanda
Séni Kouanda
Exploring barriers and drivers to a modified WHO safe childbirth checklist implementation in three West African countries: a qualitative study using the updated consolidated framework for implementation research
Frontiers in Health Services
quality of care
safe childbirth checklist
implementation science
barriers
drivers
West Africa
title Exploring barriers and drivers to a modified WHO safe childbirth checklist implementation in three West African countries: a qualitative study using the updated consolidated framework for implementation research
title_full Exploring barriers and drivers to a modified WHO safe childbirth checklist implementation in three West African countries: a qualitative study using the updated consolidated framework for implementation research
title_fullStr Exploring barriers and drivers to a modified WHO safe childbirth checklist implementation in three West African countries: a qualitative study using the updated consolidated framework for implementation research
title_full_unstemmed Exploring barriers and drivers to a modified WHO safe childbirth checklist implementation in three West African countries: a qualitative study using the updated consolidated framework for implementation research
title_short Exploring barriers and drivers to a modified WHO safe childbirth checklist implementation in three West African countries: a qualitative study using the updated consolidated framework for implementation research
title_sort exploring barriers and drivers to a modified who safe childbirth checklist implementation in three west african countries a qualitative study using the updated consolidated framework for implementation research
topic quality of care
safe childbirth checklist
implementation science
barriers
drivers
West Africa
url https://www.frontiersin.org/articles/10.3389/frhs.2025.1593083/full
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