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Table 3 Good practice indicators measured from medical records. Feasibility and reliability from two sequential pilot tests

From: Construction and pilot test of a set of indicators to assess the implementation and effectiveness of the who safe childbirth checklist

Indicator description Prevalence and adjusted bias kappa (PABAK) Pilot test 1 PABAK Pilot test 2
Hospital 1 (n:30) Hospital 2 (n:17) Pooled results Hospitals 1 and 2 Hospital 3 (n:30)
1 Percentage of women with antibiotic prescribed during the childbirth process 0.53 0.88 0.66 0.50
2 Percentage of women with antibiotic prescribed during childbirth process antibiotic and it is justified by any symptom 0.6 0.41 0.49 NF
3 Percentage of newborns who are prescribed antibiotic 0.67 1 0.79 1
4 Percentage of newborns who are prescribed antibiotic and it is justified by any symptom NF NF NF NF
5 Percentage of women who are prescribed magnesium sulfate during the childbirth process 1 1 1 1
6 Percentage of women who are prescribed magnesium sulfate during the childbirth process and it is justified NF NF NF NF
7 Percentage of women with partogram open, including: 0.38 1 0.61 1
  • Partograms with name recorded 0.59 1 0.74 1
• Partograms with age or date of birth recorded 0.59 0.76 0.65 1
• Partograms with weeks of gestation recorded 0.59 0.76 0.65 1
8 Percentage of women with completed partogram, including: 1 1 1 0.22
  • Partograms with temperature recorded every 2 h 0.52 0.76 0.61 0.48
• Partograms with heart rate recorded every 30 min 0.93 1 0.96 0.13
• Partograms with blood pressure recorded every 4 h 0.10 0.76 0.35 0.57
• Partograms with registration of vaginal exam or dilation 0.86 0.41 0.70 0.91
9 Percentage of women HIV+ with initiation of anti-retroviral treatment NF NF NF NF
10 Percentage of women with justified Cesarean delivery NF NF NF 0.83
11 Percentage of women with justified instrumental delivery NF NF NF NF
12 Percentage of women with justified episiotomy 0.92 NF 0.92 0.90
13 Percentage of women with adequate management of the 3rd period of delivery, including: 0.87 1 0.96 0.78
  • Deliveries with oxytocin administered in the first minute 0.33 0.29 0.32 0.43
• Births with traction of the umbilical cord to extract the placenta 0.20 −0.88 −0.17 0.85
• Uterine massage is performed after removing the placenta 0.87 0.88 0.87 0.93
14 Percentage of deliveries in which the presence of a second baby is checked and disconfirmed 0.20 0.65 0.36 1
15 Percentage of women with adequate management of postpartum hemorrhage NF NF NF NF
16 Percentage of newborns with adequate immediate care, including: 0.72 0.88 0.82 0.73
  • Drying and kept warm 0.24 0.76 0.43 0.73
• Administration of vitamin K 0.71 1 0.82 1
• Administration of ophthalmic prophylaxis 0.86 0.88 0.87 0.8
17 Percentage of newborns with late clamping of umbilical cord 0.87 0.53 0.74 1
18 Percentage of newborns with immediate skin to skin contact 0.72 0.06 0.48 1
19 Percentage of newborns with HIV+ mothers and anti-retroviral treatment initiated NF NF NF NF
20 Percentage of women with hemorrhage 0.87 0.88 0.87 0.93
21 Percentage of women with blood pressure disorders 0.93 0.88 0.91 0.93
22 Percentage of women with post-partum or perinatal infection 0.87 1 0.91 0.71
23 Percentage of infants with neonatal infection 0.8 1 0.87 1
24 Percentage of infants with neonatal asphyxia 0.93 1 0.96 0.87
25 Percentage of women with Cesarean delivery 1 1 1 1
26 Percentage of women with instrumental delivery 1 1 1 1
27 Percentage of women with episiotomy at childbirth 1 1 1 0.88
28 Percentage of deliveries with adverse events in women 0.8 0.88 0.83 1
29 Percentage of deliveries with adverse events in newborns 1 1 1 0.60
  1. NF Not feasible due to few or lack of cases in the general sample: it may need specific sample for routine use
  2. General indicators: #1 to 6 (applicable at any time during childbirth); Admission and labor: # 7 to 15; Newborns (immediate post-partum): #16 to 19; Complications and adverse events: #20 to 29