Abstract / Summary
Background: Maternal and neonatal mortality remain major public health challenges in Nigeria, with poor adherence to evidence-based childbirth practices contributing significantly to preventable complications and deaths. The World Health Organization Safe Childbirth Checklist (WHO SCC) was introduced to improve the quality and safety of maternal and newborn care through standardized clinical practices. However, awareness and utilization of the checklist among midwives in many Nigerian healthcare institutions remain uncertain. Aim: This study assessed the awareness, utilisation patterns, perceived barriers, and institutional factors influencing the use of the WHO Safe Childbirth Checklist among midwives in selected tertiary hospitals in Rivers and Bayelsa States, Nigeria. Methods: A mixed-method descriptive study was conducted among midwives working in maternity units of selected tertiary hospitals in Rivers and Bayelsa States, Nigeria. Quantitative data were collected using structured questionnaires, while qualitative data were obtained through in-depth interviews among selected midwives and nurse managers. Data were analyzed using descriptive statistics and thematic content analysis. Results: Findings revealed low baseline awareness and poor utilization of the WHO SCC among midwives prior to intervention exposure. Many participants reported inconsistent use of the checklist, with selective application mainly during complicated deliveries. Major barriers identified included inadequate staffing, excessive workload, lack of training, poor institutional support, irregular supervision, and unavailability of checklist materials. Participants acknowledged that the checklist improved clinical organization, communication, and patient safety when properly utilized. Midwives also emphasized the need for continuous professional training, supportive supervision, and integration of the checklist into institutional maternity care policies. Conclusion: Awareness and utilization of the WHO Safe Childbirth Checklist among midwives were generally low prior to intervention. Organizational support, training, and workforce strengthening are essential for improving adoption and sustained use of the checklist in tertiary healthcare settings. Institutionalizing the WHO SCC may enhance adherence to essential childbirth practices and improve maternal and neonatal outcomes in Nigeria.