Anqi He, MPH, was a 2021-2022 Wilbur G. Downs Fellow. Her recent paper in PLOS Global Public Health stemmed from her Downs Fellowship project and MPH thesis was. Entitled “Barriers and Facilitators for Implementing the WHO Safe Childbirth Checklist (SCC) in Mozambique: A Qualitative Study Using the Consolidated Framework for Implementation Research (CFIR)” the paper examines the challenges and opportunities surrounding the implementation of the Safe Childbirth Checklist (SCC) designed by WHO in Mozambique, a country with persistently high maternal and neonatal mortality rates and the under-researched issue of stillbirths.
Although Mozambique has national guidelines for certain childbirth procedures and complications, these guidelines are not systematically integrated. Despite being tested in over 35 countries and proven effective in improving care quality, the SCC has yet to be adopted in Mozambique. Additionally, little is known about current childbirth practices in the country, and the feasibility and acceptability of implementing the SCC in local healthcare facilities remain underexplored.
The study highlights key barriers to SCC implementation, including underfunded maternal care, lack of infrastructure and human resources, and low provider motivation, as well as facilitators such as the simplicity of the checklist and the commitment of healthcare providers to improving childbirth outcomes. These findings provide critical insights into current childbirth practices in Mozambique and inform the Ministry of Health’s decision-making on adopting and adapting the SCC to improve maternal and child health outcomes.
With the generous support of the Downs Fellowship, Anqi served as the principal investigator of the project. She designed the study and conducted data collection during the summer and winter of 2022 in Mozambique. Focused on promoting health equity, the research amplifies healthcare providers’ and decision-makers' voices while assessing the SCC’s feasibility and acceptability before potential adoption as a standard practice. The work aligns with the Downs Fellowship’s mission to foster innovative global health research by Yale students in LMICs and contributes to sustainable improvements in maternal and neonatal health outcomes.