Health Systems Strengthening Project Impact Evaluation 2015, Baseline Survey

Liberia, 2013 - 2015

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Reference ID

LBR_2015_HRBFIE-BL_v01_M

Producer(s)

Kenneth Leonard (University of Maryland), Luke Bawo, Rianna Mohammed-Roberts

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DDI/XML JSON

Created on

Jan 16, 2021

Last modified

Jan 16, 2021

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104050

Data file: o_do_1

Obstetrics - Labor & Delivery Observation Checklist

Cases:	121
Variables:	1112

Variables

q100

Q100: Was this section observed?

q101

Q101: Respectfully greets the pregnant woman

q101b

Q101b: Introduces him/herself and the medical personnel present

q102

Q102: Encourages the women to have a support person present during labor and bir

q103

Q103: Asks women (and support person) if she has any questions

q104

Q104: Checks client card OR asks client her age, length of pregnancy, and parity

q10501a

Q105:01. Health worker asks about: Vaginal bleeding

q10502a

Q105:02. Health worker asks about: Fever

q10503a

Q105:03. Health worker asks about: Severe headaches and/or blurred vision

q10504a

Q105:04. Health worker asks about: Swollen face or hands

q10505a

Q105:05. Health worker asks about: Convulsions or loss of consciousness

q10506a

Q105:06. Health worker asks about: Severe difficulty breathing

q10507a

Q105:07. Health worker asks about: Persistent cough for 2 weeks or longer

q10508a

Q105:08. Health worker asks about: Severe abdominal pain

q10509a

Q105:09. Health worker asks about: Foul smelling discharge

q10510a

Q105:10. Health worker asks about: Frequent or painful urination

q10511a

Q105:11. Health worker asks about: Whether the client has felt a decrease or sto

q10512a

Q105:12. Health worker asks about: Contractions

q10513a

Q105:13. Health worker asks about: How long ago the contractions started

q10514a

Q105:14. Health worker asks about: Rupture of membrane (Water breaking)

q10515a

Q105:15. Health worker asks about: How long ago the rupture of membrane happened

q10516a

Q105:16. Health worker asks about: If there are any other problems the client is

q10502b

Q105:02. Patient volunteers information about: Fever

q10503b

Q105:03. Patient volunteers information about: Severe headaches and/or blurred v

q10504b

Q105:04. Patient volunteers information about: Swollen face or hands

q10505b

Q105:05. Patient volunteers information about: Convulsions or loss of consciousn

q10506b

Q105:06. Patient volunteers information about: Severe difficulty breathing

q10507b

Q105:07. Patient volunteers information about: Persistent cough for 2 weeks or l

q10508b

Q105:08. Patient volunteers information about: Severe abdominal pain

q10509b

Q105:09. Patient volunteers information about: Foul smelling discharge

q10510b

Q105:10. Patient volunteers information about: Frequent or painful urination

q10511b

Q105:11. Patient volunteers information about: Whether the client has felt a dec

q10512b

Q105:12. Patient volunteers information about: Contractions

q10513b

Q105:13. Patient volunteers information about: How long ago the contractions sta

q10514b

Q105:14. Patient volunteers information about: Rupture of membrane (Water breaki

q10515b

Q105:15. Patient volunteers information about: How long ago the rupture of membr

q10516b

Q105:16. Patient volunteers information about: If there are any other problems t

q106

Q106: Checks woman's HIV status (checks card or asks woman)

q107

Q107: Offers woman HIV test

q108

Q108: Is woman HIV positive? (observer: listen and record answer; circle Don't K

q10901

01) Asks if client is currently taking ARVs

q10901a

01a) Asks client when she took last dose of ARVs

q10902

02) Explains why the mother should take ARVs

q10903

03) Explains when and how the mother should take ARVs

q10904

04) Administers ARVs to mother

q10905

05) Explains why the newborn should take ARVs

q10906

06) Explains when and how newborn should take ARVs

q110

Q110: Client has any previous pregnancies? (observer: listen and record answer)

q11101

01) Heavy bleeding during or after delivery

q11102

q11103

03) High blood pressure

q11104

04) Convulsions

q11105

05) Multiple pregnancies (twins or above)

q11106

06) Prolonged labour

q11107

q11108

08) Assisted delivery (forceps, vacuum/ventouse)

q11109

09) Prior neonatal death (death of baby less than 1 month old)

q11110

10) Prior stillbirth (baby born dead that does not breathe or cry)

q11111

11) Prior abortion/miscarriage (loss of pregnancy)

q112

Q112: Washes his/her hands with soap and water or uses disinfectant before any i

q113

Q113: Explains procedures to woman (support person) before proceeding

q114

Q114: Takes temperature

q114b

Q114B: OBSERVER, IS THE PATIENT'S TEMPERATURE HIGHER THAN 38OC?

q115

Q115: Takes pulse

q116

Q116: Takes blood pressure

q11601

01) Take client's blood pressure in sitting or lateral position

q11602

02) Take blood pressure with arm at heart level

q117

Q117: Asks/notes amount of urine output

q118

Q118: Sends urine to laboratory to test for presence of protein

q119

Q119: Performs general examination (e.g. for anemia, edema)

q12001

01) Checks fundal height with measuring tape

q12002

02) Checks fetal presentation by palpation of abdomen

q12003

03) Checks fetal heart rate with fetoscope/doppler/ultrasound

q121

Q121: Performs vaginal examination before patient is in labor

q122

Q122: Number of vaginal examinations (observer: to the best of your ability, up

q131

Q131: Wears high-level disinfected or sterile gloves for vaginal examination

q132

Q132: Informs pregnant woman of findings

q133

Q133: Was the patient treated respectfully throughout the examination?

q134

Q134: Was the patient able to have a private conversation with the caregiver?

q200

Q200: Was this section observed?

q201

Q201: At least once, explains what will happen in labor to woman (support person

q202

Q202: At least once, encourages woman to consume fluids/food during labor

q203

Q203: At least once, encourages/assists woman to ambulate and assume different p

q204

Q204: Observer: Is a support person present at some point during labor?

q205

Q205: Drapes woman (one drape under buttocks, one over abdomen)

q205b

Q205b: Checks fetal heart rate with fetoscope/doppler/ultrasound

q205b1

1) Foetal heart rate is checked for 60 seconds after contraction

q205b2

2) Foetal heart rate is checked at least every 30 minutes in the first stage

q206a

Q206a: Partogram written on more than three times

q206b

Q206b: Partograph referred to monitor and manage labor

q207

Q207: Action line on partograph reached

q209

Q209: Was any definitive action taken?

q211_1

Consult with Specialist

q211_2

Refer to other facility for specialist

q211_3

Prepare for Assisted Delivery

q211_4

Prepare for C-section

q211_5

q222c

Q222c: Was the patient treated respectfully throughout the procedure?

q225

Q225: Timer (clock or watch with seconds hand)

q226

Q226: Self-inflating ventilation bag (250 or 500 mL) i.e. Ambubag

q227

Q227: Newborn face mask size 0

q228

Q228: Newborn face mask size 1

q228b

Q228b: Oxygen cylinder / tank

q228c

Q228c: Oxygen concentrator

q229

Q229: Suction bulb

q230

q231

Q231: Suction machine

q232

Q232: At least two cloths/blankets (one to dry; one to cover)

q233

Q233: Cap/hat for the newborn

q234

Q234: Disposable cord ties or clamps

q235

Q235: Sterile scissors or blade

q300

Q300: Was this section observed?

q301

Q301: Washes his/her hands with soap and water or uses antiseptic before any exa

q302

Q302: Wears high-level disinfected or sterile surgical gloves (yes if no contami

q303

Q303: Puts on clean protective clothing in preparation for birth (goggles, gown

q303b

Q303b: Checks fetal heart rate with fetoscope/doppler/ultrasound

q303b1

1) Foetal heart rate is checked for 60 seconds at least after every second c

q303b2

2) Foetal heart rate is checked at least every 5 minutes during active secon

q304

Q304: Performs episiotomy

q306

Q306: As baby's head is delivered, supports perineum

q308

Q308: Checks for another baby prior to giving the uterotonic

q309

Q309: Second baby present?

q310

Q310: Administers uterotonic?

q312_1

At delivery of anterior shoulder

q312_2

Within 1 min of delivery

q312_3

Within 3 min of delivery

q312_4

More than 3 minutes after delivery

q313_1

q313_2

q313_3

q313_4

q318

Q318: Ties or clamps cord immediately after birth

q318b

Q318b: Cuts cord with clean blade or clean scissors

q318e

Q318e: Applies traction to the cord

q318f

Q318f: OBSERVER: WERE THE TRACTION TO THE CORD AND SUPRAPUBIC COUNTER TRACTION A

q318g

Q318g: OBSERVER: IS THE PLACENTA DELIVERED?

q319

Q319: Performs uterine massage immediately following the delivery of the placent

q320

Q320: OBSERVER: WAS UTEROTONIC GIVEN EARLIER? (CHECK Q310)

q320b

Q320b: Was placenta delivered before administration of uterotonic?

q321

Q321: Assesses completeness of the placenta and membranes

q321b

Q321b: OBSERVER: IS THE PLACENTA COMPLETE?

q321c

Q321c: Performs manual evacuation of placenta

q322

Q322: Assesses for perineal and vaginal lacerations

q323

Q323: OBSERVER: DID MORE THAN ONE HEALTH WORKER ASSIST WITH THE BIRTH?

q324

Q324: OBSERVER: DID THE MOTHER GIVE BIRTH IN LITHOTOMY POSITION (ON HER BACK)?

q325

Q325: OBSERVER: IS A SUPPORT PERSON (COMPANION) FOR THE MOTHER PRESENT AT BIRTH?

q326

Q326: Was the patient treated respectfully throughout the procedure?

q327

Q327: Was the patient given physical privacy through a separate room or the use

q400

Q400: Was this section observed?

q401

Q401: Immediately dries baby with towel

q402

Q402: Discards the wet towel

q403

Q403: Is the baby breathing or crying?

q404

Q404: Places baby on mother's abdomen 'skin to skin'

q4041

Q4041: Immediately after birth

q4042

Q4042: Later than 2-3 minutes after birth

q405

Q405: Covers baby with dry towel

q406

Q406: Wraps baby in dry towel

q407

Q407: Places warm cap on baby's head

q408

Q408: OBSERVER: WAS THE CORD CLAMPED IMMEDIATELY AFTER BIRTH? (CHECK Q318)

q408b

Q408b: Ties or clamps cord:

q408c

Q408c: Cuts cord with clean blade or clean scissors

q408e

Q408e: Applies traction to the cord

q409

Q409: Observer: Is a support person (companion) for mother present?

q410

Q410: Checks baby's temperature 15 minutes after birth

q410b

Q410b: Checks baby's temperature 30 minutes after birth

q411

Q411: Checks baby's skin color 15 minutes after birth

q411b

Q411b: Checks baby's pulse 15 minutes after birth

q412

Q412: Takes mother's vital signs 15 minutes after birth

q412b

Q412b: OBSERVER: WAS THE PLACENTA DELIVERED IMMEDIATELY AFTER BIRTH? (CHECK Q318

q412c

Q412c: Amoxicillin or Erythromycin administered intravenously (IV) 30 minutes af

q412d

Q412d: Metronidazole administered intravenously (IV) 30 minutes after birth

q413

Q413: Palpates uterus 15 minutes after delivery of placenta

q414

Q414: Mother and newborn kept in same room after delivery (rooming-in)

q415

Q415: Baby bathed within the first hour after birth

q416

Q416: Baby kept skin to skin with mother for the first hour after birth

q416b

Q416b: Baby kept wrapped in dry towel with mother for the first hour after birth

q417

Q417: Breastfeeding initiated within the first hour after birth

q418

Q418: Provides tetracycline eye ointment prophylaxis

q419

Q419: Administers Vitamin K to newborn

q424b

Q424b: Checks baby's temperature 2 hours after birth

q424c

Q424c: Baby bathed two hours after birth or later

q424d

Q414d: Was the patient treated respectfully throughout the procedure?

q424e

Q424e: Was the patient given physical privacy through a separate room or the use

q424f

Q424f: Was the patient informed of procedures?

q425

Q425: Disposes of all sharps in a puncture-proof container immediately after use

q426

Q426: Decontaminates all reusable instruments in 0.5% chlorine solution

q427

Q427: Sterilizes or uses high-level disinfection for all reusable instruments

q428

Q428: Disposes of all contaminated waste in leak-proof containers

q429

Q429: Removes apron and wipe with chlorine solution

q430

Q430: Washes his/her hands with soap and water or uses antiseptic

q431

Q431: Was the patient treated respectfully throughout the procedure?

q431b

Q431b: Was the patient given physical privacy through a separate room or the use

q432

Q432: Was there a newborn resuscitation? (observer: check answer to Q500)

q433

Q433: Disposes of disposable suction catheters and mucus extractors in a leak-pr

q434

Q434: Takes the bag and mask apart and inspects for cracks and tears

q435

Q435: Decontaminates the bag and mask in 0.5% chlorine solution

q436

Q436: Sterilizes or uses high-level disinfection for bag, valve and mask

q437

Q437: Decontaminates reusable suction devices in 0.5% chlorine solution

q438

Q438: Sterilizes or uses high-level disinfection for reusable suction devices

q439

Q439: Washes his/her hands with soap and water or uses antiseptic

q500

Q500: Was this section observed?

q502

Q502: Clears the airway by suctioning the mouth first and then the nose

q503

Q503: Stimulates baby with back rubbing

q504

Q504: OBSERVER: DOES NEWBORN START TO BREATHE OR CRY SPONTANEOUSLY?

q505

Q505: Calls for help

q506

Q506: Ties or clamps cord immediately

q507

Q507: Cuts cord with clean blade or clean scissors

q508

Q508: Places the newborn on his/her back on a clean, warm surface or towel

q509

Q509: Places the head in a slightly extended position to open the airway

q510

Q510: Tells the woman (and her support person) what is going to be done

q511

Q511: Listens woman and provides support and reassurance

q512

Q512: Checks mouth, back of throat and nose for secretions, and clears if necess

q513

Q513: Places the correct-sized mask on the newborn's face so that it covers the

q514

Q514: Checks the seal by ventilating two times and observing the rise of the che

q514b

Q514b: Administers oxygen at high flow rate

q515

Q515: OBSERVER: IS NEWBORN'S CHEST RISING IN RESPONSE TO VENTILATION?

q516

Q516: Checks the position of the newborn's head to make sure that the neck is in

q517

Q517: Checks mouth, back of throat and nose for secretions, and clears if necess

q518

Q518: Checks the seal by ventilating two times and observing the rise of the che

q518b

Q518b: Administers oxygen at high flow rate

q519

Q519 OBSERVER: IS NEWBORN'S CHEST RISING IN RESPONSE TO VENTILATION?

q520

Q520: Checks the position of the newborn's head again to make sure that the neck

q521

Q521: Repeats suction of mouth and nose to clear secretions, if necessary

q522

Q522: Checks the seal by ventilating two times and observing the rise of the che

q522b

Q522b: Administers oxygen at high flow rate

q523

Q523: OBSERVER: IS NEWBORN'S CHEST RISING IN RESPONSE TO VENTILATION?

q524

Q524: Ventilates at a rate of 30 to 50 breaths/minute

q525

Q525: Observes baby's tongue and lips for central cyanosis after 1 minute of ven

q525b

Q525b: Conducts assessment of newborn breathing after 1 minute of ventilation

q526_1

Respiration Rated 30-50 breaths/minute and no chest indrawing

q526_2

Respiration Rated <30 breaths/minute with severe indrawing

q526_3

No spontaneous breathing

q527

Q527: Continues ventilation or administration of oxygen

q528

Q528: Observes baby's tongue and lips for central cyanosis 15 minutes after star

q529_1

Respiration Rated 30-50 breaths/minute and no chest indrawing

q529_2

Respiration Rated <30 breaths/minute with severe indrawing

q529_3

No spontaneous breathing

q530

Q530: Continues ventilation

q531_1

Baby was resucitated

q531_2

q532

Q532: Conducts assessment of newborn breathing every 15 minutes during the hour

q532b

Q532b: Observes baby's tongue and lips for central cyanosis every 15 minutes dur

q533

Q533: Arranges transfer to special care either in facility or to outside facilit

q534

Q534: Explains to the mother (and her support person if available) what happened

q535

Q535: Listens to mother and responds attentively to her questions and concerns

q536

Q536: OBSERVER: IF BABY DIED, WAS THE MOTHER GIVEN COUNSELING

q537

Q537: OBSERVER: WAS THE SITUATION CHAOTIC OR CALM?

q538

Q538: OBSERVER: WERE THERE ANY MAJOR DELAYS IN NEEDED TREATMENTS?

q539

Q539: OBSERVER: WERE NECESSARY EQUIPMENT, SUPPLIES, MEDICATIONS AVAILABLE?

q540

Q540: OBSERVER: DID YOU CALL FOR HELP OR INTERVENE DURING THE RESUSCITATION TO

q601_1

Goes to post-delivery ward

q601_2

Referred to specialist, same facility

q601_3

Goes to surgery, same facility

q601_4

Referred, other facility

q601_5

q601_6

Death of mother

q601_7

q601_8

q602a

Goes to normal nursery

q602b

Referred to specialist, same facility

q602c

Referred, other facility

q602d

Goes to ward with mother

q602e

q602f

Fresh stillbirth

q602g

Macerated stillbirth

q602h

Discharged with mother

q602k

q603a

Q603: A. Use of enema

q603b

Q603: B. Pubic shaving

q603c

Q603: C. Woman routinely forced to push during second stage of labor

q603d

Q603: D. Apply fundal pressure to hasten delivery of baby or placenta

q603e

Q603: E. Lavage of uterus after delivery

q603f

Q603: F. Minor tears stitched when not bleeding

q603g

Q603: G. Episiotomy / tears not repaired with local anesthesia

q603h

Q603: H. Vagina swabbed with antiseptics after delivery

q603i

Q603: I. Disinfectant put on the perineum after delivery

q603j

Q603: J. Bladder catheterization performed postpartum

q603k

Q603: K. Cervix checked after delivery

q603l

Q603: L. Slap newborn

q603m

Q603: M. Hold newborn upside down

q603n

Q603: N. Milking the newborn's chest

q603o

Q603: O. Excessive stretching of the perineum

q603p

Q603: P. Shout, insult or threaten the woman during labor or after

q603q

Q603: Q. Slap, hit or pinch the woman during labor or after

q604a

Q604: A. Manual exploration of the uterus after delivery

q604b

Q604: B. Use of episiotomy

q604c

Q604: C. Aspiration of newborn mouth and nose as soon as head is born (neonatal

q604d

Q604: D. Routine catheterization of esophagus

q604e

Q604: E. Restrict food and fluids in labor

q604f

q605a

Q605a: Respectful

q605b

q605c

Q605c: Attentive

q610id1

q610id2

q610id3

q611

Q611: Partograph used (during or after labor)

q612

Q612: Standard Liberian partograph at 4cm dilatation used

q613

Q613: Initiated use of partograph at the appropriate time according to partograp

q613b

OBSERVER: DID THE MOTHER COME FULLY DILATED?

Total: 1112

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