This report presents six years of learnings, data, and insights from the BetterBirth Study implementing the World Health Organization’s Safe Childbirth Checklist in India (2011-2017). It draws heavily on 10 years of global implementation of the Checklist, as well. Ariadne Labs gratefully acknowledges its partners in the BetterBirth Study, and all those who have supported the development and testing of the World Health Organization (WHO) Safe Childbirth Checklist and the BetterBirth team.

We recognize the Governments of India and Uttar Pradesh for collaboration and support to conduct the BetterBirth Study in public health facilities. We are grateful to the members of the study’s Scientific Advisory Committee who contributed crucial guidance to its development and implementation, as well as the Data Safety Monitoring Board that monitored patient safety and reviewed the interim analysis. Ariadne Labs, a joint center of the Harvard T.H. Chan School of Public Health and Brigham and Women’s Hospital, carried out the work in close partnership with the World Health Organization, Population Services International, Community Empowerment Lab, Jawaharlal Nehru Medical College, and Dimagi. The more than 300 members of the BetterBirth Study team in Boston, MA, USA and Uttar Pradesh, India, were essential to carrying out the scientific vision on the ground with integrity and excellence. Most importantly, we are grateful to the laboring women, their families, and facility-based staff who participated in the study.

We thank the WHO Safe Childbirth Checklist Collaborative and colleagues from around the globe who have shared their successes and challenges in implementing the Safe Childbirth Checklist. Development of this report was made possible through generous funding from the Bill & Melinda Gates Foundation. This report was completed in close consultation with scientific experts at Ariadne Labs and partner organizations. It was visually designed by Courtney Staples and authored by Lauren Bobanski, Megan Marx Delaney, Madeline Drexler, Emily George, Rose Molina, Deborah O’Neil, Katherine Semrau, and Danielle Tuller.

BetterBirth Principal Investigators

  • Atul Gawande, 2011-2018
  • Jonathan Spector, 2011-2013
  • Steve Ringer, 2011-2014
  • Bhala Kodkany, 2012-2018
  • Vishwajeet Kumar, 2012-2018
  • Katherine Semrau, 2014-2018

BetterBirth Study Steering Committee

  • France Donnay, Jerker Liljestrand, and Mrunal Shetye, Bill & Melinda Gates Foundation
  • Neelam Dhingra-Kumar and Itziar Larizgoitia, World Health Organization
  • Atul Gawande and Katherine Semrau, Ariadne Labs, Harvard T.H. Chan School of Public Health

BetterBirth Study Scientific Advisory Committee

  • Dinesh Baswal
  • Himanshu Bhushan
  • Zulfiqar Bhutta
  • Waldemar Carlo
  • Richard Cash
  • Vinita Das
  • Director of the Department of Health and Family Welfare for Uttar Pradesh
  • Paul Francis
  • Amit Ghosh
  • Fnu Kajal
  • Amod Kumar
  • Matthews Mathai
  • Mission Director of the National Health Mission for Uttar Pradesh
  • Packirisamy Padmanbhan
  • Vinod Paul
  • Rigzin Samphel
  • Bulbul Sood
  • Rajiv Tandon

BetterBirth Study Data Safety Monitoring Board (DSMB)

  • Shally Awasthi
  • Cyrus Mehta (chair)
  • Nozer Sheriar