Kabongo, LeonardGass, JonathonKivondo, BeatriceKara, NabihahSemrau, KatherineHirschhorn, Lisa R2017-12-052017Kabongo, Leonard, Jonathon Gass, Beatrice Kivondo, Nabihah Kara, Katherine Semrau, and Lisa R Hirschhorn. 2017. “Implementing the WHO Safe Childbirth Checklist: lessons learnt on a quality improvement initiative to improve mother and newborn care at Gobabis District Hospital, Namibia.” BMJ Open Quality 6 (2): e000145. doi:10.1136/bmjoq-2017-000145. http://dx.doi.org/10.1136/bmjoq-2017-000145.http://nrs.harvard.edu/urn-3:HUL.InstRepos:34492107Background: Although there are many evidence-based practices that reduce the risk of maternal and neonatal mortality around the time of birth, there remains a gap between what is known and the care received. This know-do gap is a source of preventable maternal and perinatal deaths and is the focus of improvement efforts in many countries. Following an increase in perinatal and maternal deaths, Gobabis District Hospital initiated a quality improvement (QI) initiative to increase adherence to these WHO Safe Childbirth Checklist (SCC)-targeted essential birth practices (EBPs). Methods: We implemented the SCC with support from leadership, coaching and organisational redesign. Implementation was led by a facility champion supported by a QI team and adapted through a series of three 8-week Plan–Do–Study–Act (PDSA) cycles. Results: During the 6-month period, we observed an improvement of average EBPs delivered from 68% to 95%. We also found reductions in perinatal mortality rates from 22 deaths/1000 deliveries to 13.8/1000 deliveries largely due to a drop in fresh stillbirths. Conclusion: We conclude that replicating the programme is feasible, acceptable and effective in areas where gaps exist, but it requires local leadership, ongoing coaching and adaptation through PDSA cycles.en-USPdsaobstetrics and gynecologychecklistsJournal Article2017-12-0510.1136/bmjoq-2017-000145