Grant is closed

Feb 2016 – Jan 2019

Safe childbirth checklist - India



India – South Asia

To scale up the checklist initiative throughout Rajasthan and Andhra Pradesh and support the government's national programme to reduce newborn deaths.

$5,389,512 Grant Value

$540,000 evaluation budget

Other funders

  • Government of India -

  • MacArthur Fouhdation -

  • Norway India Partnership Initiative

In India, around 600,000 babies die every year during labour and the first two days of life. Progress over the last decade has been slow, with neonatal mortality dropping only 3% each year. The large burden of preventable mortality remains, despite institutional delivery rates doubling over this period. Currently, 80% of all births take place in a health facility. This huge opportunity to prevent newborn deaths is being lost due to poor quality of care.

CIFF’s proof of concept investment in Rajasthan, India, aimed to tackle this problem head on. It was set up to test whether a simple paper based tool - the WHO Safe Childbirth Checklist - could improve provider adherence to 29 essential delivery practices, and reduce perinatal deaths. This grant has delivered strong results, confirming that the Checklist with Jhpiego coaching and support is a powerful tool to improve quality of childbirth care. Click here for more details.

The Government of India was quick to respond to the new evidence. It launched a national programme, Dakshata, to take the checklist to eight states with the highest newborn mortality rates. In the first phase of the Dakshata initiative, the Checklist will be used in over a million deliveries each year. All core costs of scale up will be met by the national government.

Technical assistance funding to Jhpiego will help ensure the Government of India’s Dakshata is successfully scaled up across Rajasthan and Andhra Pradesh. There are three main objectives: 

In Rajasthan, Jhpiego will provide intensive support to the government's programme. They will assist with training, help ensure the required drugs and supplies are available, and provide health worker training and mentoring. There will also be technical assistance in Andhra Pradesh. 

At the national level, Jhpiego will share lessons and best practices from Rajasthan and Andhra Pradesh with other states by convening workshops and arranging study visits. They will help the Government of India develop protocols and guidelines to support roll out of Dakshata.

As the checklist is part of the patient case sheet and contains a comprehensive account of care provided, it can serve as a powerful quality monitoring tool. Jhpiego will help establish a dashboard of quality of care indicators that will enable performance to be tracked in real time at facility, district, state, and national level. 


The investment aims for a four-fold reduction in neonatal mortality in Rajasthan and Andhra Pradesh. It will support the Government of India's national programme Dakshata, to roll out the Safe Childbirth Checklist to states with the highest newborn mortality rates. It will also introduce independent auditing of practices and outcomes with a monitoring framework.