Public Health

Public Health

Share this article Share this article

What's Inside

Kindly click here to access the India Fact Sheet of Longitudinal Ageing Study in India(LASI) -- Wave-1 (released in 2021), An Investigation of Health, Economic, and Social Well-being of India’s Growing Elderly Population, India Report 2020, prepared by International Institute for Population Sciences (IIPS), National Programme for Health Care Elderly (NPHCE), Harvard TH Chan School of Public Health (HSPH), University  of Southern California (USC) and Ministry of Health and Family Welfare (MoHFW).

Please click here to read the Executive Summary of Longitudinal Ageing Study in India(LASI) -- Wave-1 (released in 2021).

---

According to the report entitled A Neglected Tragedy: The global burden of stillbirths -- Report of the UN Inter-agency Group for Child Mortality Estimation, 2020 (released in October 2020) (please click here to access):

• About one stillbirth occurs every 16 seconds, which means that every year, about 2 million babies are stillborn i.e. showing no signs of life at birth. It means every day, almost 5,400 babies are stillborn. Globally, one in 72 babies is stillborn.

• In the past two decades, 48 million babies were stillborn. Three-in-four stillbirths occur in sub-Saharan Africa or Southern Asia. Low and lower-middle income countries account for 84 percent of all stillbirths but only 62 percent of all live births.

• Stillbirths are largely absent in worldwide data tracking, rendering the true extent of the problem hidden. They are invisible in policies and programmes and underfinanced as an area requiring intervention. Targets specific to stillbirths were absent from the Millennium Development Goals (MDGs) and are still missing in the 2030 Agenda for Sustainable Development.

• There are a variety of reasons behind the slow reduction in stillbirth rates: absence of or poor quality of care during pregnancy and birth; lack of investment in preventative interventions and the health workforce; inadequate social recognition of stillbirths as a burden on families; measurement challenges and major data gaps; absence of global and national leadership; and no established global targets, such as the Sustainable Development Goals (SDGs).

• Globally, an estimated 42 percent of all stillbirths are intrapartum (i.e., the baby died during labour); almost all of these 832,000 stillborn deaths that occurred in 2019 could have been prevented with access to high-quality care during childbirth, including ongoing intrapartum monitoring and timely intervention in case of complications.

• Around 20 million babies are projected to be stillborn in the next decade, if trends observed between 2000 and 2019 in reducing the stillbirth rate continue. Among the 20 million, 2.9 million stillbirths could be prevented by accelerating progress to meet the ENAP target in the 56 countries at risk to miss the goal. Every Newborn Action Plan (ENAP) calls for each country to achieve a rate of 12 stillbirths or fewer per 1,000 total births by 2030 and to close equity gaps.

• In the first two decades of this century (i.e. 2000-2019), the annual rate of reduction (ARR) in the stillbirth rate was just -2.3 percent, compared to a -2.9 percent reduction in neonatal mortality and -4.3 percent among children aged 1–59 months. Meanwhile, between 2000 and 2017, maternal mortality decreased by -2.9 percent.

• In the year 2000, the ratio of the number of stillbirths to the number of under-five deaths was 0.30; by 2019, it had increased to 0.38. So, stillbirths are an increasingly critical global health problem.

• National stillbirth rates around the globe ranged from 1.4 to 32.2 stillbirths per 1,000 total births in 2019. Sub-Saharan Africa, followed by Southern Asia, had the highest stillbirth rate and the greatest number of stillbirths.

• Six countries bore the burden of half of all stillbirths of the world – India, Pakistan, Nigeria, the Democratic Republic of the Congo, China and Ethiopia, in order of burden (highest to lowest).

• Nearly 3,40,622 of the 19,66,000  stillbirths globally in 2019 were in India, making it the country with the largest such burden (i.e. 17.33 percent).

• In 2019, India, Pakistan and Nigeria alone accounted for one-third of the total burden of stillbirths and 27 percent of live births.

• Stillbirth rate is defined as the ratio of the number of still births per 1,000 live births and stillbirths taken together (i.e. total births).

• Some progress has been made in preventing stillbirths. Globally, the stillbirth rate declined by 35 percent since 2000. Since 2000, the stillbirth rate declined by 44 percent in Central and Southern Asia, 53 percent in India, 52 percent in Kazakhstan and 44 percent in Nepal.

• Among the lower-middle income countries, stillbirth rate fell by 39 percent since 2000. Since the year 2000, stillbirth rate in lower-middle income countries like Mongolia, India and El Salvador declined by 57 percent, 53 percent and 50 percent, respectively.

• A total of 14 countries – including three low- and lower middle income countries (Cambodia, India, Mongolia) – slashed the stillbirth rate by more than half during 2000-2019.

• The top 15 countries with the greatest percentage decline in the stillbirth rate during 2000–2019 are China (63 percent), Turkey (63 percent), Georgia (62 percent), North Macedonia (62 percent), Belarus (60 percent), Mongolia (57 percent), Netherlands (55 percent), Azerbaijan (53 percent), Estonia (53 percent), India (53 percent), Kazakhstan (52 percent), Romania (52 percent), El Salvador (50 percent), Peru (48 percent) and Latvia (46 percent).
 
• India's stillbirth rate (i.e. (stillbirths per 1,000 total births) in 2000 was 29.6, in 2010 was 20.2 and in 2019 was 13.9. The percentage decline in India's stillbirth rate during 2000–2019 was -53.0 percent. The annual rate of reduction (ARR) in stillbirth rate during 2000-2019 was -4.0 percent.

• The total number of stillbirths in India was 852,386 in 2000, 535,683 in 2010 and 340,622 in 2019. The percentage decline in stillbirths during 2000–2019 was -60.0 percent. The annual rate of reduction (ARR) in total number of stillbirths during 2000–2019 was -4.8 percent. India witnessed 24,116,000 livebirths and 24,457,000 total births in 2019.  

• Women in sub-Saharan Africa and Southern Asia bear the greatest burden of stillbirths in the world. More than three quarters of estimated stillbirths in 2019 occurred in these two regions, with 42 percent of the global total in sub-Saharan Africa and 34 percent in Southern Asia.

• In 2019, stillbirth rate per 1,000 total births in Afghanistan was 28.4 (total stillbirth in 2019: 35,384), Bangladesh was 24.3 (total stillbirth in 2019: 72,508), Bhutan was 9.7 (total stillbirth in 2019: 127), China was 5.5 (total stillbirth in 2019: 92,170), India was 13.9 (total stillbirth in 2019: 340,622), Maldives was 5.8 (total stillbirth in 2019: 41), Myanmar was 14.1 (total stillbirth in 2019: 13,493), Nepal was 17.5 (total stillbirth in 2019: 9,997), Pakistan was 30.6 (total stillbirth in 2019: 190,483) and Sri Lanka was 5.8 (total stillbirth in 2019: 1,943).

• Data are essential to understanding the burden of stillbirths and identifying where, when and why they occur.

• Immediate actions are needed to strengthen data systems and their ability to collect, analyses and use timely, quality and disaggregated stillbirth data. To improve stillbirth data availability and quality, it is recommended that countries and relevant stakeholders:

a. Align the stillbirth definition and measures with international standards
b.  Integrate stillbirth-specific components within relevant plans for data system strengthening and improvement
c. Record stillbirth outcomes in all relevant maternal and newborn health programs, including routine HMIS (registers and monthly reporting forms)
d. Provide training and support to include stillbirths within civil and vital registration systems as the coverage of these systems increases
e. Include information on timing of stillbirth (antepartum or intrapartum) in all settings and record causes and contributing factors to stillbirth where possible
f. Report and review stillbirth data locally – at facility or district level – alongside data on neonatal deaths (by day of death) to reduce incentives for misreporting of outcomes, and to monitor potential misclassification.
g. Collate reported stillbirth rate data up the data system to a national level to enable tracking of progress towards the ENAP target of 12 stillbirths or fewer per 1,000 total births in every country by 2030 and to enable monitoring of geographical inequities.

• Ending preventable stillbirths is among the core goals of the UN’s Global Strategy for Women’s, Children’s and Adolescents’ Health (2016–2030) and the Every Newborn Action Plan (ENAP). These global initiatives aim to reduce the stillbirth rate to 12 or fewer third trimester (late) stillbirths per 1,000 total births in every country by 2030.

• The stillbirth rate (SBR) is defined as the number of babies born with no signs of life at 28 weeks or more of gestation, per 1,000 total births. The stillbirth rate is calculated as: SBR = 1000 * {sb/(sb+lb)}, where 'sb' refers to the number of stillbirths ≥ 28 weeks or more of gestational age; and 'lb' refers to the number of live births regardless of gestational age or birthweight.


[Shivangini Piplani, who is doing her MA in Finance and Investment (1st year) from Berlin School of Business and Innovation, assisted the Inclusive Media for Change team in preparing the summary of 'A Neglected Tragedy: The global burden of stillbirths -- Report of the UN Inter-agency Group for Child Mortality Estimation, 2020.' She did this work as part of her winter internship at the Inclusive Media for Change project in December 2020.]

 


 

Write Comments

Your email address will not be published. Required fields are marked *

*

Video Archives

Archives

share on Facebook
Twitter
RSS
Feedback
Read Later

Contact Form

Please enter security code
      Close