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Valuing Stillbirths.

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    This study argues for including stillbirths in burden of disease estimates. Counting stillbirths, similar to neonatal deaths, can improve global health spending decisions.

    Keywords:
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    Area of Science:

    • Public Health
    • Health Economics
    • Bioethics

    Background:

    • Current burden of disease estimates, like quality-adjusted life years (QALYs) and disability-adjusted life years (DALYs), often exclude stillbirths.
    • This exclusion undervalues the prevention of over three million annual stillbirths globally.
    • Neonatal deaths, though comparable in number, significantly impact burden of disease metrics and are prioritized.

    Purpose of the Study:

    • To advocate for the inclusion of late-term stillbirths in burden of disease calculations.
    • To address ethical and practical objections to counting stillbirths.
    • To argue that incorporating stillbirths will lead to more effective health spending decisions.

    Main Methods:

    • Comparative analysis of stillbirths and neonatal deaths.
    • Ethical argumentation addressing objections to including stillbirths in population health measures.
    • Economic reasoning regarding health priority setting.

    Main Results:

    • Stillbirths share critical similarities with newborn infants, justifying their inclusion in health burden assessments.
    • Addressing objections reveals that including stillbirths does not necessitate including miscarriages or infringe on reproductive rights.
    • Current exclusion of stillbirths leads to suboptimal allocation of global health resources.

    Conclusions:

    • Incorporating stillbirths into burden of disease estimates is ethically preferable to current practices.
    • This inclusion is likely to result in improved global health spending and resource allocation.
    • Prioritizing stillbirth prevention aligns with the ethical importance of protecting vulnerable lives.