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Exploring multilevel determinants of stillbirth: a comprehensive analysis across sub-Saharan African countries
Khadijat Adeleye1, Oluwabunmi Ogungbe2,3, Yvette Yeboah-Kordieh4
1Elaine Marieb College of Nursing, University of Massachusetts Amherst, Amherst, Massachusetts, USA kadeleye@umass.edu.
BMJ Open
|June 23, 2025
Summary
Stillbirths are a major concern in sub-Saharan Africa. Maternal education and marital status reduce risk, while employment and rural living increase stillbirth risk in SSA.
Area of Science:
- Reproductive Health
- Maternal and Child Health
- Global Health
Background:
- Stillbirths represent a significant public health concern in sub-Saharan Africa (SSA), accounting for a substantial portion of global stillbirths.
- The region faces a high burden of stillbirths, necessitating research into contributing factors.
Purpose of the Study:
- To investigate the individual-level and contextual determinants of stillbirth among women in 29 sub-Saharan African countries.
- To identify key risk and protective factors associated with stillbirth in the SSA region.
Main Methods:
- Cross-sectional analysis of a weighted sample of women aged 15-49 years in 29 SSA countries.
- Inclusion criteria: women who had given birth or experienced a stillbirth.
Main Results:
- Stillbirth prevalence was 8.4 per 1000 live births.
- Increased risk associated with advanced maternal age, employment, and rural residence.
- Decreased risk observed with higher maternal education and being single compared to separated/partnered women.
Conclusions:
- Stillbirth outcomes in SSA are influenced by a complex interaction of individual and contextual factors.
- Integrated, cross-sectoral care approaches are crucial for addressing the multifaceted determinants of stillbirths and improving maternal and neonatal health outcomes.
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