Authors: Hannah Blencowe, London School of Hygiene & Tropical Medicine, and Susannah Leisher, International Stillbirth Alliance on behalf of the Stillbirth Advocacy Working Group (SAWG), founded by World Health Organization’s Partnership for Maternal, Newborn and Child Health.
Reducing stillbirths presents a solid case for economic investment with as much as a 10 to 25 times return on investment in economic and social benefits.¹ Yet this investment case cannot be made if stillbirths are not tracked through national and global monitoring systems.
Despite the enormity of the burden and the existence of evidence-based solutions to prevent many stillbirths, stillbirths have been long overlooked in global data tracking, social recognition, and in investment and programmatic action.
This must change. And signs of progress give hope.
SIGNS OF PROGRESS IN TRACKING STILLBIRTHS
After the call for intentional incorporation of stillbirths into global and national tracking mechanisms in The Lancet Ending Preventable Stillbirth series, the global monitoring bodies have taken action. First, the Global Strategy for Women’s, Children’s and Adolescents’ Health (2016) added stillbirth rate as a core indicator. Now the Countdown to 2030 report, published earlier this year, has also included stillbirth rate as part of tracking progress for maternal and child health.
But there are still gaps and we need to do more. Stillbirths count to families and economies; thus they should count to governments, donors, the UN agencies and all stakeholders.
In 2016, only 32 of the 75 Countdown countries regularly tracked stillbirths as part of their national health information systems.² With stillbirths now included in the Countdown profiles and as a core indicators in the Global Strategy, the UN needs to respond to the growing demand for regular counting of stillbirths. However, to date, the UN has not produced regular estimates of stillbirths. While they have recently been included within the global burden of disease estimates, the lack of transparency in the estimation progress, absence of a country consultation process, and limited dissemination limits their utility for programmes, policymakers or global tracking.
The UN Inter-agency Group for Child Mortality Estimation (IGME) has agreed to undertake regular country-level stillbirth rate estimates, but their ability to deliver on the commitment to regularly count stillbirths will not be possible without further investment from partners.³
BREAKING THE SILENCE
We thank UN IGME for its willingness to help break the silence around stillbirth by including stillbirth estimates in its maternal and child estimation processes. We call upon the global donor community to commit its resources as well to counting stillbirths so that we may accelerate progress in ending this avoidable tragedy. Richard Horton, editor-in-chief of The Lancet, reflected that “stillbirths are a sensitive indicator of our solidarity, cohesion and inclusiveness”.⁴ Will 2018 be the year when the international health community demonstrates their collective commitment to the counting and preventability of stillbirths?
Learn more about what has happened in the two years since The Lancet published their series on ending preventable stillbirths here.
¹ ten Hoope-Bender P, Stenberg K, Sweeny K. Reductions in stillbirths--more than a triple return on investment. Lancet. 2016;387(10018):e14-6. doi: 0.1016/S0140-6736(15)01277-5. Epub 2016 Jan 19.
² Blencowe H et al. National, regional, and worldwide estimates of stillbirth rates in 2015, with trends from 2000: a systematic analysis. The Lancet Global Health. 2016;4(2): e98 - e108 2016.
³ IGME’s role is to harmonize mortality estimates within the UN and its partners, improve methods for robust, transparent child mortality estimates, report progress towards child survival goals, and build country capacity to produce annual estimates of child mortality.
⁴ Horton, Richard et al. Stillbirths: ending an epidemic of grief. Lancet. 2016; 387(10018). DOI: http://dx.doi.org/10.1016/S0140-6736(15)01276-3