Counting and Accounting for Every Stillbirth

  • Counting and Accounting for Every Stillbirth
Following nine months of exciting wait, it is unimaginable despair for a mother to learn of stillbirth.

Every day, 96 babies are born dead in Kenya. In 2015, about 35,000 babies were born dead in Kenya (1). Mothers and their families bear the burden of stillbirth, with many experiencing psychological problems that often persist long after the death of the baby. Kenya is ranked among 20 countries with high burden of newborn deaths.

The country has committed to address Maternal and Child Survival, through commitment to provision of Free Maternity Services and roll out of Reproductive Maternal Newborn Adolescent Health (RMNCAH) Framework 2016 among other important commitments and is set to meet the target 3.2 of the third Sustainable Development Goal.

Kenya has made remarkable progress in improving RMNCAH outcomes in the past decade. Child mortality has declined by over 20 percent since 2008. However, country’s maternal mortality ratio (MMR) and perinatal mortality rate still remains high at 362 deaths per 100,000 live births and 28 deaths per 1000 live births respectively. The country is ranked 11th in the list of countries with most stillbirths (2). 

It is indicated that most stillbirths occur during delivery and labour despite a child having survived in the womb for up to nine months. Half of the still births are reported to occur during labour. Key causes attributed to stillbirth include:

  • child birth complications
  • post-term pregnancy maternal infections in pregnancy (malaria, syphilis and HIV)
  • maternal disorders (especially hypertension, obesity and diabetes)
  • fetal growth restriction
  • congenital abnormalities.

Most of these causes are preventable with quality care provided during pregnancy and birth.

The 2016 Stillbirth Lancet series fronts stillbirths as an important global public health issue. Understanding the context and events leading to stillbirth are critical to curb the high statistics. The report put emphasis to specific attention to stillbirths in advocacy, policy formulation, research, and monitoring. The MPDSR Action Network indicates fewer of the 51 priority countries have policy in place to report and review stillbirths. As such, less information has been captured and assessed on stillbirths. These babies are not counted and accounted for.  

Counting and accounting every stillbirth provides an opportunity to improve the survival of babies while providing intel into; how many stillbirths deaths take place, where and why they occur, what are the contributing factors and what can be done to prevent similar events. This information helps identify the avoidable factors, and improve service provision and overall quality of care through health systems to prevent perinatal deaths from similar causes in the future. 3 out of 10 babies could be saved by conducting perinatal death audits.

The MPDSR Action Network recognises Perinatal Audits as an important tool to addressing stillbirths. Kenya has included the ‘P’ in the MPDSR Guidelines; Maternal Perinatal Death Surveillance and Response. The guidelines provide an opportunity for every stillbirth to be counted and accounted for in Kenya.

A great step forward as every stillbirth is a dead baby that should be counted and accounted for! 

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