This week saw the launch of the Lancet series of papers on ‘ending preventable stillbirth’. The five papers show how relative to other health gains globally there has been slow progress on stillbirth prevention, leaving parents of 2.6 million babies suffering in silence each year. Notably, half of all stillbirths occur during labour and birth and are thus very amenable to prevention by high quality midwifery, obstetric and newborn care. While there are continuing challenges with detection of at-risk fetuses, prevention and timely intervention in high-income countries, most stillbirths occur in low- and middle-income countries. Stillbirth rates are a key indicator for quality of care for maternal newborn health and the ability to count them is vital for making progress. Parent voices are critical to unlocking stigma and taboos around stillbirths, which can prevent women receiving the care they need after losing a baby and prevent an active public health and service focus on improving access to services. Those interventions that help to end stillbirth will also prevent maternal deaths and reduce newborn deaths and complications, so there is a ‘quadruple return’ on investments in this area. Health economists and policy makers take note!
Paper 5 in the series, “Stillbirths: ending preventable deaths by 2030” co-authored by Professor William Stones examines the steps that are needed to achieve progress. A starting point is to ensure full access to basic elements of care, so that for example antenatal care is provided according to quality standards. We show how current coverage of these basic essential elements is variable and often lacking, for example blood pressure measuring equipment in antenatal clinics (Malawi 68%), urine testing for protein (Uganda 29%) or syphilis testing (Kenya 24%). Priority areas identified include intentional leadership; increased voice, especially of women; implementation of integrated interventions with commensurate investment; indicators to measure effect of interventions and especially to monitor progress; and investigation into crucial knowledge gaps.
contact: Prof Will Stones