Africa’s hidden stillbirth crisis: New report exposes major policy, data gaps
AFRICA: NEARLY one million babies are stillborn in Africa every year. Behind every stillbirth is a mother, a family and a story left untold.
Most of these are preventable, many unrecorded, and too often invisible. Each number hides a moment of heartbreak, and every uncounted loss represents a missed opportunity to learn and to act.
A stillbirth is the loss of a baby after 20 or 24 weeks of pregnancy, meaning the baby is born without any signs of life, and it’s a devastating experience often caused by placental issues, infections, genetic problems, or complications like preeclampsia, though sometimes the cause remains unknown.
Key signs can include reduced fetal movement, and management involves delivering the baby followed by extensive emotional and physical support for parents, who often grapple with intense grief, guilt, and the need to understand recurrence risks.
As a public health researcher specialising in maternal and newborn health, I have spent the past two decades working on strengthening health systems and quality of care across Africa.
My research has focused on understanding how health systems can prevent stillbirths and provide respectful, people centred care for women and newborns.
Most recently, I was part of the team that led a new report called Improving Stillbirth Data Recording, Collection and Reporting in Africa. It is the first continent-wide assessment of how African countries record and use stillbirth data.
The study, conducted jointly by the Africa Centres for Disease Control and Prevention, the University of Cape Town, the London School of Hygiene & Tropical Medicine and the United Nations Children’s Fund, surveyed all 55 African Union member states between 2022 and 2024, with 33 countries responding. The burden of stillbirths in Africa is staggering.
Africa accounts for half of all stillbirths globally, with nearly eight times higher rates than in Europe.
Even stillbirths that happen in health facilities may never make it into official statistics despite every maternity registry documenting this birth outcome.
Part of the challenge is that there are multiple data systems for capturing births and deaths, including stillbirths, like routine health information systems, civil registration and other surveillance systems. But these systems often don’t speak to each other either within countries or between countries.
This data gap hides both the true burden and the preventable causes. Despite advances in several countries to prevent stillbirths, large gaps remain, especially on data systems.
Only a handful of African countries routinely report stillbirth data to the UN, and many rely on outdated or incomplete records.
Without reliable, comparable data, countries cannot fully understand where and why stillbirths occur or which interventions save lives.
Strengthening stillbirth data is not just about numbers; it is about visibility, accountability and change.
When countries count every stillbirth and use the data for health system improvement, they can strengthen care at birth for mothers and newborns and give every child a fair start in life.
Findings The report was based on a regional survey of ministries of health.
This was followed by document reviews and expert consultations to assess national systems, policies and practices for stillbirth reporting and review.
The report reveals that 60% of African countries have national and subnational committees responsible for collecting and using stillbirth data, which produce national reports to respective health ministries. But data use remains limited.
Capacity gaps, fragmented systems and insufficient funding prevents many countries from translating information into action.
To guide investment and accountability, the report categorises countries into three readiness levels: Mature systems needing strengthening, such as Kenya, Rwanda and Uganda. These countries have consistent data flows but need more analysis and use.
Partial systems requiring support, where reporting mechanisms exist but are not systematically implemented, like Ghana, Malawi and Tanzania.
Foundational systems still being built, including fragile or conflict-affected countries like South Sudan and Somalia.
Here, policies and structures for data collection and use remain absent. The findings show both progress and persistent gaps.
Two-thirds of African countries now include stillbirths in their national health strategies, and more than half have set reduction targets.
Nearly all countries report that they routinely record stillbirths through their health sectors using standard forms and definitions, yet these definitions vary widely. Most systems depend on data reported from health facilities.
But the lack of integration between health, civil registration and other data systems means that countless losses never enter national statistics.
For example, if a woman delivers at home alone in Mozambique and the baby is stillborn, the loss is only known to the family and community.
Without a facility register entry or civil registration notification, the death never reaches district or national statistics.
Even when a stillbirth occurs in a health centre, the health worker may log it in a facility register but not report it to the civil registration system.
This means the loss of the baby remains invisible in official data.
What this means Stillbirths are a sensitive measure of how health systems are performing. They reflect whether women can access timely, quality care during pregnancy and at birth.
But unlike maternal deaths, which are often a benchmark for health system strength, stillbirths remain largely absent from accountability frameworks.
Their causes, like untreated infections, complications during labour, or delays in accessing emergency caesarean sections, are often preventable.
The same interventions that prevent a stillbirth also reduce maternal deaths.
These improve newborn survival, and lay the foundation for better health and development outcomes in early childhood.
Accurate data on stillbirths can guide clinical care and direct scarce resources to where they are needed most.
When data systems are strong, leaders can identify where and why stillbirths occur, track progress and make informed decisions to prevent future tragedies.
