In 2023 alone, a staggering 1.9-million babies were stillborn globally. Nearly half of these deaths occurred during labour and could have been prevented.
The findings were revealed in the latest report by the UN Inter-agency Group for Child Mortality Estimation, released as South Africa hosts the second G20 Health Working Group Meeting in KwaZulu-Natal this week.
Under the theme “Accelerate Health Equity, Solidarity and Universal Coverage” , the conference delves into strategies to strengthen health systems and promote equitable access to health care.
“Mothers in low-income countries, sub-Saharan Africa and Southern Asia and fragile, conflict-affected settings face the highest risks of experiencing the tragedy of stillbirth.
“Almost 32% of stillbirths in 2023 took place in low-income countries, and nearly 80% occurred in sub-Saharan Africa, where nearly 48% of the world’s stillbirths took place in 2023 vs only 30% of global live births,” said the report.
The report highlighted that the proportion of stillbirths that take place during labour are preventable with the right access to professional health-care givers.
“Progress in reducing the stillbirth rate has been inconsistent and far too slow, especially when compared to other areas of child survival,” the report found.
A Rwandan woman, Nonkululeko Shibula, who was interviewed for the report, said cultural beliefs often get in the way of healing after a stillbirth.
“After my daughter was stillborn, a simple funeral was arranged by our relatives. No other services were held, based on the belief that acknowledging her might bring harm to any future children I might have.
“I longed to speak about her openly and express my sorrow, but I remained silent. The absence of rituals or spaces to remember Ntando left a void in my heart. I found creative ways to honour and heal. I wrote poems and letters and drew pictures and painted. This helped me process and heal the trauma,” said Shibula.
She now works with families in her community who have been through the experience of stillbirth, teaching them to learn to embrace their traditions and find new ways to remember those they lost.
“No bereaved parent should feel alone, silenced or unable to acknowledge the profound impact of their child’s brief but meaningful existence,” she said.
Reflecting on the changing global funding dimension implemented by US President Donald Trump, Anurita Bains, associate director for HIV and health at United Nations International Children's Emergency Fund (Unicef), said the changes provide affected countries with an opportunity to rely on themselves.
We are seeing incredible leadership and progress. It is not easy to deal with a host of diseases with poor funding, which could compromise maternal health generally. It makes a world of difference that in South Africa, once you are confirmed to be pregnant, you get tested for other diseases
— Anurita Bains, associate director for HIV and health at Unicef
“It’s a very interesting moment in global health. What we are hoping for is for the issues in terms of women's health, adolescent girls and children to be on the political agenda. Something that can also lead to investment,” she said.
Asked about the impact of the change in funding, she said: “It depends on where you are and what the situation is. This poses significant challenges in reaching children with life-saving nutrition services and commodities. We’re seeing an interruption in access to health care and workers who cannot work as a result.
“We are seeing tremendous leadership from South Africa and Nigeria, we are seeing greater national ownership and investment from the countries.”
She added that poor access to quality health care remains a problem.
“The impact is not just on the [mother's] health but on children and families. Women are the ones bringing babies to clinics for immunisation and walking them through the health journey. Teenage pregnancies are high, especially in sub-Saharan Africa.
“The young women grapple with health risks, drop out of school and might face a struggle to go back due to a lack of protective policies. This later has a socioeconomic and psychological impact and affects their ability to meaningfully take part in the economy.”
She praised the South African government’s response to the global funding freeze.
“We are seeing incredible leadership and progress. It is not easy to deal with a host of diseases with poor funding, which could compromise maternal health generally. It makes a world of difference that in South Africa, once you are confirmed to be pregnant, you get tested for other diseases.
“Adolescent girls and young women who are pregnant face many challenges — they may not have support from home and the community or a partner.”
The Unicef report has recommended that there be an improvement in knowledge and evidence through better measurement of stillbirths, as reliable data was a challenge they faced when compiling the report.
“[We need to] invest in health-care systems to ensure high-quality care, including investments in comprehensive and empowering family planning services, education and programmes available to all women.”
The report recommended “sustaining financial levels by earmarking funding, supporting human resources in national and subnational plans to ensure every pregnant woman and newborn has access to high-impact interventions like antenatal care, skilled attendance at birth and emergency obstetric care”, among others.
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