"The circumstances surrounding a stillbirth, neonatal and maternal death can be painful to recount. However, this process of reviewing deaths, or near-miss cases, can highlight missed opportunities in care, leading to fewer such cases in the future".
Kate Kerber, Africa Regional Specialist with Saving Newborn Lives/Save the Children (2016)
Worldwide more than five million babies die in the last few weeks of pregnancy, during labour or soon after delivery every year. Yet most of these babies’ deaths will not be marked with a death certificate and information on their cause of death will not be recorded. The 2016 Lancet Series on Stillbirths called the “neglected epidemic of stillbirth” an urgent global health issue. But for mothers it is often a personal and unspoken tragedy.
Kiguli et al’s piece on stillbirths in sub-Saharan Africa, detailed attitudes, cultures and practices that provide insight both into why stillbirths occur and why there continues to be silence around them. Among the many reasons for keeping quiet about the loss of a baby are: fear of accusations of withcraft, adultery and cultural norms around the expression of grief. However, public health practitioners have an important role to play here not only in helping mothers and families who suffer the loss of a baby (which can often do much to de-stigmatise the issue), but also in ensuring the data on number and causes of death are kept and reflected on.
The numbers matter. Here’s why:
In 2016, the WHO published Making Every Baby Count: Audit and Review of Stillbirths and Neonatal Deaths. The guide argues strongly that "counting the numbers more accurately and gaining a better understanding of the causes of death are key to tacking the burden of stillbirths that are estimated to occur each year".
With the numbers, facilities and local, regional and national health systems can better understand how to prevent stillbirth and implement policies and practices to ensure it happens.
In Nigeria and Ethiopia the MamaYe team is supporting the governments to expand their Maternal Death Surveillance Review systems to include perinatal review – counting the number of stillbirths and causes.
"Using the data generated by the MDSR system, we have the power to make evidence-based decisions that improve quality of care and target responses to where they will be most effective in saving lives. We are taking action in response to every death – from the community to the national level. This nationwide system has the power to save maternal lives now and for generations to come".
Ethiopian Minister of Health, Prof Yifru (2016)