A stark reminder of persistent global health inequities has emerged from a new report revealing that 1.9 million babies were stillborn in 2023. Crucially, the report by the UN Inter-agency Group for Child Mortality Estimation found that nearly half of these tragic deaths occurred during labour and could have been avoided with adequate medical care.
The timing of the report’s release is particularly poignant as South Africa hosts the second G20 Health Working Group Meeting in KwaZulu-Natal. The meeting, themed “Accelerate Health Equity, Solidarity and Universal Coverage”, focuses on strategies to strengthen health systems and promote fair access to healthcare worldwide – issues intrinsically linked to the preventable nature of many stillbirths.
Disproportionate burden in low-income regions
The report underscores the severe disparities in stillbirth rates across the globe. Mothers in low-income countries, particularly in sub-Saharan Africa and Southern Asia, face the highest risk. Fragile and conflict-affected settings also bear a significant burden.
Alarmingly, almost a third (32%) of all stillbirths in 2023 occurred in low-income nations. Sub-Saharan Africa alone accounted for nearly 80% of global stillbirths, despite being home to only around 30% of the world’s live births in the same year. The report explicitly states that a significant proportion of stillbirths occurring during labour are preventable with access to skilled healthcare professionals.
Despite some gains in child survival rates, the report highlights that progress in reducing the stillbirth rate has been inconsistent and considerably slower by comparison. This sluggish improvement is a significant concern for global health advocates.
Navigating funding challenges
The report’s findings also come amidst shifts in global health funding. Anurita Bains, Associate Director for HIV and Health at UNICEF, commented on the changing landscape, noting that alterations implemented by the previous US administration, for example, have created challenges and opportunities for affected countries to increase self-reliance.
“It’s a very interesting moment in global health,” Bains stated. “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.”
Bains acknowledged that reduced funding can lead to significant challenges, including interruptions in healthcare access and the inability of healthcare workers to perform their duties effectively. However, she also praised the leadership of countries like South Africa and Nigeria in demonstrating greater national ownership and investment in health.
The ripple effect of poor healthcare access
Poor access to quality healthcare has far-reaching consequences, extending beyond maternal health to impact children and families as a whole. Bains highlighted that women are often the primary caregivers, responsible for taking children for immunisations and guiding their health journeys. High rates of teenage pregnancies in sub-Saharan Africa further exacerbate health risks, contribute to school dropout rates, and can have long-term socioeconomic and psychological impacts on young women.
Bains commended South Africa’s proactive approach, noting that once a pregnancy is confirmed, women are tested for other diseases – a crucial step in safeguarding maternal and child health, especially for vulnerable young mothers who may lack support.
Recommendations for change
The UN report makes key recommendations to tackle the stillbirth crisis. These include improving data collection and evidence through better measurement of stillbirths and acknowledging the challenges faced in compiling reliable data for the current report.
Furthermore, the report stresses the critical need to invest in healthcare systems to ensure high-quality care, including directing funds towards comprehensive family planning services, education, and programmes accessible to all women.
The report argues that maintaining financial commitment is also paramount, suggesting earmarked funding and support for human resources within national and subnational health plans. The aim is to ensure that every pregnant woman and newborn has access to high-impact interventions such as antenatal care, skilled attendance at birth, and emergency obstetric care.