The trend and distribution of stillbirth in the Eastern Region of Ghana

Abstract

Introduction: The trend of stillbirth in Ghana is on a slow decline from 22.5/1,000 total births in 2018 to 21.4/1,000 total births in 2021, and has not met its target. After many interventions implemented in the Eastern Region to reduce stillbirth, little is known about the trend of stillbirth rates in the region. This study determined the trend and distribution of stillbirths in the Eastern Region. Methods: We employed a secondary data analysis on stillbirth in the Eastern Region, 2014-2022. The data source was from the District Health Information Management System. We calculated the stillbirth rate per 1,000 deliveries at the district and regional level. The stillbirth rates were presented as a trend line graph. We tested for the consistency of the trend using the Mann-Kendall trend analysis test on STATA 13.1. We used QGIS software version 3.30 to draw choropleth maps to depict the distribution of the stillbirth rate in the region. Results: Over the nine-year period from 2014 to 2022, a total of 8,587 stillbirths were recorded out of 580, 653 total births. The highest number of stillbirths was reported in 2014, with 1,102 stillbirths, out of which macerated stillbirths accounted for 701 and a stillbirth rate of 18.0 per 1,000 total births. Across all years, macerated stillbirths outnumbered fresh stillbirths. Stillbirth rate declined from 18.0 per 1,000 total births in 2014 to 12.4 per 1,000 total births in 2022. Mann-Kendall trend analysis showed a significant decline in the total stillbirth trend over time (p <0.05). Over the nine-year period, districts with a high incidence of stillbirth (19.9-34.5/1,000 total births) were Kwahu Afram Plains North, Kwahu West, New Juaben South and Denkyembour. Conclusion: The stillbirth rate is on a decline, and there are specific districts which have a high incidence of stillbirth. We recommend that interventions for stillbirths should be strengthened to meet the SDG target of 12/1,000 total births by 2030.