Exploring multilevel determinants of stillbirth: a comprehensive analysis across sub-Saharan African countries

Background Stillbirths and associated outcomes remain a significant concern in sub-Saharan Africa (SSA), with approximately 41% of global stillbirths.Design Our cross-sectional analysis included a weighted sample of women aged 15–49 years who had given birth or experienced stillbirth.Setting Sub-Sah...

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Main Authors: Oluwabunmi Ogungbe, Khadijat Adeleye, Yvette Yeboah-Kordieh, Ashley Gresh, Favorite Iradukunda
Format: Article
Language:English
Published: BMJ Publishing Group 2025-06-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/6/e089371.full
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author Oluwabunmi Ogungbe
Khadijat Adeleye
Yvette Yeboah-Kordieh
Ashley Gresh
Favorite Iradukunda
author_facet Oluwabunmi Ogungbe
Khadijat Adeleye
Yvette Yeboah-Kordieh
Ashley Gresh
Favorite Iradukunda
author_sort Oluwabunmi Ogungbe
collection DOAJ
description Background Stillbirths and associated outcomes remain a significant concern in sub-Saharan Africa (SSA), with approximately 41% of global stillbirths.Design Our cross-sectional analysis included a weighted sample of women aged 15–49 years who had given birth or experienced stillbirth.Setting Sub-Saharan African Countries.The main outcome measures Determinants of stillbirth among women in 29 SSA countries.Result Among a sample of 197 328, stillbirth prevalence was 8.4/1000 live births. Among individual-level factors, the risk increased with age. Higher maternal educational levels were significantly associated with decreased stillbirth risk (aOR=0.62, 95%CI: 0.44 to 0.89, higher versus no education). Single women had significantly lower odds of stillbirth compared with those who no longer lived together or were separated from their partners (aOR=0.38, 95%CI: 0.25 to 0.60). Contextually, women with a job had an increased risk compared with women without a job (aOR=1.19, 95%CI: 1.06 to 1.34), and living in a rural residential area was a significant factor (aOR=1.30, 95%CI: 1.13 to 1.50).Conclusion The complex interplay between individual-level and contextual factors continues to influence stillbirth outcomes in SSA. Cross-sector integrative care approaches to maternal and neonatal health are needed to address the multifaceted determinants of stillbirths.
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spelling doaj-art-c5d52caf16ef44aaaedeeec134177c2a2025-08-20T03:29:58ZengBMJ Publishing GroupBMJ Open2044-60552025-06-0115610.1136/bmjopen-2024-089371Exploring multilevel determinants of stillbirth: a comprehensive analysis across sub-Saharan African countriesOluwabunmi Ogungbe0Khadijat Adeleye1Yvette Yeboah-Kordieh2Ashley Gresh3Favorite Iradukunda4Johns Hopkins School of Nursing, Baltimore, Maryland, USAElaine Marieb College of Nursing, University of Massachusetts Amherst, Amherst, Massachusetts, USAInternal Medicine, MedStar Union Memorial Hospital, Baltimore, Maryland, USAJohns Hopkins School of Nursing, Baltimore, Maryland, USAElaine Marieb College of Nursing, University of Massachusetts Amherst, Amherst, Massachusetts, USABackground Stillbirths and associated outcomes remain a significant concern in sub-Saharan Africa (SSA), with approximately 41% of global stillbirths.Design Our cross-sectional analysis included a weighted sample of women aged 15–49 years who had given birth or experienced stillbirth.Setting Sub-Saharan African Countries.The main outcome measures Determinants of stillbirth among women in 29 SSA countries.Result Among a sample of 197 328, stillbirth prevalence was 8.4/1000 live births. Among individual-level factors, the risk increased with age. Higher maternal educational levels were significantly associated with decreased stillbirth risk (aOR=0.62, 95%CI: 0.44 to 0.89, higher versus no education). Single women had significantly lower odds of stillbirth compared with those who no longer lived together or were separated from their partners (aOR=0.38, 95%CI: 0.25 to 0.60). Contextually, women with a job had an increased risk compared with women without a job (aOR=1.19, 95%CI: 1.06 to 1.34), and living in a rural residential area was a significant factor (aOR=1.30, 95%CI: 1.13 to 1.50).Conclusion The complex interplay between individual-level and contextual factors continues to influence stillbirth outcomes in SSA. Cross-sector integrative care approaches to maternal and neonatal health are needed to address the multifaceted determinants of stillbirths.https://bmjopen.bmj.com/content/15/6/e089371.full
spellingShingle Oluwabunmi Ogungbe
Khadijat Adeleye
Yvette Yeboah-Kordieh
Ashley Gresh
Favorite Iradukunda
Exploring multilevel determinants of stillbirth: a comprehensive analysis across sub-Saharan African countries
BMJ Open
title Exploring multilevel determinants of stillbirth: a comprehensive analysis across sub-Saharan African countries
title_full Exploring multilevel determinants of stillbirth: a comprehensive analysis across sub-Saharan African countries
title_fullStr Exploring multilevel determinants of stillbirth: a comprehensive analysis across sub-Saharan African countries
title_full_unstemmed Exploring multilevel determinants of stillbirth: a comprehensive analysis across sub-Saharan African countries
title_short Exploring multilevel determinants of stillbirth: a comprehensive analysis across sub-Saharan African countries
title_sort exploring multilevel determinants of stillbirth a comprehensive analysis across sub saharan african countries
url https://bmjopen.bmj.com/content/15/6/e089371.full
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