Your privacy, your choice

We use essential cookies to make sure the site can function. We also use optional cookies for advertising, personalisation of content, usage analysis, and social media.

By accepting optional cookies, you consent to the processing of your personal data - including transfers to third parties. Some third parties are outside of the European Economic Area, with varying standards of data protection.

See our privacy policy for more information on the use of your personal data.

for further information and to change your choices.
Skip to main content
Download PDF

Stillbirth rates, trend and distribution in the Volta region, Ghana: findings from institutional data analysis, 2018–2022

BMC Pregnancy and Childbirth volume 25, Article number: 513 (2025) Cite this article

Abstract

Background

Stillbirth is an adverse pregnancy outcome with devastating effects on families. Integration of essential interventions at all levels of the healthcare system has reduced stillbirths globally. Stillbirths are still recorded in the Volta Region. Reviewing institutional stillbirth data may reveal the regional burden and help in planning relevant strategies to reduce its occurrence. This study determined the stillbirth rate and its distribution in the Volta Region of Ghana.

Methods

A review of institutional stillbirths in the Volta Region from 2018 to 2022 was done using data extracted from the District Health Information Management System 2 database. The variables extracted were the type of stillbirth, district, and year. Microsoft Excel 2016 and ArcGIS 10.4 were used for the data analysis. Descriptive statistics were performed with results presented in a table, graph, and map.

Results

A total of 1,885 stillbirths were recorded in the Volta Region over the study period and majority were macerated 58.7% (1,106/1,885). The regional stillbirth incidence was 10.0 per 1,000 births with the district rate between 0.8 and 19.9 per 1,000 births. The highest incidence was recorded in North Tongu District. There was a general decline in stillbirth rate over the period from 11.2 per 1,000 births in 2018 to 8.8 per 1,000 births in 2022.

Conclusion

Stillbirths in the Volta region were low and declined over the study period. Majority of stillbirths were macerated. North Tongu district reported the highest incidence of stillbirth. The Regional Public Health Department could train midwives and community health nurses working in the observed high rate districts on quality antenatal care and detection of poor intrauterine fetal growth.

Peer Review reports

Background

Stillbirth is an adverse pregnancy outcome that occurs when a baby or feotus is loss after 28 completed weeks gestation [1]. The occurrence of stillbirth has devastating effects on affected families and healthcare workers [2]. An estimated 1.9 million stillbirths were recorded globally in 2021 with 77% of the burden occurring in low and middle income countries of Sub-Saharan Africa (SSA) and Southern Asia [3].

Stillbirths are significantly influenced by inadequate access to quality obstetric care and poor health infrastructure in limited resource settings [4,5,6,7,8]. The scale-up of essential interventions such as quality antenatal care, health facility-supervised deliveries and prompt referrals of pregnancy-related complications have reduced the burden of stillbirth [9,10,11,12,13]. Estimating stillbirth occurrence mostly depend on routine surveillance and verbal autopsies since stillbirth data are only available on vital statistics of high income countries [14,15,16,17].

Varying proportions of fresh and macerated stillbirths have been reported which suggests substantial number of stillbirths could be prevented during delivery [14, 15, 18, 19]. There are spatial variations of stillbirth incidence with clusters of hotspots observed in India [20] and Ethiopia [21]. The trend of stillbirths has been shown to decline over the years [3, 18].

Stillbirth is a public health problem in the Volta Region of Ghana with a reported rate of 27 per 1,000 births in Hohoe [22], despite improved access to antenatal care and skilled delivery services. This rate is higher than the global target of 12 or less stillbirths per 1,000 births for every country by 2030 [23] and may have adverse financial and social costs to women and their families [24]. The continuous occurrence of high stillbirths may have negative effects on the mental health status of affected women and the reproductive needs of families in the Volta Region. There are limited studies on stillbirth and its distribution across the Volta Region. Published literature on stillbirths in the region used data over a two year period with paucity of information about trends of stillbirth in the Volta Region of Ghana [22]. Conducting a secondary analysis of institutional stillbirth data may reveal the regional burden and distribution to help design relevant strategies to reduce the occurrence. These findings can help to evaluate the effectiveness of obstetric-related interventions implemented over the period. This study determined the stillbirth rate and its distribution in the Volta Region of Ghana from 2018 to 2022.

Methods

Study design

The study employed a retrospective review of stillbirth surveillance data extracted from the District Health Information Management System 2 (DHIMS-2) in the Volta Region of Ghana.

Study site

This study was conducted in the Volta Region of Ghana. The region has 18 districts with an estimated population of 1.7 million and 68,000 expected pregnancies [25]. Majority of residents dwell in rural communities. The residents are largely farmers. The Volta Lake and other water bodies in the region affect access to healthcare in hard-to-reach communities. The region has 557 health facilities with most being Community-based Health Planning Service (CHPS) compounds. There are six districts without Primary Hospitals.

Data collection and processing

Stillbirth data of the Volta Region was extracted from the DHIMS-2 database for 2018–2022. The data variables extracted were type/category of stillbirth (i.e., macerated stillbirth and fresh stillbirth), district and year stillbirths occurred. Data was extracted using the pivot table tool of DHIMS-2 and exported to Microsoft Excel 2016 for cleaning. The data was cleaned by replacing blank cells with zeros.

Definition of terms

Fresh/intrapartum stillbirth

Stillbirth in which the foetus was delivered with an intact skin suggesting that foetal heartbeat was present at the onset of labour and death occurred in the intrapartum period (during labour). This classification was done by midwives, nurses and doctors attending to pregnant women during delivery.

Macerated/antepartum stillbirth

Stillbirth with signs of skin degeneration suggesting absent foetal heart sound before onset of labour and death occurred in the antepartum period (before labour). This classification was done by midwives, nurses and doctors attending to pregnant women during delivery.

Data analysis

Microsoft excel 2016 and ArcGIS 10.4 were used for the data analysis. Descriptive statistics were performed with Microsoft Excel 2016 by person, place and time using frequencies, rates and proportions. Type of stillbirth was presented in frequency and proportion. The incidence of stillbirth was determined by dividing the total reported stillbirth cases per year by the total number of births per 1,000 population. The overall stillbirth incidence was determined by using the 5-year reported stillbirths divided by the total births reported per 1,000 population. The distribution of stillbirth by district (place) was illustrated using ArcGIS 10.4 software. Results were presented using tables, graphs and maps.

Results

Characteristics of births

A total of 187,569 institutional births were recorded in the Volta Region over the study period of which 1% (1,885/187,569) were stillbirths. Of the recorded stillbirths, majority were macerated stillbirths 58.7% (1,106/1,885). The year 2018 recorded most stillbirth cases 21.4% (404/1,885) (Table 1).

Table 1 Institutional births, Volta region, 2018–2022
Full size table

Trends of stillbirth rate

There was a general decline in stillbirth rate from 11.2 per 1,000 births in 2018 to 8.8 per 1,000 births in 2022. Fresh stillbirths declined from 4.2 to 3.9 per 1,000 births between 2018 and 2022 with a slight increase of 4.3 fresh stillbirth per 1,000 in 2019 and 2021. However, there was a substantial decline in trends of macerated stillbirths from 7.0 macerated stillbirth per 1,000 births in 2018 to 4.9 macerated stillbirths per 1,000 births in 2022 (Fig. 1).

Fig. 1
figure 1

Trends of stillbirth in the Volta Region of Ghana, 2018–2022

Full size image

Stillbirths’ distribution by district

Stillbirths were recorded across all the 18 districts of the Volta Region with district cumulative rates varying between 0.8 and 19.9 per 1,000 births. The highest cumulative incidence, 19.9 stillbirths per 1,000 births was recorded in North Tongu District with the lowest reported, 0.8 per 1,000 births in the Anloga District (Fig. 2).

Fig. 2
figure 2

Stillbirth distribution by district in the Volta Region of Ghana, 2018–2022

Full size image

Discussion

This study reviewed health facility stillbirth data in the Volta Region of Ghana from 2018 to 2022. The stillbirth rate was 10.0 per 1,000 births with a declining trend over the study period. The majority of stillbirths were macerated.

The study found a stillbirth rate of 10.0 per 1,000 births. This finding is lower than the estimated global and SSA rates of 13.9–28.2 and 21 per 1,000 births respectively [3, 26]. Studies across Southern Asia countries of India, Pakistan and Bangladesh reported substantially higher stillbirth rates ranging from 16.0 to 32 per 1,000 births [15, 27,28,29,30]. Similarly, findings from other SSA countries suggest high stillbirth rates varying between 55 and 92 per 1,000 births in Nigeria [31] and Ethiopia [32]. Furthermore, studies in Ghana reported substantially higher rates of stillbirths compared to the results of this study. These rates ranged from the reported national rate of 15/1,000 births to district rate of 59.0/1,000 births in Kumasi [18, 22, 33, 34]. The low stillbirth rate found in this study could be a resultant effect of effective implementations and sustenance of various maternal and child health projects across the region. The continuous expansion of Community-based Health Planning and Services (CHPS) in the Volta Region could account for the observed low stillbirth rate as the CHPS initiative has improved access to essential primary healthcare services in poor rural communities in Ghana [35,36,37].

Majority of stillbirths were found to be macerated in this study. This finding is similar to other studies which indicate that most stillbirths occur during antepartum period [3]. Additionally, findings in Nepal, India, and Italy reported that most (58.3-94.9%) stillbirths were macerated [38,39,40]. Other studies in Ethiopia and Ghana found high proportions of stillbirths to be macerated consistent with the results of this study [19, 41]. The high rate of macerated stillbirths suggests inadequate access to quality antenatal care and essential obstetric services to enable comprehensive screening and early detection of poor fetal growth to facilitate prompt actions to avert unfavorable pregnancy outcomes [26, 42]. Also, delayed reporting to a health facility at the onset of danger signs of pregnancy may have influenced the occurrence of high macerated stillbirths. However, findings from a study across 29 countries in Africa, Asia, Latin America, and the Middle East reported a majority of stillbirths being fresh [43]. Consistently, studies across low middle income countries across Asia and SAA found that most stillbirths occur during the intrapartum period [7, 15, 26, 29]. In Ghana and other SSA countries, various studies revealed that majority of stillbirths were fresh [18, 31, 32, 44]. The difference in data sources may account for the variations in the type stillbirths reported. Also, the knowledge of health personnel on the definition and classification of stillbirths may have influenced findings of our study since we utilized aggregated secondary data reported by midwives and other healthcare workers providing delivery services at various health facilities.

This study found the trend of stillbirth declined over the period. This is consistent with the global estimates of stillbirth rates, which declined from 22.1 to 13.9 per 1,000 births between 1995 and 2021, likewise that of SSA declined from 31.0 to 21.0 per 1,000 births for the same period [3, 45, 46]. Similarly, a population-based study across seven limited-resource countries indicated the declining trends of stillbirths over the period 2010 to 2018 with substantial declines from 56 to 44.4 per 1,000 and 32.5 to 16.9 per 1,000 observed in Pakistan and India respectively [26]. In Australia, the stillbirth rate significantly declined from 4.4 to 2.5 per 1,000 births between 1986 and 2010 [47]. Italy saw the continuous decline in stillbirth rate from 3.2 to 3.0 per 1,000 between 2014 and 2016 [39]. Findings in Bangladesh showed a decline in stillbirth rate between 2004 and 2014 [27]. Similarly, a study in Ghana reported a declining trend of stillbirth rate between 2003 and 2013 [18]. The implementation of Maternal, Child Health and Nutrition Programs, Networks of Practice strategy and the training of community health nurses and enrolled nurses on task-sharing on midwifery skills in the Volta Region may have contributed to the detection of danger signs in pregnancy early with resultant effects on declining stillbirths over period under review. However, in Nigeria there was no substantial decline in stillbirths between 2010 (42/1,000) and 2018 (49/1,000) after peaks in 2012 (62/1,000) and 2015 (65/1,000). The probable rise in migration of people and obstetric referrals from communities affected by conflict may have contributed to the trends of stillbirths observed in the study period [31].

The results showed variations in spatial distribution of stillbirths with clusters of high and low rates across all districts in the Volta region. This is consistent with studies using secondary data in Ethiopia [21] and India [20] which found significant and substantial variation in the geo-spatial distribution of stillbirth rates with observed hotspots. Another study in India showed spatial variations of stillbirth rate across two districts ranging from 14.7 to 25.2 per 1,000 births with four areas reporting rates above 20 per 1,000 births [15]. Furthermore, studies in low income countries of SSA and Asia showed variations of stillbirth rates ranging between 7.5 and 53.4 per 1,000 births across countries [26, 48]. North Tongu district in this study had the highest stillbirth rate with Hohoe, Ketu North, and Ho being other high rate areas in the region. The availability of an obstetrician specialist in Battor Catholic Hospital in North Tongu District may have resulted in surrounding districts without hospitals and specialists in Greater Accra and Eastern regions refer to Battor, complicated obstetric cases for specialist care contributing to the high stillbirths recorded. Additionally, the lack of hospitals in the low rate districts (Ho West, Afadjato South, Adaklu, Agortime-Ziope, Akatsi North and Anloga) may have necessitated referrals to Hohoe, Ketu North, and Ho due to their proximity accounting for the high stillbirth rates observed.

Strengths and limitations

The stillbirth data reported in DHIMS-2 is limited in data characteristics such as sex, birth weight, gestational age at delivery and type of delivery. Essential maternal characteristics are not reported into DHIMS-2. The study reported stillbirths occurring at the health facilities, therefore, this may not be an accurate representation of stillbirth incidence in the Volta Region. However, since this is the first facility study that determined the rate, trend and distribution of stillbirth in the Volta Region, the findings may suggest the prevailing burden and establish the baseline for further investigations into the potential risk factors in the high incidence districts.

Conclusion

Stillbirths in the Volta region declined over the study period. Macerated stillbirth contributed largely to the general decline of stillbirths. All districts in the Volta region recorded stillbirths with high incidence in four districts. North Tongu district reported the highest incidence of stillbirth.

The Regional Public Health Department could organize in-service training for midwives and community health nurses in the four observed high rate districts to ensure high quality antenatal care to facilitate early detection of poor intrauterine fetal growth for prompt referral. The Research Unit of the Directorate may conduct further research to determine the potential risk factors of stillbirths in the most affected districts in the region.

Data availability

The data underlying this article are available in the online supplementary material (supplementary file).

References

  1. WHO; UNICEF. Every newborn: an action plan to end preventable deaths. Geneva: WHO; 2014.

    Google Scholar 

  2. Heazell AEP, Siassakos D, Blencowe H, Burden C, Bhutta ZA, Cacciatore J, et al. Stillbirths: economic and psychosocial consequences. Lancet. 2016;387(10018):604–16.

    Article  PubMed  Google Scholar 

  3. United Nations Inter-agency Group for Child Mortality Estimation. Never Forgotten: The situation of stillbirth around the globe. 2023.

  4. McClure EM, Garces A, Saleem S, Moore JL, Bose CL, Esamai F, et al. Global network for women’s and children’s health research: probable causes of stillbirth in low- and middle-income countries using a prospectively defined classification system. BJOG Int J Obstet Gynaecol. 2018;125(2):131–8.

    Article  CAS  Google Scholar 

  5. Reinebrant HE, Leisher SH, Coory M, Henry S, Wojcieszek AM, Gardener G, et al. Making stillbirths visible: a systematic review of globally reported causes of stillbirth. BJOG Int J Obstet Gynaecol. 2018;125(2):212–24.

    Article  CAS  Google Scholar 

  6. Goldenberg RL, Harrison MS, McClure EM, Stillbirths. The Hidden Birth Asphyxia — US and Global Perspectives. Vol. 43, Clinics in Perinatology. 2016. pp. 439–53.

  7. Aminu M, Unkels R, Mdegela M, Utz B, Adaji S, van den Broek N. Causes of and factors associated with stillbirth in low- and middle-income countries: a systematic literature review. BJOG: Int J Obstet Gynecol. 2014;121:141–53.

    Article  Google Scholar 

  8. Lawn JE, Blencowe H, Pattinson R, Cousens S, Kumar R, Ibiebele I, et al. Stillbirths: where?? When? Why? How to make the data count? Vol. 377, the lancet. Elsevier Ltd; 2011. pp. 1448–63.

  9. Wastnedge E, Waters D, Murray SR, McGowan B, Chipeta E, Nyondo-Mipando AL et al. Interventions to reduce preterm birth and stillbirth, and improve outcomes for babies born preterm in low and middle-income countries: A systematic review. J Glob Health. 2021;11.

  10. Page JM, Silver RM. Interventions to prevent stillbirth. Semin Fetal Neonatal Med. 2017;22(3):135–45.

    Article  PubMed  Google Scholar 

  11. Nkosi S, Makin J, Hlongwane T, Pattinson RC. Screening and managing a low-risk pregnant population using continuous-wave doppler ultrasound in a low-income population: A cohort analytical study. South Afr Med J. 2019;109(5):347–52.

    Article  CAS  Google Scholar 

  12. Sovio U, White IR, Dacey A, Pasupathy D, Smith GCS. Screening for fetal growth restriction with universal third trimester ultrasonography in nulliparous women in the pregnancy outcome prediction (POP) study: A prospective cohort study. Lancet. 2015;386(10008):2089–97.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Chou D, Daelmans B, Jolivet RR, Kinney M, Say L. Ending preventable maternal and newborn mortality and stillbirths. BMJ. 2015;351:19–22.

    Google Scholar 

  14. Halim A, Aminu M, Dewez JE, Biswas A, Rahman AKMF, van den Broek N. Stillbirth surveillance and review in rural districts in Bangladesh. BMC Pregnancy Childbirth. 2018;18(1):1–8.

    Article  Google Scholar 

  15. Sharma B, Raina A, Kumar V, Mohanty P, Sharma M. Counting stillbirth in a community - To understand the burden. Clin Epidemiol Glob Heal. 2022;14(February):100977.

    Article  CAS  Google Scholar 

  16. McClure EM. Enhancing routine surveillance to improve stillbirth data. Lancet Glob Heal [Internet]. 2020;8(4):e464–5. Available from: https://doi.org/10.1016/S2214-109X(20)30082-6

  17. Flenady V, Wojcieszek AM, Middleton P, Ellwood D, Erwich JJ, Coory M, et al. Stillbirths: recall to action in high-income countries. Lancet. 2016;387(10019):691–702.

    Article  PubMed  Google Scholar 

  18. Nonterah A, Engelbert Isaiah AA, Id EWK, Kagura J, Tamimu M, Ayamba EY, Nonterah EW, et al. Trends and risk factors associated with stillbirths: A case study of the Navrongo war memorial hospital in Northern Ghana. PLoS ONE. 2020;15(2):1–13.

    Article  Google Scholar 

  19. Der EM, Sutaa F, Azongo TB, Kubio C. Stillbirths at the West Gonja hospital in Northern Ghana. J Med Biomed Sci. 2016;5(1):1–7.

    Article  Google Scholar 

  20. Bin Islam D, Purbey A, Roy Choudhury D, Lahariya C, Agnihotri SB. Seasonal and district level Geo-Spatial variations in stillbirth rates in India: an analysis of secondary data. Indian J Pediatr. 2023;90:47–53.

    Article  PubMed  Google Scholar 

  21. Tesema GA, Gezie LD, Nigatu SG. Spatial distribution of stillbirth and associated factors in Ethiopia: A Spatial and multilevel analysis. BMJ Open. 2020;10(10).

  22. Agbozo F, Lecturer MP, Abubakari A, Der J, Lecturer MP, Jahn A. Prevalence of low birth weight, macrosomia and stillbirth and their relationship to associated maternal risk factors in Hohoe Municipality, Ghana. Midwifery [Internet]. 2016;40:200–6. Available from: https://doi.org/10.1016/j.midw.2016.06.016

  23. WHO. Health in 2015: from MDGs, Millennium Development Goals to SDGs, Sustainable Development Goals. Geneva; 2015.

  24. Campbell HE, Kurinczuk JJ, Heazell AEP, Leal J, Rivero-Arias O. Healthcare and wider societal implications of stillbirth: a population-based cost-of-illness study. BJOG: Int J Obstet Gynecol. 2018;125:108–17.

    Article  CAS  Google Scholar 

  25. Ghana Statistical Service. Ghana 2021 Population and Housing Census: General Report Volume 3A. 2021.

  26. McClure EM, Saleem S, Goudar SS, Garces A, Whitworth R, Esamai F, et al. Stillbirth 2010–2018: a prospective, population-based, multi-country study from the global network. Reprod Health. 2020;17(Suppl 2):1–9.

    Google Scholar 

  27. Abir T, Agho KE, Ogbo FA, Stevens GJ, Page A, Hasnat MA et al. Predictors of stillbirths in Bangladesh: evidence from the 2004–2014 nation-wide household surveys. Glob Health Action 2017;10(1).

  28. Anwar J, Torvaldsen S, Sheikh M, Taylor R. Under-estimation of maternal and perinatal mortality revealed by an enhanced surveillance system: enumerating all births and deaths in Pakistan. BMC Public Health. 2018;18(1):1–14.

    Article  Google Scholar 

  29. Singh A, Kumar M. An analysis of cause of stillbirth in a tertiary care hospital of Delhi: A contribution to the WHO SEARO project. J Obstet Gynecol India. 2018;600.

  30. Newtonraj A, Kaur M, Gupta M, Kumar R. Level, causes, and risk factors of stillbirth: A population-based case control study from Chandigarh, India. BMC Pregnancy Childbirth. 2017;17(1):1–9.

    Article  Google Scholar 

  31. Dase E, Dase E, Wariri O, Wariri O, Wariri O, Onuwabuchi E, et al. Applying the WHO ICD-PM classification system to stillbirths in a major referral centre in Northeast Nigeria: A retrospective analysis from 2010–2018. BMC Pregnancy Childbirth. 2020;20(1):1–10.

    Article  Google Scholar 

  32. Mengesha S, Dangisso MH. Burden of stillbirths and associated factors in Yirgalem hospital, Southern Ethiopia: A facility based cross-sectional study. BMC Pregnancy Childbirth. 2020;20(1):1–8.

    Article  Google Scholar 

  33. Ghana Statistical Service (GSS) and ICF. Ghana demographic and health survey 2022. Maryland, USA: Accra, Ghana and Rockville; 2024.

    Google Scholar 

  34. Dassah ET, Odoi AT, Opoku BK. Stillbirths and very low Apgar scores among vaginal births in a tertiary hospital in Ghana: A retrospective cross-sectional analysis. BMC Pregnancy Childbirth. 2014;14(1):1–7.

    Article  Google Scholar 

  35. Phillips JF, Bawah AA, Bink FN. Accelerating reproductive and child health programme impact with community-based services: the Navrongo experiment in Ghana. Bull World Health Organ. 2006;84(12):949–55.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Woods H, Haruna U, Konkor I, Luginaah I. The influence of the Community-based health planning and services (CHPS) program on community health sustainability in the upper West region of Ghana. Int J Health Plann Manage. 2019;34(1):e802–16.

    Article  PubMed  Google Scholar 

  37. Binka FN, Bawah AA, Phillips JF, Hodgson A, Adjuik M, MacLeod B. Rapid achievement of the child survival millennium development goal: evidence from the Navrongo experiment in Northern Ghana. Trop Med Int Heal. 2007;12(5):578–93.

    Article  Google Scholar 

  38. Aggarwal R, Suneja A, Mohan V, Guleria K. A critical assessment of stillbirths at a tertiary care hospital. Indian J Public Health. 2022;66(1):15–9.

    Article  PubMed  Google Scholar 

  39. Po G, Monari F, Zanni F, Grandi G, Lupi C, Facchinetti F. A regional audit system for stillbirth: a way to better understand the phenomenon. 2019;1–9.

  40. Ashish KC, Wrammert J, Ewald U, Clark RB, Gautam J, Baral G, et al. Incidence of intrapartum stillbirth and associated risk factors in tertiary care setting of Nepal: A case-control study. Reprod Health. 2016;13(1):1–11.

    Google Scholar 

  41. Kebede E, Kekulawala M. Risk factors for stillbirth and early neonatal death: a case-control study in tertiary hospitals in addis Ababa, Ethiopia. BMC Pregnancy Childbirth. 2021;21(1):1–11.

    Article  Google Scholar 

  42. De Bernis L, Kinney MV, Stones W, Ten Hoope-Bender P, Vivio D, Leisher SH, et al. Stillbirths: ending preventable deaths by 2030. Lancet. 2016;387(10019):703–16.

    Article  PubMed  Google Scholar 

  43. Vogel JP, Souza JP, Mori R, Morisaki N, Lumbiganon P, Laopaiboon M, et al. Maternal complications and perinatal mortality: findings of the world health organization multicountry survey on maternal and newborn health. BJOG. 2014;121:76–88.

    Article  PubMed  Google Scholar 

  44. Tesfalul MA, Natureeba P, Day N, Thomas O, Gaw SL. Identifying risk factors for perinatal death at Tororo district hospital, Uganda: a case- control study. 2020;3:1–6.

  45. Cousens S, Blencowe H, Stanton C, Chou D, Ahmed S, Steinhardt L, et al. National, regional, and worldwide estimates of stillbirth rates in 2009 with trends since 1995: A systematic analysis. Lancet. 2011;377(9774):1319–30.

    Article  PubMed  Google Scholar 

  46. Hug L, You D, Blencowe H, Mishra A, Wang Z, Fix MJ, et al. Global, regional, and National estimates and trends in stillbirths from 2000 to 2019: a systematic assessment. Lancet. 2021;398(10302):772–85.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Farrant BM, Stanley FJ, Hardelid P, Shepherd CCJ. Stillbirth and neonatal death rates across time: the influence of pregnancy terminations and birth defects in a Western Australian population-based cohort study. BMC Pregnancy Childbirth. 2016;1–10.

  48. Ahmed I, Ali SM, Amenga-Etego S, Ariff S, Bahl R, Baqui AH, et al. Population-based rates, timing, and causes of maternal deaths, stillbirths, and neonatal deaths in South Asia and sub-Saharan Africa: a multi-country prospective cohort study. Lancet Glob Heal. 2018;6(12):e1297–308.

    Article  Google Scholar 

  49. Public Health Act. Ghana Public Health Act, Act 851 [Internet]. 2012 [cited 2024 Feb 2]. pp. 1–203. Available from: https://www.moh.gov.gh/health-sector-acts/

Download references

Acknowledgements

We are grateful to the Volta Regional Health Directorate for granting the permission for the access to DHIMS-2 data for this study.

Funding

There was no funding received for this study.

Author information

Authors and Affiliations

  1. Volta Regional Health Directorate, Ghana Health Service, Ho, Ghana

    Chrysantus Kubio, Ignatius Aklikpe, Dzidefo Kofi Agbavor, Samuel Adolf Bosoka & Senanu Kwesi Djokoto

  2. Saboba District Health Directorate, Ghana Health Service, Saboba, Ghana

    Williams Azumah Abanga

  3. Health Information Unit, Volta Regional Health Directorate, Ghana Health Service, Ho, Ghana

    Victor Zeng

  4. Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana

    Desmond Klu

Authors
  1. Chrysantus Kubio
    View author publications

    You can also search for this author inPubMed Google Scholar

  2. Williams Azumah Abanga
    View author publications

    You can also search for this author inPubMed Google Scholar

  3. Ignatius Aklikpe
    View author publications

    You can also search for this author inPubMed Google Scholar

  4. Dzidefo Kofi Agbavor
    View author publications

    You can also search for this author inPubMed Google Scholar

  5. Victor Zeng
    View author publications

    You can also search for this author inPubMed Google Scholar

  6. Samuel Adolf Bosoka
    View author publications

    You can also search for this author inPubMed Google Scholar

  7. Desmond Klu
    View author publications

    You can also search for this author inPubMed Google Scholar

  8. Senanu Kwesi Djokoto
    View author publications

    You can also search for this author inPubMed Google Scholar

Contributions

CK and SKD: conceived the study, IA and DKA: extracted the data, CK, WAA and DKA: analyzed and interpreted the data, CK and WAA: drafted the manuscript, IA, DKA, VZ, SAB, DK and SKD: reviewed the manuscript. All authors read and approved the final version of the manuscript.

Corresponding author

Correspondence to Williams Azumah Abanga.

Ethics declarations

Ethics approval and consent to participate

This study did not receive ethical approval. This was because Stillbirth is routinely reported into DHIMS-2 as part of the Integrated Disease Surveillance and Response. Also, anonymized aggregated secondary data was used for the analysis, hence no informed consent and formal ethical approval was required for this study. This aligns with the Ghana Public Health Act, 2012 (851), which mandates the Ghana Health Service to maintain and update surveillance data for epidemic-prone diseases and public health events [49]. However, we ensured that our analysis adhered to the ethical principles outlined in the World Medical Association Declaration of Helsinki and relevant data protection regulations. We obtained administrative permission to access the dataset from the Volta Regional Health Directorate. Only authorized personnel with access to password-protected computers could access the data.

Consent for publication

Not Applicable.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary Material 1

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kubio, C., Abanga, W.A., Aklikpe, I. et al. Stillbirth rates, trend and distribution in the Volta region, Ghana: findings from institutional data analysis, 2018–2022. BMC Pregnancy Childbirth 25, 513 (2025). https://doi.org/10.1186/s12884-025-07625-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1186/s12884-025-07625-w

Keywords

BMC Pregnancy and Childbirth

ISSN: 1471-2393

Contact us