By Jackson Okata
Nairobi, Kenya — Every 30 seconds, somewhere in Africa, a baby is born without life. It is a quiet, devastating rhythm that has persisted for decades, one that rarely makes headlines but continues to expose deep cracks in the continent’s health systems.
A new report shows that Africa accounts for nearly half of the world’s stillbirths, with an estimated 990,000 cases recorded in 2023 alone. Despite global health advances, progress in reducing these deaths has largely stalled, leaving the total number of stillbirths virtually unchanged over the past two decades.
Globally, about 1.9 million babies are stillborn each year, and without urgent intervention, an estimated five million more could die between 2026 and 2030.
“I think the two million mark has persisted for too long without significant change,” says Helga Fogstad, Director of Health at UNICEF’s Global Programme Division. “Yet addressing stillbirth is essential to achieving our shared goals for maternal, newborn and child survival and well-being.”
A crisis hidden in plain sight
Stillbirth remains one of the most overlooked tragedies in global health. Behind each number is a family grappling with loss, often in silence.
“Behind every stillbirth is a mother who carried her pregnancy expecting life, a family left without answers, and a community carrying grief that rarely finds a place in public discourse,” the report notes.
For many women, the pain is compounded by stigma and isolation.
Grace Mwashighadi, Co-Chair of The Lancet Stillbirth Advisory Committee, speaks from personal experience: “The longest walk I’ve ever done was walking out of a hospital three times without a baby. I know first-hand what it means to be more than a statistic.”
She adds: “Too often, these experiences are met with silence and with systems that are not fully prepared to support families through loss.”
Across many African societies, women who experience stillbirth may face blame, discrimination, and even loss of social status. These cultural and social pressures deepen the trauma, turning a medical tragedy into a lifelong emotional burden.
A symptom of deeper health system failures
Experts say stillbirth is not just a maternal health issue; it is a critical indicator of how well health systems function.
“It is one of the clearest signals indicating whether our health systems are delivering quality, timely care where it matters most at the moment of birth,” says Dr Lucy Mazaba Mazyanga of Africa CDC.
Nearly half of all stillbirths in Africa occur during labour, a period when timely medical intervention could often prevent death.
These deaths are largely preventable, driven by a combination of medical, social, and systemic failures. Common causes include untreated maternal infections such as malaria and syphilis, complications during labour, hypertension, and poor fetal monitoring.
But beyond clinical causes, deeper structural issues persist.
“Stillbirths persist because women and families face avoidable medical conditions driven by cultural, social, financial, and structural barriers to timely, high-quality care,” the report states.
Weak referral systems, shortages of skilled health workers, and limited access to emergency obstetric care continue to cost lives. In many countries, health systems lack the capacity to respond quickly to complications during childbirth.
“When stillbirth rates remain high, they reflect gaps in quality of care, delays in emergency response, shortages of skilled health workers, and weaknesses in data and accountability,” says Dr Mazyanga.
Inequality at the heart of the crisis
The burden of stillbirth in Africa is not evenly distributed. It is shaped by intersecting inequalities, which the report describes as the “5 Es”: equity, economic status, environment, emergencies, and education.
Women in rural areas, conflict zones, or impoverished communities face significantly higher risks. Poverty limits access to quality healthcare, while low levels of education reduce awareness of pregnancy risks and available services.
Climate change is also emerging as a growing threat. Rising temperatures and environmental stressors are increasingly linked to complications such as preterm births and stillbirths.
Humanitarian crises from conflict to disease outbreaks further disrupt already fragile health systems, leaving pregnant women without access to care when they need it most.
The data gap problem
One of the biggest challenges in addressing stillbirths is the lack of reliable data.
“We have heard that about two million stillbirths occur every year, about half of them in Africa. Yet for so long, these deaths have remained invisible in our policies, investments and accountability,” says Adeniyi Aderoba, Regional Advisor at WHO Africa.
Although many countries are beginning to count stillbirths, reporting remains inconsistent, and data systems are weak.
“Countries are counting stillbirths, but not consistently or in ways that fully support accountability or improvement,” Aderoba notes. “If it is not in policy and not counted, we cannot drive change.”
The report underscores that strengthening data systems is essential not just for tracking progress but for informing policies and improving care.
Signs of progress and what must change
Despite the grim statistics, there are signs of progress. Countries like Kenya are introducing innovations in bereavement care, helping families cope with loss while improving the quality of maternal health services.
Health facilities are training workers to provide compassionate care, while community support networks are expanding to ensure families are not left alone in their grief.
But experts warn that isolated interventions are not enough.
“Preventing stillbirths is not an additional priority. It is a strategic imperative,” says Dr Mazyanga. “The same investments that prevent stillbirth will also reduce maternal deaths, save newborns and strengthen resilience for future crises.”
The report calls for a comprehensive approach integrating stillbirth prevention into broader maternal and newborn health strategies, strengthening primary healthcare systems, and ensuring universal access to quality care.
Key priorities include increasing the number of skilled health workers, improving emergency obstetric services, ensuring reliable medical supplies, and strengthening referral systems.
A call for political will
Ultimately, experts say the biggest barrier is not a lack of solutions—but a lack of urgency.
“If we are serious about improving outcomes, stillbirth must be part of how we measure success and accountability,” says Fogstad.
The report emphasises that Africa already has strong policy frameworks in place, including continental strategies on maternal and child health. What is needed now is sustained political commitment, financing, and accountability.
“This must be a multi-sectoral effort that leaves no woman and no baby behind,” says Aderoba.
Health System Failure
Stillbirth remains one of the most neglected outcomes in maternal and newborn health in Africa. Despite its scale and preventability, stillbirth is often unaccounted for in data systems, under-prioritised in policy, and underfunded in health investments.
Nearly 1 million third-trimester stillbirths occurred in Africa in 2023. There has been little progress in decades, and the total number of stillbirths today is similar to 2000. Without accelerated action, 5 million stillbirths are projected between 2026 and 2030.
Most African countries remain in high- or moderate-mortality phases, requiring tailored strategies. Half of stillbirths occur during labour, many in health facilities. Africa’s intrapartum stillbirth rate is 43 times higher than that of Europe. Stillbirth is one of the clearest indicators of quality of care at the point of birth. These deaths reflect gaps in the quality of antenatal and intrapartum care, emergency obstetric readiness, referral systems, and accountability mechanisms. Less than half of African countries have a stillbirth reduction target. Stillbirth is often excluded from MNH policies, financing, and accountability frameworks. Data gaps limit visibility, prioritisation, and action.
