Epidemiology of stillbirth in the Savannah Region, Ghana, 2018-2022

Introduction: Stillbirth is an adverse pregnancy outcome and contributes significantly to poor maternal health. Globally, an estimated 1.9 million stillbirths were recorded in 2021, with 45% occurring in Sub-Saharan Africa. Substantial proportions of pregnancies in Ghana end as stillbirths, with limited information on their epidemiology in the Savannah Region. Information on the epidemiology of stillbirths will help design strategies to mitigate the burden. We determined the rate, trend and distribution of stillbirths in the Savannah Region of Ghana. Methods: We conducted a cross-sectional analysis of institutional stillbirth data of the Savannah Region from January 2018 to December 2022. Stillbirth data was extracted from the District Health Information Management System 2 (DHIMS2) database by type, district and year of occurrence. Descriptive statistics were performed using Microsoft Excel 2016 and ArcGIS 10.4, by person, place and time with results presented in a table, graph and map. Results: From January 2018 to December 2022, the region recorded a total of 761 stillbirths and 73,593 institutional deliveries. The overall stillbirth rate was 10.3 [95% CI: 9.6 – 11.1] per 1,000 total births. A little over half of the stillbirths were macerated, 51.4% (391/761). The trend of stillbirth was generally stable over the study period, ranging from 9.8/1,000 [95% CI: 8.3 – 11.6] in 2019 and 2020 to 11.3/1,000 [95% CI: 9.5 – 13.3] in 2018. All seven districts in the region recorded stillbirths, with the district-level rate varying between 5.4 and 17.2 stillbirths per 1,000 births in North-East Gonja District and East Gonja Municipal, respectively. Conclusion: Based on the available data, the stillbirth rate in the Savannah Region was low, with a little over half being macerated. There was no substantial change in the trend of stillbirth over the study period. The East Gonja Municipality recorded the highest stillbirth rate. Further studies and interventions are required to address the disparities and reduce the burden to an acceptable minimum.