Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2019 Jul 12;85(1):106.
doi: 10.5334/aogh.2348.

Perinatal Mortality in Sub-Saharan Africa: A Meta-Analysis of Demographic and Health Surveys

Blessing Jaka Akombi  1   2 , Andre Masumbuko Renzaho  1
Affiliations
Meta-Analysis

Perinatal Mortality in Sub-Saharan Africa: A Meta-Analysis of Demographic and Health Surveys

Blessing Jaka Akombi et al. Ann Glob Health. .

Abstract

Background: Sub-Saharan Africa (SSA) has one of the highest levels of perinatal mortality globally. However, there are sub-regional and country-specific disparities in its distribution.

Objective: The aim of this study was to undertake a meta-analysis of demographic and health surveys to quantify perinatal mortality rate within sub-Saharan Africa and to depict sub-regional and country-specific differences.

Methods: This study used cross-sectional data from the most recent demographic and health surveys (2010-2016) conducted in 21 sub-Saharan African countries. The countries were grouped into four sub-regions (Eastern Africa, Western Africa, Southern Africa and Central Africa), and a meta-analysis was conducted to estimate perinatal mortality rate within each of the sub-regions. Significant heterogeneity was detected among the various surveys (I2 > 50%), hence a random effect model was used. Sensitivity analysis was also performed to examine the effects of outliers. Perinatal mortality was defined as pregnancy losses occurring after seven completed months of gestation (stillbirths) and deaths to live births within the first seven days of life (early neonatal deaths).

Findings: The pooled estimate for perinatal mortality rate per 1000 births across 21 countries in the four sub-regions of SSA was 34.7 (95% CI: 32.6, 36.8). Eastern Africa reported 34.5 (95% CI: 32.2, 36.8), with the highest rate observed in Tanzania [39.5 (95% CI: 35.8, 43.4)]. Western Africa reported 35.7 (95% CI: 32.2, 39.3), with the highest rate observed in Nigeria [40.9 (95% CI: 38.3, 43.2)]. Southern Africa reported 30.3 (95% CI: 26.5, 34.0), with the highest rate observed in Lesotho [49.6 (95% CI: 42.3, 57.8)]. Central Africa reported 30.7 (95% CI: 28.0, 33.3), with the highest rate observed in Equatorial Guinea [37.3 (95% CI: 30.5, 45.1)].

Conclusions: To reduce mortality in the perinatal period, interventions should focus on improving access to high quality antenatal and postnatal care, as well as strengthening health care systems within countries in sub-Saharan Africa.

PubMed Disclaimer

Conflict of interest statement

The authors have no competing interests to declare.

Figures

Figure 1
Figure 1
Flow chart for country selection.
Figure 2
Figure 2
Perinatal mortality rate per 1000 births in the 4 sub-regions of SSA.
See this image and copyright information in PMC

References

    1. World Health Organization. Neonatal and perinatal mortality: Country, regional and global estimates Geneva, Switzerland: World Health Organization; 2006.
    1. World Health Organization. 2018 Progress Report: Reaching every newborn national 2020 milestones World Health Organization; 2018. March.
    1. National Population Commission [Nigeria] and ICF International. Nigeria Demographic and Health Survey 2013 Abuja, Nigeria and Rockville, Maryland, USA: NPC and ICF International; 2014.
    1. Chinkhumba J, De Allegri M, Muula AS and Robberstad B. Maternal and perinatal mortality by place of delivery in sub-Saharan Africa: A meta-analysis of population-based cohort studies. BMC Public Health. 2014. December; 14(1): 1014 DOI: 10.1186/1471-2458-14-1014 - DOI - PMC - PubMed
    1. Bernis L, Kinney MV, Stones W, et al. Stillbirths: Ending preventable deaths by 2030. The Lancet. 2016; 387(10019): 703–716. DOI: 10.1016/S0140-6736(15)00954-X - DOI - PubMed

Publication types