Ending preventable stillbirths and improving bereavement care: a global scorecard

Abstract

Background: The Lancet Ending Preventable Stillbirths series issued a global Call to Action to reduce stillbirths and improve bereavement care. To monitor progress, we developed a global scorecard to track performance on key indicators. Objectives: To introduce the scorecard and demonstrate its utility with a worked example by comparing global and regional performance in 2022 versus 2018. Methods: Descriptive analysis of performance across 20 nominated indicators spanning mortality targets, universal health coverage targets and milestones for ending preventable stillbirths. Data were extracted from global tracking processes undertaken by United Nations agencies and foundations. Data were summarised globally and by region, with performance against indicators coded as below expectation, in progress, on track, or fully achieved. Results: Seven of the 20 indicators had no available data to assess performance, including those related to stillbirth rate equity, subnational stillbirth rates, national reproductive health plans, the quality of antenatal and intrapartum care, and national processes for stigma reduction. As yet, there is no global consensus on respectful care after a perinatal death. Data were sparse for all indicators in Oceania, Europe and North America, and Latin America and the Caribbean. For most regions and most of the 13 other indicators with available data or estimates, progress was often modest or lacking. Central and South Asia and East and South-East Asia were ‘on track’ for more indicators than other regions, and there was substantial progress on three indicators in Sub-Saharan Africa. However, for the 10 highest-burden countries, progress remained below expectations. Progress was highest for indicators assessing the existence of plans, and worst for indicators assessing implementation. Conclusions: The Global Scorecard for Ending Preventable Stillbirths can be used to provide advocates, policymakers, and practitioners with a detailed status check on data availability and progress in ending preventable stillbirths and improving care after stillbirth.