Exploring Multilevel Determinants of Stillbirth: A Comprehensive Analysis Across Sub-Saharan African Countries

Abstract

Background: Stillbirths and associated outcomes remain a significant concern in Sub-Saharan Africa (SSA), with approximately 44% of global stillbirths Methods: Using Demographic and Health Surveys (DHS) data, this study examined determinants of stillbirth among women in 29 SSA countries. Our cross-sectional analysis included a weighted sample of women 15-49 years of age who had given birth or experienced stillbirth. We used bivariate analyses and multilevel logistic regression approaches. Findings: Stillbirth prevalence was 319.06/1000 live births. Among individual-level factors, the risk increased with age. Higher maternal education levels were significantly associated with decreased stillbirth risk. Single women had significantly lower odds of stillbirth compared to those who no longer lived together/separated from their partner. Contextually, women with a job had an increased risk compared to women without a job, and living in a rural residential area was a significant factor. Interpretation: The complex interplay of individual-level factors and contextual factors influences stillbirth outcomes in SSA. Cross-sector holistic approaches to maternal and neonatal health are needed to address the multifaceted determinants of stillbirths