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Blencowe, H; Cousens, S; Jassir, FB; Say, L; Chou, D; Mathers, C; Hogan, D; Shiekh, S; Qureshi,ZU; You, D; +87 more... Lawn, JE; Lancet Stillbirth Epidemiology Investigator Group; , COLLAB-ORATORS; Zhu, J; Liang, J; Mu, Y; Li, X; Costello, A; Colbourn, T; Fottrell, E; Prost, A; Osrin,D; King, C; Neuman, M; Shah More, N; Azad, K; Manandhar, D; Nair, N; Tripathy, P; Kumar, R;Newtonraj, A; Kaur, M; Gupta, M; Dhaliwal, LK; Aggarwal, N; Venkateshashan; Chawla, D; Hurja,A; Shivkumar, P; Jain, M; Gathwala, G; Nanda, S; Gupta, S; Singal, S; Kumar, R; Sharma, S; Mohi,M; Minhas, S; Prasad, R; Verma, S; Raina, N; Musafi li, A; Varghese, B; Pattison, R; Hirst, J; Waiswa,P; Kadobera, D; Kujala, S; Bergstrom, A; Phiri, T; Hall, JA; Day, LT; Saha, SL; Alam, Su; Rahman,A; El-Arifeen, S; Rubayet, S; Hassan, AA; Smith, L; Manktelow, BN; Draper, ES; Zhong, N; Langhoff-Roos, J; Flenady, V; Allvee, K; Gissler, M; Lack, N; Wangdi, S; Cap, J; Podmanicka, Z; Szamotulska,K; Hukkelhoven, C; Dĳs-Elsinga, J; Kyprianou, T; Klungsøyr, K; de Maria Herandez, F; Curteanu, A;Barros, H; a Correia, S; Tsiklauri, S; Lundqvist, E; Ilboudo, TF; Bah, A; Jawara, L; Zeitlin, J; Isakova,J; Poppe, O; (2016) National, regional, and worldwide estimates of stillbirth rates in 2015, with trendsfrom 2000: a systematic analysis. The Lancet Global health, 4 (2). e98-e108. ISSN 2214-109X DOI:https://doi.org/10.1016/S2214-109X(15)00275-2

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Supplementary appendixThis appendix formed part of the original submission and has been peer reviewed. We post it as supplied by the authors.

Supplement to: Blencowe H, Cousens S, Jassir FB, et al, for The Lancet Stillbirth Epidemiology Investigator Group. National, regional, and worldwide estimates of stillbirth rates in 2015, with trends from 2000: a systematic analysis. Lancet Glob Health 2016; published online Jan 18. http://dx.doi.org/10.1016/S2214-109X(15)00275-2.

1

National, regional, and worldwide estimates of stillbirth rates in 2015, with

trends from 2000: a systematic analysis

Authors Hannah Blencowe, Simon Cousens, Fiorella Bianchi Jassir, Lale Say, Doris Chou, Colin Mathers, Dan Hogan, Suhail Shiekh, Zeshan U Qureshi, Danhzen You, Joy E Lawn

For the Lancet Stillbirth investigator group

Contents Definitions and country groupings.......................................................................................................... 3

Countries by region ............................................................................................................................. 3

Data inputs .............................................................................................................................................. 5

Strategy for systematic searches of the published literature ............................................................. 5

Search terms: .................................................................................................................................. 5

SBR:NMR quality criteria ..................................................................................................................... 8

Table limitations of SBR28:NMR ratio as quality criteria: ............................................................... 8

Trends in SBR:NMR ratio in HIC countries ...................................................................................... 8

SBR:NMR ratio in higher mortality settings .................................................................................. 10

Input data meeting inclusion criteria included N=2207 ................................................................... 12

Summary of stillbirth rate data inputs meeting inclusion criteria by Millennium Development Goal

region ................................................................................................................................................ 66

Data availability over time by region ................................................................................................ 67

Comparison with previous data inputs ............................................................................................. 67

Overall input data: ........................................................................................................................ 67

National or Nationally representative data only: ......................................................................... 67

Quality categorisation of national routine data ............................................................................... 68

Table of countries with higher quality national routine data ....................................................... 70

Predictor variables ................................................................................................................................ 70

Identification of predictor variables for model input ....................................................................... 70

Source of potential predictor variables tested in models ................................................................ 71

Data adjustments: ................................................................................................................................. 72

Small countries .................................................................................................................................. 72

Non-standard definitions in Developed Region ................................................................................ 72

Adjusting for 1000g to ≥28 week definition ................................................................................. 72

Adjusting for ≥24 weeks to ≥28 weeks definition ......................................................................... 73



2

Adjusting for ‘all fetal deaths’ to ≥28 weeks definition ................................................................ 74

Adjusting where no definition is given ......................................................................................... 74

Table - summary of adjustments: ................................................................................................. 75

Non-standard definitions in Other Regions ...................................................................................... 75

Implausibility criteria ........................................................................................................................ 76

Model selection .................................................................................................................................... 76

Final model equation ........................................................................................................................ 77

Figure: Diagnostic plots for the stillbirth prediction regression model ............................................ 78

Loess region plots for countries using own data .............................................................................. 80

Calculation of stillbirth numbers....................................................................................................... 99

Uncertainty estimation ..................................................................................................................... 99

Results ................................................................................................................................................. 100

Table: Estimated stillbirth rate by country for 2000 and 2015 ....................................................... 100

Graphs by country of data inputs and stillbirth rate estimates with associated uncertainty ........ 105

Graphs of input data and estimated stillbirth rates by region ........................................................... 203

Comparison of neonatal mortality and stillbirth rate data and estimates: ........................................ 207

References .......................................................................................................................................... 208

3

Definitions and country groupings

Countries by region

Developed Region Southern Asia Caucasus and Central Asia

Eastern Asia Latin America and

the Caribbean North Africa and

Middle East South-eastern

Asia and Oceania Sub-Saharan Africa

Albania Andorra Australia Austria Belarus Belgium Bosnia and Herzegovina Bulgaria Canada Croatia Cyprus Czech Republic Denmark Estonia Finland France Germany Greece Hungary Iceland Ireland Israel Italy Japan Latvia Lithuania

Afghanistan Bangladesh Bhutan India Iran (Islamic Republic of) Maldives Nepal Pakistan Sri Lanka

Armenia Azerbaijan Georgia Kazakhstan Kyrgyzstan Tajikistan Turkmenistan Uzbekistan

China Democratic People’s Republic of Korea Mongolia Republic of Korea

Antigua and Barbuda Argentina Bahamas Barbados Belize Bolivia (Plurinational State of) Brazil Chile Colombia Costa Rica Cuba Dominica Dominican Republic Ecuador El Salvador Grenada Guatemala Guyana Haiti Honduras Jamaica Mexico Nicaragua Panama Paraguay Peru

Algeria Bahrain Egypt Iraq Jordan Kuwait Lebanon Libya Morocco Occupied Palestinian Territory Oman Qatar Saudi Arabia Syrian Arab Republic Tunisia Turkey United Arab Emirates Yemen

Brunei Darussalam Cambodia Cook Islands Fiji Indonesia Kiribati Lao People’s Democratic Republic Malaysia Marshall Islands Micronesia (Federated States of) Myanmar Nauru Niue Palau Papua New Guinea Philippines Samoa Singapore Solomon Islands Thailand Timor-Leste

Angola Benin Botswana Burkina Faso Burundi Cabo Verde Cameroon Central African Republic Chad Comoros Congo Côte d'Ivoire Democratic Republic of the Congo Djibouti Equatorial Guinea Eritrea Ethiopia Gabon Gambia Ghana Guinea Guinea-Bissau Kenya Lesotho Liberia

4

Developed Region Southern Asia Caucasus and Central Asia

Eastern Asia Latin America and

the Caribbean North Africa and

Middle East South-eastern

Asia and Oceania Sub-Saharan Africa

Malta Monaco Montenegro Netherlands New Zealand Norway Poland Portugal Republic of Moldova Russian Federation San Marino Serbia Slovakia Slovenia Spain Sweden Switzerland The former Yugoslav Republic of Macedonia Ukraine United Kingdom United States of America

Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Suriname Trinidad and Tobago Uruguay Venezuela (Bolivarian Republic of)

Tonga Tuvalu Vanuatu Viet Nam

Madagascar Malawi Mali Mauritania Mauritius Mozambique Namibia Niger Nigeria Rwanda Sao Tome and Principe Senegal Seychelles Sierra Leone Somalia South Africa South Sudan Sudan Swaziland Togo Uganda United Republic of Tanzania Zambia Zimbabwe

5

Data inputs

Strategy for systematic searches of the published literature Databases searched: Pubmed, Latin American and Caribbean Health Science (LILACS), and WHO

regional databases (Eastern Mediterranean Regional Office [EMRO] Index Medicus, African Index

Medicus, Pan American Health Organization [PAHO] Latin America and Caribbean Virtual Health

Library, South East Asian Region [SEARO] Index Medicus, and Western Pacific Region [WPRO] Index

Medicus.

Search terms: (("stillbirth"[MeSH Terms] OR "stillbirth"[All Fields] OR ("still"[All Fields] AND "birth"[All Fields]) OR

"still birth"[All Fields]) OR ("foetal death"[All Fields] OR "fetal death"[MeSH Terms] OR ("fetal"[All

Fields] AND "death"[All Fields]) OR "fetal death"[All Fields]) OR ("perinatal mortality"[MeSH Terms]

OR ("perinatal"[All Fields] AND "mortality"[All Fields]) OR "perinatal mortality"[All Fields])) AND

(timing[All Fields] OR rate[All Fields] OR "epidemiology"[Subheading] OR "epidemiology"[All Fields]

OR "prevalence"[All Fields] OR "prevalence"[MeSH Terms] OR "incidence"[All Fields] OR

"incidence"[MeSH Terms])

AND

("Developing Countries"[Mesh] OR "developing country"[All Fields] OR "developing countries"[All Fields] OR "developing nation"[All Fields] OR "developing nations"[All Fields] OR "under-developed country"[All Fields] OR "under-developed countries"[All Fields] OR "under developed country"[All Fields] OR "under developed countries"[All Fields] OR "under-developed nations"[All Fields] OR "under developed nations"[All Fields] OR "third world country"[All Fields] OR "third world countries"[All Fields] OR "third world nation"[All Fields] OR "third world nations"[All Fields] OR "less developed country"[All Fields] OR "less developed countries"[All Fields] OR "less-developed country"[All Fields] OR "less-developed countries"[All Fields] OR "less developed nations"[All Fields] OR "less-developed nations"[All Fields] OR "Low Resource Setting" [All Fields] OR "Low Resource Settings"[All Fields] OR “Poor countries” OR “Poor nations” OR “Poor country” OR “Poor nation” OR “LMIC” OR “Resource poor setting” OR “Resource poor country” OR “Resource poor nation”) OR (“Countries, Developing” OR “Country, Developing” OR “Developing Country” OR “Least Developed Country” OR “Countries, Least Developed” OR “Country, Least Developed” OR “Developed Countries, Least” OR “Developed Country, Least” OR “Least Developed Country” OR “Less-Developed Country” OR “Countries, Less-Developed” OR “Country, Less-Developed” OR “Less Developed Countries” OR “Less-Developed Country” OR “Under-developed Nations” OR “Nation, Under-Developed” OR “Under Developed Nations” OR “Under-Developed Nation” OR “Third-World Countries” OR “Countries, Third-World” OR “Country, Third-World” OR “Third World Countries” OR “Third-World Country” OR “Third-World Nations” OR “Nation, Third-World” OR “Nations, Third World” OR “Third World Nations” OR “Third-World Nation” OR “Under-Developed Countries” OR “Countries, Under-Developed” OR “Country, Under-Developed” OR “Under Developed Countries” OR “Under-Developed Country” OR “Developing Nations” OR “Nations, Developing” OR “Less-Developed Nations” OR “Less Developed Nations” OR “Less-Developed Nation” OR “Nation, Less-Developed” OR “Nations, Less-Developed”) OR (“Low income countries” OR “Low income country” OR “Low income nations” OR “Low income nation” OR “Middle income countries” OR “Middle income nations” OR “Middle income country” OR “Middle income nation” OR (“Africa” OR “Africa South of the Sahara” OR “Sub-Saharan Africa” OR “Asia” or “South America” OR “Central America” OR “Latin America” OR “Polynesia” OR “Middle East” OR “South East Asia”) OR “Africa” OR “Africa South of the Sahara” OR “Sub-Saharan Africa” OR “Asia” or “South America” OR “Central America”

6

OR “Latin America” OR “Polynesia” OR “Middle East” OR “South East Asia”) OR (“Afghanistan” OR “Bangladesh” OR “Benin” OR “Burkina Faso” OR “Burundi” OR “Cambodia” OR “Central African Republic” OR “Chad” OR “Comoros” OR “Democratic Republic of Congo” OR “Democratic Republic of the Congo” OR (“Democratic” AND “Republic” AND “Congo”) OR “Zaire” OR “Eritrea” OR “Ethiopia” OR “Gambia” OR “Guinea” OR “Guinea-bissau” OR (“guinea” AND “Bissau”) OR “guinea Bissau” OR “guinea-bisau” OR (“guinea” AND “bisau”) OR “guinea bisau” OR “Haiti” OR “Haïti” OR “Kenya” OR (“Democratic” AND “Korea”) OR “North Korea” OR “DPRK” OR “Kyrgyz Republic” OR “Kyrgyzstan” OR “Liberia” OR “Madagascar” OR “Malawi” OR “Mali” OR “Mozambique” OR “Myanmar” OR “Burma” OR “Nepal” OR “Niger” OR “Rwanda” OR “Sierra Leone” OR “Somalia” OR “South Sudan” OR “Tajikistan” OR “Tanzania” OR “Togo” OR “Uganda” OR “Zimbabwe”) OR (“Armenia” OR “Bhutan” OR “Bolivia” OR “Cameroon” OR “Cape Verde” OR (“Republic of Congo”) OR “Cote d’Ivoire” OR “Côte d’Ivoire” OR “Ivory Coast” OR “Djibouti” OR “Egypt” OR “Arab Republic of Egypt” OR “El Salvador” OR (“Georgia (republic)” OR “Georgia Republic” OR “Republic of Georgia” NOT “Atlanta, Georgia”) OR “Ghana” OR “Guatemala” OR “Guyana” OR “Honduras” OR “Indonesia” OR “India” OR “Kiribati” OR “Kosovo” OR “Lao PDR” OR “Laos” OR “Lesotho” OR “Mauritania” OR “Micronesia” OR (“Federated” AND “States” AND “Micronesia”) OR “Moldova” OR (“Republic” AND “Moldova”) OR “Mongolia” OR “Morocco” OR “Nicaragua” OR “Nigeria” OR “Pakistan” OR “Papua New Guinea” OR “Paraguay” OR “Philippines” OR (“Samoa” NOT “American Samoa”) OR “Sao Tome” OR “São Tomé” (“Sao” AND “Tome” AND “Principe”) OR (“São” AND “Tomé” AND “Príncipe”) OR “Senegal” OR “Solomon Islands” OR “Sri Lanka” OR “Sudan” OR “Swaziland” OR “Syria” OR “Syrian Arab Republic” OR “East Timor” OR (“East” AND “Timor”) OR “Timor Leste” OR “Timor-Leste” OR (“Timor” AND “Leste”) OR “Ukraine” OR “Uzbekistan” OR “Vanuatu” OR “Vietnam” OR “Viet Nam” OR “West Bank and Gaza” OR “Yemen” OR “Republic of Yemen” OR “Yemen Republic” OR “Zambia”) OR (“Angola” OR “Albania” OR “Algeria” OR “American Samoa” OR “Argentina” OR “Azerbaijan” OR “Belarus” OR “Byelarus” OR “Belize” OR “Bosnia” OR (“Bosnia” AND “Herzegovina”) OR “Botswana” OR “Brazil” OR “Bulgaria” OR “China” OR “Colombia” OR “Costa Rica” OR “Cuba” OR “Dominica” OR “Dominican Republic” OR “Ecuador” OR “Fiji” OR “Gabon” OR “Grenada” OR “Hungary” OR “Iran” OR “Islamic Republic of Iran” OR “Iraq” OR “Jamaica” OR “Jordan” OR “Kazakhstan” OR “Lebanon” OR “Libya” OR “Republic of Macedonia” OR “Macedonia” OR “Macedonia Republic” OR “FYR of Macedonia” OR “Former Yugoslav Republic of Macedonia” OR “Macedonia (Republic)” OR (“Macedonia” AND “(Republic)”) OR “Malaysia” OR “Maldives” OR “Indian Ocean Islands” OR “Marshall Islands” OR “Mauritius” OR (“Mexico” NOT “New Mexico”) OR “Montenegro” OR “Namibia” OR “Palau” OR “Panama” OR “Peru” OR “Romania” OR “Serbia” OR (“Serbia” AND “Montenegro”) OR “Seychelles” OR “South Africa” OR “St. Lucia” OR “St Lucia” OR “Saint Lucia” OR “Saint Vincent and the Grenadines” OR “St Vincent and the Grenadines” OR “Suriname” OR “Surinam” OR “Thailand” OR “Tonga” OR “Tunisia” OR “Turkey” OR “Turkmenistan” OR “Tuvalu” OR “Venezuela”)

7

Flow figure for updated systematic review

Exclusion criteria:

1. No data on intrapartum or stillbirth rates 2. Data only on specific sub-population (eg high risk diabetics, one particular ethnic minority,

high risk deliveries only in tertiary hospital) 3. <50 pregnant women 4. Duplicate publications 5. Median year of data collection prior to 1990 or unknown 6. Country has good national routine data available

(Argentina, Australia, Austria, Bahamas, Bahrain, Barbados, Belarus, Belgium, Belize, Bulgaria, Canada,

Chile, Colombia, Costa Rica, Croatia, Cuba, Czech Republic, Denmark, Estonia, Finland, France, Germany,

Greece, Guatemala, Hungary, Iceland, Ireland, Israel, Italy, Japan, Kazakhstan, Kuwait, Latvia, Lithuania,

Luxembourg, Malta, Mauritius, Mexico, Netherlands, New Zealand, Norway, Panama, Philippines, Poland,

Portugal, Republic of Korea, Republic of Moldova, Romania, Russian Federation, Saint Lucia, Saint Vincent

and the Grenadines, Serbia, Singapore, Slovakia, Slovenia, Spain, Suriname, Sweden, Switzerland, The

former Yugoslav Republic of Macedonia, Trinidad and Tobago, Ukraine, United Kingdom, United States of

America, Uruguay, Uzbekistan, Venezuela (Bolivarian Republic of).)

All databases after exclusion of duplicates:

n= 683 from 1st January, 1990 to 31st

December, 1994

n= 1293 from 1st September, 2010 to

19th January 2015

After screening: n=123

Included: n=33

16 excluded, were pre-1990

10 excluded, had <12 months

data

30 excluded, had no SBR or

IPSBR from general pop

7 excluded, were duplicate

4 excluded, were from country

with good national data

7 excluded, were unable to get

paper/translate paper to English

16 excluded, had <50 pregnant

women included

8

Eight studies included in the previous estimates were excluded in this round of estimates as our inclusion criteria for SBR:NMR ratio were more conservative. Groups and listserves used to identify contacts with possible population based stillbirth data: MHFT, HNN, Child2015, BetterCare together.

SBR:NMR quality criteria As detailed in the main paper, we used SBR(28weeks):NMR ratio as a quality criteria and excluded

data sources not meeting this criteria. This quality criteria was chosen as it was available across most

data sources, and would be expected not show large fluctuations across settings over time.

However, even in high-income settings this is affected by some misclassification of stillbirth versus

neonatal deaths,1 and this may be even greater in LMIC as evidenced by the reduction in stillbirth

rates associated with the ‘Helping Babies Breathe’ program in Tanzania where fresh stillbirths were

reduced by 24% (95%CI:10 – 36%), and with resuscitation training in 6 LMIC countries where overall

stillbirth rates were reduced by 31% (95%CI:21-46%).2,3

Table limitations of SBR28:NMR ratio as quality criteria: Scenarios shown in the table below highlight situations in which the stillbirth to neonatal mortality

rate ratio may be affected by different scenarios.

Scenario Effect on SBR(GA28):NMR ratio

Low capture of neonatal deaths or better stillbirth

capture eg weaker HMIS, CRVS, facility studies

Small population with large year on year variation

of both SBR and NMR – reporting large number of

stillbirths in given year

Misclassification of neonatal deaths as fresh

stillbirths

Increased

Low capture of both neonatal deaths and stillbirths Within normal range

Under-capture of stillbirths> under-capture of

neonatal deaths

Small population with large year on year variation

of both SBR and NMR – reporting large number of

neonatal deaths in given year

Misclassification of fresh stillbirths as neonatal

deaths

Decreased

Trends in SBR:NMR ratio in HIC countries Ability to track the SBR28:NMR ratio over time is hampered by several factors, including :

9

1) Gestational age was not routinely assessed in most settings until @30 years ago, and

reporting was therefore based on birthweight

2) Neonatal mortality was also rarely separated out from infant mortality before 1970s-1980s,

when the relative important contribution of neonatal mortality to infant mortality when

recognised (corresponding also with the development of neonatal medicine as a sub-

specialty)

Historical data located during the course of the searches under-taken for these estimates was used

to demonstrate the association between SBR:NMR ratio over time.

The figure A below shows the relationship between SBR (measured as ≥1000g) and NMR in 5 Nordic

Countries from 1975 to 2012. A gradual increase in the ratio over this period as neonatal mortality is

reduced at a more rapid rate that stillbirth rates. Data using the 28 week definition were not

available for the full time series, however based on our analysis, it would be expected that the

SBR28:NMR ratio would follow a similar trend, with slightly higher ratios. Data for England and

Wales for 1980 to 1992 using the 28 week definition however reported only a very slight increase

from 0.94 to 1.05.

Figure A:

0

1

2

3

4

5

6

SBR

10

00

g:N

MR

rat

io

SBR1000:NMR ratio in 5 Nordic Countries 1975 to 2012

Denmark

Finland

Iceland

Norway

Sweden

10

Figure B: SBR:NMR ratio versus NMR for 5 Nordic countries

From these five Nordic countries when plotting the sbr:nmr ratio versus the overall reported nmr

that the ratio remains around 1 – 1.5, until the NMR reaches very low level (around 3 per 1,000

livebirths). These data as to the changing ratio do not support the addition of an upper ratio limit for

high income/ low mortality settings.

SBR:NMR ratio in higher mortality settings High quality stillbirth rate data are lacking from most high mortality settings. We examined

relationship of stillbirth rates with neonatal mortality over time from England and Wales, where

stillbirth rate (late fetal death) and neonatal rate data are available annually from 1927-1991.

12

34

56

0 2 4 6nmr

ratio predicted ratio

11

Figure C: showing relationship with sbr:nmr ratio as England and Wales transition from a high

neonatal mortality to a low neonatal mortality setting.

This graph shows very little variation in sbr:nmr ratio in the NMR range 10 – 35 per 1,000 livebirths,

with ratios between 1 and 1.4.

Figure D: Scatter plot of the relationship between SBR:NMR ratio by NMR for all available

‘population based’ LMIC data

11.2

1.4

1.6

0 10 20 30 40nmr

01

23

SB

R2

8 to

natio

na

l N

MR

0 20 40 60 80nmr_final

12

Input data meeting inclusion criteria included N=2207 Classified by study type/ quality criteria:

1=High quality national routine information system data

2=Lower quality national routine information system data

3= Nationally representative retrospective household surveys

4= Sub-national population based

5=Sub-national other

Country Data Source

Year data

collection Definition

# stillbirths

Reported stillbirth

rate Data type

Afghanistan Dott 2004 500g NG 45.9 5

Afghanistan DHS survey 2007 28 weeks 402 20.6 3

Afghanistan WHOMCS 2011 1000g 468 23.1 5

Albania DHS survey 2005 28 weeks 6 3.8 3

Albania Ministry of Health 2010 22 weeks NG 4.2 2

Algeria National Statistical Office 1990 Not defined NG 21.4 2


Algeria WHO Global Survey 2004 1000g 111 19.5 5

Algeria WHO Global Survey 2004 1000g 244 25.7 4







Andorra Eurozone WHO 1999 Not defined 5 5.9 2












Angola WHO Global Survey 2005 1000g 169 30.5 4

Argentina consultation 1995 1000g NG 8.3 1





13

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type

Argentina National Statistical Office 2000 28 weeks 5108 7.2 1













Armenia Eurozone WHO 1990 Not defined 1313 16.2 2





Armenia Eurozone WHO 1996 Not defined NG 13.7 2



Armenia DHS survey 1998 28 weeks NG 14.9 3






Armenia DHS survey 2003 28 weeks NG 7.9 3


Armenia Eurozone WHO 2005 500g NG 17.4 2

Armenia Armenia Demographic Handbook 2006 500g 662 17.3 2


Armenia DHS survey 2007 28 weeks 8 5.5 3







Australia National Perinatal Data Collection (NPDC) 1992 20 weeks 1767 6.7 1


14

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type


Australia National Perinatal Data Collection (NPDC) 1995 1000g NG 3.8 1


















Austria MOH National Statistical Office 1990 1000g 325 3.6 1












15

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type














Azerbaijan Eurozone WHO 1998 500g NG 13.6 2

Azerbaijan DHS survey 1998 28 weeks 68 22.0 3





Azerbaijan DHS survey 2003 28 weeks 37 15.9 3






Azerbaijan Eurozone WHO 2009 500g 1719 11.2 2




Bahamas vital statistics report 2006 1996 22 weeks NG 12.9 1









Bahamas vital statistics report 2009 2005 22 weeks 86 15.3 1





16

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type

Bahrain National Statistical Office 1995 28 weeks NG 11.0 2














Bahrain National Statistical Office 2009 28 weeks 95 5.3 1




Bangladesh Matlab 1991 1000g 96 34.8 4




Bangladesh McCord 1995 Not defined NG 80.3 5

Bangladesh DHS survey 1995 1000g NG 32.5 3



Bangladesh DHS survey 1998 1000g NG 28.3 3




Bangladesh Azad 2001 1000g 266 70.9 5


Bangladesh DHS survey 2002 1000g 269 37.0 3


Bangladesh Cherry 2002 Not defined NG 34.1 4



Bangladesh Baqui 2004 1000g 1748 36.3 4

Bangladesh West (JiVitA) 2004 1000g 703 47.9 4





17

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type


Bangladesh Prost 2006 22 weeks 521 34.1 4

Bangladesh Azad 2006 1000g NG 34.3 4

Bangladesh Ellis 2006.

5 1000g 1068 33.4 4

Bangladesh Matlab 2007.

5 1000g 49 19.2 4

Bangladesh Day 2008 1000g 131 37.5 5


Bangladesh Shah 2008 28 weeks 1443 38.6 4


5 1000g 52 19.1 4

Bangladesh Nahar 2008.

5 1000g 574 25.8 4

Bangladesh Day 2009 1000g 128 41.6 5

Bangladesh Sikder 2009 Not defined 1216 44.2 4


5 1000g 48 18.5 4

Bangladesh Day 2010 1000g 123 36.6 5


Bangladesh Prost 2010 22 weeks 232 26.3 4

Bangladesh West (JiVitA-3) 2010 28 weeks 716 48.2 4

Bangladesh Day 2011 1000g 128 33.1 5

Bangladesh HMIS 2011 Not defined 17868 29.5 2


Bangladesh Owais 2011 Not defined 44 18.1 4

Bangladesh Day 2012 1000g 121 32.9 5



Bangladesh Day 2013 1000g 114 31.3 5



Belarus Demographic yearbook 2013 1990 1000g 954 6.7 2

Belarus Eurozone WHO 1993 500g 1151 9.7 2

Belarus Eurozone WHO 1994 500g 1032 9.2 2


Belarus Eurozone WHO 1995 500g NG 8.6 2










18

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type









Belgium Eurozone WHO 1990 28 weeks 677 5.4 1





















Benin Denoeud 2005 500g NG 46.7 5

Benin MOH report 2009 Not defined 5612 22.9 2





Bolivia DHS survey 2001 28 weeks 123 11.7 3

Bolivia DHS survey 2006 28 weeks 98 11.1 3

Bosnia and Herzegovina Fatusic 1990 1000g NG 8.7 5






19

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type



Bosnia and Herzegovina Demografska statistika Demographics 2008 1997 28 weeks 167 4.8 2





Bosnia and Herzegovina FATUSIC 1999 1000g NG 10.5 4


Bosnia and Herzegovina Agency for Statistics of Bosnia and Herzegovina 2000 28 weeks 159 4.0 2



Bosnia and Herzegovina SKOKIC 2001 500g NG 7.7 4

















Botswana Health Statistics Report 2009 2009 28 weeks 731 15.0 2

Botswana Vital Stats 2011 28 weeks 498 12.5 2

Brazil MOH webportal 1994 1000g 37172 14.2 2

20

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type



Brazil Duarte 1996 500g NG 22.7 4

Brazil National Statistical Office 1997 28 weeks NG 9.5 2


Brazil Nurdan 1997 500g NG 15.9 4










Brazil WHO Global Survey 2004 1000g 71 6.9 5


Brazil WHO Global Survey 2004 1000g 20 4.3 4

Brazil BARROS 2004 1000g NG 9.9 4

Brazil Amorim 2005 500g 135 33.4 5











Brazil National Statistical Office 2010 28 weeks 16736 5.6 2


Brazil INTERGROWTH-21 2010 28 weeks 52 7.7 4

Brazil WHOMCS 2011 1000g 18 5.2 5







Brunei Darussalam consultation: MoH 1995 24 weeks NG 8.1 2



21

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type



Brunei Darussalam Health Information Booklet 2000 24 weeks NG 6.5 2













Bulgaria National Statistical Institute 1990 1000g 641 6.1 2





















Burkina Faso Chalumeau - Moma trial 1995 22 weeks NG 20.9 4

Burkina Faso DHS survey 2001 28 weeks 166 15.1 3

Burkina Faso Annuaires statistique sante 2003 Not defined 6141 22.3 2

Burkina Faso Roberfroid 2005 Not defined 26 20.6 4

Burkina Faso Lindert 2007 Not defined 5 25.3 5



22

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type


Burundi DHS survey 2007 28 weeks 159 19.5 3

Cambodia WHO Global Survey 2008 1000g 47 22.8 5

Cambodia DHS survey 2008 28 weeks 72 8.7 3

Cambodia WHO Global Survey 2008 1000g 34 9.9 4

Cambodia WHOMCS 2010 1000g 64 15.9 5

Canada Statistics Canada 1991 20 weeks 2294 5.7 1



Canada Consultation 1995 1000g NG 3.6 1





Canada Consultation updated 2000 1000g 642 3.2 1











Cape Verde DHS survey 1995 28 weeks 87 20.2 3

Cape Verde DHS survey 2002 28 weeks 21 9.4 3

Chad MOH report 2012 Not defined 3119 30.0 2

Chile Estadisticas vitales informe annual 1990 All 1789 5.8 1















23

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type


Chile Estadisticas vitales informe annual 2006 28 weeks 928 4.0 1







China consultation: MoH 1996 1000g NG 13.3 2

China Wen 1997 500g NG 15.0 5

China Wu 1999 1000g 76 24.0 4


China Zeng 2003 28 weeks 99 30.6 4

China Xu 2004.

5 Not defined 211 10.3 5

China Xu 2004.

5 20 weeks 210 10.3 4

China Xu 2004.

5 20 weeks 193 47.2 4

China Liu 2007.

5 28 weeks 28 4.7 4

China WHO Global Survey 2008 1000g 48 3.8 4


China Sun 2010 22 weeks 241 3.9 4

China China NMNSS 2013 28 weeks 20200 12.8 5

China Zhong 2013 28 weeks NG 3.3 4



Colombia National Statistical Office 1998 28 weeks 5972 8.2 2

Colombia DHS survey 1998 28 weeks 53 11.5 3
















24

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type



Cook Islands National Statistical Office 1992 Not defined 4 7.5 2



















Costa Rica National Statistical Office 1995 22 weeks NG 8.6 1






Costa Rica National Statistical Office 2001 22 weeks 510 7.0 1













Cote d'Ivoire Chalumeau - Moma trial 1995 22 weeks NG 33.9 4

Croatia 2013 statistical yearbook 1990 28 weeks 246 4.4 1


25

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type









Croatia Central Bureau of Statistics 2000 22 weeks 229 5.2 1














Cuba National Statistical Office 1990 28 weeks 1896 10.1 1

Cuba National Statistical Office 1991 1000g 1891 10.8 1




















26

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type



Cyprus Perinatal Health Indicators 2007 28 weeks 8 3.6 2







Czech Republic Czech Statistical Office - Population 1990 1000g 530 4.0 2























Denmark Perinatal statistics in the Nordic countries. 1990 1000g 264 4.1 1






27

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type


















Djibouti consultation: MoH 2009 Not defined NG 35.2 2

Dominican Republic DHS survey 2000 28 weeks 89 8.1 3

DR Congo WHO Global Survey 2005 1000g 12 28.6 5

DR Congo WHO Global Survey 2005 1000g 248 31.7 4

DR Congo McClure 2006 1000g 240 30.0 4

DR Congo McClure 2007.

5 1000g 355 24.8 4

DR Congo Ntambue 2010 1000g 177 15.2 4

DR Congo WHOMCS 2011 1000g 44 63.4 5

DR Congo WHOMCS 2011 1000g 163 30.5 4

Ecuador RHS 1994 28 weeks 3532 11.1 3

Ecuador DHS survey 1997 28 weeks 90 8.9 3

Ecuador DHS survey 2002 28 weeks 112 15.1 3

Ecuador WHO Global Survey 2004 1000g 61 6.3 5

Ecuador WHO Global Survey 2004 1000g 15 7.5 4

Ecuador National Statistical Office 2008 All 2006 6.8 2

28

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type


Ecuador WHOMCS 2010 1000g 10 7.2 5


Ecuador WHOMCS 2010 1000g 42 9.4 4




Egypt STANTON 1995 Not defined 34 17.5 3

Egypt DHS survey 1998 28 weeks 166 14.4 3

Egypt Campbell 1998 28 weeks NG 16.9 3



El Salvador DHS survey 1992 28 weeks 28 14.2 3




Estonia Estonian Birth Registry 1992 28 weeks 140 7.7 1























Ethiopia BERHANE 1998 1000g NG 19.0 4

Ethiopia berhan 2002 1000g NG 65.6 5

Ethiopia Yaya 2008 1000g 226 19.2 4

Ethiopia Bayou 2009 1000g 394 78.3 5

29

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type

Ethiopia DHS survey 2009 28 weeks 204 16.9 3

Ethiopia Assefa 2009.

5 Not defined 27 20.4 4

Ethiopia Andargie 2010 Not defined 41 23.4 4

Ethiopia Adane 2013 1000g 34 71.0 5

Fiji MOH annual report 2003 1000g NG 8.9 2








Finland Consultation 1990 28 weeks 198 3.0 1

























France National Statistical Office 1990 1000g 4488 5.9 1






30

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type











France Eurozone WHO 2006 500g 7531 9.4 1






France L'etat de la sante 2012 28 weeks NG 4.3 1

France L'etat de la sante 2013 22 weeks NG 8.9 1

Gambia Ceesay 1992 Not defined 24 23.5 4

Gambia HMIS 2013 Not defined 1734 27.0 2

Georgia GEOSTAT 1995 22 weeks NG 11.5 2



Georgia DHS survey 1997 1000g 47 15.6 3







Georgia DHS survey 2003 1000g 35 15.9 3



Georgia GEOSTAT 2006 22 weeks 712 14.7 2








Germany National Statistical Office/Eurozone WHO 1990 1000g 3202 3.5 1

31

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type














Germany EURO-PERISTAT project 2004 1000g NG 2.6 1




Germany Byndesauswertung 2008 28 weeks 1559 2.3 1






Ghana Edmond 2003 1000g NG 32.6 4

Ghana Ha 2005.

5 24 weeks 2601 32.4 4

Ghana DHS survey 2006 28 weeks 40 13.6 3

Greece National Statistical Office 1990 All 735 7.1 1






32

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type



















Guatemala National Statistical Office 1999 Not defined NG 15.2 2

Guatemala National Statistical Office 2000 Not defined 6164 14.3 2

Guatemala DHS survey 2000 28 weeks 104 17.6 3



Guatemala National Statistical Office 2003 20 weeks 5318 14.0 2




Guatemala DHS survey 2006 28 weeks 183 19.4 3


Guatemala McClure 2007.

5 1000g 253 15.0 4






Guatemala Saleem 2011 1000g 398 20.0 4



Guinea DHS survey 2003 28 weeks 98 15.2 3

Guinea-Bissau Kaestrel 2001 28 weeks 31 56.0 4

Guyana DHS survey 2007 28 weeks 28 14.7 3

Honduras DHS survey 1994 28 weeks 86 10.6 3


33

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type



Hungary Hungarian Central Statistical Office 1990 28 weeks 699 5.5 2

























Iceland National Statistical Office 1992 28 weeks 16 3.5 1
















34

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type






India Bai 1991.

5 1000g 357 27.0 4

India Khandait 1995 Not defined NG 24.5 5

India Chandra 1995 Not defined NG 26.7 5

India Bang 1996 1000g NG 40.9 4

India Williams 1997 All NG 24.7 3

India Sinha 1998 Not defined NG 23.8 4

India PAUL 2000 Not defined NG 87.7 5

India Biswas 2002 Not defined NG 38.5 5

India Patel 2003 Not defined NG 18.5 5

India DLHS-2 2003 28 weeks 3499 18.3 3

India BAQUI 2003 1000g NG 31.8 4

India BALIGA 2004 Not defined NG 34.3 5

India DHS survey 2004 1000g 1105 19.2 3

India Gupta 2004 20 weeks NG 41.4 4

India McClure 2006 1000g 257 21.0 4

India McClure 2006 1000g 280 27.0 4

India Prost 2006.

5 22 weeks 280 30.2 4

India DLHS-3 2007 28 weeks 2876 13.9 3

India McClure 2007.

5 1000g 842 18.5 4

India McClure 2007.

5 1000g 526 27.3 4

India McClure 2007.

5 1000g 212 28.6 4

India WHO Global Survey 2008 1000g 39 36.7 5

India Bbhandari 2008 28 weeks 836 26.4 4

India WHO Global Survey 2008 1000g 931 41.3 4

India HMIS 2009 28 weeks 269586 15.6 2

India Goudar 2009.

5 1000g 124 29.6 4

India HMIS 2010 28 weeks 259354 14.5 2

India Spector 2010 Not defined 22 22.7 4

India WHOMCS 2011 1000g 713 36.9 5

India HMIS 2011 28 weeks 277714 17.1 2

India Kochar 2011 28 weeks 283 18.7 3

India Saleem 2011 1000g 1607 25.7 4

India WHOMCS 2011 1000g 277 26.0 4

India Saleem 2011 1000g 824 27.9 4

India HMIS 2012 28 weeks 297882 16.7 2

35

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type

India Kumar 2013 28 weeks 281 17.1 4

India Varghese unpublished 2014 28 weeks 4116 20.4 4

Indonesia DHS survey 1995 1000g NG 10.0 3


Indonesia Sunawang 2002 28 weeks 8 21.1 4

Indonesia Shankar 2003 1000g NG 17.7 4

Indonesia Poespoprodj 2005 Not defined NG 21.1 5


Indonesia Burke 2007 1000g 24 13.4 4

Indonesia DHS survey 2010 1000g 181 10.6 3

Iran (Islamic Republic of) Hajian-Tilaki 1999 20 weeks 41 10.6 5





Iran (Islamic Republic of) Abdi-Rad 2003 Not defined NG 17.6 5




Iran (Islamic Republic of) Hadavi 2006.

5 20 weeks 127 12.7 4



Ireland Eurozone WHO 1990 1000g 327 6.1 1











Ireland Perinatal Statistics Report 2012 2001 22 weeks 339 5.8 1










36

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type




Israel consultation 1995 1000g NG 4.4 1

Israel consultation 2000 1000g NG 4.2 1

Israel National Statistical Office 2002 1000g 519 3.7 1


Israel consultation 2004 1000g 462 3.4 1









Italy National Statistical Office 1990 1000g 3103 5.4 1























Jamaica National Statistical Office 2002 28 weeks NG 18.9 2




37

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type


Jamaica DHS survey 2006 28 weeks 53 11.9 3


Jamaica Pan-American Health Orginization 2008 28 weeks NG 17.0 2



Japan National Statistical Office 1990 500g 11367 9.2 1





Japan Consultation 1995 500g 6580 5.5 1















Japan Updated in consultation 2010 500g 3637 3.4 1



Jordan DHS survey 2000 28 weeks 59 10.0 3

Jordan Al-Rabee 2000 Not defined NG 18.3 3




Kazakhstan Eurozone WHO 1990 1000g 3692 10.1 2





Kazakhstan Eurozone WHO 1995 1000g NG 8.8 2




38

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type















Kenya Kavoo-Linge and K.O. Rogo 1990 1000g 74 34.1 5

Kenya DHS survey 1996 28 weeks NG 13.5 3

Kenya Gichangi 1997 Not defined NG 13.8 5

Kenya Mwanyumba 1999 1000g NG 57.1 5

Kenya English 2000 Not defined NG 57.6 5

Kenya DHS survey 2001 28 weeks 84 13.6 3

Kenya WHO Global Survey 2004 1000g 267 45.0 5

Kenya WHO Global Survey 2004 1000g 331 24.9 4

Kenya DHS survey 2006 28 weeks 68 11.5 3

Kenya McClure 2007.

5 1000g 142 22.4 4

Kenya INTERGROWTH-21 2011 28 weeks 70 9.1 5

Kenya WHOMCS 2011 1000g 264 29.5 5

Kenya Saleem 2011 1000g 581 21.2 4

Kenya WHOMCS 2011 1000g 317 29.7 4

Kenya DHIS2 2014 Not defined NG 39.4 2

Kuwait National Statistical Office 1995 28 weeks NG 7.3 1







Kuwait National Statistical Office 2002 28 weeks 325 7.4 1







39

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type





Kyrgyzstan National Statistical Office 1990 28 weeks 1149 8.8 2




Kyrgyzstan National Statistical Office 2004 All 1437 12.9 2










Latvia Central Statistical Bureau of Latvia 1990 22 weeks 226 5.9 1










Latvia Central Statistical Bureau of Latvia 2000 500g 158 7.7 1



Latvia Central Statistical Bureau of Latvia 2003 500g 130 6.1 1











Lebanon WHOMCS 2011 1000g 15 8.4 5

40

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type

Lebanon National Statistical Office 2011 Not defined 1005 12.8 2

Lebanon WHOMCS 2011 1000g 12 6.4 4

Lebanon National Statistical Office 2012 Not defined 994 12.3 2

Lesotho DHS survey 2006 1000g 63 16.6 3

Liberia DHS survey 2004 28 weeks 81 14.3 3

Liberia DHS survey 2010 28 weeks 70 10.7 3

Liberia Moseson 2011.

5 1000g 322 44.4 4

Lithuania Eurozone WHO 1990 Not defined 305 5.3 2









Lithuania Statistics Lithuania 1999 1000g NG 4.3 1

Lithuania Statistics Lithuania 1999 Not defined 207 5.7 1















Luxembourg National Statistical Office 1992 All 24 4.6 1




Luxembourg Consultation 1996 1000g NG 2.6 1

Luxembourg Consultation 1998 All NG 5.7 1






41

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type



Luxembourg Consultation 2008 28 weeks 16 3.0 1





Madagascar DHS survey 2001 28 weeks 86 13.5 3

Madagascar DHS survey 2006 28 weeks 175 13.6 3

Malawi Kulmala 1996 Not defined NG 47.4 4

Malawi DHS survey 1998 28 weeks 163 13.2 3


Malawi Metaferia 2005 Not defined NG 33.9 5


Malawi Prost 2007.

5 22 weeks 65 19.5 4

Malawi Colbourn 2009 Not defined 615 31.6 4

Malawi Hall unpublished 2013 28 weeks 66 16.6 4

Malawi DHIS2 maternity register jan-jun 2014 2014 1000g 3532 16.6 2

Malaysia Al-Mohdzar 1991 Not defined 139 19.5 5

Malaysia National Statistical Office 2009 28 weeks NG 4.4 2

Malaysia National Statistical Office 2010 28 weeks 2213 4.5 2



Maldives Consultation 1999 1000g NG 11.5 2








Maldives National Statistical Office 2007 1000g 58 8.8 2

Maldives DHS survey 2007 28 weeks 34 9.0 3





Malta Eurozone WHO 1992 1000g 28 5.1 1






42

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type



Malta Consultation 2000 28 weeks 14 3.2 1













Mauritania Chalumeau - Moma trial 1995 22 weeks NG 30.1 4

Mauritius Family planning & demographic yearbook 2012 1990 28 weeks 348 15.7 1

















43

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type







Mexico National Statistical Office 1995 Not defined NG 8.1 2






Mexico National Statistical Office 2001 1000g NG 5.5 2

Mexico estadisticas vitales INEGI 2002 28 weeks 14971 5.5 2










Monaco Eurozone WHO 1992 Not defined 5 18.5 2

Mongolia Center for health development, NSO 2000 22 weeks 606 11.7 2















Montenegro Eurozone WHO 1990 28 weeks 41 4.4 2

44

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type



Montenegro Statistical Yearbook 2012 1993 28 weeks 51 5.7 2




















Morocco MOH 1994 Not defined 6522 35.9 2








Morocco DHS survey 2001 28 weeks 102 16.6 3












Mozambique DHS survey 2001 28 weeks 211 19.5 3

45

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type

Mozambique DHS survey 2008 28 weeks 127 10.7 3

Namibia DHS survey 2004 28 weeks 46 9.1 3

Namibia DHS survey 2010 28 weeks 39 8.1 3

Nepal JAHN 1997 Not defined NG 70.0 5

Nepal Christian 1999 28 weeks 28 35.4 4

Nepal Dali 2000 1000g NG 24.8 5

Nepal manandhar 2001 Not defined NG 30.1 5

Nepal Prost 2002 22 weeks 77 23.3 4

Nepal manandhar 2002 1000g NG 23.9 4

Nepal Osrin 2002.

5 20 weeks 33 29.0 4

Nepal Shrestha 2004 1000g NG 14.5 5

Nepal DHS survey 2004 28 weeks NG 22.2 3

Nepal Lee 2004.

5 1000g 869 35.4 4

Nepal Manandhar 2006.

5 22 weeks 82 16.7 5

Nepal WHO Global Survey 2008 1000g 178 21.5 4

Nepal DHS survey 2009 28 weeks 53 9.7 3

Nepal WHOMCS 2010 1000g 99 19.1 5

Nepal WHOMCS 2010 1000g 117 20.2 4

Netherlands Eurozone WHO 1996 24 weeks 1221 6.4 1




Netherlands Perinatal care in The Netherlands 2000 28 weeks 966 5.1 1














New Zealand National Statistical Office 1990 28 weeks 247 4.1 1






46

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type

New Zealand Consultation 1996 1000g NG 3.8 1











New Zealand National Statistical Office 2007 1000g 211 3.2 1







Nicaragua DHS survey 1999 28 weeks 65 9.9 3

Nicaragua WHO Global Survey 2004 1000g 14 8.5 5

Nicaragua DHS survey 2004 28 weeks 89 9.9 3

Nicaragua WHO Global Survey 2004 1000g 27 6.9 4

Nicaragua WHOMCS 2010 1000g 19 4.5 4

Niger Chalumeau - Moma trial 1995 22 weeks NG 19.6 4

Niger HMIS 2002 1000g 2913 40.5 2

Niger HMIS 2003 1000g 2234 29.6 2

Niger WHO Global Survey 2004 1000g 97 55.7 5

Niger HMIS 2004 1000g 1954 26.9 2

Niger Zagre 2004 Not defined 44 31.9 4

Niger WHO Global Survey 2004 1000g 207 33.3 4

Niger HMIS 2005 1000g 3064 36.7 2

Niger HMIS 2007 1000g 3063 25.2 2

Niger HMIS 2008 1000g 3105 24.0 2

Niger HMIS 2009 1000g 3791 25.3 2

Niger DHS survey 2010 28 weeks 225 16.6 3

Niger WHOMCS 2011 1000g 30 76.5 5

Niger HMIS 2011 1000g 4439 20.1 2

Niger WHOMCS 2011 1000g 291 28.2 4

Niger HMIS 2012 1000g 4924 20.6 2

Nigeria Akpala 1990 1000g 61 41.1 4

Nigeria Adimora 1997 500g NG 68.1 5

Nigeria WHO Global Survey 2004 1000g 475 72.3 4

Nigeria Onyiriuka 2006 1000g NG 39.7 5

47

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type

Nigeria Mutihir 2006.

5 1000g 158 40.5 5

Nigeria WHOMCS 2011 1000g 131 46.7 5

Nigeria WHOMCS 2011 1000g 613 69.0 4

Norway The Medical Birth Registry of Norway 1990 28 weeks 270 4.4 1
























Oman Bhat 2000 500g NG 10.7 5

Oman Patel 2002 500g 154 9.1 2

Oman Statistical Yearbook 2014 2003 500g 381 9.4 2








Oman INTERGROWTH-21 2010 28 weeks 35 4.6 4




Pakistan Naseem 1996 Not defined NG 36.0 5

Pakistan Jokhio 1998 24 weeks 638 71.0 4

48

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type

Pakistan Korejo 2001 1000g NG 73.4 5

Pakistan Khaskheli 2003 Not defined NG 71.7 5

Pakistan Bhutta 2003 Not defined NG 60.5 4

Pakistan Jehan 2004 Not defined NG 33.6 4

Pakistan Bhutta 2005 28 weeks 48 53.5 4

Pakistan McClure 2006 1000g 330 33.7 4

Pakistan Bhutta 2007 Not defined 1010 43.9 4

Pakistan McClure 2007.

5 1000g 1466 32.0 4

Pakistan DHS survey 2010 28 weeks 412 33.3 3

Pakistan WHOMCS 2011 1000g 300 29.6 5

Pakistan WHOMCS 2011 1000g 82 31.8 4

Pakistan Saleem 2011 1000g 2237 56.1 4

Palestine National Statistical Office 1991 Not defined NG 10.5 2

Palestine National Statistical Office 2002 Not defined 584 6.1 2



Panama National Statistical Office 2002 28 weeks 372 6.0 2












Papua New Guinea Klufio 1990 Not defined 15 22.2 5

Papua New Guinea AMOA 1996 500g NG 22.0 5

Paraguay DHS survey 2002 28 weeks 67 14.2 3

Paraguay WHO Global Survey 2004 1000g 43 12.6 5

Paraguay DHS survey 2006 28 weeks 62 16.7 3

Peru DHS survey 1998 28 weeks 114 9.2 3

Peru Oliveros Donahue 1999 Not defined NG 16.3 5

Peru Ticona Rendon 2001 1000g NG 14.1 5


Peru WHO Global Survey 2004 1000g 144 10.8 5


Peru Gonzales 2005 1000g NG 11.6 4




49

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type

Peru WHOMCS 2010 1000g 100 8.2 5


Peru WHOMCS 2010 1000g 17 6.1 4


Philippines NSO 1990 All 11915 7.3 2

Philippines DHS survey 1996 28 weeks NG 12.0 3

Philippines DHS survey 2001 28 weeks 76 10.8 3

Philippines NSO 2005 All 10351 6.1 2


Philippines WHO Global Survey 2008 1000g 152 11.6 4

Philippines WHOMCS 2010 1000g 101 11.7 5

Philippines WHOMCS 2010 1000g 21 10.7 4


Poland Demographic year book of Poland 2007 1990 1000g 3940 7.1 1

Poland Eurozone WHO 1993 500g 3398 6.8 2







Poland Demographic year book of poland 2000 1000g NG 4.3 1




Poland Updated at consultation 2004 28 weeks 1342 3.8 1











Portugal Statistics Portugal 1996 28 weeks 538 4.9 1






50

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type














Qatar National Statistical Office 1990 28 weeks 66 6.0 2




















Qatar WHOMCS 2011 1000g 16 4.1 5

Republic of Korea Korea Statistics 2009 28 weeks 1025 2.3 1





Republic of Moldova Eurozone WHO 1991 22 weeks 1084 14.3 2




51

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type

Republic of Moldova Eurozone WHO 1995 22 weeks NG 12.4 2









Republic of Moldova DHS survey 2003 28 weeks 23 14.3 3






Republic of Moldova Ala Curteanu perinatal audit 2009 1000g 178 5.4 2





Romania Eurozone WHO 1990 1000g 2231 7.0 1







Romania National Statistical Office 1997 1000g NG 6.2 1



Romania RHS 1999 28 weeks 25 11.8 3













52

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type


Russian Federation Russia Demograhic yearbook 2010 1990 1000g 18165 9.1 1




















Russian Federation National Statistical Office 2010 1000g 8300 4.6 1

Russian Federation National Statistical Office 2011 1000g 8109 4.5 1

Rwanda DHS survey 1998 28 weeks 151 18.1 3


Rwanda Rwanda HMIS 2008 22 weeks 3092 12.5 2





Rwanda Aimable Muafili 2012 22 weeks 158 18.4 5




Saint Lucia National Statistical Office 2004 Not defined NG 15.0 1

Saint Vincent and the Grenadines National Statistical Office 2009 1000g NG 11.8 1

San Marino National Statistical Office 2010 Not defined NG 3.0 2

San Marino National Statistical Office 2011 Not defined 1 3.1 2

San Marino National Statistical Office 2013 Not defined NG 3.1 2

Saudi Arabia Archibong 1999 500g NG 10.1 4

Saudi Arabia Statistical Yearbook 2014 - updated from previous provisional 2002 Not defined 4161 17.0 2

Saudi Arabia Khashoggi 2002 500g NG 6.1 4

53

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type






Saudi Arabia Statistical Yearbook 2014 - updated 2008 Not defined 3631 13.9 2

Saudi Arabia Consultation 2008 Not defined NG 14.1 2





Saudi Arabia Statistical Yearbook 2014 - updated 2013 Not defined NG 13.2 2

Senegal Chalumeau - Moma trial 1995 22 weeks NG 22.9 4

Senegal Chalumeau - Moma trial 1995 22 weeks NG 31.0 4

Senegal Consultation 2003 Not defined NG 43.0 2

Senegal DHS survey 2003 28 weeks 215 20.0 3






Senegal Annuaire statistique sanitaires 2010 2009 1000g NG 17.6 2

Senegal HMIS 2009 Not defined NG 33.0 2

Senegal DHS survey 2009 28 weeks 192 16.5 3

Senegal Annuaire statistique sanitaires 2010 2010 1000g 1042 17.2 2

Serbia Demography statistics 2003 1990 1000g 547 6.0 2















54

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type










Seychelles Consultation 1997 Not defined NG 8.1 2



Seychelles Consultation 2015 2000 28 weeks 12 7.9 2













Singapore National Statistical Office 1990 1000g 206 4.0 2


















55

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type







Slovakia Slovak National Statistical Office 2000 28 weeks 215 3.9 1















Slovenia Demographic yearbook 1990 28 weeks 100 4.5 1




Slovenia Eurozone WHO 1994 28 weeks 104 5.3 1


















56

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type



South Africa SAStatistics 1997 26 weeks 5982 6.2 2


South Africa PPIP 1999 1000g 976 13.8 5












South Africa DHIS from HSTA 2001 All NG 27.0 2







South Africa PPIP 2004 1000g NG 16.9 5

















South Africa Ntuli 2009.

5 1000g 218 38.9 5



57

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type



Spain Eurozone WHO 1990 500g 1617 4.0 2






Spain National Statistical Office 1996 28 weeks 1227 3.4 1


















Sri Lanka National Statistical Office 1990 Not defined 1995 13.4 2










Sri Lanka DHS survey 2003 1000g 62 8.8 3

Sri Lanka National Statistical Office 2004 28 weeks 1072 4.6 2




Sri Lanka MOH report 2007 1000g 3184 8.8 2


58

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type

Sri Lanka WHO Global Survey 2008 1000g 67 4.5 4



Sri Lanka WHOMCS 2011 1000g 55 5.3 5


Sri Lanka WHOMCS 2011 1000g 48 6.3 4


Sudan Ibrahim 1990 28 weeks 150 24.1 4

Sudan Haggaz 2004 1000g 206 20.5 5

Sudan Elhassan 2005 1000g NG 28.8 5

Sudan Bader 2008 1000g NG 22.0 5

Sudan Hassan 2008 1000g 46 35.6 5

Sudan Ali 2009 1000g 44 32.8 5

Sudan Ali 2010.

5 1000g 25 30.4 4

Suriname Updated at consultation 2000 22 weeks 240 23.9 2









Swaziland DHS survey 2004 28 weeks 35 12.2 3

Swaziland Annual Health Statistics 2011 2009 Not defined NG 7.0 2

Swaziland Annual Health Statistics 2011 2010 Not defined NG 15.0 2

Swaziland Annual Health Statistics 2011 2011 Not defined 204 10.0 2

Sweden Perinatal statistics in the Nordic countries 1990 1000g 393 3.2 1








Sweden National Board of Health and Welfare 1998 28 weeks 298 3.5 1

59

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type
















Switzerland National Statistical Office 2005 22 weeks 307 4.2 1










Tajikistan Eurozone WHO 1990 Not defined 3136 15.0 2





Tajikistan Eurozone WHO 1995 Not defined NG 10.8 2



60

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type










Tajikistan DHS survey 2009 28 weeks 45 8.5 3




Thailand Chongsuvivatwong 1991 Not defined 36 15.3 4

Thailand Mo-suwwan 2001 Not defined NG 6.8 4

Thailand WHO Global Survey 2008 1000g 32 3.4 4

Thailand WHOMCS 2011 1000g 28 4.5 5

Thailand WHOMCS 2011 1000g 13 4.9 4

The former Yugoslav Republic of Macedonia National Statistical Office 1994 28 weeks 330 10.4 1















61

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type






Togo MOH report 2008 Not defined 3828 31.9 2





Trinidad and Tobago National Statistical Office 1990 28 weeks 317 13.1 2






Trinidad and Tobago Bassaw 1996 500g NG 15.1 5














Tunisia National Statistical Office 2002 Not defined 1500 9.1 2






Tunisia Nouaili 2007.

5 22 weeks 87 11.8 5




62

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type


Turkey DHS1993 1990 28 weeks NG 12.0 3




Turkey Durukan 1998 500g NG 16.5 5

Turkey Ecevit A 1998 22 weeks 541 23.8 5

Turkey Erdem 1999 500g NG 18.3 5


Turkey DHS2008 2006 28 weeks 27 7.7 3

Turkey Eurozone WHO 2007 Not defined 7305 5.7 2

Turkey Eurozone WHO 2008 Not defined 7229 5.6 2

Turkey Ecevit A 2009 22 weeks 302 16.3 5

Turkey Arslan 2009 22 weeks 241 9.3 4

Turkey Turkish Statistical Institute 2010 28 weeks 4807 3.8 2





Turkmenistan Eurozone WHO 1991 Not defined 2415 18.8 2




Turkmenistan Eurozone WHO 1995 Not defined NG 15.9 2



Turkmenistan DHS survey 1998 28 weeks 46 12.7 3



Uganda Byaruhanga 1998 500g NG 40.9 5

Uganda DHS survey 1998 28 weeks 126 16.2 3

Uganda WHO Global Survey 2004 1000g 260 37.4 5

Uganda WHO Global Survey 2004 1000g 164 25.4 4


Uganda Ndyomugyeni 2005.

5 28 weeks 108 20.7 4

Uganda Nankabirwa 2006.

5 1000g 16 19.2 4


Uganda Iganga HDSS- unpublished 2009 28 weeks 136 16.1 4

Uganda WHOMCS 2011 1000g 273 32.8 5

Uganda WHOMCS 2011 1000g 22 10.5 4

Uganda MOH report 2012 1000g 20224 27.8 2

Ukraine Eurozone WHO 1990 500g 11842 17.7 2

63

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type





Ukraine Eurozone WHO 1995 500g NG 20.4 2



Ukraine RHS survey 1997 28 weeks 14 9.0 3









Ukraine RHS survey 2005 28 weeks 4 3.4 3






United Arab Emirates Al Hosani 1999 Not defined 370 7.1 2



United Kingdom Eurozone WHO 1990 28 weeks 3721 4.6 1










United Kingdom CMACE 2009 report 2000 24 weeks NG 5.4 1








64

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type

United Kingdom Eurozone WHO 2008 24 weeks NG 5.1 1





United Kingdom 3 National Statistical Offices 2013 24 weeks 3628 4.6 1

United Republic of Tanzania wort 1997 Not defined NG 24.0 5

United Republic of Tanzania AMMP - Dar 2000 1000g NG 20.3 4

United Republic of Tanzania AMMP- Hai 2000 1000g NG 24.8 4

United Republic of Tanzania AMMP- Morogoro 2000 1000g NG 25.2 4

United Republic of Tanzania Kilonzo 2000 1000g NG 38.0 4

United Republic of Tanzania Kidanto 2001 500g NG 96.1 5

United Republic of Tanzania DHS survey 2002 28 weeks 165 18.6 3

United Republic of Tanzania Abu Habib 2002.

5 28 weeks 416 28.8 5

United Republic of Tanzania Habib 2003 500g NG 28.0 5

United Republic of Tanzania Mmbaga 2005.

5 28 weeks 1219 35.9 5

United Republic of Tanzania DHS survey 2007 28 weeks 143 17.2 3

United Republic of Tanzania Sorensen 2008 Not defined 24 21.0 5

United Republic of Tanzania Msemo 2009 1000g 300 36.3 5

United Republic of Tanzania Mosha 2012 28 weeks 41 42.4 4

United States National Statistical Office 1995 1000g NG 3.6 1







United States National Statistical Office 2003 28 weeks 12294 3.0 1











Uruguay National Statistical Office 1992 Not defined 267 4.9 2




65

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type


















Venezuela Faniete 2000 500g NG 20.1 5

Venezuela National Statistical Office 2000 Not defined 4529 8.1 2











Viet Nam Graner 2002 500g NG 15.9 4

Viet Nam Hirst 2008 22 weeks 122 25.3 5

Viet Nam Persson 2009.

5 28 weeks 151 8.9 4

Viet Nam Bergstrom 2013 22 weeks 44 5.6 4

Yemen Banajeh 1995 500g NG 47.2 5

Zambia DHS survey 2005 28 weeks 91 13.9 3

Zambia McClure 2006 1000g 201 29.0 4

Zambia Gill 2007 28 weeks 28 18.2 4

Zambia McClure 2007.

5 1000g 433 14.1 4

Zambia Stringer 2007.

5 1000g 2109 21.0 4

Zambia Chi 2008.

5 1000g 2739 23.7 4

Zambia Turnbull 2008.

5 1000g 50 27.0 4

66

Country Data Source

Year data


# stillbirths

Reported stillbirth

rate Data type

Zambia Saleem 2011 1000g 440 21.0 4

Zimbabwe Majoko 1996 Not defined NG 13.7 5

Zimbabwe DHS survey 1997 28 weeks 53 14.7 3

Zimbabwe Feresu 1998 500g NG 57.4 5


Zimbabwe HMIS 2007 500g NG 17.0 2


Zimbabwe Tachiweyika 2009 1000g 58 36.4 4

Footnote: NG=Not given. DHS survey=Demographic and Health survey.4 RHS survey=Reproductive Health survey.4 WHOMCS=WHO multi-country survey on Maternal and Newborn Health5. WHO Global Survey= Global survey on maternal and perinatal health.6

Summary of stillbirth rate data inputs meeting inclusion criteria by Millennium

Development Goal region

020

40

60

80

SB

R a

dju

ste

d to

28 w

ee

k d

efin

itio

n

Dev

elop

ed re

gion

Sou

ther

n Asia

Cau

casu

s an

d Cen

tral A

sia

Eas

tern

Asia

Latin

Am

erica

and

the

Car

ibbe

an

N.A

frica

and

Mid

dle

Eas

t

Sou

th-e

aste

rn A

sia

Sub

-Sah

aran

Afri

ca

67

Data availability over time by region

Comparison with previous data inputs

Overall input data:

Region

Number of countries Input data points

In Region With data (number of

new countries with data since last estimates)

Previous estimates

Current estimation

exercise

% increase in data

Developed region 49 48 (2) 589 1,003 70

Southern Asia 9 8 (0) 59 171 190

Caucasus and Central 8 8 (0) 117 131 12

Eastern Asia 4 2 (0) 7 36 414

Latin America and the 33 26 (5) 155 327 111 North Africa and Middle East 18 16 (2) 82 167 104

South-eastern Asia* 25 11 (4) 44 106 141

Sub-Saharan Africa 49 38 (9) 96 266 177

Total 195 157 (22) 1149 2,207 92

* Also includes Oceania

National or Nationally representative data only: Number of countries contributing at least one national data point by region

68

National routine data

(% of countries)

National representative survey

(% of countries)

Any national data

(% of countries)

Region # of countrie

s in region

2015 estimate

s

2009 estimates

2015 estimate

s

2009 estimates

2015 estimate

s

2009 estimate

s

Developed region 49 49 (100) 43 (88) 4 (8) 0 (0) 49 (100) 43 (88)

Southern Asia 9 4 (44) 2 (22) 7 (78) 3 (33) 7 (78) 4 (44)

Caucasus and Central Asia

8 7 (88) 7 (88) 5 (63) 4 (50) 8 (100) 8 (100)

Eastern Asia 4 3 (75) 1 (25) 0 (0) 0 (0) 3 (75) 1 (25)

Latin America 33 18 (55) 12 (37) 12 (37) 6 (18) 26 (79) 18 (55)

N.Africa and Middle East

18 12 (67) 7 (39) 4 (22) 4 (22) 16 (89) 11 (61)

South-eastern Asia 25 6 (24) 2 (8) 3 (12) 2 (8) 8 (32) 4 (16)

Sub-Saharan Africa 49 18 (37) 5 (10) 21 (43) 19 (39) 30 (61) 24 (49)

Worldwide 195 117 (60) 80 (41) 56 (29) 38 (19) 147 (75) 113 (58)

Change in number of included datapoints by region

National routine data National representative survey

Any national data

Region 2015 estimates

(% increase)

2009 estimates

2015 estimates

(% increase)

2009 estimates

2015 estimates

(% increase)

2009 estimates

Developed region 979 (67) 585 5 0 984 (68) 585

Southern Asia 40 (233) 12 16 (100) 8 56 (180) 20


122 (9) 112 9 (29) 7 131 (10) 119

Eastern Asia 23 (667) 3 0 0 23 (667) 3

Latin America 268 (97) 136 33 (200) 11 301 (105) 147


134 (106) 65 17 (70) 10 151 (101) 75

South-eastern Asia 75 (150) 30 9 (80) 5 84 (140) 35

Sub-Saharan Africa 114 (293) 29 38 (46) 26 152 (176) 55

Worldwide 1755 (81) 972 127 (90) 67 1882 (81) 1039

Quality categorisation of national routine data National level data were assessed as high quality using the following criteria:

CRVS strength CRVS capture of perinatal events Completeness of data

VR is considered ‘good quality’ for the purposes of maternal death reporting

Stillbirth rate (adjusted to 28 week definition): national UN-IGME NMR ratio >0.5 for all years

Earliest year of data available is before 2005

For given year female child mortality capture>85%

Latest year of data available is after 2010.

Number of years of data >0.5 *(max year – min year + 1).

69

High quality data with partial time series were data fulfilling all above, apart from first and last data year. Low quality routine data included all other CRVS data points fulfilling overall inclusion criteria, but not meeting above criteria. Table of countries with female child mortality>85%:

Aruba Finland Malta

Anguilla Fiji Myanmar

Andorra France Montenegro

Argentina United Kingdom Montserrat

Antigua and Barbuda Greece Mauritius

Australia Grenada Malaysia

Austria China, Hong Kong SAR Netherlands

Belgium Croatia Norway

Bulgaria Hungary New Zealand

Bahrain Ireland Oman

Bahamas Iran (Islamic Republic of) Poland

Bosnia and Herzegovina Iraq Puerto Rico

Belize Iceland Portugal

Barbados Israel Romania

Brunei Darussalam Italy Russian Federation

Canada Jordan Sao Tome and Principe

Switzerland Japan Slovakia

Chile Saint Kitts and Nevis Slovenia

Cape Verde Republic of Korea Sweden

Costa Rica Kuwait Seychelles

Cuba Libya Syrian Arab Republic

Czech Republic Saint Lucia Tonga

Germany Sri Lanka Tunisia

Dominica Lithuania Turkey

Denmark Luxembourg Taiwan

Algeria Latvia Uruguay

Egypt Madagascar United States of America

Spain Maldives Saint Vincent and the Grenadines

Estonia The former Yugoslav Republic of Macedonia

Venezuela (Bolivarian Republic of)

70

Table of countries with higher quality national routine data

Argentina Germany Norway

Australia Greece Poland

Austria Hungary Portugal

Bahamas Iceland Republic of Korea

Bahrain Ireland Romania

Belgium Israel Russian Federation

Bulgaria Italy Saint Lucia

Canada Japan Saint Vincent and the Grenadines

Chile Kuwait Slovakia

Costa Rica Latvia Slovenia

Croatia Lithuania Spain

Cuba Luxembourg Sweden

Czech Republic Malta Switzerland

Denmark Mauritius TFYR Macedonia

Estonia Mexico United Kingdom

Finland Netherlands United States of America

France New Zealand Uruguay

Predictor variables

Identification of predictor variables for model input Plausible covariates associated with stillbirth rate, were identified from the published literature.

These included distal determinants such as socio-economic factors, interacting and overlapping

demographic and biomedical factors, associated perinatal outcome markers and access to health

care:

71

A comparable, complete time series for all countries for 1990 – 2015 was required for inclusion in

the model, thus limiting the number of predictors that it was possible to test. Possible predictors

were grouped into four categories: ‘Socio-economic indicators’, ‘Maternal demographic and

biomedical associated factors’, ‘Perinatal outcome indicators’, ‘Access to health care indicators’.

Socio-economic indicators Maternal demographic and biomedical associated indicators

Perinatal outcome

indicators

Access to health care

indicators

GINI co-efficient Maternal NCDs Maternal Mortality Ratio Proportion c-section

% population urban GFR NMR Protected at birth

GNI Malaria PFPR/ ITN coverage Low Birthweight rate* ANC1/ ANC4

Mean years female education % mothers over 35 Preterm birth rates Skilled attendant at

birth

MDG region

Adolescent fertility rate Rates of congenital

abnormalities

Legal status of

abortion

World bank region Adult female obesity

Syphilis Index

* low birthweight rate includes all livebirths with a birthweight of <2500g – and hence is a composite outcome marker for

fetal health, including both fetal or intra-uterine growth restriction and/ or preterm births.

Indicators in bold had data or estimates available for all countries for all years 2000 – 2015 and were tested in the model

fitting process.

The syphilis index was created to include 3 categories: syphilis prevalence<1%, syphilis prevalence 1 – 5%, and syphilis

prevalence>5% based on WHO worldwide estimates of syphilis prevalence in pregnancy.7

Logarithmic transformations were performed based on the observed relationship between the

stillbirth rates and the predictor of interest untransformed or transformed – if the relationship

between the transformed covariate and the rate was more linear than the relationship between the

untransformed covariate, the transformation was included.

Source of potential predictor variables tested in models Predictor Source Notes on Methodology

Low birthweight rate World Bank1, including data from MICS/ DHS surveys and CRVS data

For missing years of data, linear interpolation was used. Extrapolated assuming a flat trend

General fertility rate (GFR) Maternal mortality estimation inter-agency group (MMEIG)

Malaria PFPR/ITN coverage Malaria Atlas Project2

Adolescent fertility rate World Health Organization3

Adult female obesity Institute of Health Metrics Evaluation5

Syphilis index Newman et al7 (see above)

Neonatal mortality rate (NMR) Inter-agency group for mortality estimation (IGME) 2014

Projection

Proportion c-section World Health Organization3

Protected at birth World Health Organization3

ANC1/ANC4 World Health Organization3 Extrapolated assuming a flat trend

72

Predictor Source Notes on Methodology

Skilled attendant at birth World Health Organization3 Extrapolated assuming a flat trend

GINI co-efficient World Bank1

% population urban World Bank1

Gross national income (GNI) World Bank1 For missing years of data, linear interpolation was used. Extrapolated with regression on GDP

Mean years female education United Nations population division (UNDP)4 For missing years of data, linear interpolation was used. Extrapolated assuming a flat trend

MDG region http://www.un.org/millenniumgoals/

World bank region World Bank1 1The World Bank (http://data.worldbank.org/indicator) 2Malaria Atlas Project (http://www.map.ox.ac.uk/ ) 3WHO Global Health Observatory (http://www.who.int/gho/en/) 4UN Population Division (http://esa.un.org/wpp/ ) 5IHME global data exchange (http://ghdx.healthdata.org/ihme_data)

Data adjustments:

Small countries For countries with time series of civil registration and vital statistics (CRVS) stillbirth rate data and

large year on year variation in stillbirth rates (coefficients of variation >10%) due to small birth

cohorts, data were smoothed using a rolling average.

Countries where adjustments applied:

Adjusted with 3 years rolling average Adjusted with 5 years rolling average

Cook Islands Andorra Luxembourg Iceland Malta

Non-standard definitions in Developed Region For countries in the developed region, without own country data to inform the relationship between

stillbirth rates using the given definition, and the ≥28 week definition, the data were adjusted based

on meta-analyses of data from countries in the region with data.

Adjusting for 1000g to ≥28 week definition Data reporting 1000g cut off were adjusted using a meta analysis of 26 population based inputs from

23 HIC countries, including 6,839,018 births:

http://www.un.org/millenniumgoals/

http://data.worldbank.org/indicator

http://www.map.ox.ac.uk/

http://www.who.int/gho/en/

http://esa.un.org/wpp/

http://ghdx.healthdata.org/ihme_data

73

Adjusting for ≥24 weeks to ≥28 weeks definition Data reporting ≥24 week cut off were adjusted using a meta analysis of 4 population based inputs

from 4 HIC countries, including 5,694,803 births (24,964 stillbirths):

Overall

Study

Portugal

Belgium: Flanders

Slovenia

Estonia

Germany

Luxembourg

USA

Slovak Republic

UK: Scotland

Malta

Ireland

Finland

Belgium: Brussels

France

Poland

Latvia

Norway

The Netherlands

UK: Northern Ireland

Lithuania

Czech Republic

UK: England and Wales

Austria

Hungary

Sweden

ID

Spain: Valencia

1.15 (1.13, 1.17)

1.02 (0.87, 1.20)

1.07 (0.86, 1.32)

1.02 (0.72, 1.44)

0.90 (0.48, 1.70)

1.07 (1.00, 1.14)

1.13 (0.54, 2.38)

1.21 (1.18, 1.24)

1.02 (0.76, 1.38)

1.13 (0.94, 1.35)

1.00 (0.49, 2.04)

1.12 (0.94, 1.34)

1.04 (0.80, 1.34)

1.32 (0.88, 2.00)

1.18 (0.84, 1.67)

1.07 (0.99, 1.15)

1.03 (0.78, 1.37)

1.03 (0.83, 1.29)

1.13 (1.02, 1.26)

1.04 (0.76, 1.41)

1.03 (0.79, 1.33)

0.94 (0.78, 1.12)

1.12 (1.06, 1.19)

1.07 (0.87, 1.30)

1.05 (0.90, 1.22)

1.10 (0.94, 1.29)

RR (95% CI)

1.05 (0.84, 1.32)

100.00

%

1.57

0.88

0.34

0.11

8.41

0.07

52.08

0.46

1.17

0.08

1.29

0.62

0.21

0.33

6.88

0.52

0.86

3.69

0.44

0.62

1.36

12.80

1.00

1.84

1.57

Weight

0.79

1.15 (1.13, 1.17)

1.02 (0.87, 1.20)

1.07 (0.86, 1.32)

1.02 (0.72, 1.44)

0.90 (0.48, 1.70)

1.07 (1.00, 1.14)

1.13 (0.54, 2.38)

1.21 (1.18, 1.24)

1.02 (0.76, 1.38)

1.13 (0.94, 1.35)

1.00 (0.49, 2.04)

1.12 (0.94, 1.34)

1.04 (0.80, 1.34)

1.32 (0.88, 2.00)

1.18 (0.84, 1.67)

1.07 (0.99, 1.15)

1.03 (0.78, 1.37)

1.03 (0.83, 1.29)

1.13 (1.02, 1.26)

1.04 (0.76, 1.41)

1.03 (0.79, 1.33)

0.94 (0.78, 1.12)

1.12 (1.06, 1.19)

1.07 (0.87, 1.30)

1.05 (0.90, 1.22)

1.10 (0.94, 1.29)

RR (95% CI)

1.05 (0.84, 1.32)

100.00

%

1.57

0.88

0.34

0.11

8.41

0.07

52.08

0.46

1.17

0.08

1.29

0.62

0.21

0.33

6.88

0.52

0.86

3.69

0.44

0.62

1.36

12.80

1.00

1.84

1.57

Weight

0.79

1.25 .5 .75 1 1.5 2

Relative Risk Stillbirth

74

Adjusting for ≥22 weeks to ≥28 weeks definition Data reporting ≥22 week cut off were adjusted using a meta analysis of 139 population based inputs,

including 30,120,462 births (154,584 stillbirths):

RR=1.47 (1.46 – 1.47)

Adjusting for ≥20 weeks to ≥28 weeks definition Data reporting ≥20 week cut off were adjusted using a meta analysis of 56 population based inputs,


RR=2.19 (2.17 – 2.22)

Adjusting for ‘all fetal deaths’ to ≥28 weeks definition Data reporting ‘all fetal deaths’ were adjusted using a meta analysis of 74 population based inputs,


RR=1.51 (1.50 – 1.52)

These data suggest in practice similar to 22 week. Countries included in this analysis were Argentina,

Chile, Malta and Slovakia that plausibly had lower capture below 22 weeks. Also Portugal – where

only stillbirths at >24 weeks are required legally to be registered. Below this threshold registration is

voluntary.

Adjusting where no definition is given For countries in the developed region, where no definition was given it was assumed to have used a

≥22 week cut off and adjusted accordingly.

Data reporting using 25 or 26 week definitions were dropped as no adjustment factor was available.

75

Table - summary of adjustments:

Stated definition # country data

years #stillbirths (# births)

Adjustment factor

95% confidence interval

≥28 weeks - - 1 (baseline) - ≥1000g

26 25,986

(6,839,018) 1.15 1.13 -1.17

≥24 weeks 4

24,964 (5,694,803)

0.72 0.71-0.74

≥22 weeks 139

154,584 (30,120,462)

0.68 0.68-0.69

≥20 weeks 56

92,289 (14,134,226)

0.46 0.45-0.46

All fetal deaths 74

105,113 (13,890,261)

0.66 0.66-0.67

The adjusted stillbirth rate is calculated as the reported stillbirth rate multiplied by the adjustment

factor. For example a data source reporting a stillbirth rate of 6.2 using the ≥22 week definition

would be adjusted as follows: 6.2*0.68 = 4.2 stillbirths ≥28 weeks per 1,000 total births.

The most commonly reported stillbirth definition in this region is the ≥22 week definition. For

countries in this region reporting stillbirth rates without a definition, it is assumed that the ≥22 week

definition is used and adjusted accordingly.

Note on data adjustments:

The relationship is highly dependent upon whether definitions include TOP or not and the capture of

stillbirths at the lower gestations. Ideally the analysis would have been undertaken separately based

on TOP policy and practice – however, insufficient data were available to inform this analysis.

Non-standard definitions in Other Regions For countries outside the developed region, no country had own country data available to inform

the relationship between stillbirth rates using the given definition, and the ≥28 week definition.

Therefore stillbirth rates using non-standard definitions were adjusted using facility based data

collected for the WHO GS and WHO MCS surveys.

Stated definition # country data

years #stillbirths (# births)

Adjustment factor

95% confidence interval

≥28 weeks or ≥1000g*

- - 1 (baseline) -

≥22 weeks or ≥500g*

96 11,911

(598,386) 0.89 0.87-0.91

*Many data sources report using birthweight rather than gestational age. Data were only available

for adjustment from ≥500g to ≥1000g, for the purposes of these estimates, it is assumed that these

approximate to the gestational age equivalents.

The most commonly reported stillbirth definition in this region is the ≥28 week definition (or

birthweight equivalent). No strong evidence of a difference between stillbirth rates was found

between studies in these regions using the 28 week definition and those providing no details of the

76

gestational age or weight cut off used to define stillbirth (p<0.05). It was therefore assumed that the

28 week cut off was used in these cases. Data from demographic and health, and reproductive

health surveys report fetal deaths after the 7 month of pregnancy, using pregnancy or birth history

questionnaires. Reported fetal deaths at ≥7 months is used to approximate to ≥28 weeks.

Implausibility criteria In general, capture and reporting of stillbirths are more problematic than the capture of deaths in

liveborn neonates (and neonatal deaths are more challenging to capture than deaths in older

children or adults). Hence, under-ascertainment of stillbirths is a common problem across data

sources, especially when close to the threshold of viability or the threshold of reporting, for example

fetal deaths are more commonly coded as miscarriages when the health provider assesses the baby

to be below the limits of viability. In many high income countries this may affect fetal deaths

especially at 22 and 23 weeks gestation, in lower resource settings, without neonatal intensive care,

fetal deaths up to 30 weeks gestation may not be included in stillbirth figures.

We excluded datapoints likely to reflect poor case ascertainment based on conservative

‘implausibility’ criteria.

Model selection All identified predictor variables with full time series were included in the initial model. For

continuous variables, a univariate analysis was undertaken to identify whether the relationship

between the ln_sbr and the predictor was best described using a ln transformation, or using the

non-transformed predictor. For all variables the BIC was calculated. Predictors were retained when

the direction of the coefficient was plausible. General fertility rate, caesarean section group, and

syphilis were dropped as the direction of the coefficients were not plausible.

We sought to maximise the predicting power of the model, whilst reducing the noise within the

model from a large number of predictors. We removed one predictor at a time from the model,

commencing with the predictor with the largest BIC on univariate analysis, and re-fitted the model. If

the model was improved by removing this predictor (lower BIC compared to the model containing

the predictor), the predictor was dropped from the model. If the BIC was higher, the predictor was

retained. The p.falciparum parasite, gini index, skilled birth attendant, female obesity, proportion of

the population that are urban and protected at birth against tetanus were dropped as a result of

this process.

Effect of dropping predictor

Outcome BIC

Full Model

- 399.1

Dropping gini Improved BIC Dropped from model 380.9

Dropping malaria Improved BIC Dropped from model 378.2

Dropping syphilis index Improved BIC Dropped from model 357.7

Dropping lbw Worsened BIC Retained in model 360.5

Dropping region Worsened BIC Retained in model 362.6

Dropping Skilled Birth Attendance

Improved BIC Dropped from model 344.5

Dropping study type (context) Worsened BIC Retained in model 562.5

Dropping Obesity Improved BIC Dropped from model 339.7

77

Dropping urban Improved BIC Dropped from model 320.8

Dropping Protected at birth Improved BIC Dropped from model 308.6

Dropping ANC Worsened BIC Retained in model 310.2

Dropping mean female education

Worsened BIC Retained in model 310.4

Dropping GNI Worsened BIC Retained in model 317.3

Dropping NMR Worsened BIC Retained in model 499.4

Final model 308.6

The final model included ln neonatal mortality rate, ln low birthweight, ln Gross National Income,

mean years of female education, coverage of 4 antenatal care visits, data type and region

Final model equation Log(Stillbirth rateij) = a + b(log(NMRij)) + c(log(LBWij)) + d(log(GNIij)) + e(mean_eduij) + f(ANC4ij) +

g(regionij) + h(datatypeij) + uj + eij

b() c() d() e() and f()represent functions each involving 2 parameters,

g() indicates a 3 parameter function associated with 3 dummy variables representing different

millennium development goal regionsh() indicates a 5 parameter function associated with 5 dummy

variables representing different data types (see paper for details)

uj represent country-specific random effects, assumed to be independent normally distributed with

constant variance

eij represent individual data point-level residuals, assumed to be independent normally distributed

with constant variance

78

Figure: Diagnostic plots for the stillbirth prediction regression model

01

23

45

Obse

rved

ln(S

BR

)

0 1 2 3 4 5Predicted ln(SBR)

-1.5

-1-.

50

.51

1.5

Resid

uals

0 1 2 3 4Predicted ln(SBR)

79

0.5

11

.5

Den

sity

-1 -.5 0 .5 1Estimated country-level random effects

0.5

11

.52

2.5

Den

sity

-1.5 -1 -.5 0 .5 1 1.5Residual ln(SBR) (observed-predicted)

80

Loess region plots for countries using own data

Argentina

Australia

45

67

8

sb

r28

a

2000 2005 2010 2015year

bandwidth = .9615385

Lowess smoother

2.6

2.8

33

.23

.4

sb

r28

a

2000 2005 2010 2015year


Lowess smoother

81

Austria

Bulgaria

3.5

44

.55

sb

r28

a

2000 2005 2010 2015year


Lowess smoother6

78

91

0

sb

r28

a

2000 2005 2010 2015year


Lowess smoother

82

Chile

Costa Rica

34

56

7

sb

r28

a

2000 2005 2010 2015year


Lowess smoother

5.6

5.8

66

.26

.4

sb

r28

a

2000 2005 2010 2015year


Lowess smoother

83

Croatia

Cuba

22

.53

3.5

sb

r28

a

2000 2005 2010 2015year


Lowess smoother6

78

91

01

1

sb

r28

a

2000 2005 2010 2015year


Lowess smoother

84

Czech Republic

Denmark

2.4

2.6

2.8

33

.23

.4

sb

r28

a

2000 2005 2010 2015year


Lowess smoother

1.5

22

.53

3.5

sb

r28

a

2000 2005 2010 2015year


Lowess smoother

85

Estonia

Finland

23

45

sb

r28

a

2000 2005 2010 2015year


Lowess smoother

1.8

22

.22

.42

.6

sb

r28

a

2000 2005 2010 2015year


Lowess smoother

86

Germany

Hungary

2.2

2.4

2.6

2.8

3

sb

r28

a

2000 2005 2010 2015year


Lowess smoother

3.4

3.6

3.8

44

.24

.4

sb

r28

a

2000 2005 2010 2015year


Lowess smoother

87

Iceland

Ireland

11

.52

2.5

3

sb

r28

a

2000 2005 2010 2015year


Lowess smoother

2.5

33

.54

4.5

sb

r28

a

2000 2005 2010 2015year


Lowess smoother

88

Israel

Italy

3.5

44

.55

sb

r28

a

2000 2005 2010 2015year

bandwidth = .8

Lowess smoother3

3.2

3.4

3.6

3.8

4

sb

r28

a

2000 2005 2010 2015year


Lowess smoother

89

Japan

Kuwait

22

.22

.42

.62

.83

sb

r28

a

2000 2005 2010 2015year


Lowess smoother5

5.5

66

.57

7.5

sb

r28

a

2000 2005 2010 2015year


Lowess smoother

90

Latvia

Lithuania

3.5

44

.55

5.5

6

sb

r28

a

2000 2005 2010 2015year


Lowess smoother3

45

6

sb

r28

a

2000 2005 2010 2015year


Lowess smoother

91

Luxembourg

Macedonia

2.5

33

.54

4.5

sb

r28

a

2000 2005 2010 2015year

bandwidth = .8

Lowess smoother8

91

01

11

2

sb

r28

a

2000 2005 2010 2015year


Lowess smoother

92

Malta

Mauritius

2.5

33

.54

4.5

5

sb

r28

a

2000 2005 2010 2015year


Lowess smoother6

81

01

21

4

sb

r28

a

2000 2005 2010 2015year


Lowess smoother

93

Netherlands

New Zealand

23

45

6

sb

r28

a

2000 2005 2010 2015year


Lowess smoother2

2.5

33

.54

sb

r28

a

2000 2005 2010 2015year


Lowess smoother

94

Norway

Poland

22

.53

3.5

4

sb

r28

a

2000 2005 2010 2015year


Lowess smoother

2.5

33

.54

4.5

5

sb

r28

a

2000 2005 2010 2015year


Lowess smoother

95

Portugal

Romania

22

.53

3.5

4

sb

r28

a

2000 2005 2010 2015year


Lowess smoother4

56

7

sb

r28

a

2000 2005 2010 2015year


Lowess smoother

96

Russia

Slovakia

45

67

8

sb

r28

a

2000 2005 2010 2015year

bandwidth = .8

Lowess smoother3

3.5

44

.5

sb

r28

a

2000 2005 2010 2015year


Lowess smoother

97

Slovenia

Spain

2.5

33

.54

4.5

sb

r28

a

2000 2005 2010 2015year


Lowess smoother

2.6

2.8

33

.23

.4

sb

r28

a

2000 2005 2010 2015year


Lowess smoother

98

Sweden

United Kingdom

2.8

33

.23

.43

.63

.8

sb

r28

a

2000 2005 2010 2015year


Lowess smoother3

3.2

3.4

3.6

3.8

sb

r28

a

2000 2005 2010 2015year


Lowess smoother

99

United States of America

Calculation of stillbirth numbers Live birth estimates from the World Population Prospects: the 2015 revision8 were used to convert the stillbirth rate to the number of stillbirths using the formula: Number of stillbirths = (stillbirth rate*number of livebirths)/(1-stillbirth rate).

Uncertainty estimation Estimates of uncertainty were generated by drawing 1000 bootstrap samples from the estimation

dataset and using the parameter estimates obtained from each bootstrap sample to generate a new

set of predictions including the estimate of the variance of the country-specific random effects. We

used this estimate of the between country variance to draw, at random, a random effect for

countries not included in the bootstrap sample assuming that the random effects are normally

distributed with mean zero and variance equal to that estimated from the model. To obtain

worldwide and regional level estimates of uncertainty, we summed the data at worldwide or

regional level for each bootstrap prediction run and used the 2.5th and 97.5th centiles of the

resulting distributions around the estimated number of preterm births by country. Because about

half of the modelled countries had a country-specific random effect generated at random for each

bootstrap prediction, some of which were positive and others negative, the relative uncertainty at

the regional and worldwide level tends to be less than that at the individual country level.

For countries with high quality vital registration and with data on reported rates fulfilling the criteria

for high quality VR, we assumed that the standard error of the reported number of stillbirths was the

square root of the reported number (i.e., to follow a poisson distribution).

2.9

2.9

5

3

3.0

53

.1

sb

r28

a

2000 2005 2010 2015year

bandwidth = .8

Lowess smoother

100

Results

Table: Estimated stillbirth rate by country for 2000 and 2015

Country

Stillbirth rate 2000

Number of

stillbirths 2000


Number of

stillbirths 2015

2000-2015

ARR % Source of estimate

Afghanistan 35.7 34794 26.7 28056 -1.9 Modelled estimate

Albania 5.8 300 4 180 -2.4 Modelled estimate

Algeria 26.0 15141 19.3 18774 -2 Modelled estimate

Andorra 2.1 1 1.6 1 -1.9 Modelled estimate

Angola 34.3 26201 27.3 30655 -1.5 Modelled estimate

Antigua and Barbuda 8.6 14 6.4 10 -1.9 Modelled estimate

Argentina 7.3 5095 4.6 3499 -3.1 Adjusted national data

Armenia 21.0 758 13.8 568 -2.8 Modelled estimate

Australia 3.4 821 2.7 813 -1.4 Adjusted national data

Austria 4.7 339 3.6 300 -1.6 Adjusted national data

Azerbaijan 25.2 3232 16.5 3925 -2.8 Modelled estimate

Bahamas 10.9 57 10.3 60 -0.4 Modelled estimate

Bahrain 9.5 121 5.5 121 -3.5 Modelled estimate

Bangladesh 42.3 160295 25.4 83060 -3.4 Modelled estimate

Barbados 9.0 32 8.5 29 -0.4 Modelled estimate

Belarus 5.6 521 3 373 -4.2 Modelled estimate

Belgium 3.5 385 3 382 -1.1 Modelled estimate

Belize 11.2 86 9.8 83 -0.9 Modelled estimate

Benin 36.1 10720 30.3 11746 -1.2 Modelled estimate

Bhutan 26.9 437 16 200 -3.4 Modelled estimate

Bolivia 17.7 4572 12.9 3209 -2.1 Modelled estimate

Bosnia and Herzegovina 6.7 328 5.4 170 -1.4 Modelled estimate

Botswana 17.5 840 15.2 895 -0.9 Modelled estimate

Brazil 12.1 46695 8.6 27808 -2.3 Modelled estimate

Brunei Darussalam 6.9 47 6.5 50 -0.4 Modelled estimate

Bulgaria 8.5 565 5.7 345 -2.6 Adjusted national data

Burkina Faso 29.4 15570 21.2 14911 -2.1 Modelled estimate

Burundi 35.9 10299 26.6 12661 -2 Modelled estimate

Cabo Verde 19.4 249 14.3 158 -2 Modelled estimate

Cambodia 20.8 6606 11.9 4311 -3.6 Modelled estimate

Cameroon 24.1 15570 19.6 16365 -1.4 Modelled estimate

Canada 3.5 1138 3.1 1162 -0.8 Modelled estimate

Central African Republic 37.3 5616 34.4 5843 -0.6 Modelled estimate

Chad 41.4 17490 39.9 25170 -0.2 Modelled estimate

Chile 3.9 996 3.1 716 -1.6 Adjusted national data

China 14.5 230279 7.2 122341 -4.6 Modelled estimate

Colombia 10.9 8992 8.1 6089 -2 Modelled estimate

Comoros 34.5 725 30.5 824 -0.8 Modelled estimate

Congo 21.0 2518 15.1 2504 -2.2 Modelled estimate

101

Country


Number of

stillbirths 2000


Number of

stillbirths 2015

2000-2015


Cook Islands 11.9 5 8.7 3 -2.1 Modelled estimate

Costa Rica 6.1 481 6 409 -0.1 Adjusted national data

Côte d'Ivoire 31.8 21833 26.7 22769 -1.2 Modelled estimate

Croatia 3.6 193 2 75 -3.9 Adjusted national data

Cuba 11.0 1720 6.2 726 -3.8 Adjusted national data

Cyprus 5.1 64 3.6 47 -2.3 Modelled estimate

Czech Republic 3.3 234 2.5 234 -1.8 Adjusted national data

Democratic People's Republic of Korea 19.4 7699 13.5 5161 -2.4 Modelled estimate

Democratic Republic of the Congo 34.2 76133 27.3 87780 -1.5 Modelled estimate

Denmark 3.4 216 1.7 90 -4.4 Adjusted national data

Djibouti 43.7 996 34.6 791 -1.6 Modelled estimate

Dominica 10.8 11 11.6 13 0.5 Modelled estimate

Dominican Republic 13.3 2780 11.1 2426 -1.2 Modelled estimate

Ecuador 10.9 3475 7.7 2531 -2.3 Modelled estimate

Egypt 18.0 31325 12.2 34656 -2.5 Modelled estimate

El Salvador 17.3 2457 12.2 1286 -2.3 Modelled estimate

Equatorial Guinea 21.2 444 16.2 469 -1.8 Modelled estimate

Eritrea 27.8 3546 22.5 3826 -1.4 Modelled estimate

Estonia 4.2 52 2.7 32 -3.1 Adjusted national data

Ethiopia 39.1 118872 29.7 96531 -1.8 Modelled estimate

Fiji 14.1 280 11.9 206 -1.1 Modelled estimate

Finland 2.7 138 1.8 107 -2.4 Adjusted national data

France 5.5 4196 4.7 3719 -1 Modelled estimate

Gabon 16.9 689 14 729 -1.3 Modelled estimate

Gambia 30.7 1719 23.9 2020 -1.7 Modelled estimate

Georgia 18.6 969 11.2 644 -3.3 Modelled estimate

Germany 2.7 2182 2.4 1680 -0.6 Adjusted national data

Ghana 29.6 19054 22.7 20841 -1.8 Modelled estimate

Greece 4.7 493 3.6 378 -1.9 Modelled estimate

Grenada 9.0 20 8 16 -0.8 Modelled estimate

Guatemala 16.9 6832 11.9 5362 -2.3 Modelled estimate

Guinea 27.1 10037 21.1 9856 -1.6 Modelled estimate

Guinea-Bissau 52.5 2834 36.7 2482 -2.4 Modelled estimate

Guyana 19.8 374 17.2 301 -0.9 Modelled estimate

Haiti 28.6 7835 24.9 6578 -0.9 Modelled estimate

Honduras 17.7 3533 12.6 2074 -2.3 Modelled estimate

Hungary 4.2 360 3.7 320 -0.9 Adjusted national data

Iceland 2.9 11 1.3 5 -5.4 Adjusted national data

India 33.3 957939 23 592086 -2.4 Modelled estimate

Indonesia 17.7 78240 13.2 73435 -1.9 Modelled estimate

Iran (Islamic Republic of) 9.4 12224 6.4 8726 -2.5 Modelled estimate

Iraq 19.6 16932 15.5 19285 -1.5 Modelled estimate

Ireland 4.6 276 2.7 183 -3.5 Adjusted national data

102

Country


Number of

stillbirths 2000


Number of

stillbirths 2015

2000-2015


Israel 4.8 635 4.2 737 -0.9 Adjusted national data

Italy 4.0 2046 3.3 1592 -1.1 Adjusted national data

Jamaica 21.0 1232 18.8 766 -0.7 Modelled estimate

Japan 3.1 3630 2.1 2172 -2.6 Adjusted national data

Jordan 13.0 1964 10.5 2183 -1.4 Modelled estimate

Kazakhstan 11.1 2356 6.5 2556 -3.5 Modelled estimate

Kenya 26.4 31695 22.5 34985 -1.1 Modelled estimate

Kiribati 18.5 49 16.3 47 -0.8 Modelled estimate

Kuwait 6.6 305 5.1 354 -1.7 Adjusted national data

Kyrgyzstan 13.8 1520 10.2 1783 -2 Modelled estimate

Lao People's Democratic Republic 31.6 5264 23.7 4214 -1.9 Modelled estimate

Latvia 5.3 97 3.6 57 -2.6 Adjusted national data

Lebanon 13.9 863 9.9 1020 -2.3 Modelled estimate

Lesotho 24.2 1461 19.5 1245 -1.4 Modelled estimate

Liberia 31.5 3944 21.4 3309 -2.5 Modelled estimate

Libya 12.5 1518 8.8 1101 -2.3 Modelled estimate

Lithuania 5.8 203 3.2 105 -3.8 Adjusted national data

Luxembourg 3.9 21 2.8 19 -2.1 Adjusted national data

Madagascar 21.5 14146 18.2 15235 -1.1 Modelled estimate

Malawi 28.7 14027 21.8 14036 -1.8 Modelled estimate

Malaysia 8.0 4459 5.8 3242 -2.1 Modelled estimate

Maldives 19.2 121 7.7 61 -5.9 Modelled estimate

Mali 44.0 23313 32.5 24410 -2 Modelled estimate

Malta 4.9 23 3.5 13 -2.3 Adjusted national data

Marshall Islands 16.9 39 15.6 21 -0.5 Modelled estimate

Mauritania 32.5 3396 27.1 3659 -1.2 Modelled estimate

Mauritius 13.1 224 9.5 136 -2.1 Adjusted national data

Mexico 7.0 17527 5.5 13093 -1.6 Modelled estimate

Micronesia (Federated States of) 20.7 69 17.8 45 -1 Modelled estimate

Monaco 8.4 2 5.7 3 -2.6 Modelled estimate

Mongolia 12.4 604 7.3 522 -3.5 Modelled estimate

Montenegro 5.9 50 3.9 27 -2.8 Modelled estimate

Morocco 33.8 21334 24.5 18144 -2.1 Modelled estimate

Mozambique 27.1 22164 19.1 20724 -2.3 Modelled estimate

Myanmar 29.8 35573 20 18745 -2.6 Modelled estimate

Namibia 13.2 765 11.3 850 -1.1 Modelled estimate

Nauru 17.8 3 15.5 2 -0.9 Modelled estimate

Nepal 28.0 22101 18.4 10332 -2.8 Modelled estimate

Netherlands 5.3 1018 1.8 329 -6.8 Adjusted national data

New Zealand 3.5 185 2.3 134 -2.8 Adjusted national data

Nicaragua 10.9 1495 7.4 895 -2.5 Modelled estimate

Niger 39.0 23257 36.7 36216 -0.4 Modelled estimate

Nigeria 52.3 278524 42.9 313706 -1.3 Modelled estimate

103

Country


Number of

stillbirths 2000


Number of

stillbirths 2015

2000-2015


Niue 11.4 0 9.7 0 -1 Modelled estimate

Norway 3.7 215 2.2 133 -3.4 Adjusted national data

Occupied Palestinian Territory 9.6 1149 7.5 1131 -1.7 Modelled estimate

Oman 9.9 549 8.5 691 -1.1 Modelled estimate

Pakistan 53.3 252258 43.1 242556 -1.4 Modelled estimate

Palau 10.1 3 8.4 3 -1.2 Modelled estimate

Panama 8.7 639 6.1 464 -2.3 Modelled estimate

Papua New Guinea 18.8 3585 15.9 3383 -1.1 Modelled estimate

Paraguay 18.8 2813 13.4 1832 -2.2 Modelled estimate

Peru 13.7 8505 9 5623 -2.8 Modelled estimate

Philippines 14.3 33182 10.9 25811 -1.8 Modelled estimate

Poland 4.7 1666 2.3 851 -4.5 Adjusted national data

Portugal 3.7 401 2.2 182 -3.5 Adjusted national data

Qatar 7.5 91 5.8 165 -1.7 Modelled estimate

Republic of Korea 2.8 1420 2.1 980 -1.7 Modelled estimate

Republic of Moldova 10.3 491 7.9 342 -1.8 Modelled estimate

Romania 6.8 1814 4.1 690 -3.2 Adjusted national data

Russian Federation 7.7 11462 4.5 8747 -3.6 Adjusted national data

Rwanda 27.1 9825 17.3 5925 -2.9 Modelled estimate

Saint Kitts and Nevis 9.5 10 7.5 7 -1.5 Modelled estimate

Saint Lucia 12.9 40 12.1 34 -0.4 Modelled estimate

Saint Vincent and the Grenadines 12.3 27 10.7 18 -0.9 Modelled estimate

Samoa 12.0 61 11.1 50 -0.5 Modelled estimate

San Marino 2.7 1 2.5 1 -0.6 Modelled estimate

Sao Tome and Principe 24.3 131 16.3 105 -2.6 Modelled estimate

Saudi Arabia 18.9 10984 13.9 8702 -2 Modelled estimate

Senegal 34.7 13687 24.5 14540 -2.3 Modelled estimate

Serbia 7.8 1003 6 554 -1.8 Modelled estimate

Seychelles 11.4 16 9.5 16 -1.2 Modelled estimate

Sierra Leone 39.1 7070 24.4 5447 -3.1 Modelled estimate

Singapore 3.5 150 2.6 137 -2.1 Modelled estimate

Slovakia 3.9 196 2.9 159 -1.9 Adjusted national data

Slovenia 2.7 50 2.9 63 0.5 Adjusted national data

Solomon Islands 19.7 277 17.6 298 -0.7 Modelled estimate

Somalia 39.2 14593 35.5 16400 -0.7 Modelled estimate

South Africa 22.4 26862 17.4 17985 -1.7 Modelled estimate

South Sudan 35.9 10521 30.1 13429 -1.2 Modelled estimate

Spain 3.3 1238 2.9 1068 -0.9 Adjusted national data

Sri Lanka 7.5 2549 4.9 1530 -2.9 Modelled estimate

Sudan 29.2 32419 24.4 32338 -1.2 Modelled estimate

Suriname 24.0 265 19.3 193 -1.4 Modelled estimate

Swaziland 15.9 537 12.3 457 -1.7 Modelled estimate

Sweden 3.8 270 2.8 323 -1.9 Adjusted national data

104

Country


Number of

stillbirths 2000


Number of

stillbirths 2015

2000-2015


Switzerland 3.2 246 2.8 241 -0.9 Modelled estimate

Syrian Arab Republic 14.5 7755 11.1 4777 -1.8 Modelled estimate

Tajikistan 19.0 3702 14 3799 -2 Modelled estimate

Thailand 7.7 6948 5 3697 -2.9 Modelled estimate

The former Yugoslav Republic of Macedonia 10.8 281 7.7 192 -2.2 Adjusted national data

Timor-Leste 26.3 1068 17.8 943 -2.6 Modelled estimate

Togo 44.2 8614 34.2 8865 -1.7 Modelled estimate

Tonga 9.2 24 8.6 22 -0.5 Modelled estimate

Trinidad and Tobago 17.6 330 11.1 212 -3 Modelled estimate

Tunisia 14.8 2538 9.2 1944 -3.1 Modelled estimate

Turkey 12.7 18239 7 9914 -3.9 Modelled estimate

Turkmenistan 22.4 2053 17 1977 -1.8 Modelled estimate

Tuvalu 17.0 5 13.8 3 -1.4 Modelled estimate

Uganda 29.4 33032 21 34151 -2.2 Modelled estimate

Ukraine 12.3 5003 8.8 3841 -2.2 Modelled estimate

United Arab Emirates 8.9 452 7.4 719 -1.2 Modelled estimate

United Kingdom 3.7 2511 2.9 2237 -1.4 Adjusted national data

United Republic of Tanzania 31.6 43764 22.4 47060 -2.3 Modelled estimate

United States of America 3.1 11612 3 11261 -0.4 Adjusted national data

Uruguay 8.5 450 6.6 318 -1.7 Modelled estimate

Uzbekistan 15.6 8601 12 8155 -1.7 Modelled estimate

Vanuatu 14.1 86 13.9 96 -0.1 Modelled estimate

Venezuela (Bolivarian Republic of) 9.0 5236 7.1 4308 -1.5 Modelled estimate

Viet Nam 15.0 18062 10.1 16122 -2.6 Modelled estimate

Yemen 36.6 24548 29 24646 -1.5 Modelled estimate

Zambia 26.3 12105 20.9 13126 -1.5 Modelled estimate

Zimbabwe 19.9 7993 20.6 11493 0.2 Modelled estimate

Footnote: rates only are reported for countries with <50 stillbirths in 2015

105

Graph of regional trends in stillbirth rate 2000 – 2015

Graphs by country of data inputs and stillbirth rate estimates with associated

uncertainty

Graph legend for marker colour to indicate data type:

Dark Green = High quality national routine information system data

Light Green = Lower quality national routine information system data

Orange = Nationally representative retrospective household surveys

Blue = Sub-national population based

Maroon = Sub-national other

0

5

10

15

20

25

30

35

40

REG

ION

AL

STIL

LBIR

TH R

ATE

Developed region

Southern Asia


Eastern Asia

Latin America and theCaribbean


South-eastern Asia

106

Afghanistan:

Angola:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

10

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

2

107

Albania:

Andorra:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

30

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

4

108

United Arab Emirates:

Argentina:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

50

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

6

109

Armenia:

Antigua and Barbuda:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

70

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

8

110

Australia:

Austria:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

90

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

10

111

Azerbaijan:

Burundi:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

110

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

12

112

Belgium:

Benin:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

130

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

14

113

Burkina Faso:

Bangladesh:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

150

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

16

114

Bulgaria:

Bahrain:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

170

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

18

115

Bahamas:

Bosnia and Herzegovina:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

190

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

20

116

Belarus:

Belize:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

210

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

22

117

Bolivia (Plurinational State of):

Brazil:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

230

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

24

118

Barbados:

Brunei Darussalam:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

250

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

26

119

Bhutan:

Botswana:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

270

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

28

120

Central African Republic:

Canada:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

290

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

30

121

Switzerland:

Chile:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

310

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

32

122

China:

Côte d'Ivoire:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

330

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

34

123

Cameroon:

Democratic Republic of the Congo:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

350

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

36

124

Congo:

Cook Islands:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

370

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

38

125

Colombia:

Comoros:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

390

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

40

126

Cabo Verde:

Costa Rica:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

410

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

42

127

Cuba:

Cyprus:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

430

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

44

128

Czech Republic:

Germany:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

450

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

46

129

Djibouti:

Dominica:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

470

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

48

130

Denmark:

Dominican Republic:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

490

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

50

131

Algeria:

Ecuador:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

510

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

52

132

Egypt:

Eritrea:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

530

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

54

133

Spain:

Estonia:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

550

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

56

134

Ethiopia:

Finland:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

570

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

58

135

Fiji:

France:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

590

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

60

136

Micronesia (Federated States of):

Gabon:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

610

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

62

137

United Kingdom:

Georgia:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

630

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

64

138

Ghana:

Guinea:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

650

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

66

139

Gambia:

Guinea-Bissau:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

670

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

68

140

Equatorial Guinea:

Greece:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

690

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

70

141

Grenada:

Guatemala:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

710

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

72

142

Guyana:

Honduras:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

730

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

74

143

Croatia

Haiti:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

750

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

76

144

Hungary:

Indonesia:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

770

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

78

145

India:

Ireland:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

790

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

80

146

Iran (Islamic Republic of):

Iraq:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

810

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

82

147

Iceland:

Israel:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

830

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

84

148

Italy:

Jamaica:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

850

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

86

149

Jordan:

Japan:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

870

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

88

150

Kazakhstan:

Kenya:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

890

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

90

151

Kyrgyzstan:

Cambodia:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

910

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

92

152

Kiribati:

Saint Kitts and Nevis:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

930

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

94

153

Republic of Korea:

Kuwait:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

950

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

96

154

Lao People’s Democratic Republic:

Lebanon:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

970

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

98

155

Liberia:

Libya:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

990

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

100

156

Saint Lucia:

Sri Lanka:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1010

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

102

157

Lesotho:

Lithuania:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1030

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

104

158

Luxembourg:

Latvia:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1050

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

106

159

Morocco:

Monaco:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1070

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

108

160

Republic of Moldova:

Madagascar:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1090

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

110

161

Maldives:

Mexico:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1110

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

112

162

Marshall Islands:

The former Yugoslav Republic of:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1130

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

114

163

Mali:

Malta:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1150

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

116

164

Myanmar:

Montenegro:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1170

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

118

165

Mongolia:

Mozambique:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1190

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

120

166

Mauritania:

Mauritius:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1210

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

122

167

Malawi:

Malaysia:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1230

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

124

168

Namibia:

Niger:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1250

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

126

169

Nigeria:

Nicaragua:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1270

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

128

170

Niue:

Netherlands:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1290

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

130

171

Norway:

Nepal:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1310

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

132

172

Nauru:

New Zealand:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1330

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

134

173

Oman:

Pakistan:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1350

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

136

174

Panama:

Peru:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1370

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

138

175

Philippines:

Palau:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1390

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

140

176

Papua New Guinea:

Poland:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1410

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

142

177

Democratic People’s Republic of Korea:

Portugal:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1430

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

144

178

Paraguay:

Occupied Palestinian Territory:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1450

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

146

179

Qatar:

Romania:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1470

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

148

180

Russian Federation:

Rwanda:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1490

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

150

181

Saudi Arabia:

Sudan:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1510

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

152

182

Senegal:

Singapore:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1530

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

154

183

Solomon Islands:

Sierra Leone:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1550

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

156

184

El Salvador:

San Marino:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1570

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

158

185

Somalia:

Serbia:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1590

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

160

186

South Sudan:

Sao Tome and Principe:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1610

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

162

187

Suriname:

Slovakia:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1630

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

164

188

Slovenia:

Sweden:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1650

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

166

189

Swaziland:

Seychelles:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1670

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

168

190

Syrian Arab Republic:

Chad:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1690

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

170

191

Togo:

Thailand:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1710

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

172

192

Tajikistan:

Turkmenistan:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1730

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

174

193

Timor-Leste:

Tonga:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1750

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

176

194

Trinidad and Tobago:

Tunisia:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1770

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

178

195

Turkey:

Tuvalu:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1790

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

180

196

United Republic of Tanzania:

Uganda:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1810

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

182

197

Ukraine:

Uruguay:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1830

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

184

198

United States:

Uzbekistan:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1850

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

186

199

Saint Vincent and the Grenadines:

Venezuela (Bolivarian Republic of):

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1870

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

188

200

Viet Nam:

Vanuatu:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1890

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

190

201

Samoa:

Yemen:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1910

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

192

202

South Africa:

Zambia:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1930

51

01

52

02

53

03

54

04

55

05

56

0

Stillb

irth

rate

2000 2005 2010 2015Year

194

203

Zimbabwe:

Graphs of input data and estimated stillbirth rates by region Developed region:

05

10

15

20

25

30

35

40

45

50

55

60

Stillb

irth

rate

2000 2005 2010 2015Year

1950

510

15

20

25

30

35

40

45

50

55

60

65

70

75

80

Stillb

irth

ra

te

2000 2005 2010 2015Year

1

204

South Asia:

Caucasus and Central Asia:

05

10

15

20

25

30

35

40

45

50

55

60

65

70

75

80

Stillb

irth

ra

te

2000 2005 2010 2015Year

20

510

15

20

25

30

35

40

45

50

55

60

65

70

75

80

Stillb

irth

ra

te

2000 2005 2010 2015Year

3

205

East Asia:

Latin America and the Caribbean

North Africa and Middle East:

05

10

15

20

25

30

35

40

45

50

55

60

65

70

75

80

Stillb

irth

ra

te

2000 2005 2010 2015Year

40

510

15

20

25

30

35

40

45

50

55

60

65

70

75

80

Stillb

irth

ra

te

2000 2005 2010 2015Year

5

206

South-East Asia and Oceania:

Sub-Saharan Africa:

05

10

15

20

25

30

35

40

45

50

55

60

65

70

75

80

Stillb

irth

ra

te

2000 2005 2010 2015Year

60

510

15

20

25

30

35

40

45

50

55

60

65

70

75

80

Stillb

irth

ra

te

2000 2005 2010 2015Year

7

207

Comparison of neonatal mortality and stillbirth rate data and

estimates: 1990-1999 2000-2009 Since 2010

Neonatal Mortality Rate

Number of countries with annual national data for neonatal mortality rate (CRVS, SRS or surveillance data)

60 (48*) 74 (55*) 73 (57*)

Frequency of global and country estimates for neonatal mortality rate

Intermittent estimates up to a decade apart

Transition to alternative year estimates and then annual estimates

Annual by UN IGME and IHME

Stillbirth Rate

Number of countries with annual national data for stillbirth rate+

54 85 86

Frequency of global and country estimates for stillbirth rate

No global estimates published

No country-level

systematic estimates.

Two global and regional estimates published for year 2000

First WHO country

level estimates for 193

countries published

2011 (for year 2009).

Second WHO country level estimates (this study)

05

10

15

20

25

30

35

40

45

50

55

60

65

70

75

80

Stillb

irth

ra

te

2000 2005 2010 2015Year

8

208

*number of countries with data fulfilling inclusion criteria for neonatal mortality rate model are given in brackets +data routine data for more than 5 years in whole decade or more than 2 years since 2010 from any national routine

source including CRVS, birth registry and HMIS

References

1. Woods CR, Davis DW, Duncan SD, Myers JA, O'Shea TM. Variation in classification of live birth with newborn period death versus fetal death at the local level may impact reported infant mortality rate. BMC pediatrics 2014; 14: 108. 2. Msemo G, Massawe A, Mmbando D, et al. Newborn mortality and fresh stillbirth rates in Tanzania after helping babies breathe training. Pediatrics 2013; 131(2): e353-60. 3. Carlo WA, Goudar SS, Jehan I, et al. Newborn-care training and perinatal mortality in developing countries. The New England journal of medicine 2010; 362(7): 614-23. 4. The DHS Program. http://www.dhsprogram.com/. 5. Vogel JP, Souza JP, Mori R, et al. Maternal complications and perinatal mortality: findings of the World Health Organization Multicountry Survey on Maternal and Newborn Health. BJOG 2014; 121 Suppl 1: 76-88. 6. The World Health Organization. Global survey on maternal and perinatal health http://www.who.int/reproductivehealth/topics/maternal_perinatal/globalsurvey/en/. 7. Newman L, Kamb M, Hawkes S, et al. Global estimates of syphilis in pregnancy and associated adverse outcomes: analysis of multinational antenatal surveillance data. PLoS Med 2013; 10(2): e1001396. 8. UN Population Division. World Population Prospects: the 2015 Revision. http://esaunorg/wpp/indexhtm 2015.

http://www.dhsprogram.com/

http://www.who.int/reproductivehealth/topics/maternal_perinatal/globalsurvey/en/

http://esaunorg/wpp/indexhtm

Documents

LSHTM Research Onlineresearchonline.lshtm.ac.uk/2534182/2/Blencowe et al 2016...Supplementary appendix This appendix formed part of the original submission and has been peer reviewed