Causes of Death Among Stillbirths and Children Aged <5 Years in Africa and South Asia — Child Health and Mortality Prevention Surveillance, Seven Countries, 2016–2024
Surveillance study uncovers that four of five stillbirths and early childhood deaths are preventable, highlighting critical gaps in antenatal care and infection control.
Key Points
To identify precise, laboratory-confirmed causes and assess the preventability of stillbirths and deaths among children under 5 years of age across high-mortality settings.
Conducted population-based surveillance across seven countries (Bangladesh, Ethiopia, Kenya, Mali, Mozambique, Sierra Leone, and South Africa) between December 2016 and December 2024.
Investigated eligible deaths using minimally invasive tissue sampling (MITS), molecular microbiology, histopathology, clinical record review, and verbal autopsies via multidisciplinary cause-of-death panels (N=8,500 completed evaluations).
Perinatal asphyxia or hypoxia contributed to 79.1% of stillbirths and 37.7% of neonatal deaths, frequently linked to maternal hypertensive disorders and placental abnormalities.
Infections contributed to 59.3% of neonatal and post-neonatal deaths, with gram-negative pathogens like Klebsiella pneumoniae and Acinetobacter baumannii predominating and polymicrobial involvement occurring in 44.5% of pathogen-positive cases.
Multidisciplinary review determined that 80.7% (6,103 of 7,558) of evaluated deaths were preventable or possibly preventable through existing maternal, newborn, and child health interventions.