Making stillbirths count, making numbers talk - Issues in data collection for stillbirths

In this report, we assess how different definitions and limits in registration affect data capture, and we discuss the specific challenges of stillbirth registration, with emphasis on implementation. We identify what data need to be captured, we suggest a dataset to cover core needs in registration and analysis of the different categories of stillbirths with causes and quality indicators, and we illustrate the experience in stillbirth registration from different cultural settings. Finally, we point out gaps that need attention in the International Classification of Diseases and review the qualities of alternative systems that have been tested in low- and middle-income settings.Obtaining high-quality data will require consistent definitions for stillbirths, systematic population-based registration, better tools for surveys and verbal autopsies, capacity building and training in procedures to identify causes of death, locally adapted quality indicators, improved classification systems, and effective registration and reporting systems.The vast majority of stillbirths are preventable, and simple interventions could lead to healthy infants as a rich reward for the resources invested [1-6]. Mothers and families could be spared the emotional burden accompanying pregnancy loss, and societies could gain by reducing a major public health problem.Being counted is essential. Stillbirths are estimated to account for more than half of the world's perinatal deaths, but only a fraction are registered in any health information system [7]. Stillbirths have been invisible in the World Health Organization (WHO) reports on the global burden of disease [8] and in the United Nations (UN) Millennium Development Goals and Targets. According to the most recent WHO reports on perinatal mortality, 90 countries worldwide lacked any kind of data on stillbirths [7,9]. Improvements in basic registrations of stillbirths are both possible and urgently needed [10]. The "Who Counts?" series in The Lan