Improving knowledge of causes and contributors to stillbirth in Papua New Guinea

It is known that 98% of stillbirths occur in low- and middle-income countries (LMIC). Australias nearest neighbour, PNG and our other close Pacific Island nations (Solomon Islands and Vanuatu) bear the burden of high stillbirth rates. Unfortunately, due to poor data collection processes the full impact of stillbirth in these nations is not realised. In LMICs, stillbirths are largely attributable to preventable or treatable conditions that occur either in conjunction with, or as a result of pregnancy, including malaria, syphilis, anaemia, diabetes, hypertension, pre-eclampsia and post-term pregnancy. Other risk factors for stillbirth, such as young maternal age, short inter-pregnancy interval, indoor air pollution and interpersonal violence against women during pregnancy also play a role. Many of these risk factors could be addressed through universal access to good-quality antenatal and intrapartum care. Modelling has suggested that up to 45% of all stillbirths could be prevented if a package of 10 proven antenatal and intrapartum interventions (including basic and emergency obstetric care) was made widely available. However, it is unknown whether these interventions would address the key issues in a country like PNG or whether they would even be feasible.

The proposed research supports the *Improving knowledge of causes and contributors to stillbirth* priority through an analysis of at least 40 stillbirths in PNG which have been collected as part of two recent and ongoing studies. This analysis will support the development of a larger project which will be developing and testing a feasible bundle of interventions to address preventable stillbirth in PNG and similar low resource countries.