Journal of Primeasia

Integrative Disciplinary Research | Online ISSN 3064-9870 | Print ISSN 3069-4353
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Journal of Primeasia

Volume 7 Number 1 2026

Article Contents

REVIEWS   (Open Access)
Contents Vol 7 (1)

Improving Hospital Care After Stillbirth and Neonatal Death: A Systematic Review and Meta-Analysis of Service Models and Quality Indicators in Low- and Middle-Income Countries

Abstract 1. Introduction 2. Determinants of Stillbirth and Neonatal Death in Hospital Care 3. Methods 4. Results and Discussion 5. Conclusion Author Contributions Acknowledgements References

Fajar Sari Tanberika 1,2 *, Tukimin Bin Sansuwito 3

+ Author Affiliations

Journal of Primeasia 7 (1) 1-8 https://doi.org/10.25163/primeasia.7110873

Submitted: 28 July 2026 Revised: 13 September 2026  Accepted: 24 September 2026  Published: 26 September 2026 

Abstract

Stillbirth and early neonatal death remain among the most under-addressed tragedies in global maternal and child health, with roughly 2.6 million stillbirths occurring each year and nearly 98% concentrated in low- and middle-income countries (LMICs). Although facility-based delivery has expanded across many of these settings, mortality reduction has not kept pace, suggesting that the quality, rather than the mere presence, of hospital-based care is the more decisive variable. We synthesized findings from existing systematic reviews and meta-analyses addressing maternal and obstetric risk factors, neonatal resuscitation training, antenatal care quality, and complicating clinical and environmental exposures. Evidence was organized into four thematic tables summarizing risk estimates, sample sizes, and intervention effects reported across LMIC hospital settings. Skilled antenatal supervision was associated with a nearly 40% relative risk reduction in neonatal death, and neonatal resuscitation training programs achieved risk ratios as low as 0.21 in some hospital cohorts. Maternal anemia, hypertensive disorders, short inter-pregnancy intervals, and delayed referral consistently emerged as modifiable predictors of adverse outcomes. Perinatal mortality following stillbirth or neonatal death is rarely attributable to a single cause; rather, it reflects the interaction between a mother's obstetric history and a health system's capacity to detect, refer, and respond in time. Strengthening antenatal quality, resuscitation readiness, and referral pathways—paired with functioning perinatal audit systems—offers the clearest, evidence-based route toward the 2030 global mortality targets. Keywords: stillbirth; neonatal death; hospital-based care; quality indicators; low- and middle-income countries

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