{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T13:45:15Z","timestamp":1783086315404,"version":"3.54.6"},"reference-count":34,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T00:00:00Z","timestamp":1750636800000},"content-version":"unspecified","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,4,30]]},"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Stillbirths and associated outcomes remain a significant concern in sub-Saharan Africa (SSA), with approximately 41% of global stillbirths.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Our cross-sectional analysis included a weighted sample of women aged 15\u201349 years who had given birth or experienced stillbirth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Sub-Saharan African Countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>The main outcome measures<\/jats:title>\n                    <jats:p>Determinants of stillbirth among women in 29 SSA countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>Among a sample of 197 328, stillbirth prevalence was 8.4\/1000 live births. Among individual-level factors, the risk increased with age. Higher maternal educational levels were significantly associated with decreased stillbirth risk (aOR=0.62, 95%CI: 0.44 to 0.89, higher versus no education). Single women had significantly lower odds of stillbirth compared with those who no longer lived together or were separated from their partners (aOR=0.38, 95%CI: 0.25 to 0.60). Contextually, women with a job had an increased risk compared with women without a job (aOR=1.19, 95%CI: 1.06 to 1.34), and living in a rural residential area was a significant factor (aOR=1.30, 95%CI: 1.13 to 1.50).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The complex interplay between individual-level and contextual factors continues to influence stillbirth outcomes in SSA. Cross-sector integrative care approaches to maternal and neonatal health are needed to address the multifaceted determinants of stillbirths.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-089371","type":"journal-article","created":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T14:20:32Z","timestamp":1750688432000},"page":"e089371","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Exploring multilevel determinants of stillbirth: a comprehensive analysis across sub-Saharan African countries"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7560-5504","authenticated-orcid":false,"given":"Khadijat","family":"Adeleye","sequence":"first","affiliation":[{"name":"Elaine Marieb College of Nursing, University of Massachusetts Amherst, Amherst, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oluwabunmi","family":"Ogungbe","sequence":"additional","affiliation":[{"name":"Johns Hopkins School of Nursing, Baltimore, Maryland, USA"},{"name":"Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvette","family":"Yeboah-Kordieh","sequence":"additional","affiliation":[{"name":"Internal Medicine, MedStar Union Memorial Hospital, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Gresh","sequence":"additional","affiliation":[{"name":"Johns Hopkins School of Nursing, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Favorite","family":"Iradukunda","sequence":"additional","affiliation":[{"name":"Elaine Marieb College of Nursing, University of Massachusetts Amherst, Amherst, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,6,23]]},"reference":[{"key":"2025121600165016000_15.6.e089371.1","doi-asserted-by":"crossref","first-page":"1798","DOI":"10.1016\/S0140-6736(10)62235-0","article-title":"Stillbirths: the vision for 2020","volume":"377","author":"Goldenberg","year":"2011","journal-title":"The Lancet"},{"key":"2025121600165016000_15.6.e089371.2","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0202603","article-title":"Stillbirth in the African Great Lakes region: A pooled analysis of Demographic and Health Surveys","volume":"13","author":"Akombi","year":"2018","journal-title":"PLoS One"},{"key":"2025121600165016000_15.6.e089371.3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s40748-020-00120-4","article-title":"Perinatal mortality and its determinants in Sub Saharan African countries: systematic review and meta-analysis","volume":"7","author":"Tiruneh","year":"2021","journal-title":"Matern Health Neonatol Perinatol"},{"key":"2025121600165016000_15.6.e089371.4","doi-asserted-by":"crossref","unstructured":"Mukherjee A , Stefano LD , Blencowe H , et al . 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