• Kiran Afshan, Ghulam Narjis, and Qayyum Mazhar.
• Department of Animal Sciences, Faculty of Biological Sciences, Quaid-i-Azam University Islamabad, 45320, Pakistan.
• Afr Health Sci. 2019 Mar 1; 19 (1): 150715161507-1516.

BackgroundGlobally 3 million stillbirths occur per year, and Pakistan is ranked 3rd among the countries having the highest burden. Despite being a major public health problem, efforts to reduce this figure are insufficient.ObjectiveThe aim of the study was to identify and measure the inequalities in stillbirth associated risk factors, causes and fertility risk behaviors.MethodsData were derived from the Pakistan Demographic and Health Surveys (PDHS) 1990-2013. Inequalities on determinants were evaluated using rate differences and rate ratios; time trends computed with annualized reduction rate (ARR).ResultsOverall ARR determined for stillbirth was -12.52 percent per annum. The high ARR were recorded for mothers age <20, urban areas, educated mothers and for highest wealth quintile. The relative inequalities were most pronounced for wealth quintiles, education and age of mothers. Stillbirth causes were unexplained antepartum (33%), unexplained intrapartum (21%), intrapartum asphyxia (21%) and antepartum maternal disorders (19%). The high fertility risk behavior was found in mothers with age >34 and birth order >3.ConclusionThe study concluded that to achieve gain in child survival, there is need to promote antenatal care, birth spacing, and family planning programs in developing countries.

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