BACKGROUND:
Stillbirth remains one of Africa’s most preventable yet neglected health challenges. Africa accounts for nearly one million third-trimester stillbirths annually, over half of the global total, yet these deaths are often invisible in policy, financing and accountability frameworks.1

METHODS:
An Africa-wide report synthesised evidence using a multi-method approach, including a desk review of published and grey literature; secondary analysis of national stillbirth estimates;1 a cross-sectional survey of stillbirth data systems and policies across 33 African countries;2 and consultations with 57 technical experts, policymakers, and parent advocates. Evidence was triangulated to present the burden, identify priority gaps, and propose priority actions.

RESULTS:
Every 30 seconds, a baby is stillborn in Africa. Nearly half occurred during labour, signalling preventable failures in quality of care. Reductions in stillbirth rates have been slow and offset by population growth, leaving the absolute burden unchanged for two decades. Stillbirths persist because women and families face avoidable medical conditions driven by cultural, social, systemic, and structural barriers to timely, high-quality care. Stillbirths impose profound emotional, social, and economic impacts on families and health workers and signal fragile health systems. Many stillbirths in Africa can be prevented by strengthening existing policy and health system platforms, including quality antenatal care, skilled care during labour and birth, and timely access to emergency services.

CONCLUSIONS:
Ending preventable stillbirths is a strategic investment in health, equity, and health security and will deliver a quadruple return: saving mothers and newborns, preventing stillbirths, reducing long-term disability, and supporting healthy child development.3 Priority actions identify for African governments include: 1) commit & invest to integrating stillbirth into national policies, budgets, and accountability mechanisms; 2) capacitate the health system; 3) count, use and learn from every stillbirth; 4) centre families and communities; and 5) tailor strategies to the context to maximise impact and equity.