Journal Article

Predictors and prevalence of perinatal mortality in Ghana: a systematic review and meta-analysis

Punguyire, Damien, Koray, Munawar Harun, Abiiro, Gilbert Abotisem

2025

Overview

Background Ghana has consistently reported a high perinatal mortality rate. This has raised concerns regarding the country’s ability to achieve the Sustainable Development Goals 3 target 2 by 2030. This comprehensive review presents the pooled prevalence and predictors of perinatal mortalities in Ghana guided by the Anderson’s framework of healthcare utilization. Methods A comprehensive literature search was conducted mainly from four electronic databases; PubMed, Web of Science, Scopus and CINAHL as they collectively index > 90% of relevant maternal health journals in Africa and also eases the burden of screening. Eligible studies, published from 1st January 2010 to 30th June, 2024, were charted and synthesized, with focus on the three primary domains of Anderson’s framework: pre-disposing factors, enabling factors and need factors. Meta-analysis was conducted to estimate the pooled prevalence of perinatal mortality rate within each of the sub-regions. Significant heterogeneity was detected among the various surveys (I2 > 50%), hence a random effect model was reported. Sub-group and meta-regression were performed to identify the sources of heterogeneity observed in the study. Results A total of 2,184 articles were initially identified for review, but after multiple rounds of screening and deduplication, only 30 full-text articles were finally included. The most frequent study design was cross-sectional, accounting for 23.3% of the studies. The Pooled estimate of perinatal mortality is 44.8 (95%CI: 15.4–74.2) per 1000 births in Ghana, with very high heterogeneity (I 2  > 99.97, p  < 0.0001) among the studies. The predictors of perinatal mortality included advanced maternal age, pre-existing health conditions, poor quality ANC, access to healthcare facilities and environmental exposures. Conclusion This review presents the complex interplay of factors determining perinatal mortality in Ghana. In addition to the predictors identified, the review reveals gaps in literature particularly the lack of case-control studies in rural settings and inadequate focus on healthcare quality, socio-economic influences, and policy impacts. Future studies should address these gaps using a holistic approach that takes into account Ghana’s diverse social and geographical factors to better reduce perinatal mortality. Systematic Review Registration. The review protocol was registered in PROSPERO (CRD42024564968).

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Ability / Analysis / Biostatistics / Births / Early neonatal death / Economic factors / Environmental Health / Epidemiology / Female / Ghana / Ghana - epidemiology / Health care / Health care access / Health care facilities / Health care policy / Health insurance / Health services / Health services utilization / Health status / Health surveys / Heterogeneity / Holistic approach / Humans / Infant mortality / Infant, Newborn / Infants / Initiatives / Literary criticism / Literature reviews / Maternal & child health / Maternal characteristics / Medical care / Medical screening / Medicine / Medicine & Public Health / Meta-analysis / Mortality / Mortality rates / Mothers / Patient outcomes / Perinatal factors / Perinatal mortality / Perinatal Mortality - trends / Population / Postpartum period / Predictors / Pregnancy / Prevalence / Prevalence studies (Epidemiology) / Prevention / Public Health / Quality / Quality management / Quality of care / Random effects / Registration / Risk Factors / Social factors / Socioeconomic factors / Still-birth / Stillbirth / Sustainable development / Systematic Review / Vaccine