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Disclaimer / Limitations
This country’s legal measures were reviewed by our legal staff in consultation with in-country lawyers and/or CRVS legal experts. All efforts were made to ensure the accuracy of the legal analysis, however, if you consider there to be any discrepancies or if there have been changes in the law of the country since our staff last updated the legal analysis, we welcome any additional information or insights. Please contact us via this form.
Stillbirth Reporting
Ghana
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Ghana
Stillbirth Reporting
Reporting System
Reporting System
Compulsory Coverage
Is stillbirth registration available and compulsory for all stillbirths occurring within the country's jurisdiction?
Compulsory for all stillbirths
Recommended Practice based on International Guidelines
Tracking stillbirths and other fetal deaths is important for statistical and public health planning purposes. Official recognition that the fetal death occurred can have significance for families and can help to facilitate cremation and burial if the family desires. If stillbirths are recorded via the civil registration system, the law should require that all stillbirths that occur in the country are registered.
The Registration of Births and Deaths Act mandates the national Registrar to keep a National Register of each fetal death. District Registrars are similarly mandated to keep a District Register of Fetal Deaths, which must contain a record of each fetal death in the District.
The same persons who have a legal duty to register a birth have a duty to register a fetal death with the District Registrar. The primary informants are the mother, the father or both parents. If both parents are deceased or incapable of registering the fetal death, the duty passes to the next of kin of either parent who has knowledge of the fetal death, an occupier of the premises where the fetal death occurred who has knowledge of it, or an adult present at the fetal death. It seems that all of these persons have a duty to report the fetal death if the parents cannot do so; the duty does not appear to apply in sequence.
Does the law mandate reporting of all stillbirths through the health sector?
Unclear
Recommended Practice based on International Guidelines
Tracking stillbirths and other fetal deaths is important for statistical and public health planning. If stillbirths are tracked through the health sector, the law (or guidelines and SOPs) should require the health sector to report fetal deaths to the central health ministry. For in-facility stillbirths, reporting responsibility should fall on the head of the health facility or attending medical professional. For community stillbirths, reporting responsibility is place on the birth attendant, who may be required to report the ministry of health directly, or may report through a local health facility.
Analysis of the legal instruments available to the reviewer did not identify any provision that makes reporting of fetal deaths by the health sector mandatory, but stillbirth statistics are recorded through the health sector in practice.
Law Source
Informant
Who is the designated primary informant for declaring stillbirths to the civil registrar?
Any parent
Recommended Practice based on International Guidelines
UN guidelines provide that, in priority order of preference, the informant for a fetal death is the same as for a live birth: first, the head of the health facility (for a fetal death that occurred in a health facility) or the birth attendant (for a fetal death that occurred outside a health facility with a birth attendant); second, the mother; third, the father; fourth the nearest relative of the mother; and fifth, any other adult person having knowledge of the facts.
The primary informants are the mother, the father or both parents. If both parents are deceased or incapable of registering the fetal death, the duty passes to the next of kin of either parent who has knowledge of the fetal death, an occupier of the premises where the fetal death occurred who has knowledge of it, or an adult present at the fetal death. It seems that all of these persons have a duty to report the fetal death if the parents cannot do so; the duty does not appear to apply in sequence.
What is the role of the health sector in stillbirth registration?
Issuing of evidence of stillbirth
Recommended Practice based on International Guidelines
UN guidelines provide that the head of the health facility is the preferred informant for stillbirths. Where the stillbirths are registered via the civil registration system this should be specified in the law. As with live births, some countries require the health sector to notify information about stillbirths even where the designated informant is the mother and/or father. Where the mother and/or father is the primary informant, the health sector would usually be required under the law to provide a notice of some sort as evidence of the stillbirth for the purposes of registration.
Any person giving notice of a fetal death must, if possible, provide a written certificate in respect of the fetal death signed by a registered medical practitioner or midwife who was in attendance when the fetal death occurred, or who has examined the fetus.
Alternatively, the person notifying the fetal death can make a declaration stating that no medical certificate can be provided because no registered medical practitioner or midwife was present at the occurrence of the fetal death or has examined the fetus.
Recommended Practice based on International Guidelines
If fetal deaths are reported through the civil registration system, the health facility, birth attendant or other informant should report a fetal death to the registration office in the location where the fetal death occurred, or at any location where access is available to the registration system, if the system is sufficiently networked. Where registration is required at the place of residence of the mother, this may reduce the rates of registration.
What is the reporting period for stillbirth registrations specified under the law?
Unclear
Recommended Practice based on International Guidelines
The time frame for reporting a fetal death is usually the same as that for a death. There should, however, be a procedure for late and delayed reporting pending a medical-legal decision if the fetal death status is unclear or disputed.
Neither the Registration of Births and Deaths Act nor its accompanying regulations provides a time period for the reporting of fetal deaths.
Law Source
Register
Does the civil register contain a separate register for stillbirths, distinct from birth and death registers?
Yes
Recommended Practice based on International Guidelines
Stillbirth should be registered in a separate fetal death (or stillbirth) register. UN guidelines indicate that stillbirths should not be registered in the birth register or the death register, as they do not establish a legal identity, retire a legal identity or affect civil status. Including stillbirths in those registers can also make it harder to disaggregate the data for statistical purposes. Instead it is recommended that a separate register of stillbirths is established. However, some countries with digital systems do include stillbirths in the register of births, with a a notation that the event is a stillbirth to allow for disaggregation.
Recommended Practice based on International Guidelines
No fee should be charged for the timely registration of a live birth, marriage, divorce, fetal death or death
To encourage registration, the legislation should clearly state that registration of a birth, fetal death and death within the time period prescribed by the law is free of charge.
