The Community Understanding of Stillbirths and Neonatal Deaths in Cambodia: Family Education and Communication is Vital to Improve Outcomes


Neonatal death, stillbirth, Cambodia, communication, silent expectation


Introduction: Globally, the proportion of childhood deaths in the neonatal period is increasing. Despite improvements in maternal health, Cambodia continues to fall behind neighbouring countries in reducing neonatal mortality. The aim of this study is to explore community attitudes towards stillbirths and neonatal deaths by exploring the understanding of these terms, and the causes of them.

Methods: A qualitative study using focus group discussions in randomly selected villages in Preah Vihear province, Cambodia. Data were analysed iteratively until saturation was reached, using thematic content analysis. Investigators’ triangulation was used throughout analysis.

Results: Six focus group discussions, involving 55 villagers, were conducted in three villages in November 2020. Participants were able to define stillbirth and neonatal death. However, their depth of understanding was limited. Participants described social determinants causing delays in obtaining timely healthcare for pregnant women. Participants with personal experience of stillbirth or neonatal death could cope and manage their grief by accepting their fate and moving on to other responsibilities, such as earning a living. Both parents were found to be equally responsible for preventing adverse outcomes of pregnancy. However, a lack of communication and silent expectations between partners was hindering prevention.

Conclusion: Perinatal education alone is not enough. Encouraging family members to actively communicate their knowledge amongst themselves could improve relationships and support of each other to cope with grief and enhance preventative measures taken in pregnancy, such as more timely and appropriate healthcare seeking. This could help avoid adverse pregnancy outcomes, and reduce the risk of stillbirth and neonatal death.