Portal-based reporting across health facilities in Bihar will serve as the delivery mechanism once the Centre's updated stillbirth surveillance and response guidelines move into active use across the state. According to those guidelines, any infant delivered without vital signs at a gestational age of 28 weeks or beyond is classified as a stillbirth. When gestational age data is unavailable, a recorded birth weight of at least 1,000 grams or a measured body length of no less than 35 centimetres serves as the applicable threshold.
Stillbirth recording — both counting deaths and identifying their causes — lacked any consistent framework until recently, according to health specialists. Across the two-year window covered by Sample Registration System data for 2022–24, recorded stillbirth figures for Bihar fluctuate between 2 and 4 per every 1,000 births depending on which official tabulation is consulted.
According to figures in the 2022 SRS report, Bihar recorded 3 deaths per 1,000 births, well below the national figure of 5. Bihar's figure stood at 4 per the 2023 data, well beneath a national count of 7 for that same period, and by the time the 2024 report was published, the state's tally had dropped further to 2 while the country-wide measure held steady at 7. The state's own HMIS figure stands at 9 deaths per 1,000 births, whereas assessments carried out by various independent organisations converge on roughly 11 — a figure that sits close to the 11.8 benchmark the UN Inter-agency Group for Child Mortality Estimation published for 2023.
Data from health professionals in Bihar place the two states — Bihar and Uttar Pradesh combined — as the source of roughly three in every ten stillbirths recorded across India. Under the Sustainable Development Goals framework, that national figure is expected to drop below ten per cent before 2030.
Historically, the documentation of stillbirth has amounted to little more than numerical entries in hospital registers. Tracking stillbirth rates at a national level, the Centre has put in place a structured system for gathering and reporting data on such deaths.
Records of stillbirths are to be captured through the maternal, perinatal, child death surveillance and response portal, known as MPCDSR. Within a 24-hour window, any incident at the facility is to be logged and passed along by the designated nodal officer. Responsibility for filling out the birth-reporting form falls to whichever healthcare provider — whether a doctor, nurse, or ANM — attended the delivery, and that form is to be submitted no later than seven days afterward or at the point of the mother's discharge, whichever comes first. Following the updated reporting guidelines, the record is entered into the portal by a data entry operator.
Recorded within each entry will be three data points tied to every stillbirth: when it occurred, what brought it about, and how many cases were logged — all categorised under the coding framework of the International Classification of Diseases. Alphanumeric codes drawn up and maintained by the World Health Organisation form the backbone of ICD medical reporting, giving clinicians a uniform framework for recording diagnoses, symptoms, injuries, and procedures. Clinicians and nursing staff rely on it as a shared framework for recording patient conditions with precision.
Each stillbirth case will have its underlying cause assigned to one of three categories: conditions arising before labour, factors linked to the mother's health, or complications occurring during delivery. Both a case summary for the patient and a review of the findings are required fields on the portal. On a monthly basis, patient cases at those facilities are scheduled for review. Monthly gatherings at the district level will handle these cases, while the state conducts its own review of a selection of them on a quarterly basis.
Data submissions from hub facilities will cover a broader array of variables, whereas sites operating at the network's edges are expected to provide a narrower collection of measurements.
Complications such as anaemia, nutritional deficiencies, high-risk pregnancy status, and other underlying health conditions in pregnant women have been identified among the principal drivers of stillbirth, according to the guidelines. Among the contributing factors the guidelines identify are inadequate prenatal care, elevated blood pressure, diabetes, infections, and transport delays that arise when women are in labour. Roughly two in every five stillbirths take place at the point of delivery.
About 4 lakh of the roughly 37 lakh pregnancies recorded annually in Bihar fall into the category requiring additional medical attention. Researchers have pointed to the practice of marrying at a young age as one contributing factor. Among girls and young women in the 15-to-19 age bracket, the proportion recorded as already married moved upward — from 11 per cent in NFHS-5 to 11.4 per cent when NFHS-6 data were collected. Covering the 2023–24 reference period, the NFHS-6 findings were made publicly available — along with breakdowns for each state and union territory — on 29 May 2026.
A programme examining four areas — the underlying causes, gaps in available capacity, how cases were being recorded, and the way protocol-driven reviews were conducted — has since been extended to cover every district across Bihar. A two-day training event held in Patna on 8–9 October brought together resource personnel from the Centre, who prepared 20 master trainers apiece from Bihar and Jharkhand under an initiative jointly convened by the Union health ministry, the Bihar State Health Society, and UNICEF.
Two officials joined the session remotely — Dr Shobhna Gupta, who holds the deputy commissioner role for child health within the Ministry of Health and Family Welfare, and Dr Nande Putta, whose position as chief of health at UNICEF India brought her into the virtual gathering. At a session focused on India's updated national stillbirth response and review guideline, Dr Siddhartha Reddy, a health specialist attached to UNICEF's Bihar operations, walked through the framework's rollout in detail.
Bihar's health secretary, Kumar Ravi, conveyed to a television outlet that investigators had identified a range of underlying factors contributing to stillbirths, with a formal response framework put in place to address them. Ravi noted that the state health department stands prepared to adopt the updated guidelines and portal-based reporting system across health facilities, in line with the protocol issued by the central government alongside its expert partners, and that a two-day training workshop, jointly convened by the MoHFW and UNICEF, had recently been held as part of ongoing efforts to bring down stillbirth rates. Physicians nominated from Bihar and Jharkhand took part in a train-the-trainer programme designed to build instructional capacity within those medical communities.
