Intersectoral interventions : integration for impact on preterm birth

Abstract

PROGRESS : The last two decades have seen a growing focus on intersectoral interventions to improve maternal and newborn health and well-being outcomes, as reflected in efforts to achieve the Millennium Development Goals (MDGs) and advance the Sustainable Development Goals (SDGs). Preterm births are linked to cross-sectoral determinants that affect health outcomes and human capital across the life-course, necessitating an intersectoral approach that addresses these multifaceted challenges. PROGRAMMATIC PRIORITIES : Recognizing that social, biological and economic determinants significantly influence health outcomes, it is critical that robust health systems are reinforced by a comprehensive intersectoral approach. Evidence suggests that the factors influencing preterm birth, and the health of small and sick newborns are vast and varied, requiring interventions that address equity and rights, education, economic factors, environmental conditions, and emergency responses, i.e., a new framework entitled "five Es". PIVOTS : Improving outcomes for newborns, including preterm and small for gestational age babies, and preventing stillbirths, requires enhanced measurement and accountability within intersectoral programs across the 'five Es'. Investment in equity-focused, gender-transformative, and rights-based policies and programs across various sectors is crucial. Priority areas include ensuring equitable and inclusive education, particularly comprehensive sexual and reproductive health education; developing innovative financing schemes that protect and support families with complicated pregnancies and vulnerable infants; creating environmentally adaptive systems that prioritize maternal and newborn health; and implementing emergency response plans that guarantee the continuity of maternal and newborn health services. Evidence-based intersectoral interventions offer a promising pathway to reducing preterm births and improving health outcomes across generations. By addressing the five Es, intersectoral interventions can create a healthier future for preterm babies, children, adolescents, women, and society as a whole.

PLAIN LANGUAGE SUMMARY Improving health requires action from many different areas beyond the health sector. Factors like income, environment, education, and access to quality services all impact the health of women and babies. This paper specifically looks at how these factors affect preterm births—babies born before 37 weeks—and how working across sectors can help address this challenge. Many factors influence preterm births and newborn health, so solutions must focus on equity and rights, education, the environment, economy, and emergency response—the "five Es." To improve survival rates and quality of life for preterm babies, we need better tracking, coordination, and accountability for programs addressing these areas. Investing in these efforts leads to better outcomes and prevents preterm births. To support vulnerable newborns, key priorities include making education more inclusive, especially sexuality education; supporting families with preterm babies through protective financial systems; improving health system capacity to adapt to environmental challenges; and creating emergency response plans that prioritize mothers and newborns. By focusing on the five Es, intersectoral approaches can reduce preterm births and improve health for future generations.

KEY FINDINGS Progress • In the past two decades, there has been a growing focus on intersectoral interventions to improve maternal and newborn health, to firstly achieve the MDGs and advance the SDGs. • Intersectoral action can reduce preterm births, benefiting mothers, babies, and future generations while enhancing human capital. Programmatic priorities • Intersectoral determinants affect women and their vulnerable newborns throughout the life-cycle. • The "five Es"—equity and rights, education, economy, environment (including nutrition and climate) and emergencies—need urgent attention through targeted evidence-based interventions. Pivots It is essential to invest in building equity-focused, gender-transformative and rights-based policies and programmes across sectors, prioritizing: • equitable and inclusive education, including comprehensive sexuality education; • innovative financing schemes that protect and support families with preterm babies; • environmentally adaptive systems that prioritize maternal and newborn health; • emergency preparedness and response plans that ensure the continuation of maternal and newborn health services