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. 2025 Jun 23;22(Suppl 2):111.
doi: 10.1186/s12978-025-02043-9.

Intersectoral interventions: integration for impact on preterm birth

Etienne V Langlois #  1 , Maria El Bizri #  2 , Kelly Thompson  2 , Amy Reid  2 , Merette Khalil  3 , Giulia Gasparri  2 , Joy E Lawn  4 , Teesta Dey  2 , Judith Robb-McCord  5 , Yousra-Imane Benaskeur  6 , Ana Bonell  7 , Amanuel Gidebo  8 , Elaine Scudder  9 , Sophie Marie Kostelecky  2 , Patricia Machawira  10 , Lars Gronseth  11 , Rajnish Prasad  12 , Diplav Sapkota  13 , Priya Soma Pillay  14 , Bina Valsangkar  15 , Bo Jacobsson #  16 , Marleen Temmerman #  17
Affiliations

Intersectoral interventions: integration for impact on preterm birth

Etienne V Langlois et al. Reprod Health. .

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.

Keywords: Equity; Intersectoral interventions; Maternal health; Newborn health; Preterm birth.

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.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not required for this paper. Consent for publication: Not required for this paper. Competing interests: No competing interests to declare.

Figures

Fig. 1
Fig. 1
Intersectoral action on preterm birth: progress over the past decade and vision for the future
Fig. 2
Fig. 2
The “5 Es” of intersectoral influence on preterm birth
Fig. 3
Fig. 3
Country Snapshot: Bangladesh’s Incentives for Women’s Education Drive Positive Impacts on Maternal and Neonatal Mortality [61]
Fig. 4
Fig. 4
Country snapshot: Reducing adolescent pregnancy through comprehensive sexuality education in Zambia [17]
Fig. 5
Fig. 5
Financial protection for maternal and newborn health services, 2022 [67]
Fig. 6
Fig. 6
Country Snapshot: Social Protection Programs as Interventions to Meet Nutritional Needs of Mothers in Pakistan [68]
Fig. 7
Fig. 7
Impacts of climate change on maternal and newborn health
Fig. 8
Fig. 8
Country snapshot: Intersectoral approach to babies’ nutrition and support breastfeeding in Burkina Faso [89]
Fig. 9
Fig. 9
WASH in health-care centres in low-income countries [93]
Fig. 10
Fig. 10
Country snapshot: Ensuring Safe Water and Nutrition for Mothers and Children in Gran Chaco [–98]
Fig. 11
Fig. 11
Country snapshot: Impact of emergencies on preterm birth and small and sick newborns in Yemen [106]
See this image and copyright information in PMC

References

    1. Born too soon. decade of action on preterm birth. Geneva: World Health Organization; 2023.
    1. Gruending A, Lawn JE, Reid A, Langlois EV, Jacobsson B, McDougall L, Khosla R, Bhutta ZA, Deorari AK, Kak L, Robb-McCord J, Zaka N, Decena DD, Fogstad H, Banerjee A, Kinney MV, Dube Q. Preterm birth: learning from the past to accelerate action in the next decade. BMC Reprod Health. In Press. - PMC - PubMed
    1. Kuruvilla S, Schweitzer J, Bishai D, Chowdhury S, Caramani D, Frost L, et al. Success factors for reducing maternal and child mortality. Bull World Health Organ. 2014;92(7):533–44. - PMC - PubMed
    1. Temmerman M, Khosla R, Bhutta ZA, Bustreo F. Towards a new Global Strategy for Women’s. Children’s Adolescents’ Health Bmj. 2015;351:h4414. - PubMed
    1. Ashorn P, Ashorn U, Muthiani Y, Aboubaker S, Askari S, Bahl R, et al. Small vulnerable newborns-big potential for impact. Lancet. 2023;401(10389):1692–706. - PubMed

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