Policy and advocacy considerations for the prevention and care of preterm birth

Abstract

Preterm birth (PTB) is the leading cause of mortality in children aged under 5 years and a major contributor to lifelong morbidity, disproportionately affecting low- and middle-income countries. Despite its significant burden, PTB remains underprioritized on global and national health agendas, with limited integration into monitoring frameworks, funding streams, and policy strategies. This paper, developed by the FIGO Committee on Preterm Birth, reviews current evidence and international experiences to highlight the urgency of elevating PTB as a maternal and newborn health priority. Effective, low-cost interventions-including quality antenatal care (ANC) and neonatal care, support for breastfeeding, infection management, and access to corticosteroids-could prevent up to three-quarters of PTB-related deaths, yet their implementation remains uneven. Moreover, addressing social determinants of health, such as poverty, gender-based violence, inadequate maternity leave, and poor access to health care, is essential to reducing inequities in outcomes. Policy innovations from Latin American countries demonstrate how national legislation and protocols can improve prevention and care. To achieve meaningful progress, PTB must be integrated into Sustainable Development Goal strategies and the Every Newborn Action Plan, supported by strong political will, multisectoral collaboration, and investment in research and innovation. Advocacy efforts should focus on developing national prevention programs, engaging community health workers (CHWs), standardizing care guidelines, and strengthening public-private and international partnerships. A comprehensive approach that integrates evidence-based interventions with policy reforms is crucial to reducing PTB incidence, improving survival, and ensuring equitable outcomes for mothers and newborns worldwide.