Kinney Mary, Ateva Elena, Cocoman Olive, Schaaf Marta, Wanduru Phillip, Khalil Merette, Sacks Emma R, Tames Regina, Suguitani Denise, Stahlhofer Marcus, Malhotra Jaideep, Bender Petra Ten Hoope
School of Public Health, University of the Western Cape, Bellville, South Africa.
Global Surgery Division, Department of Surgery, University of Cape Town Faculty of Health Sciences, Observatory, Western Cape, South Africa.
Reprod Health. 2025 Jun 23;22(Suppl 2):112. doi: 10.1186/s12978-025-02042-w.
Human rights related to preterm birth encompass access to respectful, evidence-based care; informed consent; protection from discrimination, detention, and unnecessary separation of mother and newborn; and broader social entitlements, such as parental leave and early disability support. Since the 2012 Born Too Soon report, global recognition of these rights has expanded through international treaties, global guidelines, national legal reforms, and social movements. Demand for respectful care, including respectful maternity care and family centred care, has led to its incorporation into global guidelines and policies and a greater evidence-base. However, persistent challenges, such as workforce shortages, discriminatory policies, and the erosion of sexual and reproductive rights, continue to threaten progress.
Ensuring respectful and rights-based preterm birth care requires coordinated action across the continuum of care and across sectors, with the mother-baby dyad at the centre. Programmatic priorities at the individual level include implementing respectful maternity care and family-centred care. Ensuring high-quality, respectful care demands that providers themselves are supported, protected, and empowered to deliver such care. Their well-being is a critical enabler of the rights of patients and an essential component of effective, compassionate service delivery. At the facility-level, health systems must be purposefully designed to safeguard the fundamental human rights of the individuals with them, both care seekers and care providers. Implementing respectful, rights-based care relating to preterm birth requires structural and social changes, as well as robust data systems for accountability. Multi-stakeholder action requires strengthening accountability mechanisms at all levels and partnering with those affected by preterm birth-particularly women, families and healthcare providers-in policy processes, and the design, implementation and monitoring of care. At national-level, action requires the adoption, implementation and monitoring of international and regional human rights instruments, with multisectoral collaboration and social mobilization where violations continue.
To operationalize respectful and rights-based care for preterm birth, four primary shifts are needed: scale up respectful care; empower and partner with women and families; address the shortage of healthcare providers and protect their rights; and strengthen policy action and accountability.
与早产相关的人权包括获得尊重、基于证据的护理；知情同意；免受歧视、拘留以及母婴不必要的分离；以及更广泛的社会权益，如育儿假和早期残疾支持。自2012年《过早出生》报告发布以来，通过国际条约、全球指南、国家法律改革和社会运动，全球对这些权利的认识有所扩大。对尊重护理的需求，包括尊重产妇护理和以家庭为中心的护理，已促使其被纳入全球指南和政策，并拥有了更丰富的证据基础。然而，劳动力短缺、歧视性政策以及性与生殖权利的侵蚀等持续存在的挑战，仍在威胁着进展。
确保尊重早产护理并基于权利的护理需要在整个护理连续过程以及各个部门采取协调行动，以母婴二元组为核心。个体层面的方案重点包括实施尊重产妇护理和以家庭为中心的护理。确保高质量、尊重性的护理要求为提供者提供支持、保护并赋予其提供此类护理的权力。他们的福祉是患者权利的关键促成因素，也是有效、富有同情心的服务提供的重要组成部分。在机构层面，卫生系统必须经过精心设计，以保障与之相关的个人（包括寻求护理者和护理提供者）的基本人权。实施与早产相关的尊重人权、基于权利的护理需要结构和社会变革，以及健全的问责数据系统。多利益相关方行动需要加强各级问责机制，并在政策制定过程以及护理的设计、实施和监测中，与受早产影响的人群（特别是妇女、家庭和医疗保健提供者）建立伙伴关系。在国家层面，行动需要通过、实施和监测国际及区域人权文书，在侵权行为持续存在的情况下进行多部门合作和社会动员。
为了实施尊重早产护理并基于权利的护理，需要进行四个主要转变：扩大尊重护理；增强妇女和家庭的权能并与他们建立伙伴关系；解决医疗保健提供者短缺问题并保护他们的权利；以及加强政策行动和问责制。
