Langlois Etienne V, Bizri Maria El, Thompson Kelly, Reid Amy, Khalil Merette, Gasparri Giulia, Lawn Joy E, Dey Teesta, Robb-McCord Judith, Benaskeur Yousra-Imane, Bonell Ana, Gidebo Amanuel, Scudder Elaine, Kostelecky Sophie Marie, Machawira Patricia, Gronseth Lars, Prasad Rajnish, Sapkota Diplav, Pillay Priya Soma, Valsangkar Bina, Jacobsson Bo, Temmerman Marleen
Partnership for Maternal, Newborn & Child Health (PMNCH), World Health Organization (WHO), Geneva, Switzerland.
YourEgyptianDoula, Cairo, Egypt.
Reprod Health. 2025 Jun 23;22(Suppl 2):111. doi: 10.1186/s12978-025-02043-9.
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.
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".
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.
在过去二十年中，人们越来越关注跨部门干预措施，以改善孕产妇和新生儿的健康及福祉成果，这体现在实现千年发展目标（MDGs）和推进可持续发展目标（SDGs）的努力中。早产与跨部门决定因素相关联，这些因素会影响整个生命历程中的健康结果和人力资本，因此需要一种跨部门方法来应对这些多方面的挑战。
认识到社会、生物和经济决定因素对健康结果有重大影响，至关重要的是通过全面的跨部门方法来加强强大的卫生系统。有证据表明，影响早产以及小而患病新生儿健康的因素广泛多样，需要采取解决公平与权利、教育、经济因素、环境条件和应急响应等方面的干预措施，即一个名为“五个E”的新框架。
改善新生儿（包括早产儿和小于胎龄儿）的结局并预防死产，需要在跨部门方案中加强“五个E”方面的衡量和问责。在各个部门投资以公平为重点、具有性别变革性和基于权利的政策及方案至关重要。优先领域包括确保公平和包容性教育，特别是全面的性与生殖健康教育；制定创新的融资计划，以保护和支持有复杂妊娠情况的家庭及脆弱婴儿；创建优先考虑孕产妇和新生儿健康的环境适应系统；以及实施保障孕产妇和新生儿健康服务连续性的应急响应计划。基于证据的跨部门干预措施为减少早产和改善几代人的健康结果提供了一条有前景的途径。通过解决“五个E”问题，跨部门干预措施可以为早产儿、儿童、青少年、妇女以及整个社会创造一个更健康的未来。
