Building a global policy agenda to prioritize preterm birth: A qualitative analysis on factors shaping global health policymaking
Open Access
- 22 June 2020
- journal article
- Published by F1000 Research Ltd in Gates Open Research
Abstract
Background: Preterm birth, defined as infants born before 37 weeks of gestation, is the largest contributor to child mortality. Despite new evidence highlighting the global burden of prematurity, policymakers have failed to adequately prioritize preterm birth despite the magnitude of its health impacts. Given current levels of political attention and investment, it is unlikely that the global community will be adequately mobilized to meet the 2012 Born Too Soon report goal of reducing the preterm birth rate by 50% by 2025. Methods: This study adapts the Shiffman and Smith framework for political priority to examine four components contributing to policy action in global health: actor power, ideas, political context, and issue characteristics. We conducted key informant interviews with 18 experts in prematurity and reproductive, maternal, newborn, and child health (RMNCH) and reviewed key literature on preterm birth. We aimed to identify the factors that shape the global political priority of preterm birth and to describe policy opportunities to increase its priority moving forward. Results: The global preterm birth community (academic researchers, multilateral organizations, government agencies, and civil society organizations) lacks evidence about the causes of and solutions to preterm birth; and country-level data quality is poor with gaps in the understanding required for implementing effective interventions. Limited funding compounds these challenges, creating divisions among experts on what policy actions to recommend. These factors contribute to the lack of priority and underrepresentation of preterm birth within the larger RMNCH agenda. Conclusion: Increasing the political priority of prematurity is essential to reduce preventable newborn and child mortality, a key target of the 2030 Sustainable Development Goal for health (target 3.2). This study identifies three policy recommendations for the preterm birth community: address data and evidence gaps, clarify and invest in viable solutions, and bring visibility to prematurity within the larger RMNCH agendas.Funding Information
- Gates Foundation (OPP1107312)
- UCSF Global Health Group Evidence to Policy Initiative
This publication has 24 references indexed in Scilit:
- Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysisThe Lancet. Global Health, 2018
- Prioritizing Surgical Care on National Health Agendas: A Qualitative Case Study of Papua New Guinea, Uganda, and Sierra LeonePLoS Medicine, 2016
- Network advocacy and the emergence of global attention to newborn survivalHealth Policy and Planning, 2015
- Generating political priority for newborn survival in three low-income countriesGlobal Public Health, 2014
- Born Too Soon: Accelerating actions for prevention and care of 15 million newborns born too soonReproductive Health, 2013
- Why Does Mental Health Not Get the Attention It Deserves? An Application of the Shiffman and Smith FrameworkPLoS Medicine, 2012
- Research Article: Recruitment of hard-to-reach population subgroups via adaptations of the snowball sampling strategyNursing & Health Sciences, 2010
- Issue attention in global health: the case of newborn survivalThe Lancet, 2010
- Generation of political priority for global health initiatives: a framework and case study of maternal mortalityThe Lancet, 2007
- Sampling in Qualitative ResearchResearch on Aging, 1995