2015 Global Action Agenda
on Preterm Birth & Stillbirth
Preterm birth and stillbirth are complex global health problems requiring an interdisciplinary approach and an international commitment. The Global Action Agenda (GAA) is a comprehensive set of recommendations that include short-, intermediate-, and long-term milestones, and success metrics. The primary goal of this GAA is to forge a collaborative effort toward achieving common goals to prevent preterm birth and stillbirth, and to improve related maternal, newborn, and child health outcomes.
The GAA was published in article 7 as part of the “Global report on preterm birth & stillbirth: the foundation for innovative solutions and improved outcomes” with BMC Pregnancy and Childbirth on 23 Feb 2010.
Who Created It?
The Global Action Agenda was developed by more than 200 stakeholders who attended the 2009 International Conference on Prematurity and Stillbirth. GAPPS co-convened this four-day conference with the Bill & Melinda Gates Foundation, March of Dimes, PATH, Save the Children, UNICEF and the World Health Organization. Participants included leading international researchers, policymakers, health care practitioners and philanthropists. See the visual schematic developed at this conference.
Core Objectives in the GAA
- Advance discovery of the magnitude, causes and innovative solutions
- Promote development and delivery of low-cost, proven interventions
- Improve advocacy efforts to increase awareness that preterm birth and stillbirth are leading contributors to the global maternal and newborn health burden
- Increase resources for research and implementation
- Consider ethical and social justice implications throughout all efforts
Snapshot of Short-Term Stakeholder Progress
Below are examples of short-term milestones that will be completed. Scroll down to see additional progress.
- Analyzing and building research capacity globally
- Developing preterm birth & stillbirth classification systems
- Conducting fetal and newborn growth research
- Facilitating, initiating basic & translational research
- Prioritizing research for 2010 and beyond
- Publishing, presenting ethical findings
- Advocating for increased awareness and funding
Summary of Stakeholder Achievements in Prematurity and Stillbirth
(May 2009 - May 2010)
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Stakeholders are making quick progress toward milestones identified this first year. Key accomplishments are highlighted below.
- Discovery: Epidemiology and Basic Science
- Development & Delivery of Interventions
- Advocacy
- Fundraising
- Ethics
Stakeholder Progress: Discovery: Epidemiology and Basic Science
- Developing classification systems for both preterm births & stillbirths: discussed during phenotype definitions workgroup at the University of Oxford
- Creating expert group to define phenotypes of PTB: Nuffield Department of Obstetrics and Gynecology and Oxford Maternal and Perinatal Health Institute offered to be the Lead Agency for this milestone
- Developing “think-tank” meetings on the basic biology of human parturition: establish a Special Interest Group (e.g., Physiology of Human Parturition and Preterm Birth Interest Group); develop an online presence (possibly as part of the GAPPS web site) as a forum to share data; resources and ideas and facilitate communication between group members, hold events at the SGI (mostly basic scientists) and SMFM (mostly clinicians) meetings
- Writing a stillbirth series in The Lancet: several participants at the International Conference on Prematurity & Stillbirth are contributing to this series
- Building collection of maternal and paternal data and specimens for the GAPPS Repository
- Developing CHNRI-based research processes for preterm birth and stillbirth epidemiology
- Collecting data on intrapartum stillbirths in high-impact countries
- Expanding study on fetal and newborn growth: Intergrowth 21st—the University of Oxford’s program to study fetal and newborn growth—has expanded to 10 sites around the world
Stakeholder Progress: Development and Delivery of Interventions
- Identified 21 evidence-based interventions that can be implemented in low-resource settings
- Writing papers utilizing the CHNRI research prioritizing process for community- and facility-based strategies in LMICs: completed/conducting CHNRI exercises; coincides with stillbirth series in The Lancet
- Organizing a symposium of "Neonatal respiratory and intensive care" updating recent advances in perinatal-neonatal medicine for 200 neonatologists from different parts of China: collaborating with Seattle Children’s Research Institute
- Seeking funding and feasibility for conducting a population study on the incidence of prematurity in Malaysia
- Developing intrapartum and antenatal care packages
Stakeholder Progress: Advocacy
- Countdown to 2015 now includes preterm and stillbirth rates among the priority indicators
- Increasing visibility of preterm birth and stillbirth through before and after publishing the global report on preterm birth and stillbirth: international media coverage; presentations on key findings; National Press Club event; U.S. Capitol Hill briefing
- Submitted written testimony to Health Subcommittee for hearing on prematurity
- Providing evidence-based recommendations to key stakeholders
- Presentations and/or panel discussions on prematurity and stillbirth at the following global health events: Pediatric Academic Society (May 2010)Women Deliver (June 2010); Pacific Health Summit (Pre-event in June 2010)
- GAPPS will soon hire an advocacy and communications director
Stakeholder Progress: Fundraising
- Increased focus by the Bill & Melinda Gates Foundation in maternal and newborn health
- Requested global campaign for increased cooperative funding on research and development for prematurity and stillbirth
Learn how you can help.
- Active, growing Ethics Research Group, Web page forthcoming
- Participating in bioethics conferences in Seattle and Singapore: joint symposium on "Ethical Considerations in the Global Burden of Prematurity and Stillbirth: Cross-cultural Perspectives" was accepted for the World Congress in Bioethics, to be held July 28-31 2010 in Singapore; three GAPPS ethics presenters at Sixth Annual Pediatric Bioethics Conference, July 23-24 2010, “Tiny Babies, Large Questions”, with special session on “Justice and Prenatal and Neonatal Care in the Global Context”, Seattle, Washington; developed draft instrument for measuring the ethical dilemmas faced by women surrounding the birth of premature infants, to be piloted in Zambia; preparing “Points to Consider” document for publication
- Advancing the Indian bioethics group's plans for research on the ethical and cross cultural issues on prematurity