Born Too Soon: Progress and priorities for respectful and rights-based preterm birth care.

progressHuman 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. PROGRAMMATIC PRIORITIES: 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. PIVOTS: 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.