In 2015, when a group of some 60 UC San Francisco researchers and clinicians sat down to tackle the epidemic of preterm birth, the lives of 15 million children were at stake.
That’s how many children are born premature (before 37 weeks’ gestation) each year worldwide. One million die within the first 28 days of life, and preterm birth is the largest killer of children under 5. Those infants who do survive are at considerably increased risk for a lifetime of health challenges – from neurological disorders to obesity, hypertension and diabetes. Yet despite the devastating impact – which disproportionately affects disadvantaged communities – in recent years there has been little improvement in slowing the rate of preterm birth.
Fortified by a $100 million promise from philanthropists Lynne and Marc Benioff and the Bill & Melinda Gates Foundation, the UCSF team spent a year planning its effort. Team members cast a wide net and focused intently on forging collaborations and listening closely to other health systems, community leaders, educators, civic officials and, most important, women in disadvantaged communities who have experienced or are at risk for preterm birth.
As the year progressed, the group split into two separate but coordinated initiatives, with the Gates Foundation funding the UCSF Preterm Birth Initiative East Africa (PTBi-EA) and the Benioffs funding the UCSF Preterm Birth Initiative California (PTBi-CA). Both groups have created ambitious five-year plans that involve research to make new discoveries as well as to more effectively implement existing best practices for preventing and treating preterm birth.
“In California, our long-term goal is to eliminate the disparities in care that lead to dramatically different rates of prematurity – and to improve the outcomes of babies born preterm,” says UCSF School of Nursing’s Linda Franck, who is co-principal investigator for PTBi-CA and the Jack and Elaine Koehn Endowed Chair in Pediatric Nursing.
How PTBi-CA arrived at its plan and what that plan entails present a case study in blending humility and hubris to tackle an enormously complex public health challenge.