[Editorial] The Future of Preconception Health

Why It Matters

Without robust evidence and gender‑equitable policies, preconception health cannot be scaled to improve pregnancy outcomes or meet future SDG targets, limiting global health progress.

Key Takeaways

• Men's preconception health linked to offspring outcomes
• Evidence gaps hinder policy and program design
• Surveillance framework unites individual and system-level indicators
• Gender equity needed to prevent women bearing sole responsibility
• Post‑2030 agenda should measure preconception health as SDG target

Pulse Analysis

The conversation around preconception health has shifted from a narrow focus on women to a life‑course perspective that includes men, couples, and broader social determinants. The 2018 Lancet series sparked this expansion, but implementation has stalled, leaving a fragmented evidence base. Recent reviews in The Lancet stress that men’s physical and mental wellbeing before conception can affect fetal development, yet research, practice, and policy still treat this factor as peripheral. By proposing a comprehensive surveillance framework, the authors aim to standardize metrics across individual health data and health‑system performance, offering a roadmap for policymakers seeking actionable insights.

A critical barrier to progress is the paucity of high‑quality, longitudinal studies that demonstrate population‑level impact of preconception interventions. The 2024 WHO meeting highlighted the scarcity of trial data beyond pregnancy care and the need for real‑world evidence to guide resource allocation. Heterogeneous results across regions—such as differing nutritional burdens in Southeast Asia—show that one‑size‑fits‑all solutions are ineffective. Rigorous, context‑specific research is essential to develop interventions that are both scalable and culturally appropriate, ensuring that investments yield measurable health gains.

Beyond data, the editorial warns that preconception initiatives must avoid reinforcing gender stereotypes or infringing on reproductive autonomy. Embedding human‑rights principles into indicator selection and policy design safeguards against misuse by anti‑gender groups. As the UN Sustainable Development Goals approach their 2030 deadline, the authors argue that preconception health should be codified as a distinct, measurable SDG domain in the post‑2030 agenda. Doing so would align global health priorities with upstream, preventive strategies that address inequities across generations, ultimately supporting the "survive, thrive, transform" vision for a healthier world.