As efforts to improve pregnancy planning and preconception health expand, stronger systems are needed to track progress. While some countries have made advances, no existing surveillance systems use a comprehensive set of indicators. This review outlines key system- and individual-level indicators that can be drawn from routine data to support the development of new monitoring approaches. It also introduces a new framework that, for the first time, incorporates community perspectives on what matters most before pregnancy and parenthood. Finally, it highlights an international collaboration working toward a core set of comparable indicators across countries of all income levels, and outlines future directions for strengthening global monitoring.

Cluster Leads Dr. Wendy Norman and Dr. Patti Janssen are co-authors of this publication. The full article is available here: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00192-3/abstract