Effective solutions have not been possible for preterm birth and small for gestational age because there are large gaps in the fundamental knowledge about the disease. This is largely because these are complex syndromes with multiple etiologies that include interacting biological, psychosocial, and environmental factors. It is critical that efficient solutions must be prioritized both at the national and global level. At Maternal and Child Health Program, Translational Health Science and Technology Institute, Faridabad, we started with a rationale that most available evidence for preterm birth has come from traditional approaches that analyzed data from a single time point, usually immediately after childbirth. Collection of multidimensional data over the entire period of pregnancy will provide a deeper understanding and better estimates of risk factors that lead to adverse pregnancy outcomes, enabling their prediction and prevention. An effective risk stratification that will facilitate timely referral would be a critical health system intervention, particularly in low middle-income countries like ours. We have established a multi-institutional program, GARBH-Ini (Interdisciplinary Group for Advanced Research on Birth outcomes – DBT India Initiative) to enable such a comprehensive investigation of the maternal and child health problems to develop solutions that are rapidly translatable to clinical and public health policy.