Life-Saving Lullabies: Reducing adolescent maternal and neonatal deaths in Zambia

在世界各地，看护者为他们的婴儿唱了四千多年的感伤和传统的民间摇篮曲，许多人超越了几代人的口头传统。（McDowell，1977年）。对摇篮曲文本的民族音乐学研究发现，摇篮曲充满了隐蔽和公开的目标;从爱和情感的表达以及母亲的安抚物，以收回宝贵的工作或睡眠时间（Ebeogu，2017; Klymasz，1968）。到目前为止，摇篮曲歌词作为提供基本知识和生存技能以支持行为改变和发展更好的育儿做法的方法工具，其功能目的的扩展潜力一直被忽视。“拯救生命的摇篮曲”是一种高度新颖，适应性强，可转移和可持续的基于艺术的创新战略，旨在打破传统的医疗保健实践和服务提供模式，同时提供一种新的方法来改善资源紧张环境中青少年母亲及其新生儿的健康和福祉结果。这一点的核心是我们以人为本的设计方法，它将：应对与产前护理服务（ANC）可及性相关的不平等;改进目前用于提高服务用户孕产妇健康信息技能的ANC做法;并使当地社区能够构思新的摇篮曲，以应对当地和国家的紧迫挑战。重要的是，我们将通过突出年轻母亲的需求来实现这一目标，这些需求来自她们的经验，而不是由临床医生或其他远离女性亲密的日常和夜间社会存在的人定义的需求。在认识到母亲作为女性的经验时，我们的主要重点将是支持青少年向母亲过渡，以减少整个护理过程中的孕产妇和产后死亡率：怀孕、分娩、产后和儿童期。该项目满足了赞比亚的一项紧迫战略需求-增加方便青年的服务，满足青少年的计划生育需求，并教育他们了解怀孕、危险信号和新生儿护理。该项目的目标是运用艺术、设计和人文研究方法，发现、定义、发展、提供和增强青少年父母和照顾者的能力，使他们具备满足妇女和母亲需求的应对技能。我们将运用我们的集体知识，共同谱写新的“拯救生命的摇篮曲”。这一汇编将由地方社区编写并为地方社区服务，并将直接响应总统的声明、卫生部的战略需要和第一线妇幼保健工作队的观点：怀孕和生育对妇女的影响;对怀孕期间疟疾的认识;对出生后重大危险迹象的认识（APGAR：外观，脉搏，鬼脸，活动和呼吸）;药物依从性和良好营养对更健康的母亲和婴儿的重要性;以及参加ANC服务以确保更安全的怀孕和分娩。

Across the world, caregivers have sung sentimental and traditional folk lullabies to their babies for over four millennia with many transcending the generations as oral tradition. (McDowell, 1977). Ethnomusicological studies of lullabies texts have uncovered that lullabies are imbued with both covert and overt orientated objectives; from an expression of love and affection as well as a pacifier for mothers' to reclaim precious time for work or sleep (Ebeogu, 2017; Klymasz, 1968). Until now, the potential for extending the functional purpose of lullaby lyrics as a methodological tool for delivering essential knowledge and survival skills to support behaviour change and the development of better parenting practices has been overlooked. 'Life-Saving Lullabies' is a highly novel, adaptable, transferable and sustainable arts-based innovation strategy that seeks to disrupt the traditional models of healthcare practice and service delivery, while informing a new approach to improve the health and wellbeing outcomes of adolescent mothers and their newborn in resource-stressed environments. Central to this, is our human-centred design approach that will: confront inequalities associated with the accessibility of antenatal care services (ANC); improve upon the current ANC practices used to up-skill service users with maternal health information; and empower local communities to conceive new lullabies to address immediate local and national challenges. Importantly, we will achieve this by foregrounding the needs of young mothers from their experience rather than those defined by clinicians or others removed from the intimate daily and nightly social being of women.In recognising mothers' experiences as women, our primary focus will be supporting the transition of adolescents into motherhood to reduce maternal and postnatal mortalities across the care-giving continuum: pregnancy, birth, postnatal and childhood. This project fills an urgent strategic need in Zambia- increasing the number of youth-friendly services that address the family planning needs of adolescents and educates them about pregnancy, danger signs and newborn care. The goal of the project is to apply art, design and humanities research methodologies to discover, define, develop, deliver and empower adolescent parents and caregivers with responsive skills for meeting their needs as both women and mothers. We will apply our collective knowledge to co-compose a repertoire of new 'life-saving lullabies'. This repertoire will created by and for local communities and will directly respond to the President's declaration, the strategic needs of the Ministry of Health and the viewpoint of frontline MCH teams: the impact of pregnancy and motherhood on women; awareness of malaria in pregnancy; awareness of the critical danger signs following birth (APGAR: Appearance, Pulse, Grimace, Activity, and Respiration); importance of medication compliance and good nutrition for a healthier mother and baby; and attending ANC services for a safer pregnancy and delivery.