We Are the World
This issue of The Journal of Perinatal & Neonatal Nursing focuses on global perinatal and neonatal health. International issues and clinical experiences in perinatal and neonatal nursing encompass the globe, and are becoming more relevant as the world becomes smaller and smaller and nurses care for culturally diverse women and newborns from around the world. This issue describes strategies for meeting the United Nations Millennium Development Goals 4 (neonatal health) and 5 (maternal health) by 2015.
In the perinatal section, under the guidance of Guest Editor Dr Lynn Clark Callister, Brucker provides an overview of how global maternal health can be improved as we seek to "Mother the world." This insightful work provides an overview of where the provision of healthcare is in terms of meeting Millennium Development Goal 5.
Our nursing colleagues in Turkey describe postpartum depressive symptoms in women who had been treated for primary infertility, contributing to cross-cultural research on factors contributing to perinatal mood disorders.
Dickerson and associates report on a community- and home-based maternal-newborn outreach program in rural Tibet. This initiative began with a nurse in maternal/fetal medicine at the University of Utah who had a dream to make a difference. She expanded her efforts to include a multidisciplinary team to provide culturally competent care on the basis of the best evidence. You will find this report interesting and inspiring!!
In the perinatal section of this global health issue, the "we are the world" theme also includes 2 qualitative descriptive studies focusing on the perceptions of women giving birth in 2 very different sociocultural contexts: Australia and Ecuador. These articles highlight the importance of listening to the voices of women to guide the provision of healthcare. These reports demonstrate how qualitative inquiry can be utilized to generate clinical guidelines in order to enhance the care of childbearing women and their families.
These contributing authors provide insights into global perinatal and neonatal health that are relevant to neonatal and perinatal nurses caring for women across the globe.
The neonatal section of this issue of The Journal of Perinatal & Neonatal Nursing focuses on global issues. This year, 2010, is the International Year of the Nurse in commemoration of the centennial death of Florence Nightingale.1 Suzanne Gordon in "Nursing Against the Odds"2 called nurses the backbone of healthcare.
At the International Council of Nurses 2009 meeting, this position was reaffirmed. The United Nations Development Program established Millennium Development Goals3 in the 1990s, which have been updated for 2015. They represent aims that worldwide organizations such as UNICEF, Save the Babies, governments, nongovernmental organizations, and professional associations such as the Council of International Neonatal Nurses, have partnered on to improve the health and welfare of global society. Millennium Development Goal 4 is to reduce child mortality, especially for children younger than 5 years. Prior to 2006, this mortality rate was greater than 10 million children per year.3 Four years later, some progress has been made. Yet, children in poor, developing countries still have high child mortality rates and most of this is attributable to the neonatal period. In 2005, the Lancet published the Neonatal Survival series. As part of that series, Lawn and colleagues4 reported that annually there were an estimated 4 million neonatal deaths, accounting for 38% of the world's child deaths. The causes were not surprising-infection, low birth weight, prematurity, and asphyxia, all of which were preventable and impacted directly by nursing. To date, only 16 countries or 24% have effectively reduced the child mortality rate.5 Progress on Millennium Development Goal 4 relies on good nursing care globally. The topics in this issue reflect nursing practice and education and the challenges that neonatal nurses face and range from Japanese nursing practice, to transporting infants in Finland, to use of infant massage in Chile to improve weight gain, and finally to Russia and use of professional associations and networking to increase knowledge, change practice, and influence health outcomes.
Eklund's article titled "Japan and Its Healthcare Challenges and Potential Contribution of Neonatal Nurse Practitioners" addresses the need for changes in the scope of practice of neonatal nurses. This article describes how neonates need both nurses and doctors to have advanced skills in order to meet their increasingly complex needs. This situation in which nurses cannot do health assessments or start intravenous lines is not unique to Japan. It represents the need for policy changes and interdisciplinary discussions about how practices need to change to match the complexity of care in the neonatal population.
Leppala's article from Finland represents a nice opinion piece on neonatal transport. The author holistically addresses challenges faced in moving a fragile infant from one center to another in order to provide the best care.
Serrano and colleagues describe the relationship of massage to weight gain at ages 2 and 4 months. This Chilean study examined breast-feeding and weight gain using a teaching intervention, "Baby's First Massage Program," to enable mothers to massage their full-term infants. At 2 months of age, there were no significant differences between the 2 groups of infants. At 4 months, however, the weight was appropriate for age and greater in the massage group than in the usual care group. While the research indicates a need for further study, it is exciting to think that an easily taught intervention like massage holds possibilities for fostering positive weight gain in infants.
Boykova presents a synthesis of a personal journey as a neonatal nurse from Russia to professional networking to improve her own nursing education and, ultimately, improved health outcomes of neonates and their families. The backdrop for this article is the Council of International Neonatal Nurses, which, according to the author, helps link neonatal nurses together to address common global problems.
Lynn Clark Callister, PhD, RN, FAAN
Perinatal Guest Editor Professor, College of Nursing Brigham Young University Provo, UT
Carole Kenner, DNS, RNC-NIC, FAAN
Neonatal Guest Editor Dean/Professor, School of Nursing Associate Dean, Bouve College of Health Sciences Northeastern University Boston, MA
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