I am honored to have been invited by Dr. Margaret Comerford Freda to serve as a guest editor of this special topics series during the 40th Anniversary year for MCN The American Journal of Maternal Child Nursing. This series focuses on global health using the framework of the Millennium Development Goals (MDGs), eight specific, measurable goals agreed upon in 2000 by 191 United Nation member states and targeted to be met by 2015 (World Health Organization [WHO], 2015).
Millennium Goal 3 (Promote Gender Equality and Empower Women) is a common thread among the articles in this issue. Health services inclusive of unmarried women and adolescents are desperately needed in many countries as these groups are at risk of being excluded from services available to married women, scant as the services may be. Gender-based equity access to healthcare and education are interrelated: increased education leads to better employment opportunities and financial resources and potentially empowers women to make their own decisions.
The first article in this special topic series discusses global rates of premature births. In 2010 (most recent global data), it is estimated that 15 million babies were born prematurely (WHO, 2012). Countries with limited healthcare resources, less wealth, and fewer healthcare workers are at significantly increased risk of being unable to provide basic services to pregnant women including access to prenatal care, a trained birth attendant, postpartum care, and newborn care. This is particularly true of countries ravaged by war such as the Democratic Republic of Congo, Nigeria, and Pakistan.
The next article prevents an overview of commercial transnational surrogacy in India. This is an emerging ethical issue. Although it is happening around the world, we have chosen to focus on India where it is a burgeoning aspect of medical tourism. This is a complex and poorly understood practice, particularly from the viewpoint of the women and families in India who are choosing to be surrogates.
The third article provides information on female genital cutting, a practice deeply rooted in culture, religion, and social tradition primarily in some African and Middle East countries, and considered by others to be child abuse and a severe form of violence against unconsenting women and girls. Maternal child nurses need information on female genital cutting so they can provide evidence-based, nonjudgmental, culturally competent care that may ultimately help these women heal from the traumas they have experienced.
Nurses are ideally suited to address these problems. We can advocate to move the needs of women, their newborns, and their children to the forefront of global political agendas. Educational strategies in hospitals, community, and academic settings can target the global needs of vulnerable women and children. These can be as simple as discussing the evidence developed in response to the MDGs, to openly discussing culturally sensitive topics such as commercial surrogacy or female genital cutting. Nurses in clinical practice can implement WHO-endorsed measures such as early and exclusive breastfeeding and kangaroo mother care. Finally, much more research grounded in the communities involved is needed to examine the complex issues confronting women and children globally, including the needs of the nurses providing their care. There is a lot of work to do: let's get busy.
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