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

Lead Research Organisation: Sheffield Hallam University
Department Name: College of Social Sciences and Arts

Abstract

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.

Planned Impact

Through our important scoping work in Zambia we have gained a sound situational understanding of the contextual challenges faced by MCH providers, their frontline teams and users who operate within a resource-stressed environment. Therefore, we are confident that our novel innovation strategy is the right approach to address an urgent need in Zambia, and specifically the communities in Chunga (84,464) and Kayosha (13,003) where the live birth rate stands at 88%. We anticipate our immediate impact to benefit a range of audiences across the care-giving continuum. These are categorized below as:

Newborns:
Improved life-chances for newborns in Chunga and Kayosha.

Adolescent Mothers in Chunga and Kayosha:
Every adolescent has a safer pregnancy and delivery by increasing their knowledge of maternal/neonatal health and wellbeing.
Reducing the stress and anxiety in adolescents transitioning into motherhood.
Adolescent mothers and parents gaining skills in new ways to care and parent.
Adolescent mothers and parents gaining confidence in their caring abilities.
Adolescent mothers and parents are empowered to take appropriate actions to improve the health outcomes of themselves and their newborn away from ANC facilities.

St John Zambia & MCH Teams:
Fostering an organisational culture for creative thinking, problem solving and evidence-based design.
Enhancing St John's research capacity and a capability to innovate.
The creation of a St John Youth Committee.
Strengthening St John's position as a leading MCH expert and service innovator in Zambia.

The Government of Zambia:
Improving Zambia's economic development and people's welfare through improved maternal health and outcomes.
Make a positive contribution toward the attainment of SDG goals 3, 5 and 17 and Articles 2, 6, 12 and 24 of the Convention on the Rights of the Child.

We will develop Institutional visibility for the project. During Phase 1, 2 and 3 we will disseminate our research with our respective PGR and ECR communities through seminar programmes organised by our research centres and specialist research clusters: Art & Design Research Centre (ARDC)(SHU); Huddersfield Centre for Research in Education and Society (HudCRES) (UoH). We will liaise with Zambart / University of Lusaka (with who we have contact) and UNICEF for similar opportunities to support local and regional traction. This will additionally be supported through our dissemination plan for publication in international peer-reviewed journals across a range of design, musicology, social science, early childhood and oral history disciplines; for example, Health Press Zambia, Design for Health; Design Studies; Journal of Early Childhood Education Research, Global Studies of Childhood and The Journal of British Forum of Ethnomusicology.

We will also extend the reach and impact of our research by organising the first International Maternal Child Health Innovation Symposium in Lusaka, and hosted by our partner St John. Additionally, we will explore AHRC's Follow-on Funding for Impact and Engagement to extend the International visibility of our research outputs through targeted participation at National and International conferences such as: AHRC Design Research for Change; National Health Research Conference (Zambia), UNICEF's Global Innovation Summit for Children, UNHCR Global Forum for Refugees and the World Health Organisation's Global Forum on Medical Devices.

A Collaboration Agreement will be signed by all project partners and collaborators at the beginning of the project that will set out intellectual property arrangements and how shared raw data and materials may be used during and after the project for the purposes of academic teaching, training and public dissemination. We will also agree an open licensing arrangement to maximise the impact and uptake of project within the global MCH sector through creative commons licensing.

Publications

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