Thursday, January 17, 2019 | ePaper

Neonatal nursing is a holistic approach

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AHM Nouman :
Neonatology is a subspecialty of Pediatrics that consists neonatal and newborn nursing care. It is now acceptable that, mother and child must be considered as one unit. Nursing is a holistic approach. Neonatology is a scientific total way of nursing. Neonatal is the important care part of total neonatology.
Since the bottom lining mothers' role is the integral, meaning a holistic approach needs to invest from the womb - a Bottom up-Top down match making planning. Development Organization of the Rural Poor-DORP innovated, Bangladesh Government provides having 7 criterion for Maternity Allowances to the poor mothers for 24 months (thanks Government, for extending to 36 months from next 2018 - '19 budget)  from conception day investing @ USD 10/month per mother covering 0.7 million yearly by state support, promoting, safe delivery, economic-social freedom, privacy, nutritious food, mothers' economic decision making power, hesitation free useable latrine, available safe drinking water, enough sun light, women friendly family members supportive environment, protecting child mortality, cleanliness, six steps hand washing, One month full rest before possible delivery day, Maintaining new born body temperature, mother's chest centered transmit heat care (Kangaroo style), Mothers breast feeding, colostrum, Delaying the new born's bath and Vaccinating, ANC & PNC etc. are the stewards of the mother. These are the main of many to bring into front line for self-propelling enhancement for both mother and healthy baby.
Centering Maternity Allowance bridging for graduation, further INVESTMENT needs titled Social Assistance Program for Non-Asseters (SAPNA) package, providing 1250 USD/mother with holistic partnership supports like Health, Education, Housing, Livelihood and Savings plus by 20 years a generation staggering - stands self-reliant. This innovated SAPNA Package primarily is implemented by DORP from the year 2009-2012 supported by AECID of Spain Government.  
The Public Poor Private Partnership - SAPNA broadly brings YES to marriage Registration, birth Registration, employed, all goes School, Education mainstreaming, health system mainstreaming, countable, happy couple, breast feeding, nutritional food taker, feel prestigious/honored, feel one out of many, understand self-well-being, life style visible, decision making, dialectic, shock bearing, self-confident, patriot, feel accountable, responsible, development Entrepreneurship, ownership accelerating, spread effect example/ show piece, sense of personal achievement, mentally healthy and control by being involved in decision making.
SAPNA broadly NO to early marriage, divorce/separation/multi marriage, disable birth, malnutrition birth, maternal death, infantile death, drop out from school, dependency, venerability, lonely feeling, unconscious, hesitant, suffering helplessness and children more than two (boy or girl, black & white) Homegrown, practiced, evidence based, DORP evolved loop closed SAPNA package subsequently from 2015-2017, replicated by Women and Children Affairs Ministry, for Ending Poverty linking SDG one estimating 10 million mothers lessening discrimination. Because, poverty and peace can't walk together. Poverty is the root cause of all discrimination and it matters worldly.
We all want to have a cute baby but not want to face labor pain. To have a cute baby, build and work for a generation, we have to face 'pain' and have a 'cute' baby both. Wide disparity between rich and poor needs low/ cost self-propelling in-built affordable, self-sustained authoritian management approach is very much needed for our country especially to the marginal group.
Mother is a God gifted best Coordinator, Manager, Economist, Guardian, Nurse, Teacher, Monitor, Supervisor and what not. Thus, if we can overcome Influenced, consciously or unconsciously terrorized syndication of unnecessary medical interventions, Doctors, Pharmaceutical Companies and Hospitals control and dominate over the birthing process shall defeat. WHO's global care model for healthy pregnant women, low cost, self-sustaining, to capture, self-propelling, affordable and combat maternal and neonatal well-being shall win, where another world is possible.
To make 'health truly for all' it is to be designed around 'with' people and not around 'for' medicine. Bringing health in central targeting SDG No. 1 agenda 'Ending Poverty' is an Everest Height Essential to address. Any kind of treatment or prescriptions (?) is linked to financial hardship of mass community - low income who are in poverty trap. Described holistic approach needs translation into action with short and mid-term plan and should be for at least 20 years of a generation strategy, organizing health system efficient and equitable. So that, we need not count the stars in the sky years' together - needing bottom lining. Mentionable, that the bottom lining Mothers' criterion are: 1. Only one child but not acceptable more than two, 2. Age must be more than 20 years, 3. Total monthly income is less than 1500.00, 4. Women headed family priority, 5. Disabled, 6. Only the homesteads or living in another person's place and 7. No agricultural land, fish pond or livestock.
Hence practicing Maternity Allowance centered SAPNA Package a simple designed evidence based model shall change the whole scenario for leaving no one behind.
(AHM Nouman, CEO and Founder, Development Organization of the Rural Poor - DORP, Email: nouman@dorpbd.org)

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