Life-Saving Lullabies

In May 2019, President Edgar Lungu declared maternal and prenatal deaths in Zambia a Public Health emergency. The wider context of the challenge is framed by: • Zambia experiences one birth every 50 seconds. • 10-15 women per week lose their lives due to preventable causes. • 29% of adolescent girls are mothers or pregnant with their first child. • 25% attend the minimum number of antenatal visits. Our field work with St John's MCH teams in Chunga and Kayosha revealed: • a local birth rate of 75-85%. • mothers often sang gospel songs while waiting. • the health benefits of singing lullabies were not widely known.

Caregivers have sung traditional lullabies to their babies for over 4000 years with many transcending the generations as oral tradition. Ethnomusicological studies have shown that singing lullabies reduces prenatal stress and anxiety in mothers, promotes attachment and improves the cognitive development of the unborn child. Our ethnographic research with St John's Maternal Child Health teams (MCH) captured the lived experiences of mothers. We discovered the absence of literature due to the prohibitive cost of printing leaflets. We have co-created new lullaby songs to impart critical health information to support the transitioning of adolescents into motherhood- an adaptable, sustainable zero-cost intervention.

Adolescent mothers who have engaged with the Life-Saving Lullaby project are acquiring essential knowledge, new behaviours and inspirational messages: • New knowledge such as an awareness of the danger signs in pregnancy, importance of family planning, breastfeeding and ANC attendance for a safer pregnancy and delivery. • Have a safer pregnancy and delivery. • Reduce their stress and anxiety in their transitioning into motherhood. • Gain new skills to care and parent in new ways. • On the 6th March 2020, the team four coronavirus songs to up skill local communities prior to any confirmed Covid-19 cases in Lusaka/ Zambia

From the outset, our ambition has been to conceive a theoretical ‘zero-cost’ MCH solution that is responsive, sustainable, scalable and replicable. Established in 1877, The Order of St John has a global network of 250,000 volunteers who provide charitable work in 30 countries. Access to this network provides a realistic opportunity to scale Life-Saving Lullabies into neighbouring Orders such as Malawi and Kenya. Our long-term objective of is to support economic development and welfare of Zambia through improved population health and reduced health inequalities. The project has advocacy of the Zambian Ministry of Health: ‘For the community to continue to deliver at health facilities, they continue to need sensitisation, a new interventions such as the Life-Saving Lullabies initiative will not only breathe new life into our programme but will also bring new tools and skills for the volunteers and the organisation as a whole.’ Dr C Mbwili-Muleya, Public Health Specialist Furthermore, Howitt et al. (2012) articulates that global healthcare providers face identical challenges: rising demand, exponential cost and an insufficient trained professionals to meet demand. Consequently, the creation of frugal innovations for resourced-stressed environments in the Global South may have reciprocal benefit for providers in the Global North.