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zoom RSS 子どもに最も高いプライオリティをあたえる社会/スウェーデン

<<   作成日時 : 2008/01/26 00:13   >>

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 スウェーデンは5才未満の子どもの死亡率が世界で最も低い。子ども1000人に対して3人で、英国の6、世界最高の死亡率のシエラレオーネの270にくらべて低い。出産での母体死亡率は、1/17,400だが、英国は1/8,200、シエラレオーネは1/8である。ストックホルムでは産科医2,小児科医1,麻酔科医1が待機し、監視機器も充実している。未熟児に対してはNICUでは2人のスタッフが担当する。
 スウェーデンは世界で最も医療スタッフの充実した国である。10万人当たりの医師数は320人であり、英国は230人、シエラレオーネは2人である。
 NICUに隣接して家族の部屋があり、両親のベッドが用意されているので退院までずっと病院に住んでいた。子どもが病気なので退院するまで有給休暇が取れる。ほぼ100%病院出産であり、自宅出産は推奨されない。出産のための施設は大きく、近代的であるが、内容は単なる建物以上のものがある。
 スウェーデン社会では、両親と小さな子どもに最も高いプライオリティが与えられている。両親は子どもの出生後合計480日間の休暇をとり、給与の80%を受け取れるが、多くの雇用者は90%以上支給する。両親それぞれ60日取得義務があるが、残り360日をどのようにとるかは両親に任されていて、8才になるまで有効である。
生後18ヶ月までは両親のどちらかが家にいて、18ヶ月からは保育所に入れる。スウェーデン社会には大変統一感があり、貧富の差は大きくない。父親が6ヶ月育児休暇を取ることが普通になっている。雇用者にとっては大きな負担になっているはずだが、親としてはスウェーデンは子どもを持つには完璧な場所に見える。
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Last Updated: Tuesday, 22 January 2008, 14:19 GMT
Children are Sweden's top priority
http://news.bbc.co.uk/2/hi/health/7202694.stm

画像Asa Andersson, Per and Viktor
Asa and her family received high-quality care

BBC medical correspondent Fergus Walsh has been to Sweden which has the lowest level of child mortality in the world.

In delivery suite number 11 at the Karolinska University hospital, Asa Andersson is in the middle of labour, her husband Per at her side along with a highly trained midwife.
At quarter to midnight, Asa gives birth to a healthy baby boy. Everything went well.
But had there been complications doctors and a fully equipped operating theatre were just down the corridor.
This is childbirth in Sweden, the safest place in the world to be born - fewer children die here under the age of five than in any other country.
For Sweden, the figure is three deaths per 1,000 children, compared to six per 1,000 in the UK, and 270 per 1,000 in Sierra Leone, which has the highest child mortality rate in the world.
I was also present at a Caesarean delivery, just as I had been in Sierra Leone only days before.
Expert staff
In Sierra Leone the operating theatre was almost bare: there were no monitors to check the mother's vital signs and just one doctor.
In Stockholm there were two specialist obstetricians, a paediatrician on standby and an anaesthetist.
Caesarean in Stockholm
Facilities are comprehensive and clean
Add to that a wealth of monitoring equipment and it's easy to see why childbirth in Sweden is so much safer.
One in 17,400 mothers die in childbirth, compared to one in eight in Sierra Leone and one in 8,200 in the UK.
If an infant is premature then it can be taken to the neonatal care unit where there are two staff to every cot.
Sweden has one of the best staffed health services in the world.
It has 320 doctors per 100,000 people compared to two doctors per 100,000 people in Sierra Leone. The UK has 230 doctors per 100,000 population.
Premature birth
I visited Louisa and Matias Verner and their son Gasper.
Gasper had been born three months premature weighing just 830g.

Louisa and Matias
They not only looked after our son, they cared for us too
Matias Verner

Sierra Leone's challenge
Now he was nearly 2500g and in a few days, the family would be going home.
The family room was attached to the special care unit, and Gasper was monitored in his cot.
The parents both had beds and had been living at the hospital throughout.
Matias told me that he was having paid time off work because his son was sick - his paternal paid leave would not start until Gasper went home.
Both parents praised the medical staff and said a team of more than a dozen had been on hand when Gasper was born.
"They not only looked after our son, they cared for us too," Matias said.
All-round care
So what are the factors which set Sweden apart from other developed countries in terms of child safety?
Medical staff at the hospital told me that the quality of ante-natal and post-natal care was very high.
Almost 100% of mothers give birth in hospital - home births are not encouraged.
The maternity units are large and modern.
Mothers at a child clinic in Stockholm
Services are geared to new families
But it is about more than just buildings and staff. It has something to do with Swedish society and the way parents and small children are given the highest priority.
Take for example, parental leave.
Swedish parents get 480 days off after the birth of a child. Most of it is on 80% of normal pay, but many employers top that up to 90%.
Each parent must take 60 days, but how they divide the remaining 360 is up to them.
And the time off is valid until the child is eight years old.
I went back to see Asa and Par the day after their son was born.
They had been transferred to a family post-natal room (again with beds for mother and father) and Asa was cradling their son, Viktor in her arms.
Subsidised nurseries
Asa told me she would take the first few months off: "I'll be breast feeding, which obviously Per can't help with, but after seven months then he will step in and take some time off.
"One of us will be at home for around 18 months".
Per added: "It's very important to be there when he is young, so that he has a role model. I'd miss a lot if I wasn't there."
When Viktor is around 18 months old he'll go into one of the many state-subsidised nurseries.
The fees are capped, to make them affordable to everyone.
One of the senior obstetricians at the Karolinska University Hospital said there was something special about Sweden which made it a great place for families: "Swedish society is very cohesive and there isn't a huge gap between rich and poor.
"Society has given a lot of support for parents for decades."
I went to the Ekens BVC child health clinic in Stockholm to see some new parents being given a talk on safety in the home.
Whilst there I met Anthony Hill, his wife Lena and their son Finlay, who was there for his MMR jab.
'Easy for parents'
Anthony is British and used to live in London. The family have been in Sweden for four years and now have two young children.
"Everything is easy here for parents," Anthony said.
"My brother has two children in England and there's a huge contrast between the ordered, logical system here regarding immunisations and child health checks and the one in Britain, where no-one seems to know what is happening.
"My brother got about 10 days off when his children were born.
"Here you get to share a year and a half.
"People in England can't believe it when I tell them.
"You often see men with pushchairs in the street and it's common for fathers to take six months off."
After having three children myself in the UK, I looked with admiration and a little envy at the lot of fathers in Sweden.
I have no doubt that many employers find it an incredible burden having to do without staff for months on end.
But as a parent, Sweden seems the perfect place to have children.

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