English
フィンランドでは妊娠の予兆がある時点でまずネウボラへ健診に行きます。
ネウボラはどの自治体にもあり、社会保健省と各自治体が管轄。健診は無料で、妊娠期間中は6－11回、出産後も子どもが小学校に入学するまで定期的に通い、保健師からアドバイスをもらいます。ネウボラ(neuvola)という言葉は、アドバイス（neuvo）する場所という意味で、妊娠期から就学前までの子どもの健やかな成長・発達の支援はもちろん、母親、父親、きょうだい、家族全体の心身の健康サポートも目的とします。基本的には妊娠期から子どもが小学校にあがるまで、かかりつけの保健師(通称「ネウボラおばさん」)がサポートをするので、お互いに信頼関係が築きやすく、問題の早期発見、予防、早期支援につながっています。
母子の健診：妊娠期間中は6－11回、出産後も半年間は毎月、その後も小学校入学まで定期的に健診。妊娠期間中、医師の診察は通常2－3回で、それ以外の健診はネウボラの保健師がおこなう。分娩は病院。面談は30分〜1時間。
分娩をおこなう病院や専門家の紹介、予約、連携
両親学級
父親の育児参加推進
家庭訪問を通じた住環境、家庭環境の確認とアドバイス
母親、父親、兄弟、家族全体の医療的、精神的サポート
ワクチン注射
自治体、民間団体の子育て支援プログラムの情報提供
利用者のデータは50年間保存されるため、過去の履歴から親支援に役立てたり、医療機関との連携に活用したりと、効率的に子どもとその家族を支援します。最近では親の精神的支援、父親の子育て参加推進がネウボラの重要な役割となり、また児童の虐待や夫婦間DVの予防的支援の役割も担っています。
現在、このネウボラの日本版がいくつかの市町村で導入されています。
ネウボラは乳児死亡率・周産期死亡率が高かった1920年代に、安全な出産と母子の健康状態の向上を目指して主に小児科医や保健師らが取り組みはじめました。1944年、自治体に出産・子どもネウボラの設置が義務付けられ、現在はほぼ100％の親が利用しています。ベビーパッケージの受給の条件となったことも、ネウボラの利用率上昇に貢献しました。
ネウボラはワンストップで利用者の立場にたった切れ目のないサポートとサービスを提供し、丁寧な対話を通して信頼関係を築くことで、子どもと家族の心身の健康を追求します。互いにオープンに関わることで孤立せず、家庭と行政と地域社会が一体となった子育てが可能となり、予防的支援にも役立っています。
Japanese
In Finland women visit neuvola when they have signs of pregnancy for checkups. All municipalities have neuvola jointly operated with Ministry of Social Affairs and Health. The service is free for 6-11 visits during pregnancy and for regular visits before a child enters elementary school. Public health nurses provide mothers with advice. Neuvola literally means a place for advice (neuvo) and has objectives to support healthy growth and development of children from neonatal period to school entrance and wellness of whole family including mothers, fathers and siblings. Since the basic idea is to have a charge public health nurse (called Ms. Neuvola) supporting all through the service period, it is likely that a family and a nurse develops good and trusted relationship, allowing prevention, early detection of problems and early intervention.
Well mother and child checkups：They consist of six to eleven checkups during prenatal period, monthly checkups for half a year after birth and regular checkups till a child enters elementary school. During pregnancy, a doctor sees a mother twice or three times and a nurse sees her the rest of occasions. A checkup consultation usually lasts between 30 minutes to 1 hour. Baby is delivered at a hospital.
Referral to, appointment at and collaboration with a hospital and/or professionals engaged in child delivery
Parent education (both mothers and fathers)
Promotion of father’s engagement in child care
Monitoring of safe living and family environments and advice through home visit
Medical and mental support for family members
Vaccination
Information on childcare support programs offered by municipalities and private organizations
Since the service user data is kept for 50 years, efficient support of children and families can be offered based on the past history. The data is also utilized to collaborate with medical institutions. Recently mental support of parents and promotion of fathers’ engagement in childcare have become more important roles of neuvola than ever. It is because prevention of child abuse and/or DV between partners becomes critical. The concept of neuvola has been introduced in several municipalities in Japan.
Neuvola was introduced in 1920’s when infant mortality and perinatal mortality were high in Finland. Pediatricians and public health nurses took the initiative to facilitate safe delivery and to improve mother and child health. It became a mandate in 1944 that municipalities should establish neuvola for delivery and childcare. The fact that use of neuvola became a condition to receive a baby package has contributed to increasing use of neuvola.
Neuvola offers seamless support and service for the users with one point of contact. It offers opportunity for respectful dialogue to build trusted relationship and improves physical and mental health of children and families. Open interaction prevents social isolation of families, allows collaborative childcare by families, government and communities and promotes preventive support.