First baby box surveys in!


Posted on
27th Aug 2018
by Amelia Stanley and Rona Hardie


Baby Rayne in her Baby Box.

We’ve now reached a new phase in the baby box pilot, where we are visiting mums in their homes one month after they have received the boxes to see how they’re being used. The first four follow-up surveys took place on Friday, and the Nairobi team were very pleased with the results.

It was great to hear that the four mothers surveyed had all gone for their postnatal check-ups (one of the initial aims of the baby box programme) and that three out of four of the mums had read the instructions on the lid of the box. Most of them mentioned that the mosquito net was a very important addition for the safety of the babies and they may not have got them if they were not provided.


Mum, Lilian, with baby Steven

From our point of view, it was very positive to see that the boxes were still being used and were still in good shape after a month. Fenicah, one of the first mums, said that she used the box a lot during the day, and occasionally at night, and that it was especially useful when she was working. Harriet, said that her baby Neema was happiest when he was in the box, and that he slept more soundly at night because the mosquito net stopped him from being bitten. Most of the women so far have found the box especially useful during the day when they’re working and cooking. Sarah, who has twins with a baby box each, finds the baby boxes useful because it means that the babies each have their own space, and said that the boxes help them sleep. 

Mum, Sarah, with her twins, Branice and Broiyne

As well as following up on how the boxes were being used, the surveys are also a good opportunity to check up on the health of the mums and babies. A few of the mums we visited were struggling with breastfeeding, or were anxious about how to continue when they returned to work. The Community Health Volunteers, Ammey and Chris, who came out with us, were able to use some of the training they’d received on the postnatal training day the day before to advise the mothers.

This is just a taster of the results of the baby box programme, but obviously lots more surveys are required before the definitive conclusions can be drawn. From the four mothers and five babies we met, we saw that the baby boxes are making a real difference to their lives.



Amelia and Rona are on a Charity Fast-Track placement in Nairobi with the Child.org programming team. They will learn about how our comms team collects and uses stories and other content from our programmes, while they collect valuable content for Child.org. They're also taking over the Child.org Instagram for two weeks! Follow their posts at instagram.com/childdotorg and see all thier blogs here.

Last day in the Nairobi office


Posted on
31st Aug 2018
by Amelia Stanley and Rona Hardie


It’s our last day in Nairobi, so we thought we’d share with you some of our experiences. We’ve spent the last two weeks using the mornings to visit clinics where mums were collecting baby boxes and visiting mothers’ homes for follow-up surveys on their use of the boxes. We worked alongside the programming activities to collect photos and stories. Most afternoons were spent organising our material, writing blogs and any other comms content.

We also tried something new for Child.org, collecting contact details of the mothers to report back on how their photos and stories are used. We thought it would be nice to also send the families some of the pictures taken so they had their own copies. So now every mum photographed will have either a digital or hard copy of their photo. 

The placement has been very rewarding and varied, and we both agree that we’ve loved every minute (even spending an evening in hospital when Meli fell in a ditch). We have had such great support from the Child.org Nairobi team and it’s been so fun to go out in the field with Faith and Doreen and get to know them properly. Despite their reluctance, we have also been able to take photos and videos of the Child.org Nairobi team here to share more about the work they are doing.

 

Silvia and Leonard insisted that their chicken be included in the photo ...and eventually Rona too

We have been able to collect 16 in-depth stories, the photos of 38 mums and 33 Team Mum tips, that will help the communications team with the Team Mum funding application that has been sent off to the Department for International Development. We are really excited about this campaign and hope our content will help launch it. Find out more about the appeal here.
 

We’ve loved collecting empowering and happy photos of these incredible mums and their invariably cute babies (and the occasional chicken). We have been so lucky to hear so many people’s stories, giving us a real insight into life here in Kenya and especially Nairobi. We are sure you will be seeing more content from us over the next few months, including the amazing Tyson’s story. Tyson volunteers in the Child.org Nairobi office helping Carrie with Ride Africa but has a long history with Child.org. 

 

 

Amelia and Community Health Volunteer, Ammey enjoying Mendazi while out in the field for a home visit.

Finally, a bit about Kenyan culture and most importantly food! We’ve become hooked on Mendazi (pictured above), Kenyan deep fried cakes which we’ll be missing on our return to the UK. We have also decided we will be taking our ugali making skills back home with us. We’ve had a chance to learn a few words of Swahili, which has made our experience even more worthwhile because we were able to converse more with the mothers. Our attempts at pronunciation have given us a way to make them laugh whilst taking photos. It has also been really interesting to hear different perspectives and views on the politics and social system here, with the last election being only last year. 

To sum up, our Charity Fast-Track content and communications placement in Nairobi has been an incredible and worthwhile experience; we feel as though we’ve gathered some really useful communications material and spoken to some amazing women, as well as very much enjoying ourselves! Faith and Dorreen wanted to add, "The last two weeks with you guys have been amazing, time flew by very fast, we hope to see you again." 

TOP PHOTO: In the Child.org Nairobi Office: Amelia, Tyson, Faith, Rona, Doreen and Marti.

 

To find out more about this placement, you can read all of Amelia and Rona's blogs here. If you want to train yourself for a fantastic charity career, you should apply for Charity Fast-Track 2019! Find details here on the Utopy website.

Training day to improve postnatal care for baby box goals


Posted on
24th Aug 2018
by Amelia Stanley and Rona Hardie


In an exciting development for our Baby Box programme, on Thursday Child.org organised a postnatal training day in collaboration with the Ministry of Health.

 

In Kenya, only 51% of mothers and 36% of newborns receive postnatal care within the first 48 hours of birth. One of the goals of Child.org's baby box programme is “To find out if the baby box is a successful incentive for mothers to access postnatal care services in a health facility with the help of a skilled health professional." While they've been handing out the boxes and conducting the research, the Child.org Nairobi team have noticed an added difficultly in providing more mums with postnatal care. We realised that when mothers arrive at health clinics for postnatal check-ups and to receive their baby boxes, health professionals are prioritising pregnant women or those in labour instead of mothers with newborns.

The team realised that in order for the baby box pilot to be effective, we needed to offer some additional training for nurses and Community Health Volunteers (CHVs). The day's session has been designed to improve postnatal care by delivering in depth training on how to help mothers with breastfeeding and how to identify warning signs for mothers and babies, as well as providing more information about the baby box programme. This epitomises Child.org’s motto of We Do What Works.


What happened during the day?

The programming team were so pleased that Dorcas, Senior Nursing Officer of Nairobi City Council, was able to attend to deliver sessions on general postnatal care for the nurses and community health volunteers (CHVs). Dorcas recently went to a three day national training course on postnatal care, so it was great for her to have the opportunity to cascade her knowledge so soon! Jo Aubrey, a lactation nurse and breastfeeding expert facilitated a breastfeeding session. Eight nurses and seven CHVs were able to attend and they were split up so that content could be tailored to their specific roles. 

Dorcas’ session with the nurses and CHVs provided information on what to look out for in mothers and babies after delivery. She also tested them on their knowledge, which made the session more interactive. Dorcas’ justified that postnatal care is important because it provides “a continuum of care” from pregnancy through to maternal and neonatal health.

Jo’s sessions were designed to train nurses and CHVs in how best to support breastfeeding mothers, through a combination of discussion, videos and role playing to provide information for mothers on topics such as latching and expressing breast milk. The interactive session was clearly very useful, as several participants said the information on effective breastfeeding was one of the most important things they got out of the day. 

 

Why was the day a success?

John*, one of the nurses said that one of the most important things he learnt was that postnatal care should last for at least six weeks. Previously he thought postnatal care only lasted for two weeks. This was amazing to hear as it is a really important outcome from the training. Extended postnatal care means more women and babies will receive healthcare and potentially life-saving treatment. 

It was also great to see Child.org’s new nurse volunteer interns, Herine and Teresiah, at the training day after only being interviewed the day before! Herine really enjoyed the session as she is keen to specialise in maternal health and has her own 4 month old baby. She told us she learnt, “the importance of attachment during breastfeeding so that the baby feeds properly.”

The training day gave Child.org more insight into the realities of maternal care in the clinics. Nurses and CHVs told us about their real experiences in clinic. During the breastfeeding session, the nurses said that most mums do breastfeed and it is normally a neighbour or a family member rather than a healthcare professional who shows them techniques. Jo’s session was able to provide information to show mothers how to effectively and safely breastfeed.


Several of the nurses and CHVs were keen to give us feedback and tell us how important the session was for them. Boaz one of the nurses working in Westlands clinic where Child.org gives out baby boxes said, “Very impressive presentations. Now we know the services we were giving were not completed without the important postnatal care.” 

The CHVs agreed that after the training they will be more observant and ask mothers more questions to identify warning signs. Chris, a CHV at Kangemi Health Centre, said the training was especially worthwhile and useful in providing information on how to check the breathing rate of a baby, and other signs that urgent medical treatment is required. Margaret, a CHV coordinator, was particularly impressed by the information on baby boxes as it will now be easy to explain to mothers about how they might use the box. 

Phoebe, who is the Ministry of Health appointed coordinator for CHVs in Westlands and Kangemi clinics, had a lot of praise for the training. She highlighted that she would like more Community Health Volunteers to undergo similar training so that, in her words, “more lives can be saved”. 


Amelia and Rona are on a Charity Fast-Track placement in Nairobi with the Child.org programming team. They will learn about how our comms team collects and uses stories and other content from our programmes, while they collect valuable content for Child.org. They're also taking over the Child.org Instagram for two weeks! Follow their posts at instagram.com/childdotorg and see all thier blogs here.

 

Kicking off our Charity Fast-Track content and communications placement


Posted on
21st Aug 2018
by Amelia Stanley and Rona Hardie


We’ve landed! On Sunday for Rona, and early Monday morning for Amelia we arrived in Nairobi to start our placement in Content and Communications with the Kenyan Child.org team. We’ll be gathering communications material for the Baby Box programme and the upcoming Team Mum campaign. Given that we’re staying in a flat about three minutes from the office you’d think it would be quite a smooth commute on Monday morning - you’d be wrong. We ended up going to the wrong office building and turning up late for our first day, just getting into the culture of ‘Kenyan Time’.
 

We met the lovely Marti, Doreen and Faith, who briefed us on our plan for the next two weeks and explained more about Child.org’s programming work in Nairobi, and Kenya more broadly. Our time here will be spent in a combination of visiting clinics where the baby boxes are handed out and postnatal checks take place, and going out into communities with Doreen and Faith while they conduct follow-up surveys.  

 

Part of our first afternoon was also spent sourcing Kenyan sim cards so we can stay in touch on the go, and exploring the local supermarket. We returned to our flat with a selection of Kenyan delicacies to try, including maize flour to make ugali, a traditional Kenyan carbohydrate based dish that goes with stew or curry.  With the help of our bemused airbnb host, Jane, we assembled our first Kenyan dish and enjoyed it while watching the August Charity Fast-Track webinar (what else?).

 

Today was a public holiday so we had the chance to explore Nairobi and get to know a bit more about the city and its culture. Evans, who drives all the Nairobi Child.org staff around, was our tour guide for the day. We visited the top attractions in Nairobi, which include the giraffe centre and the baby elephant orphanage! It was amazing to get so up close and personal with our new friend Stacey the giraffe and 18 baby elephants. Whilst driving to our next location, the Kitengela glass centre, we stumbled upon a herd of zebras on the side of the road (when we say road, more of a dirt track). At the glass centre we crossed a thin wire bridge across a large ravine, something we’d talked to Marti about but she’d been too nervous to do herself!

 

 

 

Now we’ve had the chance to acclimatise a bit, we are really excited to get stuck in and start gathering content from the woman at the clinic tomorrow. We’ll talk to them about their stories and experience with the baby boxes and collect quotes for our Team Mum appeal.



Amelia and Rona are on a Charity Fast-Track placement in Nairobi with the Child.org programming team. They will learn about how our comms team collects and uses stories and other content from our programmes, while they collect valuable content for Child.org. They're also taking over the Child.org Instagram for two weeks! Follow their posts at instagram.com/childdotorg and see all thier blogs here.

 

What we've learned from our Baby Box baseline survey


Posted on
07th Aug 2018
by Martina Gant


This is my first month back in the Nairobi office since having my baby in January. My first day started with a meeting with Mike from Nairobi County Council, who came to talk the team through the baseline data from the baby box pilot.

The baseline is an in-depth survey we conducted right at the start of a programme - to find out more about what the situation is like for families before we provide them with a box. The data will help us see the impact of the pilot more clearly, and it also helps us identify other opportunities - other problems we can solve to keep babies safer.

It was an enlightening day and incredibly helpful for me to catch up with what we’ve learned by speaking to women directly. I wanted to share some of our findings because there is some surprising and frankly quite shocking content that will inform our activities from here. 

What the team did

This is the summary of the baseline collection activity in numbers:

  • 200 mothers interviewed
  • 4 research assistants
  • 5 different areas in Westlands, Nairobi
  • 8 days
  • 8 ministry of health staff trained by the Child.org team
  • 1 digital platform used to collect and summarise the data

What we learned 

We asked the women a lot of questions so we learned a great deal, but the most interesting findings were around safe sleeping practices and access to health information. 

Safe Sleeping

The boxes are designed as an incentive for women to access postnatal care from their local health facilities.

What the pilot is also helping us to achieve is a better understanding of safe sleeping practices. UK readers might recognise safe sleeping campaigns, designed to reduce Sudden Infant Death Syndrome (SIDS), sometimes referred to as "cot death". We know that education around safe sleeping in the UK reduced SIDS by half between 1989 and 1992 during the ‘Back to Sleep’ campaign but in Kenya there’s very little information on SIDS or how much of a problem unsafe sleeping practices are for small babies.

From our pilot, we’ve learned that there is a significant gap in knowledge about how to keep your baby safe while they sleep. 

92% of women told us that they bedshare with their babies. Only 51% of the women interviewed had received any information about how to safely co-sleep. We wanted to check whether women could correctly answer some questions about safe sleeping and shockingly only 7% told us that the safest way to put a baby to sleep is on its back. 

21% of mothers put their baby to sleep in a bed with a parent (them or their partner) who had been drinking, meaning a significant number of babies face an increased risk when they go to sleep at night.

Health Information 

43% of women told us that it’s not easy to find out info on their family’s health. We saw strong correlations with location here: unsurprisingly where there were health centres that provided decent services, the rate was much higher. Using a digital platform with geo-location analysis will help us to identify where the most significant gaps and where Child.org can focus on supporting mothers. 

Less than 1% said they access health information from Community Health Volunteers (CHVs). This is hugely significant - CHVs are Ministry of Health positions that community members volunteer in. They are supposed to be trained and supplied with information, in order to help bridge the gap between the community and health facilities. They are vital for encouraging women to access the healthcare they need, and are entitled to, during pregnancy and beyond. 

In a similar vein, almost 30% of the new mothers we spoke to hadn’t received the Antenatal Care Booklet they’re supposed to get on their first visit to hospital. This is the equivalent of the UK's maternity notes and red book for babies, combined into one accessible booklet by the Kenyan government. It’s a great resource, full of content to assist mothers in understanding what danger signs to look out for in pregnancy, breastfeeding and their child’s growth and development. 

According to Mike, there is a problem with the distribution of these booklets from the ministry to the health centres, causing long delays with restocking when a facility runs out. This is a huge waste of a great resource and the gap can be plugged very simply by ensuring that Community Health Volunteers have a constant stock, so that every woman we work with has access to the booklet.

Other notable gaps in health education are that only 5% of women said they have access to information on water and sanitation. Our researchers witnessed people washing clothes next to open sewers so some simple health information could have a significant impact on the spread of disease in these regions. Also, under 1% of women had received information on nutrition and 27% hadn’t received any advice or education on family planning. 

How it’s going to impact what we do

As we’ve said, the key driver of the Baby Box pilot is to assess the impact of the box as an incentive to improving access to postnatal care. We’re learning about this over the course of the pilot but we’re also learning about what other gaps and problems there are that we’re already beginning to help solve, or how we might tweak our activities to plug gaps we’ve discovered. 

For example, Child.org are already providing safe sleeping information on the boxes themselves but we’re talking with the ministry of health about how we can arm Community Health Volunteers with more health information to disseminate to the women they meet.

Collecting valuable data is a key part of our work and the Baby Box baseline is a prime example of how knowing our audience can shape and improve our work. Funding such studies ensures that we’re developing the best possible solutions to real problems.

I’m so excited to be back in the office and working on this project again. In an environment where the international recommendation of putting a baby to bed in a crib next to mum isn’t feasible, because access to a crib is unobtainable, a baby box offers a mum a safe alternative to bedsharing. Perhaps most important though, is the information provided alongside the box - the knowledge of how to keep mum and baby safe and well.

 

You can read more about our Baby Box programme here. If you like the way Child.org do things, please consider supporting us with a donation, so we can reach more mums and babies. We'll use your donation to do what works. Thank you!

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