Baby boxes

The Problem

Improving provision of postnatal care and health information for mums in Nairobi

The pilot of Child.org's Baby Box pilot programme ran in 2018, our first programme to aim to keep newborn babies safer. Encouraging and improving access to postnatal care is key to protecting more mums and babies - our Baby Box programme was designed to do that for mums living in informal settlements in Nairobi.

The reports from the pilot were incredible. We're now seeking funding to scale the programme and find new ways to use the box to support mums.

Download the report (PDF)

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Goals

Child.org handed out 483 baby boxes to new mothers in informal settlements ("slums") in Nairobi, Kenya. Baby boxes have been provided to new mothers in Finland for over 75 years. In Finland, a box includes everything you need for a newborn baby, all contained in a box, which is used as a cot. This baby box concept is used all over the world, from USA to Scotland, India to Mexico! However, the possible impact of this approach had not been thoroughly tested in a low-income environment.

The Baby Box we distributed for our pilot programme was a much more simplified version than the packed box a mum would receive in Finland or Scotland. We were investigating whether the Box could encourage mothers to come back for their postnatal check-up after they had given birth. We would also find out if using the box as a cot would help the mother and the baby in the first three months of the baby’s life.

Our goals for the pilot programme were:

  • Encourage more mums to access postnatal care services
  • Provide new mums with safe sleeping information and a safe place for their baby to sleep

Our research and programme development aims were::

  • To initiate maternal health programming for Child.org
  • To learn about potential opportunities for Child.org to make a significant constructive contribution to maternal and neonatal health programming in Kenya
  • To assess the efficacy of the Baby Box as an incentive to access services from a government health facility in Kenya
  • To assess the potential impact and value of the Box itself in the Kenyan context to determine whether a Box could be a useful intervention for Kenyan mums and babies


The pilot programme saw an
81% increase
in women and babies accessing postnatal care services
We also found that
95% of mums
used the Box as a safe place for their baby to sleep

The Latest

Evidence

 

What are Baby Boxes?

A Baby Box is an inexpensive alternative to a crib made with cardboard material. The concept originated from Finland in the 1930s initially targeting women affected by poverty in order to increase attendance of antenatal care sessions and skilled delivery.

The programme in Finland was extremely popular and since the intervention was introduced, the infant mortality rate in Finland has decreased from 65/1000 to 2.4/1000 (BBC, 2013). Of course this success cannot solely be attributed to the Boxes; they were utilised as an engaging and useful intervention for mothers whilst further investments were made into maternal health which ultimately led to better health outcomes. That said, they have proved an effective vehicle through which to provide potentially life-saving equipment to new mothers, improved uptake of maternal health services and to disseminate vital health information.

Baby Boxes are now given as incentives in Scotland, some states in the U.S, parts of South Africa and Mexico among other countries, but there are few projects in developing countries, and where they are, little data is being collected on their efficacy in a low-income setting.

What did we want to learn through the pilot?

Prior to the start of the programme we knew that we wanted to assess the efficacy of the Box on access to vital maternal health services. We undertook significant research to assess three main areas of understanding before the pilot was designed:

1. Where were maternal services a particular challenge for women in Nairobi?

2. Which services were most in need of improvement?

3. What value could the box have in and of itself?

To read more about the evidence we used to design the programme and the evidence we collected through our surveys, download our pilot programme report, below.

Evidence based on:

Child.org Baby Box Pilot report (single pages view) Read article
Child.org Baby Box Pilot report (spreads view) Read article

Where we work

The extensive research we conducted when designing this programme indicated that the perfect place to test the efficacy of baby boxes was in certain areas of Nairobi, Kenya.

Here, there is a high proportion of mothers who are severely affected by poverty and living in urban informal settlements ("slums"). Infant morbidity rates are high, so it's an area that needs more protection for the health of newborns and their mums.

All our participants were mothers living in Kangemi and Westlands in Nairobi, where most mums fail to attend any postnatal care sessions at all. Our research indicated that this group could benefit hugely from some extra, specifically targeted support, particularly around the safety of a newborn.

Methodology

In our pilot programme, Child.org partnered with two health facilities to hand out Baby Boxes.

During their final antenatal visit to the clinic, mothers were given a little baby hat and a voucher to collect the full Box. They received the Box when they returned to the health clinic, with the voucher, for their postnatal mother and baby check-up. In this way we tested to find out whether the Box worked as an incentive for the mothers to come back for their postnatal care check-up. 

Data

As with all of Child.org’s programmes, the Baby Box Pilot needed to provide us with learning; about the effectiveness of our
work alongside a greater understanding of the needs and opportunities within maternal health programming.

The project design included multiple surveys to inform us of the situation in the region we identified, the perception of the interventions we presented and the change they made. We conducted three key surveys within a six month period: the baseline, the midterm and the end line evaluations.

We also engaged with the Monitoring and Evaluation department from the Nairobi County Government to help inform us of the Ministry of Health’s processes and to assist us in developing project indicators that aligned to the ministry’s own. This ensured we could share findings easily and contribute to the Ministry of Health’s own objectives in Maternal Health. The department also shared their knowledge and experience of the digital data collection tool used by development partners; Kobo Toolbox. This tool allows for easy data collection, sharing and analysis and has been adopted by the Child.org Programming Team across multiple programmes as a result.

Our surveys

Our surveys provided information on: 

  • Usefulness of the baby box as a cot, and its contents
  • If there is an increased usage of postnatal care services
  • If there is an increased understanding among mums of their own and their baby’s healthcare
  • If there is an increased understanding of their baby’s needs in the first three months of life
  • Whether there is a need for additional training for mothers

 

How you can help

For further information please don’t hesitate in getting in touch with the team to discuss the programme.
To request any of our research on Baby Boxes, please email programming@child.org.

 

As our portfolio of Maternal and Neonatal Health project portfolio grows, we’re looking for partners from a wide range of sectors and fields of expertise. If you think you could complement or add value to future MNH programming with us, please email our Head of Programming,
Martina Gant at marti@child.org.

 

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