In Kenya, one in every 26 children do not make it to their first birthday.
Child.org believe there is enormous potential to change that statistic. That's why we've decided to launch a brand new programme in 2018, to investigate ways to improve the prospects for mums and new babies in Nairobi, Kenya.
We will hand out 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!
The box we're giving to mums in the pilot programme is a much more simplified version at this stage. We're mostly investigating whether the box doubling as a cot will help the mother and the baby in the first three months of the baby’s life. We're also using this pilot to find out if the baby box encourages mothers to come back for their postnatal check-up after they have given birth.
This pilot programme is all about finding out the impact that the boxes can have in a city like Nairobi. Our goals for the pilot programme are:
- To measure the impact of the baby box on the mothers' lives in the first three months
- To better understand the needs of the mothers and their babies in the first three months after birth
- 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.
Baby hats in Nairobi
Posted on 04th Apr 2018
Why it's going to be hats first, boxes later.
A little nuggest of interest for our baby box supporters! Our programming team have been working very hard to design our brand new baby box programme, and they've devised a process for handing out the baby boxes that will help us find out if they are an effective incentive for women to attend postnatal care sessions.
We're working closely with health centres in Nairobi to run this process. At their final antenatal session at the care centre before baby arrives, each mum will receive a voucher and a little baby hat!
After the baby is born, if the mum returns to the centre for an postnatal check up, then she'll be able to swap her voucher for the complete box. This incentive gives mum a little extra reason to come back into the health centre and check up on her own health, and that of the baby.
Of course, increasing uptake of postnatal care is a big and complicated issue, and there are lots of reasons why attendance is poor. This research will just provide an extra little piece of the puzzle, to see if baby boxes are a sufficient incentive to make a difference. There's evidence from other areas and contexts that incentives may increase health service provision (this study, for example.) As baby boxes are popular with funders, it would be great to discover unexplored ways for them to be used to benefit the health of the families receiving them!
The photograph I've used here is actually a hat and voucher from our Happy Parenting Treat. Anne Liese tells me it's very similar to what we'll be handing out in Nairobi - but those haven't been ordered quite yet. I'll be very excited to share photographs of the real thing, including our gorgeous boxes, as soon as they arrive at the Nairobi office.
You can read more about the status and plan for our Baby Box programme on this page.
Doreen and Anne-Liese, from our programming team, have shared a photograph of some sample hats from a Kenyan supplier, below. Ordering them has been slightly complicated becuase we've asked to just order the more gener-neutral hat designs, but the supplier has told us we can only purchase a full selection of designs. The samples look cute though! My fave is the one that says Fish...
This programme is all about collecting evidence.
Does having a box to sleep in help to improve infant safety in the home for families living in urban settlements in Nairobi? Does the incentive of a beautiful baby box mean that more women attend postnatal appointments? These are the questions that this pilot will answer.
Where we work
The perfect place to test the efficacy of baby boxes is 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 are mothers living in Kangemi and Westlands in Nairobi, where most mums fails to attend any postnatal care sessions at all. Our research has indicated that this group could benefit hugely from some extra, specifically targeted support, particularly around the safety of a newborn.
If the baby boxes are effective, there is potential to scale up the programme in Kenya, and beyond! Already our team are in discussions about running a similar pilot in Sierra Leone and potentially Malawi.
In this pilot programme we will be partnering with two health facilities to hand out baby boxes to around 500 women.
During their final antenatal visit to the clinic, mothers will be given a little baby hat and a voucher to collect the full box. They will then receive the box when they return to the health clinic, with the voucher, for their postnatal mother and baby check-up. In this way we will be testing to find out whether the box works as an incentive for the mothers to come back for their postnatal care check-up.
We will monitor the mothers with a full survey three months after they deliver their baby. We will also be collecting additional observations and interviews with a small group of women one month after giving birth.
Our surveys will provide us with 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
If our pilot is successful, we're going to want to scale this programme up. In future boxes, we would love to include items that will impact the rates of the most common child diseases in Nairobi: diarrhoea, pneumonia, malaria and malnutrition. Already, our design of the pilot has highlighted an urgent need for better postnatal care for young mothers, so we would love to design ways to tackle this gap in provision too.
We do what works. If this programme proves that baby boxes are effective, we'll want to go big. We hope to issue over a thousand boxes within informal settlements around Nairobi over a period of two and a half years.
We'll need more funding to make that happen. Each baby box currently costs us around £14.