Baby Box Pilot programme
The Baby Box Pilot was Child.org's first mother and newborn programme, and the first delivered direct by our Team in Nairobi. It was also funded by our first ever Christmas appeal - £6000 raised from individual donations from UK supporters and matched by the Bush Hospital Foundation.
Between June and December 2018, Child.org used that money to deliver 483 specially-designed Baby Boxes to mothers with newborn babies living in informal settlements ("Slums") in Nairobi County, Kenya. Each box included a mattress, two sheets, a cellular blanket and a mosquito net, and was printed with safe sleeping advice.
Using the baby boxes, Child.org wanted to:
- 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 results of this pilot were astounding.
More families accessed vital health services, and life threatening infections were identified earlier. Mums had a far better understanding of the safest way to put their baby to sleep. Our extensive surveys and the experience of running the programme also highlighted some key opportunities for Child.org to improve the lives of mums and babies in Kenya in the future. Here are some key successes:
- 96% of mothers accessed postnatal care services following the birth of their baby, compared to only 15% at baseline. The project saw an 81% increase in women and babies accessing life changing services.
- 21% of babies checked during their postnatal care consultation were diagnosed and treated for an umbilical cord infection. That’s 122 babies that were treated for a life threatening infection.
- Based on the improved access to postnatal care, that’s 98 babies that had their infection detected earlier (as a result of the mother going for postnatal care earlier in order to collect the Box.) Cord stump infection is one of the causes of blood infections such as sepsis and tetanus. These contribute to 17% of newborn deaths in Kenya.
- 95% of mothers that received the Box are using it as a place for their baby/babies to sleep either during the night or during the day.
- Parents are using the Boxes a lot more consistently during the day (93%) and only 2% are putting their baby to sleep in the Boxes at night. This is because co-sleeping is encouraged by medical professionals in Kenya to facilitate breastfeeding. Child.org did not discourage this practice in favour of the Boxes as a place to put baby to sleep at night. (For more information on why this is - download the report, available at child.org/babyboxes.)
- Before the programme, just 7% of mothers knew that the safest position for a baby to sleep is on their back. After the programme, 43% of mothers knew this.
- 80% of newborn babies were being exclusively breastfed
- The number of mothers and babies sleeping under a mosquito net at night increased from 71% to 80%
SURPRISING FACTS FROM THE REPORT
1. Child.org worked directly with the the Ministry of Health on this programme, and when we discovered gaps in provision of postnatal care - we ran our own training session with staff and volunteers. We also made sure we were using monitoring and evaluation tools and measurements that would work with the data used by the Ministry of Health, so we could share and compare data easily.
2. We initially registered 478 mothers, reserving 22 of our 500 boxes in case any of the mothers had multiple births. This turned out to be prudent because nine mothers in the project had twins. Only one of these mums had a scan, and her scan was inaccurate - so none of those mothers knew they were expecting more than one baby!
3. In an early focus group, we showed local young mums a prototype of the box and they were shocked, saying that it looked like a sanduku/coffin! To ensure mums wanted to collect and proudly use the box, it had to look like a beautiful crib for a baby, so we worked with illustrator Jaqueline Fryers to create beautiful boxes in a cost-effective black and white. The boxes were printed and manufactured in Kenya.
4. Mums told us that the boxes were most useful as a safe place to put the baby during the day, while they were working or cleaning up. Imagine the impact on your day-to-day life when you're given a safe place to put your baby down, in an environment where that wasn't possible before.
More information, and our full report, is available at child.org/babybox