For the past nine months Barry Doyle, Director of the Centre for Health Histories, has been involved in an exciting inter-disciplinary project with Dr Jim Reid (PI) from the School of Education, along with colleagues from the School of Art, Design and Architecture at the University of Huddersfield, academics at Sheffield Hallam, Bristol and Tampere (Finland) Universities, the University of Africa (Zambia) and University of Social Sciences and Humanities, Vietnam National University. The key aim of the project is to explore the opportunities to adapt the principle of the Finnish Maternity Package (The Baby Box) for use in two low and middle-income countries (Zambia and Vietnam). A related objective is to develop a historical research project exploring the cultural history of the baby box in Finland. This pilot project has been generously funded by the University of Huddersfield URF Global Challenges Research Fund Sandpit Events.
The Maternity Package was launched in Finland 80 years ago this year as a key strategy in the nation’s attempts to reduce a stubbornly high infant mortality rate (IMR). Like many of the nations that gained independence in the wake of the First World War, Finland saw social welfare in general, and health policies in particular, as a means to build legitimacy and strengthen national identity. The original maternity package was targeted at the most vulnerable mothers but ten years later was turned into a universal benefit for all women irrespective of income or the number of children they had borne. The box – which is big enough for a baby to sleep in – contains a selection of items designed to provide the parents with the basics for their new baby, including clothing, nappies, feeding aids and other simple essentials. Over the years the contents have changed, from a selection of life saving products to more fashion conscious items that reflect the aspirations of parents. Similarly, the form of the box has been altered, from a functional government ‘archive box’ to a brightly decorated receptacle with a design that changes each year. Although a cash benefit is available, even today around 95% of parents choose the box – though we don’t know if all, or even most, of the contents is used.
The maternity package idea is increasingly used across the world. In the UK the Scottish Government commenced a universal baby box scheme on the Finnish model in 2017. It has also been piloted in a number of English localities while research currently underway in Tampere has found sixty countries deploying a version of the package – though often the benefit is not universal nor is it necessarily the work of the government. Indeed, in poorer countries it is likely to be charities and other NGOs involved in delivering the service.
Our project began with a desk review of current policy and services in Zambia and Vietnam conducted by an intern, Nuala Doyle. This showed that Zambia had one of the highest IMRs in the world, with particular problems in rural areas and among the poorest groups in the cities. Vietnam has made huge strides in reducing IMR but problems remain among ethnic minority groups and especially in the highland areas in the north west of the country. This provided the base information for an initial exploratory workshop in Huddersfield in June 2018 which brought together the core team members (Reid, Doyle, Vahtikari, Swann, Mushibwe and Dinh) with colleagues from Art and Design (Dr Omar Huerta Cardoso), Human and Health Sciences (Dr Serena Bartys) and the Business School (Dr Julia Meaton) to explore how to develop the project. This led to the firming up of three work packages.
In package one we will be working with Dr Tanja Vahtikari of the History Faculty of the University of Tampere to develop a project on the cultural and emotional history of the use and meaning of the Baby Box in the Finnish context since the 1940s. This will include background research on Finland’s IMR crisis in the 1930s which ultimately led to the maternity package policy. It will be placed in an international context, exploring other nations’ responses including child welfare centres, health visitors and ‘social nursing’, mother and child feeding policies and the provision of layettes. However, its primary focus will be how people used and have remembered the baby box in Finland. To pursue this we will be working with Kela (The Social Insurance Institution of Finland) instituted in 1937 to pay pensions but now a cradle to grave organisation managing most of the state’s social welfare commitments, including the maternity package. We also aim to partner with the Finnish Literature Society, an organisation that, to a great extent, is the custodian of the nation’s cultural history and heritage. Through these two organisations we hope to uncover the material and emotional history of the boxes. We expect to submit applications for funding for this aspect of the project soon.
Zambian Baby Carrier
Our second work package is led by Professor David Swann and aims to adapt the maternity package for use in Zambia. Working with Professor Christine Mushibwe, Vice Chancellor of the University of Africa in Lusaka, we are exploring appropriate ways to deliver assistance to new parents, with a particular focus on very young mothers giving birth while living on the streets of Lusaka. Plans are still in their infancy, but David has been working with his Product Design students to develop prototype ideas that could be used in this context. Barry will be visiting Lusaka in November to discuss plans with Christine and to meet with NGOs, government and academics. More news to follow!
A Hmong Baby Carrier
The third package brings together Omar Huerta Cardoso and Linh Dihn to examine potential product designs for use among the highland populations of western Vietnam, the area of the country with the most intractable IMR problems. Jim Reid will be visiting Vietnam in the next few months to discuss prototype designs with state agencies and NGOs along with a range of potential academic partners.
This is a very exciting departure for the Centre for Health Histories. We are really looking forward to developing an interdisciplinary project that could have a significant impact on the life chances of women and children around the world. It also opens up opportunities to extend the international focus of the historical research we undertake into the history of health and healthcare in Finland and, it is hoped, Zambia, both nations with very limited historical healthcare research in English.