A baby box? Why not?

“Have you ever been to Fabella Hospital?” Health Secretary Enrique Ona asked me over lunch during a break at the recent “Women Deliver” conference in Kuala Lumpur.

When I shook my head, he leaned in: “Naku,  ma-iiyak  ka  talaga” (My goodness, you will really be moved to tears), he related, and when I said I had heard, and seen on TV, the conditions in Fabella, the country’s prime public maternity hospital, Ona shook his head. “You really need to see it for yourself.”

Apparently, reports and even videos of mothers and babies lying three-to-a-bed in a ward, cannot convey the full misery of the conditions in Fabella. The health secretary threw in stories of pregnant women in the final throes of pregnancy, who come flocking from all over Metro Manila and environs, parking themselves in hallways and even out on the sidewalk to make sure room was made for them when their time to deliver came.

Secretary Ona was actually making a pitch for the PPP (public-private partnership) schemes he was hatching for government hospitals, saying government funds were not enough to upgrade these facilities and would thus need private investments, plus experience, expertise and standards, if they were to better serve their primary publics.

But the secretary’s horror stories about Fabella could also partly explain why maternal and child deaths remain such stubborn problems for this country. Clearly, the health and safety of mothers and their babies don’t receive as much attention—and the requisite budget—they require and deserve. Second, despite the long waiting lines and crowded conditions at hospitals like Fabella, too many women still deliver their babies at home, under less-than ideal conditions, and in the hands of untrained and ill-prepared folk midwives (hilot).

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Consider then the situation of mothers and babies in Finland, one of the Nordic countries that have achieved “one of the world’s lowest infant mortality rates.”

Thanks to my cousin-in-law Loy Jimenez for passing on this item from the BBC, about the “maternity package” that the Finnish government sends to every pregnant woman “designed to give all children in Finland, no matter what background they’re from, an equal start in life.”

The article is titled “Why Finnish babies sleep in cardboard boxes” because the entire package comes in a box that is convertible into a crib, equipped as it is with a mattress and bedcovers. Each package, a tradition that dates back to the 1930s, contains body suits, a sleeping bag, outdoor gear, bathing products for the baby, as well as diapers (back to cloth diapers after a brief flirtation with disposable ones), bra pads, condoms, a picture book and a teething toy. The box used to contain baby bottles, too, but health authorities decided not to include them any more to encourage breast feeding.

“With the mattress in the bottom, the box becomes a baby’s first bed,” says the BBC report. “Many children, from all social backgrounds, have their first naps within the safety of the box’s four cardboard walls. Mothers have a choice between taking the box (and) a cash grant, currently set at 140 euros, but 95 percent opt for the box as it’s worth much more.”

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The “baby package” also serves to promote maternal health. Heidi Liesivesi, who works for the social insurance institution of Finland, said later legislation required that mothers-to-be, in order to get the grant or the maternity box, “had to visit a doctor or municipal pre-natal clinic before their fourth month of pregnancy.”

In the 1930s, when the box was first conceived, Finland was a poor country and infant mortality was high—65 out of every 1,000 babies died. It is in the low single digits now. But lack of funds did not prevent Finnish officials from prioritizing babies and their mothers. “The box provided mothers with what they needed to look after their baby,” notes the BBC, “but it also helped steer pregnant women into the arms of doctors and nurses of Finland’s nascent welfare state.”

At 75 years old, the BBC says, “the box is now an established part of the Finnish rite of passage towards motherhood, uniting generations of women.”

Mark Bosworth, who has two children with his Finnish partner Milla, says of receiving the box for his children: “This felt to me like evidence that someone cared, someone wanted our baby to have a good start in life. And now when I visit friends with young children it’s nice to see we share some common things. It strengthens that feeling that we are all in this together.”

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With the government hard put just getting pregnant Filipino women to get competent prenatal care in health centers and deliver in birth facilities attended by trained personnel, giving each and every pregnant woman a “maternity package” seems a distant possibility.

But why not? The State could be spending as much, if not more, for emergency obstetric services and emergency newborn care, services which could be avoided if we got pregnant women to go for prenatal visits regularly, deliver in accredited clinics or hospitals, and seek competent care for their newborns, in exchange for a package.

Besides which a “maternity package,” as that young father attests, would show parents that “someone cared, someone wanted our baby to have a good start in life.” Maybe receiving a box that could be used as a crib, filled with all the necessities, could drive home to parents the responsibility they have been given, and assure them that the State and the rest of the nation are alongside them in this greatest and most important endeavor.