Best Fed Babies
“The Best Fed Babies Scheme was a great help to me, and my baby. Thanks to them I live a healthy lifestyle now.”
Key Contact: Elaine Little
Email: elaine@bnh-sip.co.uk
Address: Blantyre and North Hamilton Social Inclusion Partnership, David Dale House, 45 John Street, Blantyre , G72 0JG
Telephone No: 01698 527940
Web Address: www.localgossip.org
Best Fed Babies in a nutshell
Best Fed Babies (BFB) provides all expectant mums in the Social Inclusion Partnership (SIP) area with £50 vouchers each month, which can be used to purchase groceries in local ASDA stores. The vouchers are provided ante-natally for six months and continue for three months after the baby is born provided the mum is still breastfeeding.
The issues addressed
Best Fed Babies responds to the high incidence of low birth weight babies and low incidence of breastfeeding within the Blantyre & North Hamilton SIP area. Low birth weights are a key indicator of poverty.
The approach to the issues
The project was set up to provide a practical incentive for pregnant mums to eat healthily whilst pregnant and breastfeed their babies once born. The project works to promote the health of the baby and the capacity of the family to provide good quality nourishment and nurturing of the child. By supporting the family’s income and providing educational support, the project can have a practical and immediate impact on physical health and a long-term impact on the choices made by the family.
Evidence of success
Best Fed Babies has been very successful in working with its target group. Although it is a voluntary scheme its performance is notable. No young mum has refused the opportunity and to date there has been 100 per cent uptake, with over 800 mums taking part in the scheme. This shows that there is no perceived stigma of being ‘on vouchers’.
And it does work, a recent independent evaluation showed that Best Fed Babies resulted in:
A decrease in the incidence of low birth weight – from 11 per cent to 6 per cent
An increase in breastfeeding – from 12 per cent to 30 per cent
The project is having a significant impact on the health of the unborn child and breastfed baby. However it has also impacted on the whole family health. The evaluation highlighted that the eating habits of mums were influenced through participating in the project. As one respondent in the evaluation pointed out, the voucher “sort of mentally directs you to get extra fruit and vegetables.”
The patterns of food purchase showed that mums involved in the project were buying more food and buying food they would not previously bought. Some mums recorded that they were able to buy better quality food.
The health of the whole family is also influenced by the economic benefits of the project. It enabled families to manage their household budgets better at a time when budgets can be seriously stretched. However in families on lower incomes the vouchers were mainly seen as an essential addition to their food budget rather than releasing funds for other family items and Best Fed Babies can been seen to have the greatest impact within these families.
Testimonials
Recently profiled in the Social Justice Annual Report 2002 in the chapter Every Child Matters.
Midwives involved in project have been runners up with the Evening Times Local Hero’s Awards.
Setting up the project
The driving force for the establishment and smooth running of the project has been the Partnership Development Officer. In the initial stages she pulled together a short life steering group who worked on developing the project from an idea to a fully functioning community based service. The steering group involved a range of partners who are now ultimately involved in delivering the service on the ground. These included community midwives, health visitors and a community dietician.
This team worked closely with the staff at the local ASDA store and its Regional Director. The commitment of staff time from across the statutory services and from ASDA has been significant in ensuring that the project is well set up and well run. This project is unique in having a service that integrates a private sector organisation in such a way.
The short life steering group worked hard to ensure that the protocols and systems were well set up and appropriate. The input of the community midwives and health visitors was crucial. As Elaine says:
“We had the idea, but without the advice and knowledge of the health professionals we couldn’t have got the project operational”.
Part of this was ensuring that the paperwork was appropriate without being too time-consuming. It was important that the midwives and health visitors were motivated to return information to the SIP office on the mums taking part as this ensured that the mums received their vouchers on time.
Making sure that the project appealed to the young mums without stigmatising them was a highly important consideration for the steering group. Considerable effort was put into the appearance and content of the information pack used by the health team. The resulting pack markets the benefits of participation whilst containing other useful information on breastfeeding and healthy eating.
Integral to this was ensuring that the project was going to run smoothly within ASDA. Using the vouchers had to be straightforward, anonymous and care taken to ensure that they were spent on appropriate items, for example healthy food options. ASDA trained its staff in the handling of vouchers and identifying the items available with a discrete sticker, further limiting the stigma attached to using them. ASDA also contributed to the cost of producing the vouchers and took responsibility for redeeming the vouchers through a central Clearing House.
At times the length of time required to discuss and prepare the protocols and systems of operation was frustrating when the need to deliver the system was so evident. However, at the end of the day it only took six months to set up the project. Many projects take a lot longer to become established and this reflects the commitment of the partners involved.
Partnerships
On a day-to-day basis the project is delivered through a partnership approach, with each partner having a clearly defined role as follows:
The SIP manage the finances & operations; administer the vouchers; monitors and evaluates the process; co-ordinates multi-agency involvement; and works to the sustain project.
The midwives identify mums and get their consent; register mums and undertake the paperwork; and refer mums to the health visitor.
Health visitors inform the SIP office when the mum comes into caseload; monitor the feeding status of mum; and keep the SIP informed
ASDA
• Operate vouchers in-house:
• Train and manage staff
• Redeem cost of vouchers
Sustaining Best Fed Babies
Although it has produced significant benefits and is well established locally, Best Fed Babies is still a pilot project. At the moment it receives the following support every year:
NHS Lanarkshire £60,000
South Lanarkshire Council £10,000
Blantyre North Hamilton SIP £15,000
This does not include the significant gifts in kind which contribute to the running of the project. These include the commitment of the staff and the time they allocate to the running of the project e.g. community midwives, health visitors, ASDA Store Managers and other staff, SIP staff. ASDA also subsidises the project through facilitating its operation within the store, printing the vouchers and redeeming the cost of the vouchers.
The pilot phase and funding has been extended until 2006. SIP staff are currently looking at how they resource the project in the future. They are well aware of the constraints on statutory funding sources and appreciate that they cannot take any funding they have now for granted. However a recent evaluation demonstrated the health outcomes and benefits to the local population. This kind of project with clear targets and outcomes which relate directly to the NHS targets nationally and locally would support its campaign for funding from NHS sources.
Looking at how to support the project financially in the future has led the project to look at how it is currently run. Specifically, they are currently re-assessing the blanket coverage they provide for all mums within the SIP area and considering how they could replace this with an alternative system for targeting mums including means testing or a professional assessment leading to a referral.
This would reduce the cost of the service and ensure that it is targeted towards those who would most benefit. The disadvantage of this is that it would be more difficult to administer and more discriminating for the mums involved.
The SIP is also considering the possibility of funding from the private sector in the form of sponsorship and donations. Some areas of the project naturally lend themselves to this and build on the support already received from the private sector.
BFB is still learning and the staff involved are keen to structure this learning further. They would like to carry out further evaluative work in the future looking at many aspects of the scheme. At the moment they have hard information that the unborn child is benefiting through the increase in birth weights. The staff would welcome a longitudinal study on these children to assess if this translates into improved health in later life and what other factors may be influencing this. More information on the economic impact of the scheme would also be beneficial given the anti-poverty approach that the SIP is taking.
A final message
The mums involved in Best Fed Babies are the best advert for the scheme. As one summed up when taking part in the evaluation:
“Bought better messages, could save for my baby, had a better diet”
