About the Project

The project was developed based on research findings, including a literature review, scanning existing baby box programs, and informed by previous community engagement with parents and families in the NWT.

A pilot project of baby boxes took place in the Northwest Territories from 2016-2020 in partnership with the Inuvialuit Regional Corporation, Yellowknives Dene First Nations, Hay River Health and Social Services Authority, and Northwest Territories Health and Social Services Authority – Fort Smith Region.

Based on feedback from parents and caregivers on the pilot project, the Baby Bundle was refined to better meet their needs.

Issue

To ensure the well-being and health of the baby, it is imperative that the safety and developmental needs of the newborn are met. The early years are both the most critical and vulnerable time in a child’s life. When families are not supported with basic needs to provide for and nurture their infant/child, it can have significant impacts on early childhood health and development.

The project seeks to address gaps in perinatal, infant, and child health outcomes, encourage access and uptake of health and community services, and provide every family with equitable access to essential and developmentally appropriate items needed in the first six months of life.

What we did

We used a social innovation approach, the Baby Bundle, to address a complex social issue. The design, development, and implementation of the Baby Bundle were inspired by:

A new way of doing things (a new program) that seeks to address a complex social problem and ultimately transform the system that created the problem in the first place (Waterloo Institute for Social Innovation)
“Innovation isn’t always about creating new things. [Indigenous] Innovation sometimes means looking back at our old ways and bringing them forward to a new situation” (Senator Murray Sinclair). Communities, Elders, and Knowledge Holders have shared what is important to raise a child well. This program is informed by that knowledge.

How we did it

Literature Review – Key Learning

Emerging evidence globally indicates that baby box programs can promote the wellbeing of babies and parents, ease financial and parenting burden, increase the rates of uptake and access to antenatal care, and provide psychosocial support for the birthing parent during the vulnerable time of childbirth.

Jurisdictional Scan of Baby Box Programs – Key Learning

It is important the design and delivery of Baby Box programs consider the following factors:

Local context and cultural relevancy
Defining desired outcomes and establishing a robust monitoring and evaluation plan
Integrating the Baby Box within the existing health and social services system, encouraging access to perinatal programs
Includes discussion and education with health care workers around the items included in the Baby Box and how/why they can support infant and caregiver health and well-being
Evidence-based selection of items and products with careful attention to ethical, environmental, and social impacts

Community Engagement

A renewal of the Healthy Family Program began in 2018 based on a strong partnership between the Department of Health and Social Services and Hotıì ts'eeda: NWT SPOR Support Unit.

The renewal process involved extensive community engagement with over 180 staff, families, parents, and caregivers from across the Northwest Territories. The community engagement process provided an understanding of community priorities for activities and services for parents/caregivers, as voiced by families with young children and staff who work with families in their communities.

The engagement sought to answer the following questions: 1. What is needed to raise a child well? 2. What are the challenges and barriers faced by families and communities?

The themes from family sharing circles and staff workshops included:

Overall, families want opportunities to grow and learn for both themselves and their children.
Parents in all communities prioritized inclusive and accessible programs for parents. Programs should be inclusive of the age of children, cultural background, of gender – open to all family members of all communities who care for young children. They should also be accessible and held at times that accommodate working families.
Families prioritized support for meeting basic needs, such as food hampers and basic supplies for babies.

The engagement finding informed the design of the Baby Bundle Program, where the program seeks to build on the strengths of communities in supporting children and families, including:

Belonging and identity within the community;
Connection to Indigenous culture, language, and way of life; and,
Community-based and family-friendly programs and services

Piloting and Prototyping

A pilot project of baby boxes took place in the NWT from 2016-2020 in partnership with the Inuvialuit Regional Corporation, Yellowknives Dene First Nations, Hay River Health and Social Services Authority, and Northwest Territories Health and Social Services Authority – Fort Smith Region.

Change Management and Staff Training

The Baby Bundle is intended to be embedded in a family-centered and relationship-based approach to perinatal care. It is delivered as part of a discussion with families that supports shared decision-making. This approach requires thoughtful change management and staff training that takes place in anticipation of the program launch.

A robust change management approach was undertaken to facilitate program awareness, and encourage staff engagement and confidence in delivering the Baby Bundles Program to families.

Health and social services staff from across the territory were involved in the co-design, review and validation of the Baby Bundle and its contents. In-person and virtual meetings have taken place with key leads in each region of the NWT throughout the project planning and implementation phases. This was critical to allow for distributed championing of this work among communities and regions.

Staff awareness and training events took place during the Summer of 2022 and are ongoing. They included the following audiences: senior leadership, administrators, Community Health Nurses, Midwives, Physicians, Health Family Program Staff, and Public Health.

Steps to embed this within the system of care before, during, and after pregnancy are ongoing and connections with community-based programs are being explored.

Impact

The Baby Bundle Program initiative is our commitment to developing a relationship-based and family-centered approach to perinatal care services, where families are part of the shared decision-making.

The Baby Bundle is an entry point and forms a strong beginning for building relationships of trust between caregivers and Health and Social Services staff as part of striving for a culturally safe health and social services system.

The Baby Bundle is an education and health promotion tool. As a program it seeks to act as an entry point to accessing community health services during pregnancy and after the baby arrives and forms a strong beginning for building relationships of trust between caregivers and Health and Social Services staff as part of striving for a culturally safe health and social services system.

The prenatal period is an ideal time to provide expectant parents and caregivers with information and resources to prepare for a child.

Early and regular prenatal care is important to prevent pregnancy complications, support the health of parents and infants, and is recognized as a critical part of early childhood development and lifelong health.

The Baby Bundle aligns with a community vision where:

Pregnancy and birth are celebrated and respected as integral to identity, cultural continuity and connection to place.
Families have access to integrated, culturally safe, and family-centered perinatal and early childhood programs and services.
Caregivers are cared for by the community and provided with information and resources to support child development and wellbeing that are relevant to their lives, experiences, and Indigenous world views.
All children are nurtured, through environments and responsive relationships, to become strong and capable people.

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Baby Bundle