Baby Box: evaluation

6. Views on universal availability

Key findings

• Parents across all income groups were, in the main, supportive of the scheme’s universal availability as a way of promoting an equal start for all children in Scotland.
• Parents and health professionals reflected on the advantages of universal schemes in terms of reducing stigma and conveying benefits beyond the purely financial.
• When asked how the scheme could be improved, only 2% of parents mentioned any changes relating to means-testing or universality. However, during qualitative interviews with parents some questioned whether items were potentially being wasted by parents who did not need them.  Questions were also raised over whether providing boxes to parents on high incomes was necessarily the best use of scarce resources.

As discussed in Chapter 1, by making baby boxes universally available to all expectant parents in Scotland, it was intended that the scheme would contribute to a shared understanding of a society that values and supports all children. While this evaluation cannot definitively assess the extent to which the scheme has achieved this objective, it can assess whether the idea that the box contributes to every child having an equal start resonates with parents and health professionals, and whether they support the idea of the box as a universal gift to all new babies. These issues were addressed primarily in qualitative interviews with parents and health professionals, and in the survey of midwives, health visitors and family nurses.

Outcomes

• A shared understanding of a society that values and supports all children

Research Questions

• Has the Baby Box scheme changed people's perceptions about universal benefits?
• What is the workforce's understanding of the purpose of the Baby Box scheme?

Attitudes towards the universal availability of the baby box

Parents who took part in qualitative interviews for this evaluation were, on balance, supportive of baby boxes being available universally. Parents from across the income spectrum spontaneously mentioned the idea that the scheme helped contribute towards giving all children in Scotland an 'equal start', regardless of their household income, and suggested that the scheme conveyed that the Scottish Government cares about, and is working for, all families in Scotland. Parents who felt they would not normally qualify for similar schemes, as they were on high incomes or incomes above the threshold for any state benefits, reported feeling pleasantly surprised to have been offered a baby box, given that they were not usually eligible for government schemes.

Parents and health professionals suggested that the universal nature of the scheme might help to prevent stigma around taking up the box and using the items in it and thus ensure that those who might benefit most do actually take it up. The benefits of the box were also seen as extending beyond the financial and material – parents commented on the educational benefits (see Chapter 4), and its value in alleviating stress about what they needed to care for their baby by providing an essential starter kit for all new parents. Receiving the box was therefore seen as valuable even for families where the financial benefit of receiving the box might be less.

However, although parents and professionals both discussed the potential benefits of offering the scheme universally, there were nonetheless some reservations expressed in the qualitative research about the resource implications of this. This was reflected in an initial ambivalence among some parents with higher incomes and/or with older children about registering for the box. In spite of feeling they had benefited from receiving the box, they reported having initially felt unsure whether to take it up, on the basis that may not need it as much as others. Parents who participated in qualitative interviews also expressed some concerns that, in the context of limited resources, the scheme meant resources were not being targeted to those who most needed them, and that money was potentially being 'wasted'.

As noted, these views emerged primarily in more in-depth, qualitative interviews with parents. The quantitative survey of parents did not ask directly about their views on the universal availability of the baby box. However, when asked how the scheme could be improved only 2% mentioned any changes relating to means testing when asked if the scheme could be improved in any way – suggesting that concerns about the cost of providing baby boxes universally are not top of mind for most parents.

Midwives, health visitors and family nurses interviewed in the qualitative research who said they would prefer a more targeted approach felt the scheme was providing too much for families who they felt did not need it (as they already had, or could easily afford, what they needed themselves), and not enough for those who needed resources the most. As with parents, some concerns were expressed in the qualitative interviews about the perceived level of wastage, with items believed to be going unused.

Parents' suggestions for addressing potential issues around wastage included asking higher income parents to contribute to the cost of the box if they still wanted one or offering a 'stripped-down' version to those who already had children (and therefore might not need to receive every item again).^[36]

Question for consideration: Is it worth exploring the scope to offer an alternative, reduced version of the box and/or its contents to parents who already have children, or who might not feel they need everything that comes with the box?