Health

Medicine

Fieldwork

Child mortality

When Per and Ulla Ashorn first moved to Malawi in south-eastern Africa in 1993, almost one in four children died in the country before reaching the age of five.

Now, the under-five mortality rate in Malawi is only about one-fifth of this, at five per cent.

“Development is slow, and it cannot be said that it was only us who did it, but we have done our fair share,” Per Ashorn says.

Per Ashorn is professor of paediatrics at Tampere University and director of the Tampere Center for Child Health Research. Docent Ulla Ashorn, Per’s wife, is a senior research fellow in the same Global Health Research Group. Together, they work to promote the health of children in the world’s least developed countries.

If you ask the Ashorns what the world’s biggest health problem is, they will not say cancer or cardiovascular disease. To them, the biggest problem is poverty.

“The most important requirement for good health is peace. If we could eradicate wars and poverty, people’s health would improve enormously,” Per Ashorn points out.

<h2>Second home in Malawi</h2>

Due to COVID-19, we are conducting this interview via Zoom, even though the Ashorns are currently in Tampere.

In a small town in Malawi, a little house awaits the Ashorns. This is where they live and conduct research with a team of about a dozen research assistants. There is also a car and a couple of suitcases of personal belongings, such as kitchen utensils and lamps in case of a power failure.

Why is Malawi the place where you want to return time after time?

“Malawi has become our second home because our research station and friends are there. And of course, the warmth of Africa and friendly people are also important,” Ulla Ashorn says.

However, perhaps the main reason is that the Ashorns already have a long research history in Malawi, which makes it easier to answer some of the research questions using population cohorts than to look for answers elsewhere.

“However, we have recently done research collaborations with research institutes in other African and Asian countries as well,” Per Ashorn adds.

<h2>Cultural differences and misconceptions</h2>

There are big and important scientific questions to be answered. The Ashorns’ tasks include solving them, but they must also overcome everyday snags and practical difficulties.

For example, at one point there was no petrol in Malawi for two years. The research station also lacked electricity at the time, but the biological samples still needed cold storage, meaning that petrol had to be procured in one way or another for the generator that produced electricity for the research station.

At the Lungwena clinic in Malawi, the Ashorns’ research team member Data Monitor Martin Ndelemani measures the development of a 4-year-old.

Smaller problems constantly occur: the bicycles of the research assistants must be repaired, cars break down and internet connections stop working. Cultural differences also cause some headaches.

“Quite often, there are moments when we think that this cannot be happening. The working methods, work culture and communication methods of different countries are so varied,” Ulla Ashorn says.

However, she also finds that different people from different backgrounds add spice to her work.

“Every day there are new insights that ‘oh well, that’s how people can think, and I didn't realise this on my own,’” Ulla Ashorn adds. At best, both parties learn something new.

<h2>Nutrition affects the brain</h2>

In Malawi, the Ashorns are conducting research on, among other things, how child malnutrition can be treated.

A follow-up study is about to begin with children approximately 10 years of age who in early childhood received food supplementation using a product that resembled peanut butter but was fortified with nutrients. The growth and development of the participants are now examined in a more detailed way using various development tests, such as electroencephalography (EEG). To this end, the Ashorns are taking an EEG device to Malawi.

<blockquote>
More than five million children under the age of five still die each year.
</blockquote>

Thus, one of the aims is to study whether the nutritional supplement has been beneficial for the neuro-cognitive development of the children.

“The same children will also be monitored closer into adulthood. We are interested in the entire lifespan – what kind of environment the children grow up in and how they will fare as adults," Ulla Ashorn says.

Several other child cohorts are also being followed up in Malawi. Most recently, a group of research participants aged about twenty years came in for a follow-up study. These data are currently being analysed.

<h2>Antibiotics for the infants of Mali</h2>

A larger project led by the Ashorns has just begun in Mali, West Africa.

This trial is aiming to assess if the high mortality in children under one year of age can be reduced by giving asymptomatic children an antibiotic called azithromycin. The American Bill &amp; Melinda Gates Foundation is providing $20 million of research funding.

However, the Ashorns have not been able to get to Mali recently, nor will they for a while longer.

“First came COVID-19, then there was a military coup in Mali and next riots against France broke out. The safety situation is not stable, so we are not going there right now,” Per Ashorn says.

In Mali, Dr Fatoumata Diallo has just given a child a dose of the azithromycin antibiotic.

However, a local research organisation in Mali has been able to begin the study. The first doses of the antibiotic were administered to children in October.

The aim is to study approximately 110,000 babies in 830 Malian villages. Some participants receive azithromycin every three months, some twice a year, and some are given a placebo.

The Ashorns coordinate the research remotely over the phone and through virtual connections.

“Local families have welcomed the study and so far, there have not been many refusals,” Per Ashorn says.

If the results are good, azithromycin may be used more widely to reduce the high infant mortality. However, the potential disadvantages of using the medicine, such as the increase in antibiotic-resistant bacterial strains, will be closely monitored.

<h2>Relief for the corona epidemic</h2>

When the coronavirus became a global pandemic in the spring of 2020, the Bill &amp; Melinda Gates Foundation wanted to help prevent the spread of the disease in Sub-Saharan Africa.

The project led by the Ashorns received an additional $1 million for research into the spread and impact of COVID-19 in Mali.

The funding has mainly been used to purchase diagnostic tests, digital thermometers, oxygen saturation measurement equipment and other devices, and to hire Malian staff.

“This was actually public health money disguised as research funding. The focus is that we support Mali’s health system in curbing the epidemic,” Per Ashorn says.

At the same time, the impact of the COVID-19 epidemic on health services in Mali will be studied, the exposure of healthcare workers to the virus will be assessed and the typical symptoms of the COVID-19 infection in patients with a suspected or confirmed infection will be analysed. A population sample will also be gathered in order to measure antibodies to the virus.

“In general, there have been significantly fewer infections in African countries than feared at the beginning of the epidemic. This may be partly due to a lack of testing, but it seems that so far the epidemic is playing out differently in Africa,” Per Ashorn points out.

<h2>Small vulnerable newborns</h2>

The Ashorns are also currently working to produce a series of scientific articles on the theme of the “Small Vulnerable Newborn” for the prestigious medical journal The Lancet.

The couple is responsible for writing one and coordinating all five articles due to be published in May 2022. The work is funded by the British Children’s Investment Fund Foundation.

Although child mortality has declined worldwide in recent decades, more than five million children under the age of five still die each year.

“About a half of infant deaths occur during the first month of life, and the number of these deaths has fallen more slowly than expected,” Ulla Ashorn says.

Per Ashorn and Data Monitor Amina Atwabi look at old logbooks recording research visits to the Lungwena health clinic. Having started in 1995, Atwabi is the longest-standing member of the team.

Infant mortality is typically associated with foetal growth failure or premature birth. About a quarter of all babies in the world are born underweight, premature, or too small for the duration of pregnancy.

The purpose of the series of articles in The Lancet is to provide a scientific basis for measures to reduce premature births and deaths caused by foetal growth failure.

“Although The Lancet's series of articles have scientific aims, they also seek to shape global policies, meaning that our series of articles can have a big impact on how deaths related to prematurity and intrauterine growth restriction can be reduced around the world,” Per Ashorn explains.

<h2>Dreaming of a week without a computer</h2>

The Ashorns usually spend more of the year abroad than at home in Tampere.

“I’ve said before that we spend four months in Finland, four months in Malawi and four months in airports,” Per Ashorn jokes.

However, 2020 turned out to be different.

Like other university employees, the Ashorns started to telecommute in spring. International conferences were replaced by video conferences and face-to-face meetings by endless correspondence via email.

“I dream of spending a week without a computer. Especially during the COVID-19 pandemic, when we have Zoom meetings from morning to night, you start feeling the strain,” Per Ashorn sighs.

In Malawi, video conferencing is less common due to the unreliable network connections. According to the Ashorns, everyday life is still the same as in Tampere: in the morning you wake up, in the evening you go to sleep and in between you work on your computer.

However, there are still some differences in everyday life. When rain and sleet fall in Finland, the Ashorns can watch the starry sky in the dark, warm evenings.

<h3>Per and Ulla Ashorn</h3>

Per Ashorn is a physician specialised in paediatric infectious diseases and a professor of paediatrics. He is the director of the Tampere Center for Child Health Research and leads its Global Health Research Group. He is also Chair of the Finnish Paediatric Society.

Ulla Ashorn is docent and university researcher in the same Global Health Research Group. Her background is in the social sciences, and she is researching social and health policy.

The Ashorns’ research focuses on maternal and child health in low-income countries in Sub-Saharan Africa. Their main research topics are maternal and childhood infections, premature births and childhood malnutrition.

They live in Pispala, Tampere, and a part of the year in Malawi. When the COVID-19 epidemic subsides, they will enjoy films and concerts in their free time.

Their adult son Mikael Ashorn is working for a UNICEF ​​water, sanitation and hygiene project in Nepal.

Read more about the Tampere Center for Child Health Research: <a href="https://research.tuni.fi/tamcam-gh/">https://research.tuni.fi/tamcam-gh/</a>

Working for the health of the children

Technology

Internationality

Education

Working life

Invention

Innovation

For most of us, a tattered plastic bag is ugly and worthless, but inventors see the world differently. A scrap of plastic attached to the door of a woodshed and swinging in the wind is an important indicator for Ilmari Tamminen.

“It shows me that the air is moving,” Tamminen says.

Tamminen studies staining and imaging techniques in the Faculty of Medicine and Health Technology at Tampere University. In lay terminology, his work entails dying cells and tissues so that their internal structures can be visualized using biomedical imaging.&nbsp;

“To put in another way, I am trying to figure out how to tap into the full potential of run-of-the-mill X-ray machines,” Tamminen describes.

Tamminen’s scientific creativity comes to life in a laboratory, but he is also excited about his homemade inventions. The family heats their home with wood and, since wood must be properly seasoned for it to burn well, Tamminen came up with an ingenious workaround to accelerate the drying process.

“I switched the hinges to the other side and wedged the door open at a specific angle. Now the door catches the wind blowing from a clearing and speeds up drying.”

The ingenuity of this invention lies in the simplicity of the idea. The way inventors approach the world around them is what sets them apart from the rest of us: when they see problems, their mind begins to see solutions.

“The key is having plenty of ideas but not falling in love with any of them. Ideas must be coolly assessed to determine what works and what does not. It is important to write down one’s thoughts and carry out bold experiments, because few of us will hit the jackpot right away, at least when working on large-scale projects,” Tamminen says.

“There is this exhilarating moment of discovery when you witness a hypothesis coming to life in a test tube,” Ilmari Tamminen says.

An invention can make our everyday life easier, like a dish drying cabinet, or change the world, like penicillin. Still, an invention is always something that is new to the general public.

&nbsp;

<h2>Matching a problem with a solution</h2>

In 2020, Industry Professor Tero Joronen was presented with Tampere University’s Inventor of the Year Award. Joronen has always wanted to look at the world with fresh eyes. His inquiring mind has resulted in a number of patents – last year alone, Joronen invented or co-invented ten inventions. Joronen has come up with most of his inventions while working in industry, Valmet to be specific, and the rest in academia.

“The first step is to identify a problem and describe it in clear and simple terms. A complex problem requires a complex solution,” Joronen points out.

Joronen is naturally curious and more or less constantly looking for ways to improve things. While most of his inventions are in the field of heavy industry, inventing is also a hobby for Joronen. His home is full of small labour-saving innovations.

“The joy of discovery fuels my passion for inventing. I get a kick out of creating something new. And I have always had a lively imagination,” he muses.

&nbsp;

<h2>Every other application results in a patent</h2>

In total, 1,685 patent applications were submitted in Finland in 2020, the largest number in the past five years. The vast majority of patent applications are filed by large industrial companies, such as Valmet where Joronen works.&nbsp;

There are two reasons: these companies make R&amp;D a priority and have money to spend on it. Turning an idea into a patent costs a minimum of €10,000 in Finland but applying for patent protection abroad will multiply the costs. Patent agent and attorney fees are the largest single item of expenditure.

“The number of patent applications seems to be levelling off after years of steady decline, but why this is happening is anyone’s guess. Of all applications filed, roughly 50% result in a patent,” says Olli Sievänen, head patent advisor in the Finnish Patent and Registration Office.

<blockquote>
Scientific knowledge and expertise both spark and steer innovation.
</blockquote>

In 2020, 602 patents were awarded in Finland. To be granted a patent, an invention must be new, inventive – not just a simple modification to something that already exists – and industrially applicable.

&nbsp;

<h2>Creativity is an important quality for engineers, too</h2>

Pasi Keinänen, project manager in the Faculty of Engineering and Natural Sciences at Tampere University, has a brain that looks at problems but sees opportunities. When Keinänen once again hoovered up pieces of his children’s Lego, a pedagogically oriented father might have reminded his children to tidy up after themselves. Being an accomplished inventor in the field of nanotechnology and having worked as an IP advisor at Tampere University, Keinänen had a different approach: he modified the vacuum cleaner. By manipulating airflow, Keinänen was able to separate Lego from dust, and vacuuming is now a breeze. Physicists know how this is done. We non-physicists might not, no matter how hard we try (Keinänen tried to explain it – to no avail).

“Scientific knowledge and expertise both spark and steer innovation. For example, the vacuum cleaner modification would not have been invented had I not been familiar with the basics of physics,” Keinänen notes.

“Patents are granted to inventions that can be utilised and scaled up to industrial proportions,” Pasi Keinänen says.

Tero Joronen agrees. He says that inventing is 10% brainstorming and 90% experimentation, the application of knowledge and hard work.

“Creativity is often associated with artistic occupations, but I find that pursuing a career in engineering also requires a great deal of creativity. Creativity is about rethinking the basics of engineering sciences to create something new,” Joronen says.

&nbsp;

<h2>Your idea has already been invented – so keep working!</h2>

All three are familiar with the painful disappointment of coming up with an amazing idea only to discover that it already exists. So many great things have already been invented.

“There is a limit to the amount of information the brain can store. When being hit with a brainwave, one cannot be aware of all the information that is, for example, available online. I sometimes wonder why all the great ideas out there are not being exploited to their full potential. But we have to keep working and pushing the boundaries,” Tamminen says.

<blockquote>
The number of patents illustrates the level of commercial awareness in a university.
</blockquote>

As Pasi Keinänen says, there is no shortage of talented and innovative researchers in the world. In each field of research, the basics are the same, and with all the world’s brightest minds reading the same research papers and refining the ideas further, overlaps are inevitable.&nbsp;

But recognising this is no reason to stop inventing. On the contrary.

“If you come up with an idea that you think is new, you should immediately look into what others have done in this field. Don’t give up as you are already well on your way. If your original idea does not pan out, there is sure to be some other aspect that you can improve on,” Keinänen encourages aspiring inventors.

&nbsp;

<h2>Being in the zone is a sign that a breakthrough is close</h2>

The journey from an idea to an invention depends on the inventor. During a typical workday, Ilmari Tamminen switches between studying biomedical stains and imaging, thinking and testing. He combines his theoretical knowledge and scientific expertise with observations and thinking outside of that famous box.

“I compare my ideas to the existing body of knowledge and move from there,” Tamminen describes.

The theories will either work or not, but it is Nature that decides the outcome, not anyone’s opinion.

“There is this exhilarating moment of discovery when you witness a hypothesis coming to life in a test tube,” Tamminen adds.

“Creativity is often associated with artistic occupations, but I find that pursuing a career in engineering also requires a great deal of creativity. Creativity is about rethinking the basics of engineering sciences to create something new,” Tero Joronen says.

All the three inventors inherited their inventive streak, but the ability to see the world from a different perspective can also be learned. Tero Joronen's method of choice is to tune his mind to a specific frequency.

“As comical as this may sound, it is almost a trance-like state. I close off the outside world to create imaginary visions and try to see beyond the ordinary. Inventing is more about intuition than analytical thinking, but a useful result depends on an interplay between analysis and creativity,” Joronen says.

&nbsp;

<h2>Women are not inventors, or are they?</h2>

The gender gap in patenting reflects the educational and career choices of men and women.&nbsp;

“As a whole, there are more men in the world of inventing,” Olli Sievänen says.

According to the World Intellectual Property Organization (WIPO), 16.5% of inventors named in patent applications were women in 2020. In the past 20 years, the number of patent applications that name at least one female inventor has increased from 20% to 35%.&nbsp;

Biotechnology, chemistry and new drug development are the sectors with the highest proportion of female inventors. More than 59% of the patents related to these fields have at least one female inventor.

The design of mechanical components and engines was at the bottom of the list, with less than 18% of patents having at least one female inventor. Overall, one in four patents is granted to women.

“There are more men working in technology and engineering, and the majority of patent applications are related to these fields. For example, construction engineering and IT are both male-dominated and patent-active sectors in Finland,” Sievänen says.

<blockquote>
An invention does not equal important research.
</blockquote>

The chances of being issued a patent largely depend on one’s field of research. It is not about supremacy or the degree of creativity and ambition.

“Patents are granted to inventions that can be utilised and scaled up to industrial proportions,” Pasi Keinänen says.

“Breakthroughs and new ways to conduct research are being continuously discovered by social scientists. And while it is incredibly difficult to obtain patent protection for an effective new psychological treatment, it can greatly help large numbers of people and also generate new business,” he adds.

&nbsp;

<h2>Patents are a barometer for academia</h2>

A patent is a formal recognition of the novelty and innovativeness of an invention. Companies need patents, among other things, to protect their business, engage in collaborative R&amp;D and make money from their intellectual property.

Innovation activities are geared towards making money in the corporate world, but an innovation-oriented approach should also be increasingly embraced in academia, Pasi Keinänen finds. If researchers lack commercial awareness, their inventions may not be placed in the public domain to benefit others.

“Patents are like a barometer for the academic world. The number of patents illustrates the level of commercial awareness in a university. In this respect, the Nordic countries are lagging behind Central Europe,” Keinänen says.

Broadly speaking, the innovation activities of universities are about reconciling academic values with industry needs and sharing world-class Finnish expertise with the rest of the world. Innovative companies need professionals with an innovative mindset.

Tamminen points out that inventions cannot be used for assessing the importance of research. However, an invention can be both a scientific discovery and a commercial success.

“An invention could function as a confirmation of quality and relevance if someone is willing to pay for the results of scientific thinking. This type of integrated career would be my all-time invention,” Tamminen says.

&nbsp;

<h3>World firsts invented in Tampere</h3>

<ul>
	<li>2017 Optical gripper</li>
	<li>2016 Real-time tissue-identifying spinal needle</li>
	<li>2015 Nokia OZO – VR Camera</li>
	<li>2014 Smartphone with Supersensitive Touch (Works with gloves) 
	Smartphone with Dolby Digital Plus Recording</li>
	<li>2013 Nokia Lumia 1020 PureView (41 Mpix camera phone)</li>
	<li>2009 &nbsp;Antibiotic-releasing biodegradable implant</li>
	<li>2008 Preservative-free prostaglandine eye-drop for glaucoma treatment 
	New jaw bone from patient’s fat cells was grown using stem cell tech</li>
	<li>2004 Automated container terminal</li>
	<li>2003 Fog screen walk-through display</li>
	<li>2001 Automated mine loading, mobile camera phone (Nokia 7650)</li>
	<li>1998 Digital x-ray image</li>
	<li>1996 First communicator (Nokia 9000)</li>
	<li>1995 Walking forest machine</li>
	<li>1994 GSM data card</li>
	<li>1993 Analogue cellular data card</li>
	<li>1991 First commercial GSM call</li>
	<li>1988 Micro-crystallized chitosan</li>
	<li>1985 Electromechanical film</li>
	<li>1984 Bio absorbable implant</li>
	<li>1974 NMT phone call</li>
	<li>1936 First winter tire</li>
</ul>

Source: Business Tampere

&nbsp;

From dream to reality: inventions come about through hard work and applied scientific knowledge

Society

Well-being

Baby box

Around a century ago, Finland was an agricultural society where most of the population lived in poverty.

Many families lacked basic necessities such as clothes. Poor hygiene and nutrition and infectious diseases led to 10% of babies dying before the age of one year.

In 1922, the newly established Mannerheim League for Child Welfare began lending baskets to low-income families, which contained clothes and sheets for the baby sewn by volunteers.

“As the babies grew, the clothes in the baskets were washed, mended and given to the next family,” says Researcher Ella Näsi from Kela, the Social Insurance Institution of Finland.

In 1938, the first governmental versions of the maternity package were introduced and given only to underprivileged mothers. Four years later, the items began to be packed in a cardboard box designed to act as a crib for the newborn.

In 1949, the government decided to issue a maternity grant either as the maternity package or as a cash sum to all expectant mothers on the condition that they visit an antenatal health clinic. The Finnish baby box was born.

<h2>Famous babies in cardboard boxes</h2>

In 2013, the maternity package received special international media attention.

First, the BBC published a story titled “Why Finnish babies sleep in cardboard boxes”. Kela soon donated a maternity package to Prince William and Duchess Catherine of the British royal family, who were expecting their first baby.

After this, many NGOs and other actors began to set up their own baby box programmes around the world.

“Finnish embassies have showcased the maternity package as an example of a Finnish social innovation. This is another way by which many partners have received information and become interested in the issue,” says Postdoctoral Research Fellow <a href="https://research.tuni.fi/ghsp/annariina-koivu/">Annariina Koivu</a> from Tampere University.

In addition to clothing, the 2020 maternity package contains a sleeping bag, bedding, toiletries and a cuddly toy.

Koivu led a research group at Tampere University that investigated how the Finnish maternity package or baby box has spread across the world. The research group found a total of 91 baby box programmes in 63 countries.

Among them, the group chose 29 projects, and the contents of the boxes and the projects’ goals were investigated with in-depth surveys and interviews. Half of the interviewees reported that they had got the idea for their project from the Finnish baby box.

<h2>Buckets and mosquito nets</h2>

However, the Finnish baby box has not been copied by these projects wholesale, because the programmes have been tailored to local needs.

The items are not necessarily packed in a cardboard box. Alternatives include, for example, a bag, a bucket and a woven basket. Local conditions and needs have also been considered in the planning of the contents. For instance, a mosquito net is included in many areas where mosquitoes spread malaria and other diseases.

“Baby box programmes often have more general goals concerning the well-being of mothers, babies and the entire community. In addition to material assistance, mothers are offered counselling and training on breastfeeding or family planning among other things,” Koivu says.

The programmes often target the most vulnerable families. In Colombia, the baby box is offered to most low-income teens and single mothers and immigrants from Venezuela. The goals include reducing inequities and promoting non-violent parenting.

“The condition for receiving a baby box can be for instance that the mother attends antenatal care or that she gives birth at a clinic instead of at home. The baby box can therefore save lives in settings where the use of these health services would otherwise be low,” Koivu adds.

<h2>Work for women in a refugee camp</h2>

Several baby box programmes have targeted women and children who have had to flee their homes due to natural disasters or conflicts.

In the Za’atar refugee camp in Jordan, for example, women can earn a living by making the baby boxes that are distributed to mothers who give birth at the camp.

“The programme benefits women at both ends of the production line by encouraging refugee women to attend antenatal care and by providing them with a livelihood which strengthens their agency, restores social engagement, and reduces isolation,” says Jad Abuhamed, a doctoral researcher at Tampere University.

The baby box has the potential to address many issues related to well-being, because it can be used in demanding environments and tailored to the population groups that are in the direst need of help.

In the future, the number of displaced people will only increase as climate change and political unrest force people to leave their homes, which will create humanitarian challenges that require innovation and cooperation.

“The baby box has a lot of potential because it can be used in demanding environments and tailored to the population groups that are in the direst need of help,” Abuhamed points out.

<h2>More scientific evidence is needed</h2>

According to Koivu, the effects of baby box projects have rarely been scientifically evaluated, which is why it is difficult to ascertain what kind of benefits the programmes really provide.

“I hope that in the future there will be more evidence on how the baby box can be used in different circumstances and for different groups of people in order to achieve health and social benefits,” Koivu says.

In Finland, the effects of the baby box have not been systematically studied either. Since the creation of the maternity package in Finland, child mortality has fallen considerably. However, the significance of the baby box is indistinguishable from other developments, such as antenatal and child health care, antibiotics and vaccinations.

According to Näsi, it would be interesting to study what the current meaning of the baby box is in Finland. Is it just a financial benefit or do people consider it important for other reasons?

“The baby box may have an intergenerational symbolic meaning. It is possible that its very existence communicates that Finnish society appreciates babies and wants to support the well-being of children and families,” Näsi says.

Annariina Koivu, Yen T H Phan, Ella Näsi, Jad Abuhamed, Brittany L Perry, Salla Atkins, Mikko Perkiö, Meri Koivusalo (2020):&nbsp;<a href="http://urn.fi/URN:NBN:fi-fe2020081360377">The baby box. Enhancing the wellbeing of babies and mothers around the world</a>. Kela Research. Finland.

<a href="https://helda.helsinki.fi/handle/10138/319524">https://helda.helsinki.fi/handle/10138/319524</a>

<h3>Money or things</h3>

In Finland, mothers can choose between a maternity package and a tax-free cash benefit of €170.

A prerequisite for receiving the maternity grant is that mothers have a health check-up before the end of the fourth month of pregnancy.

The 2020 version of the maternity package contains 56 items in addition to the box, which may be used as a cot. In addition to clothes, the package contains, among other things, a sleeping bag, bedding, toiletries and a cuddly toy.

Multiple-birth families receive multiple maternity grants.

<a href="https://www.kela.fi/aitiysavustus">Source: </a><a href="https://www.kela.fi/web/en/maternity-grant">https://www.kela.fi/web/en/maternity-grant</a>

Selected articles

Working for the health of the children

From dream to reality: inventions come about through hard work and applied scientific knowledge

A baby box can save lives

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