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In Singapore today, first-time mothers lack the experience to take care of themselves and their newborns hence they face many difficulties such as unable to coax the baby and lack of knowledge to take care of newborns. Furthermore, an increasing number of couples with babies do not stay with their parents.
Hence, they have to go through the trouble of looking for a babysitter.
Postpartum service is important after child birth as mothers are weak after pregnancy. Thus, mothers often hire nannies, who may lack sufficient proven knowledge, to take care of them and their newborn. This is a problem as nannies may not necessarily provide helpful and safe treatment for mothers and newborns.
We feel that this is a problem as the mothers and babies' health are jeopardized.
Our group has thus decided to set up a Postpartum Centre(PC) through which we will provide better quality care for mothers and their newborn. Furthermore, we hope to provide a platform for mothers to look for reliable postpartum services.
We have thus far gathered the opinions of mothers and the results show that they are in favour of our proposed postpartum centre.
Percentage of Yes
Have you ever had confinement services?
Have trouble finding a caretaker
Challenges faced when taking of child
Interests in our CC
Based on our survey results, 75% of the mothers had not hired a confinement nanny and two-third of them had trouble finding a caretaker. 74% of the total respondents also face challenges taking care of their newborn. Majourity of our respondents are also interested in our PC.
Chapter 2: Case Study: Education in Singapore
Mainstream Education in Singapore
Mainstream Education standardizes education programmes for students of different backgrounds. This often restricts the creativity of students to a bounded framework. Though the government has diverse methods of assessing students, students still lack other forms of aptitude assessment.
Thus, we look into alternative ways, to spark innovation and better realise a student's potential.
Alternative Choices of Education in Singapore
Integrated Programme (IP)
IP has been introduced as early as in the year of 2004, where secondary education would be merged with college education. The curriculum under IP is focused on the "A" Levels syllabus. Students of academic excellence are chosen into the IP.
Fig. 1.1: Simple illustration of education process in Singapore
It is compulsory for students to undergo Primary education in Singapore. Upon leaving primary school, a student could choose to take a 6-year IP course or proceed to secondary school and take a 4-year IP course in Secondary 2. Both routes ultimately lead to the GCE "A" levels. The easy route to higher learning undeniably has its advantages and disadvantages.
abolishment of the "O" Levels examination
â‡’ continuous route towards higher learning (tertiary education) with greater depth
greater flexibility of time
â‡’exposed to more knowledge within a flexible time schedule.
Lack of recognised academic qualifications like "O" Levels certificate
â‡’ Disadvantaged when looking for a job.
IP "drop-outs" waste their time and efforts
Specialised Schools (SS)
Singapore has introduced the first specialised school as early as 2004, expanding to four currently. They are namely Singapore Sports School (SSS), School of the Arts (Sota), NUS High School of Mathematics and Science as well as the forthcoming School of Science and Technology (SST).
SS train students with immense interest and great talents in these fields, providing them an opportunity to venture into a new education programme that is unique to the different disciplines in their studies.
A wider variety of subjects.
SS focus on the students' passions and strengths, realising their potential at a young age and developing them to become professionals.
SS education is highly specialised, but students may not necessarily pursue their interests in future as their interest might change.
SS education may result in lack of time to achieve grades. This results in the students retaining to pursue their academic studies.
Figure 1.3: 4 Specialised Schools in Singapore - NUS High School, School of Science and Technology, School of the Arts and Singapore Sports School
International Baccalaureate (IB)
The IB Programme's assessment varies vastly from the mainstream education. Students are assessed through 3 main forms of assessments of university standard: Extended Essay, Theory of Knowledge and Creative, Action, Service.
There is also more freedom to venture into their field of interest, learning knowledge of greater depth.
Co-curricular Activities and Community Involvement Programmes are assessed too. This contributes to their holistic learning environment.
Diploma Certificate makes it easier to enrol in top universities.
Lack of recognised academic qualifications like "O" Levels certificate
â‡’ Disadvantaged when look for a job.
Drop-outs waste their time and efforts
Figure 1.4: Anglo-Chinese School (Independent) - One of the schools in Singapore to offer IB
Reasons for Choice of Case Study and Lesson Learnt
Best approach chosen to deal with problem of Mainstream Education:
IB awards the most internationally recognised qualification compared to IP and SS. With the broad-based education advocated by the IB Programme, students are prepared for challenges in society.
Lessons learnt from IB Programme
How it is connected to Confinement Service (Area of Project)
IBprovides a broad-based and holistic education.
All-rounded confinement servicewhich covers more areas of needs of new mothers.
IB is an internationally recognised diploma due to its highly respected academic curriculum.
By improving the CSinto an All Rounded Maternity Service, it would be more recognised and professional.
Chapter 3: Taking baby steps forward
This chapter aims to study the research findings gathered thus far to finalise our project and test out its feasibility.
Aims of Research
From our research, these are the key areas which we hope to gain insights:
Challenges mothers face so as to focus on these areas.
Price range to charge that is competitive but yet able to meet mother's major needs.
Effective means to promote our PC so as to ensure its success.
Measure of success of project which ultimately determines the feasibility of our proposal.
Challenges mothers face when taking care of babies
Firstly, we have conducted surveys for young mothers to procure the problems they face when handling babies. 38% of our respondents face difficulty in coaxing the babies while another 30% lack knowledge in areas such as changing of diapers. Our group has categorised these problems and attribute these to lack of parenting techniques. This highlights the need for our PC to include parenting courses so as to aid parents in handling their babies more effectively.
Chart 1: Challenges faced by young mothers
Furthermore, our interview with a KK nurse, Michelle Soong, specialising in the Children Intensive Care department has revealed that mothers face problems in handling their babies, like breast-feeding their babies and how to judge if the babies are in discomfort. This substantiates our survey results which emphasise the need for our centre to include parenting classes, to train mothers in these areas.
Moreover, besides problems in handling their children, mothers face is sleep deprivation. Therefore, we suggests that the nannies in our PC work in shifts so that mothers need not wake up at night to attend to the babies.
Price range chargeable
Another area we look into would be the market price of confinement services. From our survey, 62% of mothers who have engaged CS indicated that market price is between $50-$75 per day.
Chart 2: Market price for confinement services
In order to keep our PC rates close to $50-$75 per day, but simultaneously offering quality services for mothers, we have to eliminate certain services that are unnecessary. This probes us to find out which services are in high demand so that we can focus on these areas so as to cut cost.
Chart 3: Mothers' preference of services
Our survey has shown that 40 and 43 out of 50 respondents demanded for personalised diets and parenting classes respectively. Thus, parenting classes and personalized diets ought to be our priority, while others, such as personalised rooms would have less emphasis. Other non-medical services can be contracted out to further reduce costs.
In the case of personalized diets, Ling-jie supported the need for this as she pointed out that mothers need nutrition to recover from pregnancy. Thus, having personalized diets would provide the right types of nutrients for each mother as each mother's constituition varies from person-to-person. This serves as a warning to us that a "one-size-fits-all" approach should not be employed in the provision of meals to mothers. Instead, prior to drawing up dietary plans for the mothers, thorough check-up should be conducted for every mother to ascertain the type of diets an individual should have and therefore, design a personalized diet plan for each mother.
Effective ways to promote our PC
Our survey results revealed that 56% of the respondents got to know postpartum services through word-of-mouth, thus being the most effective channel of promoting CS.
Chart 4: Channels through which mothers get to know confinement services
Furthermore, Ling-jie, also substantiate our result that the most effective means of publicity would be through word-of-mouth, pointing out that she was mostly recommended to clients by friends and previous clients who were satisfied by her services.
Thus, to promote our PC, we can merge the 2 most effective channels of creating awareness by creating online platforms like forums. This would also be able to reach out to IT savvy moms in this modern society.
Measure of success
Finally, we need to find out if our project would be a success. Thus, we surveyed mothers to find out if they are supportive of our proposed PC.
Our group define success if at least 65% of our respondents show willingness to engage the service of our PC. As seen, 71% of the 51 respondents are in favour of our CC, there showing that our project is feasible in our society.
Chart 5: Respondents' keeness towards our PC
Moreover, Ling-jie is supportive of our idea of a PC in Singapore. We asked if she was in favour of our project and her answer was affirmitive.
Ling-jie has indicated that there are several centres, similar to our proposed idea, that has been set up in Johor Bahru, and thus, she agrees that our idea is feasible based on the fact that the Postpartum Centres are successful in that country. Therefore, this shows support for our PC. Ling-jie's assumption that our PC would be successful is proven when we cross-refered to other PCs in other countries that have a largely similar context to that of Singapore.
We made reference to PCs in Taiwan as Singapore and Taiwan are economically-developed countries with families becoming increasingly smaller. Furthermore, studies conducted in Taiwan shows a growing market demand for postpartum care. Since there is increasing popularity for such services, we predict a similar situation in Singapore.
Thus, our project has been proven to be feasible in Singapore.
Limitations and modifications
This chapter aims to draw attention to the limitations of our proposed plan and thus, lead us to come up with modifications to address the shortcomings.
Due to a small network of respondents, feedback obtained is insufficient in ensuring the success of our project which aims to benefit mothers nation-wide.
Employ more far-reaching methods to conduct surveys e.g. Feedback through hospitals, online surveys, focus groups
Our PCwill require large capital which, as students, we will not have enough.
We can request funding from Customer-Centric Initiative (CCI)for Healthcare and Young Entrepreneurs Scheme for Startups (YES! Start-ups). This will allow us to have sufficient capital to start our PCin Kandang Kerbau (KK) Women's and Children's Hospital
Information is obtained during present circumstance and thus, may be outdated in time to come.
Constantly be updated on changing postpartum system to ensure our PC remains an advantage over others
Nannies must be able to provide a whole range of services from taking care of babies to conducting parenting classes, which many may not be equipped with currently as most of their jobs mainly revolve around taking care of babies.
Trainings can be conducted to raise the calibre of nannies to a satisfactory standard such that they can provide the holistic care that our PC aims to provide for mothers.
Chapter 4: Postpartum Care-Wellness Centre in Singapore
This chapter aims to introduce our group's idea of a Postpartum Centre in Singapore as well as highlight its special features and difference from typical confinement services provided by Confinement Nannies in the market today.
Purpose of Centre
As introduced in Chapter 1, the first PC in Singapore is a platform to provide knowledge in parenthood, quality help and environment for post-natal recovery for mothers.
Details of Centre
This section focuses on the features of the Centre.
Phase 1 - Immediately after delivery: Stay in Centre
Mother and child without medical complications are posted to the Centre within the week of delivery.
Personalized rooms with baby cot, pantry and toilet and laundry services for mother and child
Makes consumers feel at home and can have undisrupted rest without the need to do household chores.
Modification:Restructuring of Rooms
Fig. (number) A screenshot of our floorplan
As the survey responses reflected that mothers do not place high emphasis on the need for personalized rooms, we have decided to modify our room into 2 types: "Personalized Rooms" and "General Rooms" to suit different consumers of different income groups.
There would be a rescaling of the plan to reduce the number of "Personalized Rooms" and an increase in "General Rooms" that can be shared by 3 to 4 mothers at any point in time. This not only allows mothers to interact with one another; sharing personal experiences and helping them foster new friendships during their stay at the Centre, but also allowing the Centre to house more mothers at a point in time, cutting the maintenance costs.
We also seek to purchase more sophisticated machines such as better sterilizing equipments to create a germ-free and healthy environment which could widen the difference between a stay at the Centre and at home, making a stay at the Centre more worthwhile.
24-hour emergency mother-child care
Ensures safety of both mother and child should any complication arises.
5 meals daily : Selection of food for different races and religions
Personalized diets to suit mothers' preferences and needs instead of mundane meals, giving them greater freedom of choice.
Modification:Recruiting In-house Doctors
To better facilitate our plans to ensure good health in mother and child and improve the quality of our 24-hour emergency care service, we would like to hire Gynaecologists and Paediatricians to monitor the health of mothers and children. These doctors can assess mothers' health conditions before recommending personalized diets to meet certain nutritional needs as well as check on babies' growth.
Phase 2 - After discharge from Centre: Nanny visits
Licensed CNs would visit the employer's home daily for a month, providing 3 meals according to doctor's recommendation, and provide counselling for new parents on coping with a new family member.
Rationale:To assist mothers in preparation of becoming independent of nanny.
Modification: In view that the success of this service would be require the PC to be more established, we would only launch it in future. Please refer to Chapter 5 for more details.
Phase 3 - Additional Services: Massages and Trainings
During and after the stay in the Centre, mothers can opt for the below services for their child, husband and themselves:
Pre-pregnancy body-shape recovery
Body pain relief
For mothers to recover back to pre-pregnancy form.
Exercise and Training Packages:
Modification:Contracting out Services
In view of reducing the maintenance costs of the Centre, we have decided to contract out certain services like Laundry as well as exercise and massage packages to private companies who may keen to provide these services.
The below diagram explains the connections we seek to achieve with private companies.
Fig. 1.5: Illustration of interaction between Postpartum Centre and private companies
Packages for Babies: Swimming and massage
For development of child.
Training for Fathers:
Bathing and feeding child
For fathers to grasp basics and assist mothers in parenting.
Other modifications of Centre
We hope to implement this scheme where nannies of our Centre would each be assigned to a few mothers. Each day, these nannies would observe the interaction between mother and child during the designated bonding time of each mother with their child. Nannies would guide these mothers in feeding, bathing and diaper-changing for their children, providing mothers a hands-on approach in taking care of their babies. This is beneficial to mothers as they learn the ropes of parenting at a slower pace and learn through having their mistakes corrected.
Rationale: Mothers need a longer of period of time to start to adapt to motherhood and grasp the tactics of taking care of the child.
Revised Training Schemes for Nannies
To ensure that quality of services is equal for all consumers, we have improved our trainings for the nannies to better equip them with professional knowledge and skills to attend to the mothers in the Centre. We have introduced training schemes based on current nursing courses and confinement nanny training packages in the market.
Trainings would be carried out in 2-tiers:
General Training includes:
Clearing up myths of traditional Confinement services
Hygiene concerns: Inform nurses that mothers can shower during Confinement Period
Dietary concerns: Address concerns of preparation of food and understanding that food for mothers in the Centre varies from persons to persons. Teach nannies to cook different types of food, e.g. Malay food that must be Halal, Indian food or Chinese food that may be vegetarian.
Removing misconceptions: Create awareness that past myths like abstinence from exposure to wind is not necessary. Provision of scientific proof to clear myths and old wives' tales.
Ensuring quality of service: Assessment of nannies' ability to take care of children. Nannies are required to undergo course of learning how to communicate effectively with new mothers staying in the Centre to teach mothers how to take care of their children.
Specialized Training includes:
Assigning more experienced Confinement Nannies to undergo midwifery courses to assist in-house doctors in monitoring mothers' and babies' health conditions.
Assigning more experienced Confinement Nannies to undergo "Effective Communication" courses to train them to coach fathers who come to Centre for Parenting Courses.
Impacts of Centre
Licensed nannies ensure health of mothers and children as free-lance nannies may not be certified by Ministry of Manpower, causing their services to lack credibility and thus dangerous.
Mothers find platform to recover resilience, returning back to work earlier. During the stay in the Centre, mothers enjoy peace away from issues back at home.
The Centre eases the process of searching for different services after delivery as it caters all forms of Maternity Service a mother may need.
Confinement nannies working in the Centre would receive regular income with state laws to protect their welfare.
Difference of Project with Existing Ideas
With reference to present CNs in Singapore, we modified our services by:
catering our meals to suit preferences of different races and religions in Singapore while some nannies lack knowledge in some diets.
providing additional services that nannies are untrained for.
creating an official location to house the mothers and nannies rather than having nannies to stay in their employer's house.
regulating prices instead of having varying charges by nannies.
Chapter 5: The future awaits...
Our group feels that a PC should be built to improve CS in Singapore. It reinforces the needs of a mother after birth services and also prevents the
increase of informal confinement services, which may be unsafe to newborns and vulnerable new mothers as mentioned in our introduction.
In addition, the PC provides a wide range of course to improve the health of both the mothers and child.
However, due to the limited scale of our project, we are unable to carry out an aspect of our proposal on the dispatching of nannies to the homes of mothers after their stay in our PC. It was originally proposed to re-educate mothers should they forget parts of their training in our PC, equipping they with adequate knowledge to take care of themselves and their newborn. Thus, this would only be possible when our Centre has been more established with greater number of nannies to allow flexibility in work deployment.
Also, due to insufficient capitals, we are unable to set up an independent building for our PC. However, should the PC be earning enough profits in the span of 3 to 5 years after set-up, an independent building would be constructed.It is estimated to accommodate more mothers and have more areas to conduct activities such as exercises and even parenting talks for new parents. More freedom is given to work on feedback gathered on the changing preferences of our consumers.
As a whole, as we have a positive outlook on the setting up of a Postpartum Centre in Singapore from our surveys, interviews and other materials, we believe that our project is supported by the public. In addition, the Centre is a novel idea and new industry in Singapore with good future prospects, thus we believe that it would be a great success.