The article does not claim that the cardboard box itself played a big role.
It implies that the requirement to get prenatal care in order to receive the box played a role. EDIT: And it's not even making a strong claim about that. From the article "Mika Gissler, a professor at the National Institute for Health and Welfare in Helsinki, gives several reasons for this - the maternity box and pre-natal care for all women in the 1940s, followed in the 60s by a national health insurance system and the central hospital network."
well the thing about the article is that it singles out finland as if something special happened there, while similar improvements happened basically everywhere in the first world
I wouldn't dream of saying national healthcare in finland is the same as italy or US, which appears to imply that what really happened is mostly just science marching on and general improvements in wealth.
I don't read the articles focus as being on the reduction in infant mortality, but as a piece about cultural differences in care for infants, by describing one aspect of what Finland does, and where the reduction in infant mortality was mentioned in passing and not much more.
You'll note the title is not "How did Finland reduce its infant mortality rate?" or similar, but "Why Finnish babies sleep in cardboard boxes".
It's a human interest piece more than anything else.
"It implies that the requirement to get prenatal care in order to receive the box played a role."
This is the hack of the box that is not being understood here on HN. The hack isn't that its a box or that cellulose is the ideal crib material, the hack is this is the nearly ideal carrot/stick to get moms to prenatal care. There are zillions of other ways to get moms to prenatal care across the whole spectrum of human experience ranging from intensive education, shoved at army bayonet point, bureaucracy and paperwork, tax codes, legal enforcement by goons with guns, who knows what else.
The true hack, the reason this is on HACKER news, is this is an amazing intersection of minimal overall total system cost and its incredibly polite and pleasant and basically civilized.
Its like all the skinner box psychological manipulation brilliance of Zynga, but applied to lowering infant mortality rates at the absolute minimum possible cost.
Frankly I'm not surprised, as a cultural thing, Scandinavian types might not have all the answers to everything, but when they do have an answer, its inevitably always the most elegant and efficient. Health care, architecture... baby boxes... no great surprise once again they rocked it.
Same thing happens here in the state where I live (São Paulo, Brazil). A similar box (it's actually a bag) is given to lower income expecting women, but only if they sign-up to the Mãe Paulistana program (São Paulo Mothers, loosely translated), which then has them going through all the prenatal and postnatal care that is the actual main focus of the program.
Did you read my comment, what about the article? They only give the box (or money) to mothers who visit a doctor. I was suggesting that the doctor was the reason, not the box, and that the the gift pack (which includes a cardboard box) is just an incentive.