Project Play
Play is critical for healthy childhood development and is an important part of malnutrition treatment, but many children don't have access to play stimulation. UNICEF will repurpose RUTF cardboard boxes and other packaging as fun and appropriate toys.
The challenge
Play is critical for healthy childhood development, helping to build cognitive, social and physical skills. It is also an essential part of severe acute malnutrition treatment. According to the World Health Organization guidelines, psychosocial stimulation interventions are recommended as part of routine care to improve child development and anthropometric outcomes for children under 5 years. However, many children enrolled in malnutrition treatment do not have access to relevant toys. Many caregivers are also not aware of the importance of play.
Every year, UNICEF delivers thousands of tons of ready-to-use therapeutic food (RUTF), a fortified, peanut paste for treating malnutrition in children under five. In 2023, nearly 7.5 million cardboard boxes used to transport RUTF were dispersed across the globe. There is an opportunity to repurpose these boxes, traditionally discarded directly after use, into relevant and fun toys.
UNICEF is also working to address climate change through sustainable procurement across all supplies. Our environmental impact has consequences for children, their future and planet they will inherit.
Psychosocial stimulation interventions
WHO guidelines recommend psychosocial stimulation interventions as part of routine care to improve child development and anthropometric outcomes for children under 5 years.
8.7 million
In 2022, 8.7 million cardboard boxes circulated the world as part of RUTF packaging.
7.3 million children
UNICEF could reach an estimated 7.3 million children by repurposing RUTF carboard boxes into toys to support malnutrition recovery.
The response
Inspired by a supplier initiative, UNICEF is broadening the concept and will print and pre-cut toys in corrugated cardboard cartons, repurposing boxes into toys to aid in malnutrition recovery and promote learning through play.
UNICEF offers a diverse catalogue of cardboard toys which help develop cognitive, motor and social skills in children aged six months to five years. The toys are inclusive, designed with contrast colours, tactile features, easy grip, ensuring all children with and without disabilities can play with them. How-to-use guides will also be included for caretakers, and UNICEF programming will emphasize positive parenting and nurturing care.
Project Play is already bringing smiles to children in several countries during proof-of-concept testing that started in late 2022. The initiative is currently piloted in Uganda, Sierra Leone, and Pakistan, within existing UNICEF-supported health centres offering RUTF treatment for wasting. The learnings will inform a number of project parameters, such as using the supply chain for delivery, platform and modalities as well as accessibility of toys and parent engagement.
The impact
Through this frugal innovation UNICEF will provide simple, fun and easy-to-use toys to children with severe acute malnutrition, increasing the likelihood of recovery. Additionally, providing toys and ‘how-to-use’ guides enables to raise awareness of the importance of play.
By repurposing packaging and giving cardboard boxes a second life, UNICEF also minimizes waste, contributing to a more sustainable world for future generations.
If scaled, this project has the potential to reach up to 7.3 million children per year – the number of children who received UNICEF-supported malnutrition treatment and care in 2022. If toy designs are added to the packaging of other supplies, UNICEF could potentially reach tens of millions of children per year.
Project Play generates smiles and supports recovery for malnourished children in Pakistan, Sierra Leone, and Uganda
In 2023, Project Play was piloted in Pakistan, Sierra Leone and Uganda in partnership with three RUTF suppliers, integrating inclusive toy designs into the standard RUTF packaging and distributing them within ongoing nutrition and Early Childhood Development (ECD) programming in each country.
In Uganda, the project helped to integrate play as a standard practice at health facilities. Healthcare workers were designated as “play therapists” who “prescribed play” as part of the standard recovery process for children. This approach proved successful, with healthcare workers who were previously unaware of its importance beginning to observe positive changes in the children. In places fraught with sadness, smiles and laughter emerged, as one mother noted:
“The day that we started play is when my child started crawling on the ward.”
- Mother of malnourished child in Uganda
In Sierra Leone, introducing toys to nutrition centers created an uplifting environment, where children of different ages and genders played together for extended periods. The project encouraged engagement by both mothers and fathers, helping them learn to respond to their children’s cues during play, which boosted their confidence in their children’s recovery. A female teacher in Port Lok who observed the children playing on several occasions when she passed by the treatment centre after school explains:
“When mothers see their children playing, they develop more confidence in the recovery of their children. And because they are improving, that makes them play and be more active. I see the children happy playing with the Project Play toys."
- Teacher in Port Lok, Sierra Leone
In Pakistan, Project Play enabled children to express their emotions more freely as parents noticed their children becoming more expressive with the toys. It also fostered creativity, with the standard designs of pop-out toys (animal blocks and two disks to make a rolling ball) being adapted to build toy cars. The initiative was embraced by the entire community, including siblings, grandparents, and community leaders, who all learned about the importance of play through this frugal innovation. The toys were well-suited to the needs of a resource-limited area affected by flooding, as noted by a UNICEF staff member:
“Project Play is well suited to the environment: it doesn’t introduce fancy toys or cultural shock and avoids conflict of interest for healthcare workers or caregivers who might use the toys for other purposes, like theft or reselling. These toys were greatly appreciated as they match the environment.”
- Sabina Shuja, Early Childhood Development Manager, UNICEF Pakistan
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