Sönke Siefert with a white background and wearing a light brown sweater
Ashoka Fellow seit 2023   |   Germany

Sönke Siefert

Sönke Siefert
Sönke is building the institutional ecosystem for a healthy upbringing in Germany independent of the economic background of families. As a doctor and founder of Babylotse, he is pioneering a new…
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This description of Sönke Siefert's work was prepared when Sönke Siefert was elected to the Ashoka Fellowship in 2023.


Sönke is building the institutional ecosystem for a healthy upbringing in Germany independent of the economic background of families. As a doctor and founder of Babylotse, he is pioneering a new intervention model that helps at-risk parents provide healthy, nurturing environments for their children through preventative support. By accompanying vulnerable families during pregnancy and early childhood, Sönke’s innovative approach aims to break detrimental cycles by empowering parents with the skills and resources to raise thriving families. This systemic solution has demonstrated significant impact, leading Sönke to advocate nationally for policy reform that prioritizes early prevention over curative child welfare measures.

Die neue Idee

Sönke has developed a model to train and deploy specialized "baby guides" who assist vulnerable families in navigating the intricate web of Germany's social welfare system during pregnancy and the first year of a child's life. Baby guides serve as a bridge between the healthcare system and social welfare system, connecting pregnant women and families to existing services and support based on psychosocial needs. This unprecedented linkage closes a critical gap in care during the most formative phase of human development.

Recent medical research underscores the importance of Sönke's approach by demonstrating the impact of maternal distress on fetal development. Studies show that stress hormones released when mothers experience distress can negatively impact babies' brain development in utero, with life-long consequences. This provides a compelling scientific rationale for the need to reduce psychosocial stresses on at-risk pregnant women that Sönke's model aims to address.

For pregnant women, the first point of contact with the baby guides is in the gynecology practice from the moment a pregnancy is detected and when registering the birth in the hospital about three months before birth. The process begins by screening all pregnant women through expanded health checks that identify not just medical risks, but also potential issues around finances, relationships, mental health, and other psychosocial factors that can impact fetal development. Out of all women screened, approximately 20% face challenges around which the baby guides have in-depth eye-level conversations to jointly assess their needs, priorities, and preferences. The guides then leverage their expertise in the health care and social welfare terrain to connect women and families to relevant services and peer networks. This approach represents a profound shift in how pediatric health is viewed, addressing the non-medical issues that shape childhood outcomes.

Concomitantly, on a systemic level, his foundation helped establish national quality standards for baby guides and a federal taskforce to mandate cooperation between the healthcare and social welfare sectors. He has successfully lobbied health ministries in multiple states to alter laws and fund Babylotsen programs. These efforts have normalized a new paradigm and narrative that reduces stigma around psychosocial problems in the medical sector. Sönke envisions a fundamental bridging of gaps between the healthcare system and social welfare system to create a more efficient, user-focused, and responsive social welfare state in Germany. He aims to reorganize and connect systems, people, and resources to foster a holistic, prevention-oriented model of care rather than isolated crisis response. This exemplifies the type of cross-sector collaboration needed to build a social welfare system centered on improving life outcomes for all.

The compounding societal benefits of detecting issues early and offering support during a child's formative phase are immense. The Babylotsen program by now reaches about 20% of all birth in Germany being available in 88 hospitals and 32 practices in 12 German states. Sönke has also shown how the baby guide concept is replicable for other health conditions and life situations. His comprehensive model - blending specialized counseling, institutional partnerships and policy transformation - provides a blueprint to repair critical fractures in the welfare system so that all citizens can thrive.

Das Problem

Germany possesses one of the most sophisticated healthcare and social welfare systems in the world, renowned for providing high-quality care and support to a diverse populace. However, strict divisions between these two critical systems have led to a troubling gap, wherein pregnant women and families with psychosocial needs are falling through the cracks without the preventative care and early support essential to lifelong wellbeing. This disconnection results in countless vulnerable individuals being unsupported during formative early stages of life, leading to detrimental health impacts that burden families and societies for generations. Where the baby guides program is implemented, every fifth woman screened needs additional support.

Though its healthcare and social welfare schemes offer thousands of services aimed at assisting people across the lifespan, Germany's bifurcated administrative approach has fostered entrenched siloes. Healthcare operates centrally, while social welfare is managed federally, requiring complex coordination to bridge the divide. As a result, abundant solutions exist in theory but fail to be effectively delivered in an integrated manner responsive to multifaceted demands. Nowhere is this breach more acutely experienced than among expectant mothers beset by financial, domestic, or psychological duress. Though substantial research confirms that maternal stress anatomically alters fetal development, setting babies on trajectories for increased disease, dysfunction, and mortality, Germany's disconnected systems continue to allow high-risk pregnancies to slip through without the psychosocial interventions that could alter life courses.

Several factors account for this divided system leaving vulnerable individuals unsupported. Healthcare and social welfare agencies function in institutional isolation, lacking the communication channels and protocols needed to coordinate cross-disciplinary care. Siloed data systems prevent insight into complex family situations, while different funding bodies discourage collaborative solutions. Referrals are made in piecemeal fashion, if at all. Individuals are tasked with navigating tangled bureaucracies alone to patch together support, often to no avail. Mothers facing domestic violence or mental health crises during pregnancy rarely receive the spectrum of care needed, as providers operate in narrowly defined lanes unable to address multifaceted needs. Expectant families are thus left to slip through the chasms, with babies starting life at steep disadvantage.

This disproportionately impacts groups facing societal stigma, including low-income families, single parents, immigrants, and minorities. Negative stereotypes regarding these demographics often prevent providers from recognizing their needs and offering support without judgment. Accordingly, research shows individuals with the greatest psychosocial challenges are least likely to proactively seek assistance from institutions perceived as hostile or paternalistic. Vulnerable segments thereby remain silent and unsupported, with generations-long consequences.

Meanwhile, abundant research confirms that prenatal stress causes neurological changes in babies, portending elevated risks of disorders ranging from ADHD to schizophrenia. The astronomical costs of remedying preventable childhood damage to cognitive, educational, social, and emotional development are borne by families, communities, and social welfare agencies. The societal impacts of this issue are clearly evidenced by stark life expectancy differences within regions. Studies show that in a German city like Hamburg, a mere 10 kilometers can mean a decade less of life, largely attributed to socioeconomic factors. According to the Federal Statistical Office of Germany (Statistisches Bundesamt), youth welfare costs in Germany doubled between 2009 to 2019, totaling 54.9 billion euros per year. These burgeoning expenses to address issues left unresolved from earliest life stages reveal the false economy of disjointed systems.

In sum, fractured healthcare and social welfare siloes fail families during the most critical phase of growth. Fundamentally addressing this issue requires a mindset shift in Germany to recognize pregnancy and the first 3 years as the most critical developmental period, when cross-system collaboration matters most. The resultant lack of psychosocial support for pregnant women cascades into lifelong health, social, and economic repercussions. Systemic reform to enable collaborative, integrated care is essential to detect and assist at-risk families early, averting preventable harm to both babies and budgets. Germany's bifurcated support schemes must be bridged effectively to catch the vulnerable and give every child an equal chance to thrive.

Die Strategie

Sönke's overarching strategy is to bridge the gap between the healthcare system and social welfare system to provide tailored support services for pregnant women and families with high psychosocial stress. To directly serve the primary beneficiary group of vulnerable expecting and new parents, Sönke developed the baby guide program. This innovative approach identifies at-risk families within the healthcare system and offers customized transition assistance into the social welfare system. By linking families to available resources, the program empowers parents to experience greater self-efficacy and strengthens family bonds from the start.

Baby guides are social workers, often with a background as family midwives or nurses, that become an integral part of the staff in the gynecology practices and hospitals they are active in. The baby guide program works by first screening pregnant women for psychosocial needs during routine gynecological checkups and registration of birth in the respective hospital. The screening is done by using targeted questions around finances, relationships, and psychological factors, through which baby guides can identify families facing stressors. These are added to the standard questionnaire in the gynecology practices and hospitals putting emphasis on non-physical related factors of disease for the first time in the medical sector in Germany.

Roughly 20 percent of women require further in-depth conversations after the first screening to fully assess their needs. In the gynecological practice, women are reached at a moment where they have many questions around the preparation of birth and the first year with the baby. After childbirth, Sönke identified the days in the hospital right after as the window of opportunity; women are open to receiving help while once they are at home with their newborns, they feel guilty to admit that they need help. Therefore, in this critical window, baby guide social workers approach all families in need directly at their hospital beds. There they assist them in navigating the complex landscape of social services. This involves identifying the families’ specific needs, building networks with relevant programs and resources, and following up to support continuity of care. Also, women and families with similar psychosocial needs are connected for peer support and exchange. This significantly reduces their stress and frustration levels and increases the self-efficacy and responsibility taken on by the families for themselves and their child, strengthening the resources they already have.

One young woman benefitting from the support, for instance, explained that she had been very overwhelmed at the beginning as she had no partner to accompany her and was in a difficult financial situation. The continuous support from her baby guide gave her the strength and self-confidence to decide in favor of having the child in the first place and, after birth, to be able to focus on the wellbeing and her relationship to her child. The connection made to other peers in comparable situations made her overcome her fear of failing her child. Even the support with very practical things like the process of applying for parental benefits made her life easier and her feeling like she could do what was needed for herself and her child’s upbringing.

To scale up Babylotsen nationally, Sönke shares the successful blueprint with stakeholders like hospitals and social organizations so they can establish similar transitional support systems. Through this open-source collaborative approach, Sönke aims at reaching all pregnant women and families in need in Germany. This scaling through implementation partners has already brought the program to over 88 maternity hospitals and more than 32 gynecology and pediatric practices in 12 German states, reaching up to 20% percent of births in Germany.

Whether the baby guide programs are organized in an inbound or outbound model, is left to each German state to decide to ensure a fit in the complex health and social welfare system within Germany. In Hamburg, where the program was born, Sönke’s foundation SeeYou trains and hires baby guides receiving state funding and sends them to the respective hospitals and gynecology practices. In Berlin, in contrast, baby guides are hired directly by the hospitals and practices that in return receive state funding. The Hamburg Social Welfare Department and as well as the Berlin Senate Department of Health have anchored the Babylotse program in all maternity clinics of the two cities as an integral part of the city's early help services and are committed to securing and further developing the prevention program. To ensure the quality of the program across German states, the quality association Babylotse e.V. was founded in 2019. Its role is the definition of common standards and quality indicators, to develop and implement certification training for baby guides and continuing education programs, and to foster exchange and knowledge transfer among institutions implementing the Babylotsen program.

In addition, Sönke conducts research and innovation projects to create systemic improvements in care. His projects explore integrating cross-system health guides into standard practice, developing scientific evidence to inform nationwide policies around psychosocial support services. For example, a government-funded study provided empirical evidence that the baby guide model is vastly more effective at identifying and addressing patient needs compared to traditional maternity care. It found that the program is 16 times more effective at connecting high-risk patients to follow-up care compared to traditional practices. These tangible results pave the way for long-term impacts on the wellbeing of children and strength of families. By intervening early when parental stress most acutely affects childhood development, Babylotsen equips parents to better support their children’s growth. Reducing parental distress likewise minimizes adverse health effects passed on to babies. Higher utilization of psychosocial services from the start is expected to lower the downstream need for remedial interventions. Generating proof points for this enables Sönke to transfer knowledge and prototype solutions between different disease areas.

Sönke also engages in political advocacy to break down barriers for cross-system coordination. Since 2012, he has co-founded and led a federal working group to channel voices of on-the-ground programs to shape federal policies around early childhood interventions. Bringing together diverse actors from politics, healthcare, and social services, this group advocates for integrating successful support models into public systems. Through building relationships with decision-makers, Sönke fosters political will for sustained solutions benefiting pregnant women and families. This has already let to significant public funding being allocated to baby guide solutions across Germany. Sönke's advocacy further contributed to legal changes mandating psychosocial support as part of maternity hospitals’ duties in multiple states. His federal working group continues to grow, uniting cross-sector voices to advocate for policy changes.

Organizationally, Babylotsen is embedded within Sönke's non-profit foundation, enabling him to make strategic decisions. He mobilizes funding from diverse partners like government programs and hospital fees to financially sustain operations. The volunteer-based federal working group provides a platform for political agenda setting and advocacy. Based on the outcomes of the research and his success in influencing the political landscape, Sönke plans to focus more intensely on advocacy by bringing additional stakeholders on board to champion systemic linkages between health and social care. He will continue to share the Babylotsen blueprint while also cultivating decentralized community networks to customize support locally. By pursuing integration into policy mandates and public financing structures, Sönke aims to cement cross-system coordination as a normalized practice embedded in institutional frameworks. His multidimensional strategy underscores an unwavering commitment to dismantling barriers facing vulnerable families across the care journey.

Die Person

Sönke's upbringing played a significant role in shaping his values and drive for social change. His mother, an educator, and his father, a creative engineer with numerous patents, nurtured his creativity and passion for helping others. Though not the strongest student, Sönke won the lottery for a spot at medical school, embarking on a career pathway where he could fulfill his calling to care for vulnerable populations. Sönke's strong work ethic and determination to make a positive impact on the lives of vulnerable children and families have been evident throughout his career.

Over 20 years as a pediatrician, Sönke worked in various hospitals serving vulnerable populations. He witnessed harsh realities and inequities faced by struggling families, with social issues profoundly impacting children's health. This exposed systemic gaps between healthcare and social services in supporting parents' holistic needs. Sönke quickly realized the long-term societal consequences of inadequate psychosocial support for families during critical early stages. A pivotal moment came with the premature birth of Sönke's twin sons, when he saw parents' vital need for guidance transitioning to a caretaker role. This personal experience inspired him to pioneer an integrated support system embedding social workers into pediatric clinics. During a family trip to Southern Germany, Sönke discovered a pediatric aftercare program called Bunter Kreis. Immediately inspired, he returned to his hospital in Hamburg and established a similar initiative focused on supporting families of sick children after discharge. However, Sönke realized one critical limitation: this aftercare support was restricted only to parents of ill children, overlooking the many psychosocial needs of parents with healthy newborns. Identifying this systemic gap paved the way for Sönke’s creation of the Babylotsen program to provide universal transition support, which based on the newest medical research, was soon complemented with pre-natal care realizing the significant impact of stress on the development of a baby in the uterus during the nine months before birth.

To be able to fully focus on his new idea, Sönke stopped practicing as a pediatrician in 2012. Bridging healthcare and social welfare reflected Sönke's creativity in weaving together disparate systems to address unmet needs. With deep understanding of medical and social contexts, Sönke exemplifies a systems entrepreneur. His background shaped a strong mission to find effective ways of creating social impact for vulnerable families. Sönke's dedication and pragmatic approach make him a standout figure capable of changing policies, narratives, and lives.