Conference Material > Slide Presentation
Bossard C, Payotte S, Scarpa G, Diallo AK, Lissouba P, et al.
MSF Paediatric Days 2024. 2024 May 3; DOI:10.57740/hbFEFb2
Conference Material > Abstract
Le Roch K, Nguyen AP, Rahaman KS, Clouin L, Murray S
MSF Paediatric Days 2022. 2022 November 26; DOI:10.57740/spmc-3h07
BACKGROUND AND AIMS
Despite the well-recognised risk poor maternal mental health poses to child growth, it is still rarely addressed in global health programming. There is also a relative lack of evidence for low-intensity psychosocial programmes aiming at improving or promoting maternal mental health in humanitarian contexts within low- and middle-income countries (LMICs). In Bangladesh, we sought to evaluate the effectiveness of a psychosocial support programme for Rohingya refugee mothers and their malnourished infants under two years old.
METHODS
Using matched pair randomisation, ten Baby-Friendly Spaces (BFS) programme sites were allocated to either service delivery “as usual” or to an “enhanced BFS programme” after re-training and providing continuous supervision of the Mental Health and Psychosocial Support (MHPSS) staff. 600 mothers and their infants were enrolled in the study, with data collected at baseline and 8-week follow-up. Primary outcomes included maternal distress and well-being; functioning; and coping. We also collected data on child gross motor milestones and child psychosocial stimulation.
RESULTS
Relative to “as usual” sites, mothers in “enhanced BFS programme” sites reported greater reductions in distress (B=-0.30) and improvement in well-being (B=0.58). These differences were small, but marginally significant (p=0.058; p=0.038 respectively) with standard estimation. Among children who, at baseline, were at both a similar age and similar stage of development, the average stage of development score at follow-up for children in the intervention group was 0.14 points lower than for children in the control group, but this difference was not significant (p=0.488).
CONCLUSIONS
Integrating psychosocial support activities with nutrition services has the potential to reduce distress and improve subjective well-being of conflict-affected mothers of malnourished children. Results were weaker for improving functioning and positive coping. Small but feasible adjustments to implementation can both improve programme delivery to maximise impact and support the effectiveness of research.
Despite the well-recognised risk poor maternal mental health poses to child growth, it is still rarely addressed in global health programming. There is also a relative lack of evidence for low-intensity psychosocial programmes aiming at improving or promoting maternal mental health in humanitarian contexts within low- and middle-income countries (LMICs). In Bangladesh, we sought to evaluate the effectiveness of a psychosocial support programme for Rohingya refugee mothers and their malnourished infants under two years old.
METHODS
Using matched pair randomisation, ten Baby-Friendly Spaces (BFS) programme sites were allocated to either service delivery “as usual” or to an “enhanced BFS programme” after re-training and providing continuous supervision of the Mental Health and Psychosocial Support (MHPSS) staff. 600 mothers and their infants were enrolled in the study, with data collected at baseline and 8-week follow-up. Primary outcomes included maternal distress and well-being; functioning; and coping. We also collected data on child gross motor milestones and child psychosocial stimulation.
RESULTS
Relative to “as usual” sites, mothers in “enhanced BFS programme” sites reported greater reductions in distress (B=-0.30) and improvement in well-being (B=0.58). These differences were small, but marginally significant (p=0.058; p=0.038 respectively) with standard estimation. Among children who, at baseline, were at both a similar age and similar stage of development, the average stage of development score at follow-up for children in the intervention group was 0.14 points lower than for children in the control group, but this difference was not significant (p=0.488).
CONCLUSIONS
Integrating psychosocial support activities with nutrition services has the potential to reduce distress and improve subjective well-being of conflict-affected mothers of malnourished children. Results were weaker for improving functioning and positive coping. Small but feasible adjustments to implementation can both improve programme delivery to maximise impact and support the effectiveness of research.
Conference Material > Abstract
Bossard C, Payotte S, Scarpa G, Diallo AK, Lissouba P, et al.
MSF Paediatric Days 2024. 2024 May 3; DOI:10.57740/K4bnf08
BACKGROUND AND OBJECTIVES
Early psychosocial stimulation for infants in precarious situations can yield both short- and long-term benefits to cognitive and social development. Comprehensive programmes, covering health, nutrition, and psychosocial stimulation prove most effective in preventing cognitive impairment and enhancing treatment for children with severe acute malnutrition (SAM). The StimNut study assesses the effects of early psychosocial stimulation on maternal mental health and mother-child relationship, as well as the acceptability of integrating such an intervention into the existing Médecins Sans Frontières (MSF) nutrition programme in Koutiala, during a 5-week period.
METHODS
Mixed-methods data were collected through standardised pre- and post- intervention questionnaires and included: a ‘Dusukasi’ screening tool for local perinatal depression-like symptoms; observations of mother-child interactions using an adapted PICCOLO (Parenting Interactions with Children: Checklist of Observations Linked to Outcomes) tool; as well as semi-structured interviews with caregivers, MSF psychosocial workers, and healthcare staff.
RESULTS
149 psychosocial stimulation sessions were conducted with 36 families by three supervised MSF psychosocial workers. Perinatal depression symptoms were found in 53% of mothers before the intervention and 28% after the intervention (p=0.001). Positive changes in the mother-child relationship were observed in 83% of families after the 5-week intervention and more frequent and appropriate responses of the caregivers to the child’s emotional state were noted. Positive changes were also perceived by the mothers as the sessions progressed: their sense of parenting skills was strengthened, their children’s health improved, and the other family members became more involved in childcare practices. The intervention also dismantled healthcare staff prejudices towards mothers of children with SAM, fostering a trusting relationship between them.
CONCLUSIONS
This study demonstrates the positive impact of the early psychosocial stimulation of children with SAM on maternal mental health and the quality of mother-child relationship. As MSF pursues further endeavours in this direction, it is important to recognise the transformative potential these interventions hold for promoting the overall wellbeing of families of children with SAM in humanitarian and low-income countries.
Early psychosocial stimulation for infants in precarious situations can yield both short- and long-term benefits to cognitive and social development. Comprehensive programmes, covering health, nutrition, and psychosocial stimulation prove most effective in preventing cognitive impairment and enhancing treatment for children with severe acute malnutrition (SAM). The StimNut study assesses the effects of early psychosocial stimulation on maternal mental health and mother-child relationship, as well as the acceptability of integrating such an intervention into the existing Médecins Sans Frontières (MSF) nutrition programme in Koutiala, during a 5-week period.
METHODS
Mixed-methods data were collected through standardised pre- and post- intervention questionnaires and included: a ‘Dusukasi’ screening tool for local perinatal depression-like symptoms; observations of mother-child interactions using an adapted PICCOLO (Parenting Interactions with Children: Checklist of Observations Linked to Outcomes) tool; as well as semi-structured interviews with caregivers, MSF psychosocial workers, and healthcare staff.
RESULTS
149 psychosocial stimulation sessions were conducted with 36 families by three supervised MSF psychosocial workers. Perinatal depression symptoms were found in 53% of mothers before the intervention and 28% after the intervention (p=0.001). Positive changes in the mother-child relationship were observed in 83% of families after the 5-week intervention and more frequent and appropriate responses of the caregivers to the child’s emotional state were noted. Positive changes were also perceived by the mothers as the sessions progressed: their sense of parenting skills was strengthened, their children’s health improved, and the other family members became more involved in childcare practices. The intervention also dismantled healthcare staff prejudices towards mothers of children with SAM, fostering a trusting relationship between them.
CONCLUSIONS
This study demonstrates the positive impact of the early psychosocial stimulation of children with SAM on maternal mental health and the quality of mother-child relationship. As MSF pursues further endeavours in this direction, it is important to recognise the transformative potential these interventions hold for promoting the overall wellbeing of families of children with SAM in humanitarian and low-income countries.
Conference Material > Slide Presentation
Le Roch K, Nguyen AP, Rahaman KS, Clouin L, Murray S
MSF Paediatric Days 2022. 2022 December 1; DOI:10.57740/kr18-9r27
Conference Material > Poster
Bossard C, Lissouba P, Payotte S, Diallo AK, Keane G, et al.
MSF Paediatric Days 2022. 2022 November 30; DOI:10.57740/05ty-ra38
Conference Material > Video (talk)
Le Roch K
MSF Paediatric Days 2022. 2022 November 29; DOI:10.57740/14mz-3555
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