Abstract
BACKGROUND AND AIMS
Early psychosocial stimulation with disadvantaged infants can lead to short- and long-term benefits in cognitive and social development. Programs with multiple
components, including health, nutrition, and psychosocial stimulation have shown to be the most successful at enhancing the rehabilitation of severe acute malnourished (SAM) children. The STIMNUT study assesses the feasibility of integrating an adapted version of the ‘Follow-Up of Severe Acute Malnourished children’ (FUSAM) protocol developed by Action Contre la Faim into the Médecins Sans Frontières (MSF) Therapeutic Feeding Programme in Koutiala (Mali) for SAM children aged 6-23 months and their primary caregivers.
METHODS
A convergent mixed methods study was implemented between July 2022 and May 2023 in two outpatient health facilities and the general hospital in Koutiala. An adaptation of the PRECEDE-PROCEED conceptual framework was used to adapt, implement and evaluate the psychosocial stimulation intervention. The study was
divided into 3 successive phases: (1) a mixed methods initial assessment at community level, (2) the contextual adaptation of the FUSAM protocol through a participatory approach (PAR) and (3) an assessment of its acceptability. For this assessment, 15 individual interviews with mothers were conducted. Qualitative and quantitative data were analyzed and interpreted concurrently.
RESULTS
During the PAR process, various stakeholders including, development workers and health professionals, parents of SAM children and traditional healers, worked together to practically adapt the intervention. They proposed for instance to include a community-level ceremony at the beginning of the intervention with traditional authorities, villages chiefs and other local stakeholders to increase its appropriation and to sensitize community members. During phase 3, a total of 149 psychosocial stimulation sessions (122 individual and 27 collective) were delivered by a team of 3 psychosocial workers to the 36 families included. The preliminary acceptability results showed that the sessions were well appreciated by the mothers. They became more acceptable as the intervention progressed because of the resulting positive changes in their children’s wellbeing, in theirs and their families’ relationship with their children, and in the mothers' relationships with their husbands and extended family.
CONCLUSION
The implementation of the adapted version of FUSAM protocol and its acceptability assessment at primary and secondary health care levels will now be used to inform the further deployment of the intervention. In particular, the results have allowed the development of a framework for the StimNut intervention to make it locally relevant and to guide its reproducibility in other contexts.
KEY MESSAGE
StimNut is a mixed method feasibility study on the integration of a psychosocial stimulation intervention into the standard nutritional care for SAM children aged 6-23 months In Koutiala, Mali.
This abstract is not to be quoted for publication.
