Abstract
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.
