Does combining infant stimulation with emergency feeding improve psychosocial outcomes for displaced mothers and babies? A controlled evaluation from Northern Uganda.

Abstract

Combined psychosocial and nutrition interventions improve the development of infants. However, there is a paucity of studies examining the effectiveness of such interventions in humanitarian settings. This article examines the impact of combining a group-based psychosocial intervention with an existing emergency feeding program for internally displaced mothers in Northern Uganda. The intervention consisted of mother and baby group sessions and home visits for mothers attending 3 emergency feeding centers. Psychosocial outcomes were compared with a contrast group of mothers who received nutritional support alone. The outcomes investigated were infant stimulation and maternal mood. After controlling for the effects of interview site and baseline scores, mothers in the intervention group (n = 70) showed greater involvement with their babies, more availability of play materials, and less sadness and worry at follow-up in comparison to the contrast group (n = 77). The intervention was acceptable to the mothers and easily taught. A proportion of the mothers chose to continue the intervention spontaneously with other mothers in their neighbourhoods. Further research needs to be done to validate these preliminary findings and explore the longer term impact on child growth and intellectual development as well as maternal mood.

Interventions for common perinatal mental disorders in women in low- and middle-income countries: a systematic review and meta-analysis

“…1). [22][23][24][25][26][27][28][29][30][31][32][33][34][35] China contributed three trials; India, Pakistan and South Africa contributed two trials each, and Chile, Jamaica, Mexico and Uganda contributed one each. Twelve studies were controlled and randomized either at the individual or the cluster level and one study 28 used a historical matched control from another epidemiological study.…”

“…Ho et al 33 and Lara et al 31 provided information about the symptoms and causes of postpartum depression in an information booklet and supplemented this with either supportive discussion with a primary care nurse to encourage early help-seeking behaviour, 33 or participation in a series of group discussions facilitated by professionals. 31 Five studies 22,24,26,28,35 did not address maternal mental health directly. However, the researchers hypothesized that individual parenting education provided by a supportive home visitor or within the context of a mother's group might also improve maternal depression and improve infant health and development.…”

“…In South Africa, Cooper et al 26,28 demonstrated what neonates could do using a neonatal assessment scale. In a study conducted by Baker-Henningham et al 22 in Jamaica and in the adapted Learning Through Play (LTP) programmes implemented in Pakistan 24 and northern Uganda, 35 mothers were shown ageappropriate play activities and how to craft toys out of affordable, accessible materials to stimulate infant cognitive development. In broad terms, the theoretical rationale underpinning these approaches was that optimal child development requires maternal caregiving that attends explicitly to development in the physical, social, emotional and cognitive domains.…”

“…In broad terms, the theoretical rationale underpinning these approaches was that optimal child development requires maternal caregiving that attends explicitly to development in the physical, social, emotional and cognitive domains. The interventions carried out in these five studies aimed to enhance mothers' knowledge about normal child development, improve maternal sensitivity and responsiveness towards infants and, through group programmes, 24,35 reduce social isolation and improve maternal mood by means of peer support.…”

Broadening the scope of epidemiology in conflict-affected settings: opportunities for mental health prevention and promotion

“…Although evidence-based strategies exist to improve early childhood outcomes in LMICs (e.g., breastfeeding, parenting and pre-school programmes), there is a need for the development of integrated interventions that can address the multiple stressors that children are commonly exposed to (Engle et al, 2011). More evidence is required to determine whether the treatment of maternal mental disorders will improve developmental outcomes, or how integrated nutrition and early stimulation can best be applied in conflict-affected settings (Morris et al, 2012).…”