Follow-up of Severely Malnourished Children (FUSAM): Effectiveness of a Combined Nutrition Psychosocial Intervention on Health and Development

Grant awarded: £270,384

Lead organisation: Action Contre La Faim France

Partnering organisations: International Centre for Diarrhoeal Disease Research Bangladesh (ICDDR-B); District Public Health Office, Rajbiraj; Child Health Divison; NEEP

Project length: 2015-2017

Study locations: Saptari district, Nepal

Principal Investigator: Cécile Bizouerne, Senior Advisor for Mental Health and Care Practices Sector, Action Contre La Faim.

  • Young mother with her daughter with Severe Acute Malnutrition during a mother-child interaction activity during home based testing in Saptari, Nepal for the FUSAM research.

  • Young mother with her son with Severe Acute Malnutrition during a psychosocial intervention session dealing with Severe Acute Malnutrition, its effects and its treatment in the health centre of Sakhda – Saptari, Nepal as part of the FUSAM research.

  • Mother of a child with Severe Acute Malnutrition encouraging her child to participate in an activity during child development testing in Saptari, Nepal for the FUSAM research.


Purpose:

The majority of Severe Acute Malnourished (SAM) children are treated with therapeutic food in community/home-based care, and little is known about the long-term sustainability of the nutritional and health benefits of treatment after rehabilitation. The research intends to assess the cost-effectiveness and long-term impact of a brief combined nutrition/psychosocial intervention (in comparison to a stand-alone nutritional treatment) on the growth and development of children with SAM aged 6 to 24 months in the Saptari District of Nepal. The psychosocial intervention focuses directly on the key underlying determinants of acute malnutrition within children’s early years, such as child care practices, parent-child relationships and maternal mental health. It includes the mother/caregiver but also empowers her as the key ally in the treatment of the undernourished child. Adding a brief psychosocial component to the standard medico-nutritional treatment is expected to pay off in terms of sustainable recovery, health, and development outcomes of children.

Expected outcomes:

This research will contribute to the growing body of research on the added benefits of a brief psychosocial support to Severe Acute Malnourished (SAM) children’s caregivers as a complement of the nutrition treatment. The combined treatment is expected to be more effective in improving the nutritional and health status of SAM children living under high vulnerability (e.g. weight-gain, MUAC, WHZ, recovery rates, relapse, morbidity and mortality prevention), in optimizing their cognitive, social and emotional development, in promoting good mother-child relations and care practices, and in boosting maternal mental health and general well-being. Moreover, the new combined treatment is expected to be more cost-effective as improved health outcomes should outweigh costs per SAM child recovered.
A guideline will be developed for establishing adequate inpatient and/or community-based psychosocial intervention with recommendations for scaling-up. Finally, a paper will be submitted to a scientific journal.

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