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.


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.


Elrha is a registered charity in England and Wales (1177110).

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