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| Name | Class |
|---|---|
| International Centre for Diarrhoeal Disease Research, Bangladesh | OTHER |
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The overall objective of the research is to assess the long-term and cost-effectiveness of a combined nutrition psychosocial intervention to a stand-alone nutritional treatment of children with Severe Acute Malnutrition (SAM) aged 6 to 24 months in the Saptari District of Nepal.
In Nepal, the majority of 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 two treatments will be compared in terms of costs of treatment and convened health benefits (child nutritional status and development, cured rate and relapse, maternal mental health, and family care practices) at both short and long-term periods after admission. The proposed complementary psychosocial intervention focuses directly on the key underlying determinants of acute malnutrition within children's early years, such as child care practices and stimulation, parent-child relationships and maternal mental health. It includes the mother/caregiver as patient of psychosocial support, 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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| new combined NUTPSY treatment | Experimental | 2-month combined nutrition and psychosocial intervention |
|
| standard NUT treatment | Active Comparator | 2-month of standard nutritional treatment only |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| NUTPSY treatment | Other | The psychosocial component of the new combined treatment involves seven weekly counselling sessions with mothers focused on feeding, emotional attachment, stages of child development, stimulation, emotional responsiveness and interaction, and on concerns/strategies of child care and parenting. |
| Measure | Description | Time Frame |
|---|---|---|
| Child motor, cognitive, emotional and social development assessed with Ages and Stages Questionnaire | The Ages and Stages Questionnaire (Squires et al, 1999), is a low-cost, easily administered, parent-report screening test of development in communication, motor, problem-solving and personal-social domains. The questionnaire has been adapted and used in low- and middle-income countries in Africa, Asia and Latin America, where it has demonstrated sensitivity to child nutritional status and psychosocial stimulation. While it is not a diagnostic test, it offers an opportunity to systematically obtain information about children's development with an instrument that does not require extensive training | up to 11 months after inclusion |
| Measure | Description | Time Frame |
|---|---|---|
| Child Care Practices | The quality of care practices is measured by assessing the level of knowledge and the practices. It comprises sub-thematics: care for women, pregnancy and delivery, care for the newborn, breastfeeding and feeding, access to resources for care, as well as child development and psychosocial care. The Child Care Knowledge & Practices Questionnaire has been developped by Action Contre la Faim. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Cecile Bizouerne, PhD | Action Contre la Faim | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| ACF, Nepal | Kathmandu | Nepal |
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| Label | URL |
|---|---|
| Media link from the first communication event of the FUSAM project in Nepal and steering committee meeting | View source |
| Oral presentation at the ACF International conference in Nepal, June 2017 | View source |
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| ID | Term |
|---|---|
| D000067011 | Severe Acute Malnutrition |
| ID | Term |
|---|---|
| D044342 | Malnutrition |
| D009748 | Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
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| NUT treatment | Other | Only the standard nutritional treatment in the form of Ready-to-use Therapeutic Food (RUTF) is administered. |
|
| Up to 11 months after inclusion |
| Mother-child interaction | Action Contre la Faim's Mother-Child Interaction Grid will be used for assessing the quality of mother-child interactions and interpersonal sensitivity and responsiveness. | Up to 11 months after inclusion |
| Child stimulation | Family Care Indicators (FCI) (Frongillo et al, 2003) is used to assess the quality of child stimulation | Up to 11 months after inclusion |
| Maternal perinatal mental health | The Edinburgh Post-natal Depression Scale (Cox et al, 1987) is a valuable and efficient way of identifying mothers at risk for "perinatal" depression. | Up to 11 months after inclusion |
| Perceived Social Support | The Multidimensional Scale of Perceived Social Support (Zimet et al, 1988) measures perceived support from 3 sources: family, friends and significant others. | Up to 11 months after inclusion |
| Maternal self-esteem | The Rosenberg self-esteem scale (Rosenberg, 1965) assesses maternal self-esteem. | Up to 11 months after inclusion |
| Maternal mental health | The WHO Self Reporting Questionnaire (SRQ-20) (WHO, 1994) assesses the frequency of depressive symptoms, anxiety, and psychosomatic complaints in the past month. The measure has been shown to be an accurate predictor of common mental disorder and has been successfully used in several studies in developing countries. | Up to 11 months after inclusion |
| Child growth (height) | Child growth measures change in height | Up to 11 months after inclusion |
| Child nutritional status defined by Mid-Upper Arm Circumference (MUAC) | Comparison of the mean MUAC adjusted to age, sex and height | Up to 11 months after inclusion |
| Child nutritional status defined by Weight-For-Height Z-score | Comparison of the mean Weight-For-Height Z-score | Up to 11 months after inclusion |
| Child nutritional status defined by height-for-Age Z score | Comparison of the mean height-for-Age Z score | Up to 11 months after inclusion |
| Child health status (morbidity rate) | Follow-up of morbidity rate | Up to 11 months after inclusion |
| Child death (mortality rate) | Follow-up of mortality rate | Up to 11 months after inclusion |