Child play and caregiver support to promote convalescence following severe acute malnutrition in Zimbabwe

The Tamba‐SAM pilot study

Datos Bibliográficos

ID15535820
AutoresJacqueline Kabongo (0009-0009-0345-479X, Zvitambo Institute for Maternal and Child Health Research), Louisa Mudawarima (0000-0001-6742-3989, University of Zimbabwe), Florence D Majo (0009-0006-1282-0462, Zvitambo Institute for Maternal and Child Health Research), Anesu Dzikiti (Zvitambo Institute for Maternal and Child Health Research), Joice Tome (Zvitambo Institute for Maternal and Child Health Research), Bernard Chasekwa (0000-0001-8080-7573, Zvitambo Institute for Maternal and Child Health Research), Batsirai Mutasa (Zvitambo Institute for Maternal and Child Health Research), Lloyd Dzapasi (Family Aids Caring Trust), Epiphania Munetsi (0000-0001-9174-3827, Family Aids Caring Trust), Isabella Cordani (Queen Mary University of London), Robert Ntozini (0000-0002-8543-2835, Zvitambo Institute for Maternal and Child Health Research), L Langhaug (0000-0002-9131-8158, Zvitambo Institute for Maternal and Child Health Research), Lisa F Langhaug (Zvitambo Institute for Maternal and Child Health Research Harare Zimbabwe), Mutsa Bwakura-Dangarembizi (0000-0001-7751-6177, University of Zimbabwe), Andrew J Prendergast (0000-0001-7904-7992, Queen Mary University of London, autor de correspondencia)
Año2024
Volumen21
Número1
Páginase13726-e13726
Fecha de publicación2024-09-13
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaMaternal and Child Nutrition (JOURNAL)
Identificadores de la revistaISSN: 1740-8695 • E-ISSN: 1740-8709
EditorialWiley (PUBLISHER • GB)
DOI10.1111/mcn.13726
PMID39267583
OpenAlexW4402525768
IdiomaEN
Citas recibidas1
Referencias citadas27

Children hospitalised for severe acute malnutrition (SAM) have a high risk of mortality, relapse and rehospitalisation following hospital discharge. Current approaches fail to promote convalescence, or to address the underlying social determinants of SAM, meaning that restoration of long-term health, growth and neurodevelopment is not achieved. Although guidelines recommend play and stimulation to promote recovery, most caregivers are not supported to do this at home. We set out to evaluate the feasibility and acceptability of a codesigned intervention package aimed at providing child stimulation through play, and strengthening caregiver capabilities through problem-solving skills, peer support and income-generating activities. We evaluated the intervention in two phases, enroling 30 caregiver-child pairs from paediatric wards in Harare, Zimbabwe, once children who had been hospitalised with SAM were ready for discharge. Children were median 17.8 months old, and 28.6% had human immunodeficiency virus. Trained intervention facilitators (IFs)-lay workers whose own children had previously had SAM-delivered the intervention over 12 weeks with nurse supervision. Qualitative interviews with caregivers and IFs showed that the intervention was feasible and acceptable. Participants reported benefiting from the psychosocial support and counselling, and several started income-generating projects. Caregivers appreciated the concept of play and caregiver-child interaction, and all reported practising what they had learned. By Week 12, caregiver mental health and caregiver-child interaction improved significantly. Overall, the intervention was feasible, acceptable and showed promise in modifying caregiver knowledge, attitudes and practice. An efficacy trial is now needed to evaluate whether the intervention can improve child convalescence following complicated SAM

Convalescence · Malnutrition · Severe Acute Malnutrition · Child Nutrition and Feeding Issues · Child Nutrition and Water Access · Medicine · Poverty, Education, and Child Welfare · Internal Medicine · Pediatrics · Surgery