Family Centered Developmental Intervention on Severely Acutely Malnourished Children
Condition: Severly Acutely Malnourished Children
MeSH terms: Malnutrition
Study type: Interventional

Summary: 
      Children with severe acute malnutrition (SAM) are at serious risks that compromise their
      growth and development. Studies have shown the benefits of psychosocial intervention in
      mitigating the negative consequences of SAM. However, such intervention studies have targeted
      the critical period in child development and thus focused on children under three years of
      age. Dietary rehabilitation is usually included as part of the intervention package.
      Moreover, these young children in such studies customarily obtain more care than older ones
      and have access to breast milk, more frequent interaction with mother and other caregivers in
      the family. Therefore, effects of psychosocial interventions targeting such age groups may be
      different for older children. Much is not known if children older than three years of benefit
      from similar interventions, and if family-based psychomotor/psychosocial intervention can
      benefit SAM children in low income contexts such as Ethiopia where access to balanced diet
      remains hardly possible. In Ethiopia, one of the poorest countries in the world, many
      children are admitted to hospital for treatment due to SAM. The nutritional rehabilitation
      unit at hospitals provide dietary treatment to the SAM children who are also treated for
      related illnesses and complications. Once discharged from hospital, however, the SAM children
      return to the same poor home environments with inadequate care and unbalanced diets. The main
      objective of this study was to evaluate the effect of play-based family-centered
      psychomotor/psychosocial stimulation on linear growth, nutritional status and developmental
      outcomes of under-six SAM children in the Jimma Zone, south west Ethiopia. This was done by
      randomly assigning the SAM children admitted to Jimma University's Specialized Referral
      Teaching Hospital into control and intervention groups. Both groups were receiving the
      routine medical and dietary treatment services. The intervention group additionally received
      play-based psychomotor/psychosocial stimulation. Caregivers, supported by periodic visits
      made to their homes, continued the simulation. Measurements were taken after six months of
      home follow-up. It was hypothesized that the intervention would significantly improve some of
      the developmental skills of these children, and that the effect may be age-dependent.
    


Intervention name(s): Play-based family centered stimulation; no intervention
Intervention type(s): Behavioral; Other
Intervention description(s): Children in the intervention group received routine medical treatment and nutritional rehabilitation services in hospital; their primary caregivers were given basic orientations on child care, feeding and nutrition. Children attended play-based stimulation sessions in which trained nurses demonstrated caregivers on how to stimulate the SAM child using play materials and facilities at playroom and playground of the hospital. After discharge from hospital, they were followed up at home and visited three times over a period of six months. During the visits, new play materials were provided and caregivers were shown how to use them to stimulate the SAM child.; On the other hand, the control SAM group did not receive the guided psychomotor/psychosocial stimulation services although they had access to the playground facilities. Both the intervention and the control groups received all the routine medical care and dietary rehabilitation services at the hospital.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Other