Introducing psychosocial stimulation to the treatment of children with acute malnutrition in Mali: a randomized clinical trial
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Background: Undernutrition affects 200 million children under five-years-old. The
causes of malnutrition are multifactorial; in the mid and low-income countries, the
causes include political, economic and environmental factors that provoke an unstable
situation. Thus, producing food insecurity and insufficient health services. In these
conditions, children suffer from a lack of emotional, social, motor and cognitive
stimulation contributing to a worse children’s condition, as well as, affecting the
relationship between the child and their caregiver. The actual treatment of
malnutrition is based on an effective nutritional protocol without taking into
consideration the lack of stimulation. Nonetheless, in the last years, the WHO includes
psychosocial stimulation to the nutritional treatment in their recommendations to
treat malnutrition. Anyhow, evidence to support including psychosocial stimulation in
the treatment of undernourished children is scarce. Several projects have tried to fill
the evidence gap by conducting trials that show isolated improvements in the
development of the children that received the psychosocial intervention when
compared to a control group. With this study, we wanted to contribute to fill the
evidence gap and add information around the effects of psychosocial stimulation in
malnourished children.
Objective: The aim of this study is to examine whether anthropometric measures
improve when psychosocial stimulation to food supplementation is added in children
with malnutrition.
Design and methods: A randomized controlled trial will take place at the “Hôpital
Femmes et Enfants”, located in the city of Koutiala in Mali. 230 children between the
ages of six months and fifty-nine months will be randomly assigned to the control
(n=115) or the intervention group (n=115). The psychosocial intervention will consist of
one session a week for a total of six weeks. Anthropometric measures such as weight
for height and mid-upper arm circumference (MUAC) will be collected to do the
statistical analysis adjusting them for all covariates
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