Adaptation and integration of psychosocial stimulation, maternal mental health and nutritional interventions for pregnant and lactating women in rural Bangladesh

Fahmida Akter, Mahbubur Rahman, Helen O. Pitchik, Peter J. Winch, Lia C.H. Fernald, Tarique Mohammad Nurul Huda, Tania Jahir, Ruhul Amin, Jyoti Bhushan Das, Khobair Hossain, Abul Kashem Shoab, Rizwana Khan, Farzana Yeasmin, Jesmin Sultana, Stephen P. Luby, Fahmida Tofail

Research output: Contribution to journalArticlepeer-review

Abstract

Supporting caregivers’ mental wellbeing and ability to provide psychosocial stimulation may promote early childhood development. This paper describes the systematic approach of developing an integrated stimulation intervention, identifying the feasibility and challenges faced throughout the period. We developed an integrated curriculum by culturally adapting three interventions (Reach Up, Thinking Healthy, and general nutrition advice) and piloted this curriculum (Mar–April 2017) in courtyard groups sessions and individual home visits with pregnant women (n = 11) and lactating mothers (of children <24 months) (n = 29). We conducted qualitative interviews with the participants (n = 8) and the community health workers who delivered the intervention (n = 2). Most participants reported willingness to attend the sessions if extended for 1 year, and recommended additional visual cues and interactive role-play activities to make the sessions more engaging. Participants and community health workers found it difficult to understand the concept of “unhealthy thoughts” in the curriculum. This component was then revised to include a simplified behavior-focused story. Community health workers reported difficulty balancing the required content of the integrated curriculum but were able to manage after the contents were reduced. The revised intervention is likely feasible to deliver to a group of pregnant and lactating mothers in a low-resource setting.

Original languageEnglish (US)
Article number6233
Pages (from-to)1-16
Number of pages16
JournalInternational journal of environmental research and public health
Volume17
Issue number17
DOIs
StatePublished - Sep 1 2020

Keywords

  • Adaptation
  • Early childhood development
  • Integrated intervention
  • Maternal mental health
  • Nutrition
  • Psychosocial stimulation

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis

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