Psychosocial impacts of Baby Friendly Spaces for Rohingya refugee mothers in Bangladesh: A pragmatic cluster-randomized controlled trial.

Background: This study evaluated the effectiveness of Baby Friendly Spaces (BFS), a psychosocial support program for Rohingya refugee mothers of malnourished young children in Bangladesh. Because BFS was already being implemented, we examined the benefit of enhancing implementation supports. Methods: In matched pairs, 10 sites were randomized to provide BFS treatment as usual (BFS-TAU) or to receive enhanced implementation support (BFS-IE). 600 mothers were enrolled and reported on maternal distress, functional impairment, subjective well-being and coping at baseline and 8-week follow-up. Data were analyzed using multilevel linear regression models to account for clustering; sensitivity analyses adjusted for the small number of clusters. Results: Significant within-group improvements in BFSIE were observed for distres (-.48, p = .014), functional impairment (-.30, p = .002) and subjective well-being (.92, p = .011); improvements in BFS-TAU were smaller and not statistically significant. Between-group comparisons favored BFS-IE for distress (ß = -.30, p = .058) and well-being (ß = .58, p = .038). Sensitivity adjustments produced p-values above .05 for all between-group comparisons. Discussion: Feasible adjustments to implementation can improve program delivery to increase impact on maternal distress and well-being. Although results should be interpreted with caution, study design limitations are common in pragmatic, field-based research.

Pratiques de soin et santé mentale en Haïti: Rapport dÆévaluation

Ce document est une évaluation des pratiques de soins et santé mentale en Haïti en 2009, suite aux cyclones Hanna et Ike de septembre 2008 qui ont affectés Haïti et particulièrement la ville de Gonaïves. ACF a détecté lors de l'exécution de ces actions dans un autre domaine, le fort besoin de prise en charge psychologique des populations bénéficiaires. Pour cela l'organisation a décidé de réaliser cette évaluation dont les objectifs sont d'évaluer les besoins et les ressources en santé mentale et pratiques de soin suite aux cyclones, afin de proposer un positionnement pour ACF et développer de nouveaux projets.