Acceptability and feasibility of integrating psychosocial stimulation interventions in the inpatient care of children with severe acute malnutrition in resource-poor settings: a qualitative study.

Abstract

Children with Severe Acute Malnutrition (SAM) are at risk of developmental problems. Psychosocial stimulation can improve the developmental outcomes of hospitalised children with SAM. However, the intervention has remained underutilised in health facilities in resource-poor settings. Moreover, there is limited evidence on the acceptability and feasibility of the intervention. We conducted a qualitative study to explore the acceptability and feasibility of integrating psychosocial stimulation interventions in the inpatient care of children with SAM in selected areas in the Silti Zone, Central Ethiopia. Nine focus group discussions and 15 key informant interviews were conducted with parents, health workers, and other stakeholders. The data were transcribed, translated, and analysed using a thematic approach. Caregivers and health workers had positive attitudes toward the intervention and perceived it beneficial for the children's development, recovery, and bonding with the mothers. Health workers reported barriers such as lack of materials, time, and space, capacity building training, and supervision for the effective implementation of the intervention. At the household level, gendered factors such as the housework burden of mothers and the inadequate engagement of fathers in childcare were the main challenges to the implementation of the intervention. Overall, psychosocial stimulation intervention was found to be acceptable and feasible for routine implementation with inpatient care provided for children with SAM. The study recommends supporting health facilities, health workers, and partners with the necessary resources and skills to promote the implementation of stimulation interventions along with the existing care provided in health facilities in resource-poor settings.