In 2021, an estimated 52 million children under the age of 5 were affected by wasting (too thin for their height) worldwide, and a further 155 million were affected by stunting (too short for their age)*. In Chad, HI offers a range of interventions for malnourished children and their parents: stimulation therapy for malnourished children delivered by our physical therapists, and psychosocial support, including group recreational activities, provided by our psychosocial support workers.
More specifically, HI’s rehabilitation specialists have developed an approach called stimulation therapy for malnourished children, which, when combined with nutritional and medical care and psychosocial support, gives them the best chances of survival, greater resilience and improves their future quality of life.
* UNICEF/WHO/WB Joint Child Malnutrition Estimates (JME) 2021.
The emotional bond – essential during sessions
The quality of the relational bond is an essential factor in individual stimulation therapy sessions and in the group recreational activities organised as part of psychosocial support. Young children are dependent on adults, but so is their development. So, all the exploratory activities – play, physical contact and discovery of the environment - are necessary for children's neurological maturity and psycho-affective development and depend on the bonds they have with their entourage. Interventions are therefore proving effective not only for the development of malnourished children, but also for improving parents' ability to stimulate their children and help them grow.
"The interaction between the parents and children is very important. Not only does it strengthen the bond between them, it also allows the children to feel more secure and to fully immerse themselves in play. It's also crucial because it motivates the parents to continue to stimulate their children as much as possible and to be attentive to their needs," explains Nestor Sainkam, HI Psychosocial Support Officer.
The aim of these sessions is to help establish a relationship of trust so that the children can explore the world around them in complete safety. Therefore, a good quality relationship provides a solid foundation for the activities and the games proposed, and is the key to successful treatment.
Support for Zenaba and her mother, Amina
Amina and her daughter, Zenaba, live in the town of N'Djamena, Chad. Zenaba experienced an episode of severe acute malnutrition with medical complications. The little girl was hospitalised for several weeks in a Therapeutic Feeding Unit and then, after recovering from this episode, she was transferred to the Outpatient Feeding Unit in the same hospital. Mother and daughter then received psychosocial support and stimulation therapy sessions as part of a programme to strengthen the parent-child bond.
"Zenaba was 16 months old when she began the sessions. Before her episode of malnutrition, she had a very good relationship with her mother, but during her stay in hospital, she reacted less and less to her mother's stimulation and interacted less with her brothers. After a few sessions of stimulation therapy for malnourished children and recreational activities, and especially after discussions with her parents on positive parenting, Zenaba and her mother were able to work well together. Today, Amina calls us from time to time to tell us how well Zenaba is progressing, not only psychosocially but also physically, cognitively, linguistically and sensorially", adds Nestor Saikam.
Amina and Zenaba were cared for by HI physical therapists for stimulation therapy sessions, and were then redirected to the teams in charge of psychosocial support for recreational activities. After an individual interview aimed at strengthening the positive parent-child relationship, and a number of activity sessions (presentations on positive parenting, drawings, games, mother-daughter massages, etc.), Amina expressed her thanks:
"I'm very happy about everything HI has done for me and my daughter. I have learnt a lot about the importance of the affection and attention that a parent should give to their child. These activities have given me a better understanding of my daughter's needs. Today, I'm able to give her all the love and attention she needs to thrive."
The young mother has now learned about positive parenting, the main pillars of positive education, and the impact of play, contact and shared discovery in stimulating her child and supporting her growth.
The RIMSCASSA project provides rehabilitation, inclusive humanitarian action, mental health and psychosocial support, as well as a stimulation therapy for malnourished children for vulnerable groups in sub-Saharan Africa. The project aims to increase access to basic and specific services for victims of improvised explosive devices and explosive remnants of war, people with disabilities, malnourished children and people in psychological distress among crisis-affected populations. It provides direct support to 4,800 malnourished children who benefit from stimulation therapy for malnourished children and psychosocial support, and 180 people with physical disabilities who benefit from targeted rehabilitation services.
