BFS+: Process evaluation of an integrative health
approach for lactating women and their babies in humanitarian emergencies, Nguenyyiel refugee camp, Gambella, Ethiopia Key words: lactating woman, babies, breastfeeding, Baby Friendly Spaces, maternal mental health, emergencies, Ethiopia
Study rationale • During humanitarian emergencies, pregnant and lactating women experience heightened risk of maternal morbidity and mortality. The problem is even worse for infants and young children. Evidence from Low and Middle Income Countries shows that environmental stressors such as poverty and exposure to violence place children at a high risk for cognitive and psychological delays and general mental health disorders. • Approximately 30% of women in developing countries suffer from depression during pregnancy or following childbirth; these rates increase during emergencies. • A systematic review of maternal depression and child development in developing countries revealed that children of mothers with depression or symptoms of depression are found to have 1.5 times greater probability of being underweight or stunded. • Maternal depression has also been demonstrated to have a link with suboptimal rates of immunization, hospital visits, and exclusive breastfeeding; higher rates of diarrheal and fever related illnesses; and negatively affects cognitive, motor, and socio-emotional child development indicators. • Even though maternal mental health has been demonstrated as a key factor for child growth, this component is still too rarely taken into consideration in global health programming. • Although Baby Friendly Spaces (BFS) programs are implemented globally, there has been a lack of formal research to date to evidence their impact on the lives of the beneficiaries. Thus, it is necessary to conduct this research to evidence its effectiveness and strengthen program implementation.
Objective of the Research
© Léa Vollet for Aciton Against Hunger - Ethiopia 2017
• The study is conducted with the goal of evaluating the current effectiveness of an integrated health approach, as well as strengthening the implementation and acceptability of the Baby Friendly Spaces intervention programs delivered to lactating women and their babies in humanitarian emergencies.
Where we work • The fieldwork takes place in Nguenyyiel refugee camp in Gambella, Western Ethiopia. The camp currently hosts around 74,000 South Sudanese refugees who have fled conflict and hunger. About 88% of the refugees in the camp are women and children and 5% of the camp population constitutes under-two children. The physical and psychosocial wellbeing of arriving refugees are poor and the prevalence of malnutrition in the camp is alarmingly high (14.3% SENS survey 2018).
The methodology • We use mixed-methods triangulation design that draws on new data collection and analysis of routine monitoring data collected through a strengthened and streamlined system. We plan to recruit 248 respondents from three categories; Group 1: BFS completed, Group 2: BFS dropped out and Group 3: non-attendant groups of women.