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PSYCHOSOCIAL CARE IN NUTRITION PROGRAMS

PSYCHOSOCIAL CARE IN NUTRITION PROGRAMS. PSP Castelldefels 2010. Main Principle of Malnutrition & Intervention. SYSTEMIC APPROACH!. HARDLY EVER ONE UNIQUE CAUSE. Unicef extended model 2006. MAIN CAUSES OF MALNUTRITION. Child care practices -Care for women & children -Hygiene

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PSYCHOSOCIAL CARE IN NUTRITION PROGRAMS

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  1. PSYCHOSOCIAL CARE IN NUTRITION PROGRAMS PSP Castelldefels 2010

  2. Main Principle of Malnutrition & Intervention SYSTEMIC APPROACH! HARDLY EVER ONE UNIQUE CAUSE

  3. Unicef extended model 2006 MAIN CAUSES OF MALNUTRITION Child care practices -Care for women & children -Hygiene -Food preparation -Feeding practices Food intake Access to Health Care Child development (Growth & Development) Resources Caretaker -Knowledge -Control resources -Workload -Mental Health -Social support Health -WatSan -Medical -Security Food -Production -Income -Property

  4. Konrad Lorenz on imprinting, John Bowlby ’s Attachment theory, and Spitz ‘s hospitalism

  5. WHO 2006 Mental Health and Psychosocial Well–Being among Children in Severe Food Shortage Situations Severe food shortage Insufficient care / stimulation Lack of nutrious food Poor health Malnutrition Psychosocial deprivation Developmental delays and Mental health problems

  6. Nutritional Problems and mental health problems Nutritional problems and psychosocial stimulation and social difficulties Nutritional problems and developmental problems

  7. Attachment mother-child Insecurity: insisting on closeness Anger, refusal food (anorexia) Separation mother-child (Kwashiorkor) Family, other caregivers support Role model (mother or other family) Cultural factors (ancestors, reincarnation..) CAREGIVER – CHILD LINK PLEASE NOTE: CHILD-CAREGIVER RELATIONSHIP OFTEN STRAINED BEFORE MALNUTRITION

  8. INDICATORS FOR INTERVENTION Child: -Never Smiles, not drawing attention -Always lying down -Not playing -Relapses/ no weight gain Caretaker: -Rejects the child, no pleasure in breastfeeding -Always wants to go out, no time with child -Complaints about the child -Alone / Not talking to others -Looks sad or cries -Age (absence of role model) Special groups: -Widows -Geographically isolated caretaker -High child mortality in family

  9. Malnutrition behavioural symptoms Phase 2 -Emotional distortion - stop in development -Incontinence, -Repetitive play, words Phase 1 -Apathy, no interest -Regression behaviour -Hostility, Irritability -Clinging to mother -Eye-contact reduced -Anorexia Phase 3 -Completely peaceful -Disconnected (closed eyes, food refusal, no reaction to auditive stimuli)

  10. PSYCHOSOCIAL CARE IN NUTMAIN OBJECTIVES • Improving caretaker-child relationship • Stimulating the child • Extra-care to caretakers with Mental Health problems • Education regarding appropiate feeding practices to caretakers

  11. Discussion • What have you been observing yourself in nut programs? • What can we put in place to address those issues? • Hospitalisation • Ambulatory Care

  12. ITFC, Hospi, Stab centres • Reception, triage • Observation mother – child interaction: holding and feeding practices • Appetite test • Stimulation mother-child interaction: holding, touching, looking, talking • Emotional support to mothers

  13. Psychomotor stimulation of children • Information and education to mothers • Breast feeding group • Playground • Preparation to dismissal

  14. Ambulatory • Observation mother child relationship at admission • Detection of most vulnerable • Home visits • Weekly, bi-weekly check up and food distribution • Observation of meals taken on the spot • Breast feeding group

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