Promoting Maternal Mental Health and Early Childhood Development in Communities Exposed to Violence and Forced Displacement in Colombia

• Development Workshop

Date and Location

Thursday, March 3, 2022, 12:10 PM - 1:30 PM

Abstract

By the end of 2020, 1 out of every 6 children was living in a region affected by
violence and armed conflict. Repeated and traumatic exposure violence at an early
age can affect children’s mental health and therefore hinder healthy development and
derail their life trajectories. We report the results from a cluster-based randomized
trial of Semillas de Apego, a community-based psychosocial model for mothers (or
primary caregivers in general) of young children affected by violence and forced
displacement. The program aims to promote maternal mental health as an outcome
itself but also as a pathway to foster the healthy child-mother emotional bonds that
are essential to moderate children’s stress response and to protect early childhood
development amid systematic and traumatic exposure to violence.
We implemented the program in Tumaco, Colombia, a setting of active conflict, and
randomized access to the program across 18 Early Childhood Development Centers
that serve vulnerable and underserved families, many of whom are also victims
of violence and forced displacement. Over the course of four sequential cohorts,
1,372 caregivers participated in the evaluation, with 714 assigned to the treatment
group and 662 to control. Group-sessions were led by community members without
formal training in psychosocial models but who were trained and supervised for this
purpose.
At the 8-month follow-up, we find positive impacts of 0.14 standard deviations (sd)
on a maternal mental health index (95% CI 0.03 - 0.24); 0.23 sd on an index of
child-mother interactions (CI 0.07 - 0.41); 0.17 sd on early childhood mental health
(CI -0.061 - 0.323); and of 0.21 sd on a early-childhood development index (CI
0.05 - 0.37). We also find that the program allowed caregivers to better cope with
the shock of the Covid-19 pandemic and exhibit lower symptoms of anxiety and
parental stress 9 months into the pandemic. Taken together, our findings speak
to the need and feasibility of implementing quality psychosocial programs in fragile
and conflict-affected settings but also on the importance of designing comprehensive
strategies that address the social and economic determinants of mental health.