357 million children live in conflict zones. Children’s mental health is a major but complex issue as needs and interventions depend on the age of the child, caregivers, daily safety and protection, etc. EMDR and CBT are the recommended therapies to treat PTSD according to the WHO, but there is not enough standardized evidence-based protocol for children. Testing and evaluating trauma management systems for children is essential for trauma treatment interventions to be implemented in emergency contexts, such as war and conflict situations.

This research compares two intervention protocols for children aged 6 to 17 years suffering from Post Traumatic Stress Disorder after exposure to conflict traumatic events in the Central African Republic: the protocol “Kôno” developed by Action contre la Faim, based on a CBT and narrative approaches and the EMDR/G-TEP (Group Traumatic Events Protocol). After a psychoeducation session, the children were assigned to the ACF-KONO or EMDR/G-TEP groups for 5 sessions. The Child Psychosocial Distress Screener (CPDS) to measure general well-being and functioning and the Child Revised Impact of Events Scale (CRIES) to assess trauma, were administered before and after treatment.

793 children participated in the research, 391 were included in the ACF-KONO protocol and 402 in the EMDR/G-TEP protocol. Both protocols have been shown to be equally effective in improving well-being and reducing traumatic symptoms. 185 children (90 ACF-KONO and 95 EMDR/G-TEP) were also re-evaluated after 5 months. The CPDS and CRIES-8 measurements reveal that the results are stable over time, with the use of both protocols. Detailed results will be presented.

This research contributes to the discussion on a framework for group protocols for children in mental health and psychosocial support interventions in humanitarian programs. The two protocols tested showed very good results in reducing symptoms of PTSD in children. How to choose between EMDR/G-TEP and CBT? What contextual and cultural adaptations are to be expected? Are there differences in children’s appreciation? And in that of mental health practitioners? Ideas for reflection will be shared.

It is possible to widen access to therapeutic treatment of PTSD for children in emergency situations such as war and conflict. Further research in other contexts is needed. These studies should explore qualitative elements, such as children’s appreciations, but also the impact of these different protocols on the vicarious trauma of professionals involved in the treatment of children’s trauma.

None Declared

In DRC, the North Kivu province has been plagued by recurring humanitarian crises for nearly two decades, with multiple displacements of populations triggered low intensity armed inter-communal conflicts spread throughout nearly all territories. 818,605 people (displaced, returnees and indigenous) affected by these movements are in alarming psychosocial vulnerability.

In 2019, the NGO Action contre la Faim started a psychological intervention with the objective to contribute to reducing the vulnerability of conflict-affected populations.

Participants have been identified through psychoeducation sessions in the community in which people recognizing corresponding symptoms in themselves were evaluated through a short one-on-one interview. Persons identified as particularly in distress, including those who have experienced gender-based violence, have been involved in a short group therapeutic intervention. Two different options have been proposed in order to evaluate the most effective for the specific context: six sessions with a weekly or bi-weekly frequency.

767 people participated in the psychosocial intervention, 457 with weekly frequency and 310 bi-weekly. The measures of post traumatic symptoms (PCL-5), anxiety and depression (HAD) and resilience (CD-RISC) show that the two approaches have the same positive effects. This is very important in volatile contexts with difficulties of access to the population due to security problems.

The fact that even a short intervention focused on a bi-weekly frequency, can reduce the distress and increase the psychological resilience of populations living in contexts of conflict, gives us the possibility of intervening in areas with limited access, while guaranteeing therapeutic efficacy.

Poor maternal mental health during the perinatal period leads to serious complications, especially in humanitarian settings where both mothers and children have often been exposed to multiple stressful events. In those contexts, culturally relevant mental health and psychosocial interventions are required to support mother-infant dyads and ultimately to alleviate potential negative outcomes on child’s health and development.

This study aims at assessing the use of postnatal services by mothers and infants under 2 and its impact on maternal mental health.

A process evaluation of Baby Friendly Spaces (BFS) program was conducted in Nguynyel refugee camp (Ethiopia) and a prospective quantitative assessment was administered to lactating women at baseline and endline (2 months later) to measure maternal functional impairment (WHODAS 2.0), general psychological distress (Kessler scale-K6); depression symptoms (Patient Health Questionnaire-PHQ9) and post-traumatic stress symptoms (PTSD Checklist-PCL-6).

201 lactating women and their babies were enrolled between October 2018 and March 2019. Statistically significant reductions were observed in all mental health outcomes at follow-up. Total mean scores decrease by 19% (p<0.001) for general psychological distress and posttraumatic stress, by 23% (p<0.001) for the depression and by 15% (p<0.001) for the functional impairment. Examination of the compliance to the services revealed that mothers who dropped out early had statistically significantly lower depression scores (p=0.01), and functional impairment scores (p<0.001) than mothers who stayed in the program.

The integration of maternal mental health interventions within perinatal services is challenging but essential for identifying and treating maternal common mental disorders.

No significant relationships.

A large part of the Central African population has been exposed to potentially traumatic events as a result of the recent conflict, which has led to the breakdown of social ties.

Faced with this situation, the NGO Action contre la Faim proposed a psychosocial intervention aimed at helping the displaced people to reduce their psychological suffering and strengthen individual and community resilience.

After psychoeducation sessions organized in communities affected by the conflict, people identified with traumatic symptoms are invited to participate in a psychological support intervention. The protocol used is based on the Problem Management Plus (PM+), developed by the WHO. The approach was adapted in groups to reach more suffering people and also to take advantage of the group dynamic in the possibility of recovering and developing better resilience.

946 IDPs in the country’s capital, participated in the group intervention led by a team of paraprofessionals. Data collected from 111 participants show that after five weeks of intervention, there was a significant reduction in post-traumatic symptoms (PCL-5) and functional impairment (WHODAS). These results were confirmed during the post-intervention evaluation four weeks later. In addiction, participants declared that they had observed effects on their ability to live together in the community and to regain social cohesion.

This experience gives encouraging results with regard to the feasibility and replicability of the group protocol, taking into account specific cultural and contextual adaptations.

No significant relationships.

Observational studies have shown a relationship between maternal mental health (MMH) and child development, but few studies have evaluated whether MMH interventions improve child-related outcomes, particularly in low- and middle-income countries. The objective of this review is to synthesise findings on the effectiveness of MMH interventions to improve child-related outcomes in low- and middle-income countries (LMICs).

We searched for randomised controlled trials conducted in LMICs evaluating interventions with a MMH component and reporting children's outcomes. Meta-analysis was performed on outcomes included in at least two trials.

We identified 21 trials with 28 284 mother–child dyads. Most trials were conducted in middle-income countries, evaluating home visiting interventions delivered by general health workers, starting in the third trimester of pregnancy. Only ten trials described acceptable methods for blinding outcome assessors. Four trials showed high risk of bias in at least two of the seven domains assessed in this review. Narrative synthesis showed promising but inconclusive findings for child-related outcomes. Meta-analysis identified a sizeable impact of interventions on exclusive breastfeeding (risk ratio = 1.39, 95% confidence interval (CI): 1.13–1.71, ten trials, N = 4749 mother–child dyads, I2 = 61%) and a small effect on child height-for-age at 6-months (std. mean difference = 0.13, 95% CI: 0.02–0.24, three trials, N = 1388, I2 = 0%). Meta-analyses did not identify intervention benefits for child cognitive and other growth outcomes; however, few trials measured these outcomes.

These findings support the importance of MMH to improve child-related outcomes in LMICs, particularly exclusive breastfeeding. Given, the small number of trials and methodological limitations, more rigorous trials should be conducted.