Zambia

Using Resilience Training to Prevent Alcohol Misuse Among Vulnerable Children

Challenge

Alcohol misuse is a growing problem in sub-Saharan Africa, where nearly half the population is under 14 years old.

Where We Started

Zambia has few prevention efforts targeting alcohol misuse among youth. Religion and spirituality play a key role in Zambia, which self-identifies as a Christian nation. Programs that build character virtues such as resilience have been shown to prevent substance misuse and have lasting effects into adulthood. We worked with a Zambian NGO to test a 24-week character-training curriculum rooted in positive psychology and spirituality called Global Resilience Oral Workshops (GROW). We began by conducting a pilot cluster-randomized controlled trial of GROW in 21 schools serving low-income children ages 10 to 13.

Our Impact

Our pilot study demonstrated that GROW Zambia was acceptable and feasible, as indicated by high class attendance (median classes attended 23 out of 24) and strongly positive stakeholder feedback applauding its “100 percent cultural fit.” We observed significant increases in self-reported resilience and hope scores as well as a lower past-30-day alcohol use rate among children who received the curriculum compared to a delayed-start control group.

Moving Forward

We will adapt the curriculum for the next older age group, ages 14 to 16, to analyze the prevention effect as risk for alcohol misuse heightens.

Contact

Sion Harris, PhD

Creating a Center of Excellence in Primary Care

Challenge

Linda Compound is a peri-urban clinic just outside of Lusaka; in this community, 50 percent of children are stunted (having impaired growth and development) because of malnutrition; close to 75 percent of the population lives in poverty. Almost every family in the community has a family member infected with HIV.

Where We Started

Neri Clinic is a small, primary care health post that started in 2009 and treats all primary care conditions as well as specialty services in HIV and nutrition. Shela Sridhar, MD, partnered with the clinic to conduct a needs assessment of the clinic and their monitoring and evaluation capacities to ensure quality healthcare delivery.

Our Impact

A full needs assessment of the primary care clinic and nutrition clinic has led to operational changes within the clinic for improved efficiency as well as the development of a food package pilot program as an intervention to address malnutrition in the community.

Moving Forward

Boston Children’s has now partnered with Neri Clinics and i4life to address the root causes of malnutrition through addressing food insecurity and improving clinical mentorship in pediatric conditions.

Contact

Shela Sridhar, Global Pediatrics Service Delivery Fellow