Calor extremo, lactancia materna exclusiva y salud mental materna en el norte de Senegal: protocolo de investigación en intervenciones de salud poblacional para el estudio SPRINT-Sen
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Introducción: El calor extremo ha sido siempre un desafío de salud pública en el Sahel, y existe cada vez más evidencia de sus efectos adversos sobre la salud materna, n eonatal e infantil (SMNI), incluida la salud mental. En la región de Matam, en Senegal, las altas temperaturas estacionales pueden afectar las prácticas de lactancia materna exclusiva (LME) y la salud mental materna a través de los efectos directos de la percepción del calor y del conocimiento sobre este. SPRINT-Sen tiene como objetivo codiseñar, implementar y evaluar una intervención comunitaria de salud poblacional para mejorar la LME y la salud mental materna en un clima cálido y árido.
Métodos: SPRINT-Sen es un estudio de investigación en intervenciones de salud poblacional (IISP) que utiliza un diseño longitudinal cuasiexperimental con cuatro encuestas transversales independientes en una cohorte abierta. La evaluación de impacto sigue un diseño pre-post y utiliza un enfoque de métodos mixtos para evaluar la aceptabilidad y el proceso de implementación. Las participantes elegibles son mujeres embarazadas y madres de lactantes de 0 a 12 meses. La intervención codiseñada combinará: (1) promoción de la LME adaptada a condiciones de calor extremo; (2) apoyo a la salud mental materna mediante actividades de promoción y apoyo psicosocial; y (3) monitoreo continuo de la temperatura para informar un sistema de alerta por calor. El resultado principal es la LME a los seis meses. Los resultados secundarios incluyen efectos sobre la salud mental materna, como ansiedad, estrés y conflicto interpersonal. La exposición ambiental será evaluada mediante datos meteorológicos y cartografía térmica.
Resultados: El estudio generará evidencia sobre los mecanismos y la implementación de intervenciones relacionadas con calor y LME, así como sobre los efectos del calor en la salud mental dentro de la SMNI. Los hallazgos orientarán los esfuerzos para fortalecer un sistema de salud resiliente al calor mediante soluciones comunitarias. La transferencia de conocimientos se apoyará mediante la codifusión con las partes interesadas y su integración en políticas de salud materna y adaptación al cambio climático.
Conclusiones: SPRINT-Sen aportará evidencia novedosa y específica al contexto sobre la factibilidad, la implementación y la efectividad de una intervención integrada que aborda tanto la salud mental materna como la LME en el contexto del calor extremo. Los hallazgos informarán estrategias de adaptación para programas de SMNI y contribuirán a los debates globales sobre las IISP en contextos sahelianos.
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