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Prenatal stress, often overlooked in refugee care, has profound long-term consequences on unborn children, heightening their risk of mental health challenges and perpetuating intergenerational health disparities. Despite the pivotal role of informal supportive actions—termed invisible care—these practices are rarely acknowledged in Monitoring and Evaluation (M&E) frameworks, leaving their impact unrecognized and underfunded. This research aims to document and validate these unacknowledged practices, offering insights that could significantly improve maternal and child health outcomes while addressing structural gaps in humanitarian aid systems.

The study is led by an interdisciplinary team with extensive expertise in humanitarian aid and health: Dr. Roanne van Voorst (FMG), Prof. Tessa Rosenboom (Amsterdam UMC), Dr. Marjette Koot (Amsterdam UMC). 

This research focuses on informal, often unrecognized support. What are some of the biggest consequences of overlooking these care practices in refugee health policies? 

“We get a skewed picture of the kind of important work aid workers do; of what really matters in refugee aid. Formal reporting often focuses on the number of aid items distributed, or on medication. That's also an incredibly important part of what aid workers do. But they do much more. To give you an example: they give a mobile phone number to pregnant women in refugee camps, so they can always call someone if they are worried. That is incredibly valuable, but organizations don't get funding for that from sponsors, and so it's often not included in Monitoring and Evaluation. Therefore, we - the sponsors, the politicians, and the broader public - get a skewed picture of the ways in which refugees are cared for.” 

Your research brings together multiple disciplines. How does combining anthropology, public health, and policy analysis help create a more complete understanding of refugee health? 

“We're combining surveys, in-depth interviews, and observations in refugee centers throughout Europe, so we're not only hearing from staff members what they actually provide in terms of care on a day-to-day basis, but we're also seeing it. Often, staff members don't mention some actions at all during an interview, either because they don't think of them or because they think they're insignificant: for example, laughing with a refugee, patting someone on the shoulder, or bringing someone a backpack they had at home. They're not even aware of these actions, but they can be incredibly helpful and supportive for pregnant women. We'll integrate our findings into policy advice, not just into academic articles: we want sponsors and policymakers to be more aware of the value of these unrecognized forms of help, for the health of future generations.” 

Your project collaborates with "Because We Carry" and other groups. How will you balance academic research with the practical realities faced by frontline humanitarian workers? 

“Our team of fieldworkers has extensive experience in refugee camps, including a postdoctoral member who is a general practitioner with working experience in Greek refugee centers. This experience, combined with our anthropological approach, will highlight the contextual factors contributing to the stress faced by pregnant women and the daily interactions among staff, volunteers, and refugee mothers. Insights from maternal health research will guide the development of an evidence-based framework to evaluate stress impacts on mothers and their children, drawing on existing literature on pregnancy outcomes in refugee populations.” 

“Collaborating with refugee organizations enhances our access to a broad network of participants and helps address funding and evaluation frameworks, ensuring that supportive actions are acknowledged in policymaking. By fostering communication across disciplines and stakeholders, the project aims to improve care for pregnant women in refugee settings and enhance intergenerational health outcomes, allowing us as scientists to make a meaningful, practical contribution.”