Prenatal stress has profound, long-term consequences for unborn children, increasing their risk of mental health issues and perpetuating intergenerational health disparities. Despite their importance, informal supportive actions—referred to as invisible care—are often excluded from Monitoring and Evaluation (M&E) frameworks, leaving their impact unrecognized and underfunded. This research seeks to document and validate these unacknowledged practices, offering practical insights to improve maternal and child health outcomes while addressing structural gaps in humanitarian aid frameworks.

The study is led by an interdisciplinary team with extensive expertise in humanitarian aid and health: Dr. Roanne van Voorst (Principal Investigator; FMG, UvA), Prof. Tessa Rosenboom (Co-Investigator; Amsterdam UMC), Dr. Marjette Koot (Postdoctoral Researcher; Amsterdam UMC), and Dr. Loes Loning (Postdoctoral Researcher; Rutgers, UvA Anthropology).

Focusing on refugee reception centers in Europe, the study examines how invisible care, delivered by staff and volunteers, reduces stress in pregnant women and improves health outcomes for their children. By bridging anthropology, public health, and policy analysis, the project highlights gaps in existing M&E systems and offers recommendations to integrate these practices into formal evaluations. For this research project the research team collaborates with AMURTEL and Because We Carry. Both organizations were selected because of their unique approach to refugee and maternal care, often highly valued by pregnant refugee women. Through this collaboration between scientists and practitioners, the research project seeks to enhance maternal and child health, ensure the value of invisible care is recognized, and improve funding opportunities for organizations delivering these critical interventions.

Principal Investigator Roanne van Voorst: “Formal reporting in refugee aid 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: Some practitioners 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. To create a more holistic and realistic picture of the important types of aid that organizations such as AMURTEL and Because We Carry offer, we’re combining in-depth interviews and observations in refugee centers in Greece, 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.”

Roanne has written a newsletter on this topic, you can read it here.