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Climate-Responsive Nutrition, WASH, and Heat Counselling for Maternal and Child Health in Sindh, Pakistan

Sponsor: The Hospital for Sick Children • ClinicalTrials.gov ID: NCT07819994

Registry updated: 2026-10-07

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Description

The goal of this clinical trial is to evaluate whether a climate- and gender-responsive integrated package of nutrition, hygiene (WASH), and heat-adaptation counselling can improve maternal and child health and nutrition outcomes among women of reproductive age and young children in rural Sindh, Pakistan. The main questions it aims to answer are: 1. Does training Lady Health Workers, at the community level improve women's knowledge, attitudes, and practices related to maternal nutrition, infant and young child feeding, hygiene, and heat-adaptation behaviours? 2. Does training healthcare providers at facilities improve women's knowledge, attitudes, and practices related to maternal nutrition, infant and young child feeding, hygiene, and heat-adaptation behaviours? Researchers will compare communities receiving the enhanced training package to those receiving standard care to determine its effectiveness. Participants will: 1. Receive counselling from trained Lady Health Workers and healthcare providers on nutrition, hygiene, and heat-adaptation practices. 2. Take part in household surveys assessing knowledge, attitudes, and practices. 3. Followed over time during pregnancy and early childhood (only applies to a cohort of participants).

Interventions

Training of Lady Health Workers (LHWs) (Behavioral)
Lady Health Workers receive training aimed at improving their ability to deliver climate- and gender-responsive information and counselling to women on maternal nutrition, infant and young child feeding, hygiene, and heat-adaptation behaviours.
Training of Healthcare Providers (HCPs) at Facilities (Behavioral)
Healthcare providers at health facilities receive training to strengthen their delivery of climate- and gender-responsive information and counselling to women on maternal nutrition, infant and young child feeding, hygiene, and heat-adaptation behaviours.

Eligibility criteria

Inclusion Criteria: * Household has at least one pregnant or lactating woman (PLW) OR woman of reproductive age (WRA) with a child less than 24 months old * Resident of the selected clusters of the district * Permanent resident of the household * Willing and able to provide informed consent Cohort: All pregnant women identified at baseline who are \<18 weeks' gestation will be invited to enroll in the prospective longitudinal cohort nested within the trial. Only women who provide informed consent and agree to longitudinal follow-up at four-month intervals throughout pregnancy and until their child reaches 12-18 months of age will be enrolled Exclusion Criteria: * Household does not include a pregnant or lactating woman (PLW) OR a woman of reproductive age (WRA) with a child less than 24 months * Household does not provide informed consent * Woman is a known case of chronic hypertension * Woman is a known case of pre-eclampsia * Woman is a known case of type 1 diabetes * Woman is a known case of type 2 diabetes * Woman is a known case of gestational diabetes * Woman is a known case of hypothyroidism or hyperthyroidism * Woman is a known case of tuberculosis * Child has congenital anomalies or medical conditions

Conditions

Maternal Nutrition Child Nutrition

Locations

The Aga Khan University — Karachi, Sindh, Pakistan

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Official Source

Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

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