Microbe-Literacy Germ-Watching Workshops for Hygiene and Vaccine Acceptance in Sargodha, Pakistan

Development Synergies International (Private) Limited1,200 enrolled

Overview

This cluster randomized controlled trial evaluated whether a single microscope-based "germ-watching" workshop, delivered by Lady Health Workers (LHWs) to mothers and female caregivers of children under three years, improves hygiene practices, vaccination attitudes and intentions, routine immunization, and trust in LHWs. Twelve Union Councils in Sargodha District, Pakistan, were allocated 1:1 to the intervention or routine services, with outcomes measured by structured baseline and endline surveys and facility immunization records.

In intervention clusters, LHWs used portable microscopes (\>=400x) to show caregivers the microorganisms present in their own household water and food samples during a single 120-minute workshop for 25-30 participants, linking observed microbes to hygiene and vaccine-preventable disease. Control clusters received routine LHW services and standard national health messaging. Allocation used restricted, covariate-constrained randomization at the Union Council level; outcome data entry and analysis were blinded to allocation. Analyses accounted for clustering.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Enrollment

1,200

Conditions

Vaccination Hygiene

Eligibility

Sex: FEMALEMin age: 14 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Mother or female caregiver, permanent resident of the study area * At least one child aged under 3 years * Written informed consent Exclusion Criteria: * Already enrolled in a similar intervention * Unable to participate due to physical/psychological constraints * Intending to relocate during the study period

Outcomes

Primary Outcomes

Proportion of caregivers/children reporting always washing hands (self-reported)

Percentage of caregivers (and their children) reporting they "always" wash hands with soap / before eating, from a structured interviewer-administered survey item, compared between arms.

Time frame: Baseline and 4 months (endline, immediately after the intervention period)

Third-dose oral polio vaccine (OPV3) coverage (facility records)

Percentage of index children with a documented third dose of oral polio vaccine, ascertained from facility immunization records, compared between arms.

Time frame: 4 months (endline)

Proportion with self-reported completion of the age-appropriate immunization schedule

Percentage of caregivers reporting the index child had received all age-appropriate vaccinations (structured survey item), compared between arms.