Effectiveness of 'SAFAL MATRUTV GATS' (Stunting alleviation by facilitation of antenatal-postnatal-interventions for low birth weight reduction) – A peer-led self-empowerment group at rural villages in Eastern Maharashtra: Protocol for a pragmatic cluster randomized controlled trial

Background: Stunting or chronic malnutrition has been one of the major challenges to mankind for ages. The trends from the National Family Health surveys are more or less stagnant with a huge failure of the public health systems to tackle the problem of malnutrition. Innovative approaches are needed to tackle malnutrition. Objective: This pragmatic cluster randomized controlled trial (CTRI registration no. Trial REF/2023/08/071521) is planned to assess the effectiveness of a multifaceted antenatal and postnatal health educational intervention package implemented from the first trimester of pregnancy up to one year of infant age in reducing the rates of Low Birth Weight and improving the maternal-infant growth and developmental indicators in a cohort of rural pregnant women as compared to existing standards of care. Implication - The study emphasizes the importance of an ongoing continuum of care during the first 1000 days for effective birth weight, preventing malnutrition, and fostering infant growth and development as its programmatic pathway to impact. Results: We anticipate that the intervention will complement the existing health programs and will be implemented through the grassroot-level workers along with a community peer named “Safalta Tai” enabling community ownership of the intervention. Discussion: It also has a robust inbuilt monitoring and evaluation system through participatory action research for making it scalable and sustainable beyond the implementation period. Conclusion: The program leverages on the existing goverment programs like the poshan abhiyaan and the digital health mission. It has the potential to be incorporated in the exsiting health infrastructure without any additional resources and scaled up if found effective in reduction of low birth weight which is an important determinant of stunting in under five children.