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Completed

NCT Number: NCT07771738

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

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.

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Key information

Conditions

Vaccination Adherence Interventions Behavior Health Behavior Health Education Health Knowledge Attitudes and Practice Hygiene Medication Adherence Patient Acceptance of Health Care Patient Compliance Treatment Adherence and Compliance Treatment Refusal Vaccination Hesitancy Vaccination Refusal Vaccine Hesitancy

Age range

14 year and older

Sex eligibility

Female

Study type

Interventional

Phase

Not applicable

Primary location

Community Study

Sargodha, Punjab Province, 40100, Pakistan

About this study

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.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

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

Treatment and study plan

Microbe-literacy germ-watching workshop

Behavioral

Group demonstration (25-30 participants) using portable microscopes to visualize microorganisms in participants' own environmental samples, linked to hygiene and immunization messages

Primary outcomes

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

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

    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.

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

    Time frame: 4 months (endline)

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

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

    Time frame: Baseline and 4 months (endline)

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

Secondary outcomes

  1. Proportion reporting high trust in Lady Health Workers

    Time frame: Baseline and 4 months (endline)

    Percentage of caregivers responding "yes, a lot" to a single-item survey question on trust in Lady Health Workers for vaccine information, compared between arms.

  2. Proportion aware that germs cause infectious disease

    Time frame: Baseline and 4 months (endline)

    Percentage of caregivers identifying germs (rather than, e.g., "bad weather") as the cause of infectious disease on a survey item, compared between arms.

  3. Proportion perceiving vaccines as safe

    Time frame: Baseline and 4 months (endline)

    Percentage of caregivers responding "yes, safe" to a survey item on perceived vaccine safety, compared between arms.

  4. Proportion intending to vaccinate ("very likely")

    Time frame: Baseline and 4 months (endline)

    Percentage of caregivers responding "very likely" to a survey item on intention to vaccinate the child in future, compared between arms.

  5. Proportion willing to recommend vaccination to others

    Time frame: Baseline and 4 months (endline)

    Percentage of caregivers responding "yes" to a survey item on willingness to recommend vaccination to other mothers, compared between arms.

Sponsors and collaborators

Lead sponsor

Development Synergies International (Private) Limited

Other

Collaborators

  • Microbe Literacy Initiative
  • National University of Science and Technology, Pakistan

Registry information

Official study title

Enhancing Vaccine Acceptance, Hygiene, and Trust in Community Health Workers Through a Microbe-Literacy Intervention: A Cluster Randomized Controlled Trial in Sargodha District, Pakistan

Acronym: MLI-Sargodha

Important dates

Study start
2024
Primary completion
2024
Study completion
2024
First posted
Aug 18, 2026
Registry last updated
Aug 18, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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