Mapping research priorities related to maternal and infant nutritional health in the context of climate change in Pakistan: a mixed-methods study.

Abstract

Objectives: This study aimed to identify research priorities for maternal and infant nutrition in the context of climate change in Sindh, Pakistan, using an eco-social framework to examine structural, environmental and gendered inequalities.

Setting: The study was conducted from March to May 2024 in Sindh province of Pakistan. Survey respondents were drawn from across Sindh province, while the priority-setting workshop and a focus group discussion were conducted with both male and female participants in Karachi and Matiari District, respectively.

Participants: In total, 127 participants were engaged, including community members, doctors, female health workers, nurses, nutritionists, climate experts, advocates and researchers from across Sindh province of Pakistan.

Results: Among survey respondents, 89% expressed extreme or very high concern about the impact of climate change on maternal and infant nutritional health. Across the survey and workshop, 'lack of awareness of proper nutrition' emerged as the top nutritional priority, while 'dehydration, weakness and exhaustion' ranked highest among maternal health concerns. Infant health priorities differed slightly: survey respondents prioritised 'heat exposure and low birth weight', whereas workshop participants highlighted 'heat waves and infant hospital admissions'. Participants also identified climate-resilient nutritional interventions and addressing the nutritional needs of pregnant women as critical research priorities. Focus group findings from Matiari District highlighted structural drivers of vulnerability, including flood-related displacement, disrupted agriculture, gendered labour burdens and limited social protection.

Conclusion: Awareness and concerns about the increasing impacts of climate change and associated extreme weather events, including floods, extreme heat and changing weather patterns affecting food production, are increasing. However, understanding how these intersect with the everyday realities of affected people, places and communities remains significant for developing meaningful and equitable responses.