Brief Summary: Improving Maternal and Child Health via Indigenous Structures

The goal of this cluster randomized controlled community trial is to assess the effect of community-based interventions using indigenous community structures on the improvement of health and nutritional status in pregnant women (recruited before 16 weeks of gestation) and their children in Northwest Ethiopia. The main questions it aims to answer are:

• Does a community-based intervention using indigenous structures significantly improve the uptake of maternal health services (ANC, delivery, and PNC)?
• Does the intervention effectively reduce the prevalence of maternal depression during the pregnancy and postpartum periods?
• To what extent does the intervention improve the nutritional status (reducing thinness and stunting) of mothers and their children? Researchers will compare a group of women receiving counseling from trained indigenous social support groups to a control group receiving only the routine health and nutrition education provided by the standard healthcare system to see if the indigenous approach leads to better health and nutritional outcomes.

Participants will:

• Receive four counseling sessions during pregnancy (starting before 16 weeks of gestation) and four additional sessions during the lactation period, conducted in their homes by trained social support groups.
• Receive educational leaflets containing core health and nutrition messages and appropriate pictures.
• Participate in two rounds of surveys (baseline, and endline) involving interviewer-administered questionnaires.
• Undergo physical measurements, specifically mid-upper arm circumference (MUAC), to assess nutritional status.

Inclusion Criteria:

Pregnant women residing in the selected study clusters (kebeles)

Pregnant women who are in their first trimester (gestational age less than 16 weeks) at the time of recruitment.

Pregnant women who intend to reside in the study area for the duration of the pregnancy and at least six months postpartum.

Exclusion Criteria:

Pregnant women with known pre-existing chronic medical conditions (e.g., chronic hypertension, diabetes mellitus, or cardiac disease) that require specialized medical management.

Pregnant women who are unable to communicate or undergo the interview process due to severe illness or cognitive impairment.

Pregnant women who are already participating in another clinical trial or health intervention study.