{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:30:23Z","timestamp":1786116623201,"version":"build-2736575974"},"reference-count":36,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"unspecified","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000691","name":"Academy of Medical Sciences","doi-asserted-by":"publisher","award":["GCRFNGR8"],"award-info":[{"award-number":["GCRFNGR8"]}],"id":[{"id":"10.13039\/501100000691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Glob Health"],"accepted":{"date-parts":[[2026,7,30]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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, \u2018lack of awareness of proper nutrition\u2019 emerged as the top nutritional priority, while \u2018dehydration, weakness and exhaustion\u2019 ranked highest among maternal health concerns. Infant health priorities differed slightly: survey respondents prioritised \u2018heat exposure and low birth weight\u2019, whereas workshop participants highlighted \u2018heat waves and infant hospital admissions\u2019. 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjgh-2026-023722","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T11:20:37Z","timestamp":1786015237000},"page":"e023722","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Mapping research priorities related to maternal and infant nutritional health in the context of climate change in Pakistan: a mixed-methods study"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0771-8130","authenticated-orcid":false,"given":"Sadiq","family":"Bhanbhro","sequence":"first","affiliation":[{"name":"Centre for Applied Health and Social Care Research, Sheffield Hallam University, Sheffield, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5321-8885","authenticated-orcid":false,"given":"Zahid A","family":"Memon","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wardah","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2151-1670","authenticated-orcid":false,"given":"Fizza","family":"Ansar","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gulfishan","family":"Tahir","sequence":"additional","affiliation":[{"name":"Centre for Applied Health and Social Care Research, Sheffield Hallam University, Sheffield, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3208-0952","authenticated-orcid":false,"given":"Nadia","family":"Agha","sequence":"additional","affiliation":[{"name":"Department of Sociology, Shah Abdul Latif University, Khairpur, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally-Fowler","family":"Davis","sequence":"additional","affiliation":[{"name":"Health and Care Research Centre, Anglia Ruskin University, Chelmsford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9611-6777","authenticated-orcid":false,"given":"Hora","family":"Soltani","sequence":"additional","affiliation":[{"name":"Centre for Applied Health and Social Care Research, Sheffield Hallam University, Sheffield, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"2026080604202650000_11.8.e023722.1","unstructured":"World Health Organisation . Protecting maternal, newborn and child health from the impacts of climate change: a call for action. ISBN: 9789240085350. 2024."},{"key":"2026080604202650000_11.8.e023722.2","doi-asserted-by":"crossref","first-page":"103092","DOI":"10.1016\/j.ijdrr.2022.103092","article-title":"District health systems capacity to maintain healthcare service delivery in Pakistan during floods: A qualitative study","volume":"78","author":"Pradhan","year":"2022","journal-title":"Int J Disaster Risk Reduct"},{"key":"2026080604202650000_11.8.e023722.3","unstructured":"Sayeed A , Mallah H . Climate change vulnerabilities and climate action in Sindh province, Pakistan. Research Collective; 2024. Available: https:\/\/bit.ly\/4l5jotL"},{"key":"2026080604202650000_11.8.e023722.4","doi-asserted-by":"crossref","unstructured":"Bhanbhro S , Ali I . Birthing in burning places: intersecting climate crises, maternal health challenges and structured vulnerabilities in Sindh province of Pakistan. J Mat-Fet & Neo Med 2025;38. doi:10.1080\/14767058.2025.2539354","DOI":"10.1080\/14767058.2025.2539354"},{"key":"2026080604202650000_11.8.e023722.5","first-page":"1","article-title":"Effect of climate change on health in Pakistan: climate change and health in Pakistan","volume":"57","author":"Iqbal","year":"2020","journal-title":"Proceedings of the Pakistan Academy of Sciences: B Life and Environmental Sciences"},{"key":"2026080604202650000_11.8.e023722.6","doi-asserted-by":"crossref","unstructured":"Asad S . SDGs in Pakistan: an analysis. In: Social development and the sustainable development goals in South Asia. Routledge, 2019: 92\u2013110. Available: https:\/\/bit.ly\/405hNKL","DOI":"10.4324\/9781351035262-6"},{"key":"2026080604202650000_11.8.e023722.7","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1093\/trstmh\/traf036","article-title":"Statistical modeling of acute diarrhea in pediatric malnutrition based on the assessment of nutritional status and clinical manifestations: a retrospective study in South-Punjab, Pakistan","volume":"119","author":"Hassan","year":"2025","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"2026080604202650000_11.8.e023722.8","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pgph.0003540","article-title":"Impact of climate change on maternal health outcomes: An evidence gap map review","volume":"4","author":"Meherali","year":"2024","journal-title":"PLOS Glob Public Health"},{"key":"2026080604202650000_11.8.e023722.9","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2011.300544"},{"key":"2026080604202650000_11.8.e023722.10","doi-asserted-by":"publisher","DOI":"10.1891\/2156-5287.6.1.5"},{"key":"2026080604202650000_11.8.e023722.11","doi-asserted-by":"crossref","DOI":"10.1186\/1742-4755-11-61","article-title":"Maternal and perinatal health research priorities beyond 2015: an international survey and prioritization exercise","volume":"11","author":"Souza","year":"2014","journal-title":"Reprod Health"},{"key":"2026080604202650000_11.8.e023722.12","doi-asserted-by":"publisher","DOI":"10.3102\/0013189X033003014"},{"key":"2026080604202650000_11.8.e023722.13","doi-asserted-by":"publisher","DOI":"10.1258\/jhsrp.2007.007074"},{"key":"2026080604202650000_11.8.e023722.14","doi-asserted-by":"crossref","DOI":"10.7189\/jogh.14.04116","article-title":"Health research priorities in Pakistan: A Child Health and Nutrition Research Initiative (CHNRI) exercise","volume":"14","author":"Motevalian","year":"2024","journal-title":"J Glob Health"},{"key":"2026080604202650000_11.8.e023722.15","unstructured":"The James Lind Alliance (JLA) guidebook version 10, 2021. Available: www.jla.nihr.ac.uk"},{"key":"2026080604202650000_11.8.e023722.16","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"2026080604202650000_11.8.e023722.17","doi-asserted-by":"crossref","unstructured":"Bhanbhro S . Navigating positionality in transnational research: the researcher\u2019s dilemma of being an insider and an outsider. In: The Routledge handbook of field research. Routledge, 2025: 322\u201331.","DOI":"10.4324\/9781003404903-45"},{"key":"2026080604202650000_11.8.e023722.18","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2024.12026","article-title":"Preterm and Early-Term Birth, Heat Waves, and Our Changing Climate","volume":"7","author":"Dresser","year":"2024","journal-title":"JAMA Netw Open"},{"key":"2026080604202650000_11.8.e023722.19","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph14080853"},{"key":"2026080604202650000_11.8.e023722.20","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1038\/s41586-022-05243-6","article-title":"The missing risks of climate change","volume":"610","author":"Rising","year":"2022","journal-title":"Nature"},{"key":"2026080604202650000_11.8.e023722.21","doi-asserted-by":"crossref","first-page":"100433","DOI":"10.1016\/j.envc.2021.100433","article-title":"Climate Impacts on the agricultural sector of Pakistan: Risks and solutions","volume":"6","author":"Syed","year":"2022","journal-title":"Environmental Challenges"},{"key":"2026080604202650000_11.8.e023722.22","doi-asserted-by":"crossref","first-page":"1216","DOI":"10.3390\/su12031216","article-title":"Economic Effects of Climate Change-Induced Loss of Agricultural Production by 2050: A Case Study of Pakistan","volume":"12","author":"Khan","year":"2020","journal-title":"Sustainability"},{"key":"2026080604202650000_11.8.e023722.23","unstructured":"UNCTAD . A world of debt 2025: It is time for reform. UNCTAD secretariat calculations based on the IMF World Economic Outlook. 2025. Available: https:\/\/share.google\/nxaM6I9aoMrFF93vM"},{"key":"2026080604202650000_11.8.e023722.24","doi-asserted-by":"crossref","unstructured":"World Bank . Malawi poverty statistics [as cited in analysis of public debt trends and poverty reduction, Taylor & Francis online]. 2025. Available: https:\/\/doi.org\/10.1080\/23322039.2025.2525480","DOI":"10.1080\/23322039.2025.2525480"},{"key":"2026080604202650000_11.8.e023722.25","unstructured":"Khan R , Morrissey O , Mosley P . Colonial legacy and poverty reduction in sub-Saharan Africa. Discussion papers 2016, University of Nottingham. 2016. Available: https:\/\/ideas.repec.org\/p\/not\/notcre\/16-01.html"},{"key":"2026080604202650000_11.8.e023722.26","doi-asserted-by":"crossref","first-page":"11848","DOI":"10.1007\/s13132-023-01527-y","article-title":"Gender Inequality and Poverty: The Role of Financial Development in Mitigating Poverty in Pakistan","volume":"15","author":"Kanat","year":"2024","journal-title":"J Knowl Econ"},{"key":"2026080604202650000_11.8.e023722.27","doi-asserted-by":"crossref","DOI":"10.1111\/mcn.13444","article-title":"Maternal and child nutrition must be at the heart of the climate change agendas","volume":"19","author":"P\u00e9rez-Escamilla","year":"2023","journal-title":"Matern Child Nutr"},{"key":"2026080604202650000_11.8.e023722.28","doi-asserted-by":"crossref","DOI":"10.3390\/nu15143124","article-title":"Drivers of Nutritional Change in Pakistan: A Decomposition Analysis","volume":"15","author":"Rehman","year":"2023","journal-title":"Nutrients"},{"key":"2026080604202650000_11.8.e023722.29","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-019-6688-2","article-title":"Determinants of stunting, underweight and wasting among children <\u20095\u2009years of age: evidence from 2012-2013 Pakistan demographic and health survey","volume":"19","author":"Khan","year":"2019","journal-title":"BMC Public Health"},{"key":"2026080604202650000_11.8.e023722.30","doi-asserted-by":"crossref","DOI":"10.1177\/17455057241302032","article-title":"Transformative strategies for enhancing women\u2019s resilience to climate change: A policy perspective for low- and middle-income countries","volume":"20","author":"Aziz","year":"2024","journal-title":"Womens Health (Lond)"},{"key":"2026080604202650000_11.8.e023722.31","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-publhealth-012420-105026"},{"key":"2026080604202650000_11.8.e023722.32","doi-asserted-by":"crossref","first-page":"960","DOI":"10.21608\/ejhc.2023.309373","article-title":"Knowledge and practices of maternity nurses related to the potential impacts of climate change on women\u2019s health","volume":"14","author":"Shalaby Awad Mahmoud","year":"2023","journal-title":"Egypt J Health Care"},{"key":"2026080604202650000_11.8.e023722.33","doi-asserted-by":"crossref","unstructured":"Idris I . Social protection and resilience in Pakistan. IDS OpenDocs; 2024. Available: https:\/\/opendocs.ids.ac.uk\/articles\/report\/Social_Protection_and_Resilience_in_Pakistan\/29423180","DOI":"10.19088\/K4DD.2025.056"},{"key":"2026080604202650000_11.8.e023722.34","doi-asserted-by":"crossref","DOI":"10.1016\/j.heliyon.2022.e08964","article-title":"Targeting Women\u2019s vulnerable employment through social protection: A quasi-experimental regression discontinuity design","volume":"8","author":"Sarfraz","year":"2022","journal-title":"Heliyon"},{"key":"2026080604202650000_11.8.e023722.35","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1002305","article-title":"Impact evaluation of different cash-based intervention modalities on child and maternal nutritional status in Sindh Province, Pakistan, at 6 mo and at 1 y: A cluster randomised controlled trial","volume":"14","author":"Fenn","year":"2020","journal-title":"PLoS Med"},{"key":"2026080604202650000_11.8.e023722.36","unstructured":"Pakistan Institute of Development Economics . Making Sehat Sahulat program sustainable. 2023. Available: https:\/\/bit.ly\/4rsOTQ5"}],"container-title":["BMJ Global Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjgh-2026-023722","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T11:20:46Z","timestamp":1786015246000},"score":1,"resource":{"primary":{"URL":"https:\/\/gh.bmj.com\/lookup\/doi\/10.1136\/bmjgh-2026-023722"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":36,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8,6]]},"published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1136\/bmjgh-2026-023722"],"URL":"https:\/\/doi.org\/10.1136\/bmjgh-2026-023722","relation":{},"ISSN":["2059-7908"],"issn-type":[{"value":"2059-7908","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]}}}