Assessing the effectiveness of Heat Adaptation & Heat Reduction Interventions for vulnerable population in urban and rural settings of a low- and middle- income country

Climate change has resulted in increased average global temperatures and increased number, duration and intensity of extreme heat events with South Asia emerging as one of the worst affected regions. The objectives of this study are to 1)synthesize global evidence-base of community interventions for heat adaptation/reduction strategies; 2)conduct an assessment of feasibility and acceptance of possible interventions through community participation and pilot testing; 3)evaluate a heat adaptation and reduction bundle (HAB) comprising of education, behavioural change and incentivized structural interventions through a cluster randomized controlled trial(cRCT). The intervention will be implemented in a representative urban and rural setting of Pakistan and target children, women including pregnant women, and other vulnerable adult labourers and elderly. The cRCT will primarily evaluate the impact of HAB on heat-related illnesses and a range of secondary outcomes including standardized heat measurements at household level, physiological strain, dehydration, thermal comfort/sensation, sleep hygiene, pregnancy outcomes (gestational weight gain, low birthweight, preterm births, stillbirths), mental health and overall cost effectiveness 4)assess the feasibility, and generalisability of scaling up the trial findings. This project will emphasize capacity building and gender equity and findings will be disseminated to relevant policy makers and researchers globally for potential uptake in other LMICs.