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AdolescentsPhase 3NCT03287882

Effect of Micronutrients and Life Skills Education on the Health and Nutrition of Adolescent and Young Women in Pakistan

A Phase 3 study testing Multiple micronutrients (UNIMMAP composition) and Life skills based education in people with Adolescents and Anemia, run by Aga Khan University at 1 site in Pakistan.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The primary aims of this study are: 1) To evaluate the impact of supplementation with multiple micronutrients (MMN) from preconception and life skills education among women 15-18.9 years of age at enrolment on the prevalence of anemia in a population setting; and 2) To evaluate the impact of supplementation with MMN… Read more about this study

Who is it for?
Ages 15 to 24 years, women onlyHealthy volunteers can take part
Conditions the study is for
Adolescents, Anemia, Pregnancy
What is being tested?
Multiple micronutrients (UNIMMAP composition) and Life skills based education
Could I receive a placebo?
No, everyone receives an active treatment
How many people
25,447 participants
Where
1 sitePakistan
Study dates
30 Jun 2017to Feb 2022
Phase
Phase 3
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 15 to 24 years
  • Women only
  • Healthy volunteers accepted
  • Child, Adult

Who may be able to join

  • Minimum age at enrolment: 15 years
  • Maximum age at enrolment: 23 years
  • Any marital status
  • Intend to comply with study intervention and follow up

Who cannot join

  • Women participating in other nutrition trials
  • Women who intend to leave the study area
  • Women who are already pregnant

Trial locations and contacts

1 site in 1 country.

Pakistan1 site
  • Matiari Research and Training Centre

    Matiari, Sindh

Other trials in Pakistan

About this study

Official title: Prospective, Cluster Randomized Effectiveness Trial of Multiple Micronutrient Supplementation and Life Skills Education Provided From Preconception on Health and Nutrition Outcomes of Young, Reproductive-age Pakistani Women (15-24 Years)

The primary aims of this study are: 1) To evaluate the impact of supplementation with multiple micronutrients (MMN) from preconception and life skills education among women 15-18.9 years of age at enrolment on the prevalence of anemia in a population setting; and 2) To evaluate the impact of supplementation with MMN from preconception and life skills education among young women 15-24 years of age on the rate of low birth weight (LBW) in a population setting. Infants born to mothers enrolled in the study will be followed for 1 year. This study aims to enrol 25,400 non-pregnant young women in Matiari district. This sample size is anticipated to equate to 1456 births. Participants will be randomized by cluster to receive either MMN supplements and life skills education or the standard of care at enrolment. Clusters have been defined based on health facility catchment areas. MMN supplements will be provided twice weekly during the preconception period, once daily during the pregnancy period, and once daily until 6 months after giving birth during the postpartum period; and a package of life skills education materials will be provided bi-monthly during the preconception period. In addition to the primary outcomes, measurements will include micronutrient status, anthropometrics, birth outcomes, dietary intake and feeding practices, adherence, and indices of empowerment.

Being tested
Multiple micronutrients (UNIMMAP composition), Life skills based education
Keywords
preconception supplementation, multiple micronutrients, low birth weight
Medical subject headings
Anemia, Empowerment

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Multiple micronutrients (UNIMMAP composition)Dietary supplement

    Also called UNICEF, Micronutrient tabs, pregnancy/PAC-1000

    The intervention is an oral tablet containing 15 different vitamins and minerals at the UNIMMAP composition (includes 30 mg iron, 400 μg folic acid, 15 mg zinc, 2 mg copper, 65 μg selenium, 800 μg RE vitamin A, 1.4 mg vitamin B1, 1.4 mg vitamin B2, 18 mg niacin, 1.9 mg vitamin B6, 2.6 μg vitamin B12, 70 mg vitamin C, 5 μg vitamin D, 10 mg vitamin E and 150 μg iodine). Each tablet is small (approximately 10 mm diameter) and has been procured using the UNICEF supply catalogue. A single MMN supplementation dose will consist of a single tablet.

  • Life skills based educationBehavioural

    The life skills based education will be provided bi-monthly in the format of a group session throughout the preconception period. Three topic areas related to empowerment have been prioritized, including preventing early marriage; personal and menstrual hygiene practices; and the importance of nutrition to good health. Integrated within these topics will be messages related to the importance of continuing one's education, mental health, gender norms and equality, decision making, advocacy, resiliency, participation, communication skills, facing challenges, agency, conflict resolution, and the prevention of violence.

Study groups in NCT03287882
Study groupRoleWhat they receive
Standard of careNo intervention1. Preconception period: none 2. Pregnancy period: daily iron (60 mg) and folic acid (400 µg) supplementation from confirmation of pregnancy; daily balanced energy protein supplements will additionally be provided to those participants who are underweight at the confirmation of pregnancy for the duration of the pregnancy 3. Postpartum period: daily iron and folic acid supplementation to 6 months postpartum
MMN supplementation and life skills educationExperimental1. Preconception period: twice-weekly MMN supplementation and bi-monthly group session including life skill based education materials 2. Pregnancy period: daily MMN supplementation from confirmation of pregnancy; daily balanced energy protein supplements will additionally be provided to those participants who are underweight at the confirmation of pregnancy for the duration of the pregnancy 3. Postpartum period: daily MMN supplementation to 6 months postpartum
Receives: Dietary Supplement: Multiple micronutrients (UNIMMAP composition); Behavioral: Life skills based education

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Anemia status

    Hemoglobin concentration <12 g/dL

    Measured: 0, 12*, 24 months (*in subgroup only)

  2. Low birth weight

    Birth weight <2500 g

    Measured: At birth

Secondary outcomes (21)
  1. Biomarkers: serum ferritin, serum transferrin receptor, hepcidin, serum retinol, serum 25(OH)D, alpha-glycolytic protein, C-reactive protein (women)

    Measured: Preconception (subgroup only): enrolment, 1 year, 2 years; Pregnancy: 4-12 weeks, 32 weeks; Postpartum: 1 week

  2. Anthropometrics: height (women)

    Measured: Preconception: enrolment, 6 months*, 1 year, 2 years (*in subgroup only); Pregnancy: 4-12 weeks, 32 weeks; Postpartum: 1 week, 6 months

  3. Anthropometrics: middle upper arm circumference (women)

    Measured: Preconception: enrolment, 6 months*, 1 year, 2 years (*in subgroup only); Pregnancy: 4-12 weeks, 32 weeks; Postpartum: 1 week, 6 months

  4. Anthropometrics: weight (women)

    Measured: Preconception: enrolment, 6 months*, 1 year, 2 years (*in subgroup only); Pregnancy: 4-12 weeks, 32 weeks; Postpartum: 1 week, 6 months

  5. Gestational age

    Measured: At birth

  6. Preterm birth

    Measured: At birth

  7. Stillbirth

    Measured: At birth

  8. Small for gestational age

    Measured: At birth

  9. Birth size: length

    Measured: Within 24 hours of birth

  10. Birth size: head circumference

    Measured: Within 24 hours of birth

  11. Birth size: middle upper arm circumference

    Measured: Within 24 hours of birth

  12. Birth size: weight

    Measured: Within 24 hours of birth

  13. Birth defects

    Measured: At birth

  14. Infant growth: length

    Measured: 1, 3, 6, 9, 12 months

  15. Infant growth: head circumference

    Measured: 1, 3, 6, 9, 12 months

  16. Infant growth: middle upper arm circumference

    Measured: 1, 3, 6, 9, 12 months

  17. Infant growth: weight

    Measured: 1, 3, 6, 9, 12 months

  18. Age at marriage

    Measured: Enrolment, 1 year, 2 years

  19. Completion of 10th grade education

    Measured: Enrolment, 1 year, 2 years

  20. Use of sanitary pad during last menstrual period

    Measured: Enrolment, 1 year, 2 years

  21. Dietary intake: 24-hour recall (subgroup of women)

    Measured: Preconception: enrolment; Pregnancy: 4-12 weeks, 32 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted19 Sep 2017
  2. Study start30 Jun 2017
  3. Primary completion12 Mar 2021
  4. Study completionFeb 2022 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Investigator, Outcomes assessor
Enrolment
25,447 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03287882
Sponsor's protocol ID
4324-Ped-ERC-16
Status last verified
Jul 2021
First submitted
21 Aug 2017
Last updated
27 Jul 2021
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Baxter JB, Wasan Y, Daniel AI, Begum K, Hussain A, Iqbal J, Aufreiter S, Beggs MR, Duan L, Greco A, Huang C, Soofi S, Bandsma RH, Bhutta ZA, O'Connor DL. Maternal multiple micronutrient supplementation in rural Pakistan increased some milk micronutrient concentrations, but not infant growth, at three-months postpartum: a randomized controlled trial substudy. Am J Clin Nutr. 2025 Jul;122(1):174-184. doi: 10.1016/j.ajcnut.2025.05.019. Epub 2025 May 21.

    PubMed 40409469
  • Baxter JB, Wasan Y, Hussain A, Soofi SB, Ahmed I, Bhutta ZA. Drivers of malnutrition among late adolescent and young women in rural Pakistan: a cross-sectional assessment of the MaPPS trial. BMJ Open. 2023 May 23;13(5):e063734. doi: 10.1136/bmjopen-2022-063734.

    PubMed 37221027
  • Baxter JB, Kortenaar JL, Wasan Y, Hussain A, Soofi SB, Ahmed I, Bhutta ZA. Age-Based Anthropometric Cutoffs Provide Inconsistent Estimates of Undernutrition: Findings from a Cross-Sectional Assessment of Late-Adolescent and Young Women in Rural Pakistan. Curr Dev Nutr. 2021 Nov 10;5(11):nzab130. doi: 10.1093/cdn/nzab130. eCollection 2021 Nov.

    PubMed 34901693
  • Bhutta ZA. Reply to NF Krebs and KM Hambidge. Am J Clin Nutr. 2019 Aug 1;110(2):521-522. doi: 10.1093/ajcn/nqz078. No abstract available.

    PubMed 31367763
  • Bhutta ZA. Balancing the benefits of maternal nutritional interventions; time to put women first! Am J Clin Nutr. 2019 Feb 1;109(2):249-250. doi: 10.1093/ajcn/nqy336. No abstract available.

    PubMed 30721972
  • Baxter JB, Wasan Y, Soofi SB, Suhag Z, Bhutta ZA. Effect of life skills building education and micronutrient supplements provided from preconception versus the standard of care on low birth weight births among adolescent and young Pakistani women (15-24 years): a prospective, population-based cluster-randomized trial. Reprod Health. 2018 May 31;15(1):104. doi: 10.1186/s12978-018-0545-0.

    PubMed 29855317
  • Baxter JB, Wasan Y, Soofi SB, Suhag Z, Bhutta ZA. Feasibility and effect of life skills building education and multiple micronutrient supplements versus the standard of care on anemia among non-pregnant adolescent and young Pakistani women (15-24 years): a prospective, population-based cluster-randomized trial. Reprod Health. 2018 May 30;15(1):103. doi: 10.1186/s12978-018-0547-y.

    PubMed 29848335

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Multiple micronutrients (UNIMMAP composition) and Life skills based education in people with Adolescents and Anemia, run by Aga Khan University at 1 site in Pakistan.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 27 Jul 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Anemia status (time frame: 0, 12*, 24 months (*in subgroup only)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03287882, which also lists 7 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Jul 2021.

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