Interventions, adaptive strategies and best practices improving maternal nutritional health in changing climatic conditions and diverse cultural contexts in low- and middle-income countries: a systematic review protocol.

backgroundThe impact of poor nutritional health on maternal and infant morbidity and mortality remains high in low- and middle-income countries (LMICs), exacerbated by climate change-linked disasters. Maternal nutritional health, as a modifiable factor, is influenced by various social, political, economic and environmental factors, as well as cultural practices. Identifying climate change-related interventions, adaptive strategies and best practices targeting maternal nutritional health and well-being in LMICs within a cultural context helps inform the co-production of sustainable, culturally sensitive interventions to improve health outcomes for mothers and babies. METHODS AND ANALYSIS: We will undertake a systematic review of the literature employing the six steps of the Protocol, Search, Appraisal, Synthesis, Analysis and Report (PSALSAR) framework, including both peer-reviewed and grey literature. The Population, Concept and Context approach will be used to formulate the review question and the inclusion and exclusion criteria. We will include primary research comprising all study designs published in English from 2007 onwards. We will conduct searches in online academic databases, including CINAHL, MEDLINE, Global Health (CABI), AGRIS (FAO) and SCOPUS, as well as defined grey literature sources (ie, Google Scholar). Titles, abstracts and later full-text articles will be independently accessed and screened for eligibility criteria by four researchers. Following the integrative review methodology, we will present findings narratively, organised around the components of the PSALSAR framework to provide a comprehensive synthesis of the available evidence. ETHICS AND DISSEMINATION: As no primary data will be collected, the systematic review does not require formal ethics approval. However, we will give attention to ethical considerations within the identified studies. Findings will be published in a peer-reviewed journal and presented at relevant conferences. The findings of our systematic review and the ethnographic component of our research project will inform the development of appropriate maternal nutritional health interventions using co-production methodology in Pakistan. PROSPERO REGISTRATION NUMBER: CRD420251080897.