Sampling procedures
Sixteen clusters were selected based on MWH availability in the study area. These clusters were randomly assigned to intervention and control groups. Census and health post records were used to identify eligible pregnant women in the chosen clusters, resulting in the formation of a sampling frame. The study participants were then selected using a simple random sampling technique from the sampling frame. Each cluster had 20 couples. The same sample of participants assessed at baseline were assessed at endline to measure the outcomes (Fig. Schematic presentation of sampling procedure for a cluster-randomized trial in rural Ethiopia, Sep 15, 2022 to Apr 30, 2023.