Flow of participants through the SHINE early child development (ECD) substudy.

1In all, 212 clusters were randomized, 53 in each of the 4 trial arms. After randomization, 1 cluster was excluded as it was determined to be in an urban area, 1 cluster was excluded as the village health worker covering it mainly had clients outside the study area, and 1 more was merged into a neighboring cluster based on subsequent data on village health worker coverage. Three new cluster designations were created due to anomalies in the original mapping: for 2 of these, the trial arm was clear; the third contained areas that were in 2 trial arms, and was assigned to the underrepresented arm, resulting in 53 clusters in each arm. All of this occurred before enrollment began. When enrollment was completed, however, there was 1 standard-of-care cluster in which no women were enrolled, leaving a total of 211 clusters available for analysis. 2SOC, standard of care; IYCF, infant and young child feeding; WASH; water, sanitation, and hygiene.3Children were not eligible for the ECD substudy if they turned 2 years of age (allowable range 102–112 weeks) before March 1, 2016.4Children were eligible for the ECD substudy if they turned 2 years of age (allowable range 102–112 weeks) between March 1, 2016, and April 30, 2017.5Children were eligible for the ECD substudy because they turned 2 years of age (allowable range 102–112 weeks) between March 1, 2016, and April 30, 2017, but they were not contactable or were not approached for consent because the number of children becoming 102–112 weeks of age between March 1, 2016, and April 30, 2017, exceeded the capacity of the 11 ECD-trained nurses.