Study design and participants
Alive
This non-masked, cluster-randomised, controlled trial took place in two regions: SNNPR, a primarily agrarian region, and Somali, a region with a high population of pastoralists, which were selected with the Federal Government of Ethiopia and regional health bureaus. Alive & Thrive selected seven woredas (districts; four in SNNPR with 31 schools and three in the Somali region with 23 schools) as potential intervention areas on the basis of having adequate security and primary school access and infrastructure.The study included primary schools with grades 1–8 within the government education system. A baseline survey, covering a small subsample of adolescent girls across all study schools, was conducted to examine balance between study groups and to inform intervention design and context. A smaller sample size was included at baseline due to budgetary constraints, and the study impact was intended to be estimated at endline only.Adolescent girls were eligible for inclusion in the surveys if they were enrolled in a study primary school, were aged 10–14 years of age and enrolled in grades 4–8, and had received parental consent and given assent. Either parent of the adolescent girl (mother or father present at the time of interview) was invited to participate in the survey, and informed consent was sought from the parent before the baseline and endline surveys.Ethical approval for this study was granted by the Institutional Review Boards of the International Food Policy Research Institute (IFPRI) in Washington, DC, USA, and the Addis Continental Institute of Public Health (ACIPH) in Addis Ababa, Ethiopia. 