AC condition
The CHWs implementation model in the AC was adapted from the Philani Maternal, Child Health, and Nutrition Programme [Two experienced Philani supervisors were allocated to provide supportive supervision to the CHWs allocated to the AC, even though the official supervisor remained the government clinic supervisor. Supportive supervision requires the following: the psychoeducational and interpersonal skills to both motivate and support CHWs to conduct effective home visits; the ability to identify and act effectively when either mothers or children are failing to maintain healthy routines; and the ability to hold CHWs accountable for not visiting mothers’ homes nor sharing key information about risk and protective factors for mothers and children. The supervisor randomly dropped in on the typical home visits on an ongoing basis (once every 2 weeks), covering 4 to 6 households a day. CHWs and supervisors then jointly identified at-risk children. These visits allowed them to support and validate the CHWs, as well as provide a role model for coping well with the mother on the home visit. CHWs in the AC group were expected to complete 6 home visits a day and were required to briefly log each visit onsite on a mobile phone with global positioning coordinates. Supervisors regularly checked the logging of home visits through an online portal and were able to quickly identify when CHWs were not out in the field, which was then addressed by a phone call or visit [