Discussion
deaths
This study assessed the impacts on equity of the multicomponent ECD ‘Learning Clubs’ intervention, which has previously been found to be an effective intervention to improve child development (Household wealth and maternal education are well-known social determinants of children’s health. Multi-country studies have found that around half of the total deaths in children aged under-5 were in those in the poorest two quintiles (Research evidence in equity-informative cost-effectiveness of ECD intervention is scarce. To our knowledge, no existing studies have examined the distributional cost-effectiveness of multicomponent ECD interventions in low- and middle-income countries. A scoping review on equity in economic evaluations of ECD interventions in low- and middle-income countries identified that most studies solely focused on health, and no study measured child cognitive, language, motor or social and emotional development (Better value for money of interventions for children from low socioeconomic backgrounds does not mean that ECD policies and programmes should only target the poorest children. Marmot and colleagues argued that focusing solely on the most disadvantaged may stigmatize them and weaken social cohesion across the population (Our findings should be interpreted with some caution considering study limitations. First, the study was not powered to detect subgroup differences as this equity analysis was not planned beforehand. A descriptive assessment study noted that many studies have been underpowered for subgroup analyses because sample size calculations are usually based on comparison between trial arms rather than on differential effects within subgroups (