Study design
We evaluated an integrated community-based intervention using a Cluster-Randomized Control Trial (C-RCT) design. We ensured all cluster members received similar interventions. Administratively, districts are subdivided into talukas or blocks in India. One taluka has around five Primary Health Centers (PHCs), and PHCs comprise five to six sub-centers (SCs). Sub-center caters to nearly five to six villages with a population of around 5,000. Each village has an Anganwadi center (AWC) catering to a population of 1,000 in a rural area.We selected two adjacent blocks in central India, the Seloo and the Hingna blocks. The study team has strong community linkages in these areas, so delivering intervention and data collection in selected blocks was convenient. Since the community volunteers administered the intervention at the village level (Anganwadi center area) and the villages are situated very close to each other, we defined the sub-center as a unit of randomization to minimize the risk of contamination across the intervention and control groups. We used a stratified randomization approach.