Households in both the “Mother Leaders” arm and the “Mother Leaders and Affirmation” arm report experiencing significantly fewer dimensions of food insecurity over the past seven days, with the effect generally being the largest for those in the Cash + Mother Leaders arm. Interestingly, as seen in Appendix Table 2, the provision of cash by itself has no statistically significant effect on this measure of short-term food insecurity.

Finally, while point estimates all suggest that households in the three behaviorally enhanced arms all reported experiencing fewer months without enough food during the preceding 12 months than households in the cashonly arm, this effect is only statistically significant for households in the arm where the cash is supplemented by “Mother Leaders and Planning”. Once again (see Appendix Table 2) cash by itself does not lead to a statistically significant diminution in this measure of longer-term food insecurity (except in the specification where we are able to control for baseline values for the smaller sub-sample which was surveyed at both points in time). Overall, self-reported food insecurity is only significantly reduced when cash is supplemented by the Mother Leader groups and additional behavioral nudges.

# **6.3: Long-Term Outcomes**

As Table 5 shows, only the treatment arm where cash is augmented with the Mother Leaders groups shows statistically significant positive differences in overall child development as measured by the MDAT, as adapted to the Malagasy context. It is worth noting that the size of this effect is approximately as large as the effect from the provision of cash alone (see Appendix Table 3). Thus, the addition of the Mother Leaders treatment roughly doubles the effect on early childhood development as the provision of cash alone – a striking finding.

When we look at the component indices that make up the overall MDAT score, we see that children in several of the enhanced arms have significantly higher social skills than children in the cash-only arm. Once again, a comparison with the corresponding section of Appendix Table 3 shows that the magnitude of the effect from the enhancements is almost as large (0.11-0.13 vs 0.14) as the effect on social skills from the provision of cash. Again, adding the behavioral enhancements leads to almost as much of a bump in social development as providing cash. Similarly, children in the arms where cash was augmented by Mother Leader groups as well as the arm where this was further augmented by the Planning tool display significantly higher language learning than children in the cash-only group. The differences engendered by the addition of the Affirmation nudge are generally positive but not large enough to be statistically significant. As seen in Appendix Table 3, the provision of cash does not make any statistically significant difference to language learning at all – so this is an area of child development where we see significant improvements only once cash is supplemented with the behavioral enhancements we test.

Finally, we see no statistically significant evidence of improved fine motor skills from any of the behaviorally enhanced arms – but, as Appendix Table 3 shows, cash also does not lead to significant effects on this component of child development.

# **6.4:  Dosage Analysis**

Although our interventions were designed to be delivered with the same intensity to all participants in the enhanced arms logistical hurdles led to a slightly delayed rollout in one district, which together with the timing of the midline survey created some (albeit not exogenously assigned) variation in intensity of treatment. This meant that while the median village in the relevant arms received 5 nudge sessions, a quarter of villages received 4.5 or less, while a quarter had received between 6 and 7 by the time of the midline survey. This variation, albeit not experimentally induced, allows for an analysis (albeit a cursory one) of the effects of intervention intensity (dosage) for the behavioral variants (Table 6). We find that the number of ‘nudge’ sessions carried out at the fokontany/village level is positively correlated with most of the main long-term outcome variables on which we see robust intervention impacts. Although this is very rough analysis, it does suggest, encouragingly for this study, both that the sessions themselves (rather than, say, simply being in a group setting with other beneficiaries) are a pathway through which beneficiaries are able to change their behavior and that this utility could potentially be extended through repeated exposure.

# **6.5 Cost Effectiveness**

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