weighing session. The community nutrition workers are paid and get help from a group of local volunteers (support group)<sup>6</sup> in their activities related to Seecaline.

The ACN carries out a yearly census of all the children under the age of three, registering their names and mobilizing the mothers to participate in the weighing and education sessions. The promotion of behavioral change (besides the direct counseling to mothers) includes nutrition and hygiene education sessions, and cooking demonstrations by the community nutrition worker where she emphasizes the proper weaning practices and prepares recipes that rely on locally available products to promote a healthy and diversified diet.

The program was gradually phased in. Seecaline activities started in 1999 in four provinces and expanded to all six provinces in 2000.<sup>7</sup> The selection of the district was based on a nationally representative anthropometric survey collected in 1997/98, which represents the baseline data for our evaluation. All districts (46 out of 111) that had an average malnutrition rate (moderate underweight) above the national average were selected for the intervention (43%). In addition, ten rural districts affected by droughts and cyclones in the year 2000 were added to the program.<sup>8</sup> The program expansion stopped at the end of 2001/beginning of 2002 to reach about 3,600 project sites.

The program expansion followed a sequential contractual engagement of NGOs across districts. NGOs were selected based on a bidding workshop organized every year around August/September<sup>9</sup> . The selected NGOs were then assigned a number of sites in any given district, based on an estimate of the target population in the districts.

The program in each province was initially advertised to all mayors of the communes included within the district. Mayors would then organize a meeting with all the communities to make them aware of the program and to encourage them to participate. A community had to be eligible to open a project site and geographically accessible for most part of the year (by auto/motorbike, chariot or pirogue). Accessibility in Madagascar is a major constraint for

> 6 The support group generally consists of eight members who help the ACN in organizing her weighing session and in other regular activities of the community program. Besides growth monitoring, the program provides other activities.  All of the children are given micronutrient supplementation (vitamin A) and de-worming (for children 1-3).

> 7 CNII is an extension of an earlier Bank pilot project originally targeted to two provinces (Antananarivo and Toliara).

> 8 The total number of sites to be opened in each district was chosen to reach a coverage rate of 50% of all children below three years of age in the intervention areas. The 50% target was to be achieved gradually over time, with 10% coverage per year in the first two years of operation and 15% coverage per year in the third and forth years. Finally six additional urban districts that cover the province capitals were added in 2002, in the aftermath of a political crisis. Emergency sites were opened to alleviate the cost of the crisis on urban populations, and were subsequently made permanent. We exclude these large cities from the analysis because the nature of the intervention as well as the socio-economic environment is substantially different from the rest of the country.

> 9 Eligible NGOs had to have had at least one year of experience in the district of intervention.

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