most Malagasy children were passing the majority of the questions in the gross motor module, and so that module was cut from the version used in Madagascar for this study, which therefore assesses children for fine motor skills, language learning, and social skills.

Note that the MDAT is only used for one child per household within the age range that the MDAT is designed for. If there was more than one eligible child in the household, one of the eligible children was chosen at random. As such, the sample size for the MDAT and its component indices is smaller than the total number of households surveyed since not all households have children in the appropriate age range, resulting in a sample of 2,757 for the child development outcomes.

# **4.3: Key Variables**

Key outcome variables are defined as below. As discussed earlier in the theory of change, we broadly classify our outcome variables into Behaviors, Proximate Outcomes, and Long-Term Outcomes. The list below reflects this classification.

- **Behaviors:** These are variables measuring various parenting or nutrition ‘actions’ that caregivers may take. Positive Parenting Behavior: This variable captures how many of three positive parenting behaviors (following up on the education of the child, checking up on the child’s health, and playing with children) the parent reports engaging in over the preceding twelve months. Thus, it ranges in value between 0 and 3.

Interaction With Children: This variable captures how many of each of 6 parenting behaviors(read a book, told stories, sang songs, went for a walk, played with, taught to count or draw) the parent reports engaging in with their two youngest children over the preceding 3 months. Each of these behaviors is coded as a 0-1 binary, so that this variable ranges in value between 0 and 6.

Preparing Diverse Meals: A binary variable taking the value 1 if the household reports having usually prepared ‘diverse meals’ including fruit over the preceding 12 months, and 0 otherwise.

- **Proximate Outcomes:**

Food Diversity: Defined as the sum of the number of 10 different categories of food (cereals, flours, legumes, vegetables, fruits, roots, meat, etc.) that the household reports consuming over the last 7 days; takes a maximum value of 10 if household reports consuming all the categories of food. Dietary diversity was included instead of attempting to measure nutrition directly, since it has been found to be a good predictor of micronutrient intake in Madagascar specifically (Moursi et al., 2008).

Number of Meals Prepared: Defined as number of meals the household reports preparing on the day prior to the survey; higher values are desirable.

Food insecurity, 7 day: Defined as the _mean_ number of days over the preceding 7-day period that the household reportedly experienced seven types of food insecurity. (The 7 potential types include: cooked food they did not like, was not able to properly diversify food, had to reduce quantity per meal, had to reduce the number of meals, adults had to reduce amount of food eaten to give to children, had to borrow food or rely on friends and family, had nothing to eat.) For example, if the household reported that for 7 days they had to cook food they did not like, but reported 0 days for the remaining types of food insecurity, the value of this variable would be 1). A reduction in the value of this variable is desirable.

Food insecurity, 12 month: Defined as the number of months in the past 12 months the household reported experiencing not having enough food. A lower value is desirable.

**Long-Term Outcomes (Child Development):** The only longer-term outcomes we measure at midline are (various components of) early childhood socio-cognitive development, as measured by the Malawi Developmental Assessment Tool (MDAT) as adapted to the Malagasy context.

Language Learning/Fine Motor Skills/Social Skills: These are normalized scores over the relevant sections of the Malawi Development Assessment Tool (MDAT) as adapted to the Malagasy context. Composite Development: This is the normalized aggregate score over all sections of the MDAT, as adapted to the Malagasy context.

10