Weinhardt 2017.

Study characteristics
Methods	Study design: PCS How were missing data handled? missing data for the analysis of the particular outcome were excluded, but the HH with missing data were retained and all other observations were included. Randomisation ratio: N/A Recruitment method: NR Sample size justification and outcome used: study's statistical power was determined for the primary HIV sexual risk outcome and the primary food security outcome. The sample size was 598 for the control group and 301 for the intervention group. The study authors stated that effect sizes (d) were used in the calculation, but did not report any values. Sampling method: selected HHs in 3 intervention TAs received the intervention, compared with those in 3 non‐intervention TAs (matched for demographics and distance from urban centre. Study aim or objective: to evaluate the impact of a large‐scale multilevel economic and food security intervention on health outcomes and HIV vulnerability in rural Malawi. Study period: 2009–2012 Unit of allocation or exposure: TAs
Participants	Baseline characteristics Intervention or exposure group: Age: respondent age, mean, years: 40.4 (range 18–84) Place of residence: NR Sex: females, n/N (%): 398/598 (66.6) Ethnicity and language: language: Chichewa Occupation: most important income source, n (%): crop farming: 372/598 (62.2%); casual labour: 72/598 (12%); trading/selling: 17/598 (5.6%) Education: HHs with literate head, n (%): 472/598 (78.9); HH heads with, n (%): primary education: 447/598 (74.7); secondary education: 81/598 (13.5); no schooling: 68/598 (11.4) SES: HH size, mean: 5.3 (range 1–11); male‐headed HHs, n (%): 495/598 (82.8); HHs with economic crisis, n (%): due to illness/hospitalisation: 343/562 (61.0); due to environmental disaster: 88/559 (15.7); HHs with ganyu engagement, n (%): adult: 290/564 (51.4); child: 85/553 (15.4) Social capital: NR Nutritional status: HHs with food security, n (%): HH food secure: 165/564 (29.3); consuming vitamin A‐rich vegetables: 536/586 (95.0); consuming other vegetables: 426/564 (75.5); consuming vitamin A‐rich fruits: 27/564 (4.8); consuming groundnuts: 396/563 (70.3); HHs reducing amount/number of meals to cope with shortage, n (%): 59/398 (14.8); HHs with malnourished children, n (%): 62/420 (14.8) Morbidities: self‐reported HIV‐positive status, n (%): 16/564 (2.8) Concomitant or previous care: NR Control group: Age: respondent age, mean, years: 38.5 (range 19–86) Place of residence: NR Sex: females, n (%): 201 (66.8) Ethnicity and language: language: Chichewa Occupation: most important income source, n (%): crop farming: 203/301 (67.3); casual labour: 33/301 (11); trading/selling: 64/301 (10.7) Education: HHs with literate head, n (%): 236/301 (78.4); number of HH heads with, n (%): primary education: 225/301 (74.8); secondary education: 28/301 (9.3); no schooling: 47/301 (15.6) SES: HH size, mean: 6.3 (range 2–14); male‐headed HHs, n (%): 265/301 (88); number of HHs with economic crisis, n (%): due to illness/hospitalisation: 120/263 (45.6); due to environmental disaster: 12/263 (4.6); number of HHs with ganyu engagement, n (%): adult 111/263 (42.2); child 39/260 (15.0) Social capital: NR Nutritional status: HHs with food security, n (%): HH food secure: 71/262 (27.1); consuming vitamin A‐rich vegetables: 248/263 (94.3); consuming other vegetables: 198/263 (75.3); consuming vitamin A‐rich fruits: 47/263 (17.9); consuming groundnuts: 191/262 (72.9); HHs reducing amount/number of meals to cope with shortage, n (%): 17/191 (8.9); HHs with malnourished children, n (%): 48/213 (22.5) Morbidities: self‐reported HIV‐positive status, n (%): 9/263 (3.4) Concomitant or previous care: NR Overall: NR Inclusion criteria: NR Exclusion criteria: NR Pretreatment: participants in intervention group were older, had smaller HHs and the HHs were less dominated by males. The intervention group and control group had significant differences in income sources (P = 0.025), and practice/applying sustainable agriculture methods. Higher number of HHs with malnourished children in the control group (22%) compared to intervention group (14.8%). Attrition per relevant group: total attrition was 5.7% (34/598) in the intervention group and 12.6% (38/301) in the control group. No differential attrition was detected for the study conditions, or between HHs who attrited and those who did not. Attrition per outcome: for reported HIV testing and self‐reported HIV status there was no additional attrition; for food security there was no additional attrition with the exception of groundnut consumption (0.2% for intervention and 0.4% for control) and HH food security (0.4%, control only); for reduction of amount/number of meals to cope with food shortage additional attrition was 29.4% for intervention and 27.4% for control; and for child anthropometric measurements additional attrition was 25.5% for intervention and 19.0% for control. Description of subgroups measured and reported: NR Total number completed and analysed per relevant group: intervention group (SAFE intervention group): 564 HHs; control group: 263 HHs Total number enrolled per relevant group: intervention group (SAFE intervention group): 598 HHs; control group: 301 HHs Total number randomised per relevant group: N/A
Interventions	Intervention characteristics Intervention or exposure Food access intervention category: increase buying power Intervention type: income generation Description: multilevel economic and food security programme (increased VSL groups; improved farming practices; capacity building of local governance structures; HIV education and gender empowerment). Support to able‐bodied vulnerable groups to achieve food security (SAFE) programme consisted of 4 components: 1. improving farming practices and sustainable agriculture through FFSs, 2. increasing access to savings and investment through VSL groups, 3. building capacity of local governance structures, and 4. integrating HIV education and gender empowerment into programmes through training and education. Duration of intervention period: 24 months (January 2008 to December 2010) Frequency: NR Number of study contacts: 3 (baseline: February–August 2009), 18‐month follow‐up (November 2010 to April 2011) and 36‐month follow‐up (February–August 2012) Providers: NGO (CARE International). Delivery: community‐based, structural, multilevel health and development programme. Co‐interventions: non‐CARE agricultural education programme in few participants Resource requirements: NR Economic indicators: NR Control group: Food access intervention category: N/A Intervention type: HIV prevention education Description: brief HIV prevention programme for school children Duration of intervention period: NR Frequency: NR Number of study contacts: 3 (baseline February–August 2009), 18‐month follow‐up (November 2010 to April 2011) and 36‐month follow‐up (February–August 2012) Providers: NGO (CARE International). Delivery: school‐based programme. Co‐interventions: non‐CARE agricultural education programme in few participants Resource requirements: NR Economic indicators: NR
Outcomes	Food security: mean number of months with less food than necessary to meet needs Dietary intake: self‐reported types of foods consumed in past 3 days Anthropometry: WAZ, HAZ, % malnourished, child BMI
Identification	Sponsorship source: National Institutes of Health, Eunice K. Shriver National Institute of Child Health and Human Development grant R01‐HD055868 (2008–2015). Country: Malawi Setting: poor HHs in rural areas Author's name: Lance S Weinhardt Email: weinhardt@uwm.edu; yanf@uwm.edu Declarations of interest: yes; no conflicts of interest. Study or programme name and acronym: Study name: Savings, Agriculture, Governance, and Empowerment for Health (SAGE4‐Health); Programme name: Support to Able‐Bodied Vulnerable Groups to Achieve Food Security (SAFE). Type of record: journal article
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (Selection bias)	High risk	CBA study; no randomisation.
Allocation concealment (Selection bias)	High risk	CBA study; no allocation concealment.
Baseline characteristics similar (Selection bias)	Low risk	Intervention HHs had significantly older respondents (P = 0.040), and significantly smaller HHs (P = 0.001) and higher likelihood of being male‐headed (P = 0.039). These factors were treated as covariates in the assessment of intervention effects.
Baseline outcome measurements similar (Selection bias)	Low risk	Proportion of food insecure HHs was similar between groups at baseline.
Blinding of participants and personnel (Performance bias)	Low risk	There was no blinding but outcomes unlikely to be influenced by lack of blinding of participants or personnel administering the intervention.
Blinding of outcome assessment (Detection bias)	High risk	Most outcomes were self‐reported and knowledge of treatment allocation, due to lack of blinding, could have influenced outcome assessment. Objective anthropometric measurements were included and unlikely to be influenced by blinding.
Protection against contamination (Performance bias)	Low risk	Contamination was assessed and it was found that no control participants received any components of the intervention.
Incomplete outcome data (Attrition bias)	High risk	Low attrition overall that was differential (Intervention vs control: 5.7% vs 12.6%), but higher attrition for outcomes such as reduction of number/amount of meals during shortage (33.4% vs 36.5%) and child anthropometric measurements (29.8% vs 29.2%); however these were balanced between the groups.
Selective outcome reporting (Reporting bias)	Low risk	Study protocol and methods available. All a priori stated outcomes in the methods sections were reported on in the results section.
Other bias	Unclear risk	Misclassification bias: unlikely. Measurement bias: unlikely. Seasonality bias: unclear. Baseline survey conducted during 2009. No details reported in terms of the time period of data collection. The study authors did not specify that the month of data collection was included in their analysis to adjust for the possible effect of seasonality on consumption.

(?): not clear in report; AAY: Antyodaya Anna Yojana; ADRA: Adventist Development and Relief Agency; AE: adult equivalent; AM: Ajuda Mútua; APL: above poverty line; ARI: acute respiratory infection; BCC: behaviour change communication; BDH: Bono de Desarrollo Humano; BDT: Bangladeshi taka; BLT: unconditional cash transfer program; BMI: body mass index; BMIZ: body mass index‐for‐age z‐score; BPL: below poverty line; BPO: Bangladesh Post Office; BOS: school operational assistance program; CBA: controlled before‐after; CCG: child cash grant; CCT: conditional cash transfer; CDS: Child Diet Score; CES‐D: Center for Epidemiologic Studies Depression Scale; CFPR‐TUP: Challenging the Frontiers of Poverty Reduction – Targeting the Ultra Poor; CFSS: the paper doesn't provide full name ; CGP: Child Grant Programme; CI: confidence interval; CMC: community management committee; CNW: community nutrition worker; CNY: Chinese yuan; COP: Colombian peso; cRCT: cluster randomised controlled trial; CWAC: Community Welfare Assistance Committee; DDI: Dietary Diversity Index; DDS: Dietary Diversity Score; DfID: Department for International Development; ECHO: European Civil Protection and Humanitarian Aid Operations; DID: difference in differences; EHFP: enhanced‐homestead food production; EA: enumeration area; ECD: Early Childhood Development; ED: electoral division; EGP: Egyptian pound; EPA: extension planning area; ESD: enumerator subdistrict; ESDO: Eco‐Social Development Organization; ETB: Ethiopian birr; ETT: effect of treatment on the treated; F2F: farmer to farmer; FA: Familias en Acción; FAO: Food and Agriculture Organization; FCS: Food Consumption Score; FDC: food distribution committee; FDP: food distribution point; FDS: Food Diversity Score; FFS: Farmer Field School; FISP: fertiliser input subsidy programme; FSI: Food Security Index; GD: GiveDirectly; GDP: gross domestic product; GHQ‐12: 12‐item General Health Questionnaire; GPS: Global Positioning System; GVH: group village headmen; HAZ: height‐for‐age z‐score; Hb: haemoglobin; HC: health committee; HDDS: Household Dietary Diversity Score; HH: household; HFAIS: Household Food Insecurity Access Scale; HKI: Helen Keller International; HSNP: Hunger Safety Net Programme; IADB: Inter‐American Development Bank; ICC: intraclass correlation coefficient; IDDS: Individual Dietary Diversity Score; IDR: Indonesian rupiah; IFPRI: International Food Policy Research Institute; IGIDR: Indira Gandhi Institute of Development Research; IHS3: Integrated Household Survey 3; INR: Indian rupees; IQR: interquartile range; ITT: intention to treat; IYCDDS: Infant and Young Child Dietary Diversity Score; KBK: Kalahandi‐Balangir‐Koraput; KES: Kenyan shilling; LGA: local government authority; LPG: liquid petroleum gas; LSL: Lesotho loti; LTFU: loss to follow‐up; MASAF: Malawi Social Action Fund; MDD: minimum dietary diversity; MIS: management information system; MoSS: Ministry of Social Solidarity; MPCE: monthly per capita expenditure; MUAC: mid‐upper arm circumference; MUACZ: mid‐upper arm circumference z‐score; MWK: Malawian kwacha; MXN: Mexican peso; MZN: Mozambican metical; n: number of participants; N/A: not applicable/available; NGO: non‐governmental organisation; NIO: Nicaraguan córdoba; NPO: non‐profit organisation; NPR: Nepalese rupee; NR: not reported; NWG: non‐women's group; OLS: ordinary least squares; OWL: older women leader; PCS: prospective controlled study; PDS: Public Distribution System; PEN: Peruvian sol; PIM: Policies, Institutions and Markets; PHP: Philippine peso; PKH: Program Keluarga Harapan; PKR: Pakistani rupee; PM2A: Preventing Malnutrition in Children under 2 Approach; PMT: Proxy Means Test; POG: Pass‐on‐the‐Gift; pp: percentage point; PPSC: Post and Postal Savings Corporation; PSLSD: Project for Statistics on Living Standards and Development; PSM: propensity score matching; PSNP: Productive Safety Net Program; PSS: Perceived Stress Scale; PVDI: photovoltaic drip irrigation system; PWP: public works programme; RCT: randomised controlled trial; RDA: recommended daily allowance; RPS: Red de Protección Social; SAFE: Support to Able‐Bodied Vulnerable Groups to Achieve Food Security; SAR: South African rand; SCTS: Social Cash Transfer Scheme; SD: standard deviation; SE: standard error; SES: socioeconomic status; SFP: supplementary food programme; SMG: Solar Market Garden; TA: traditional authority; TASAF: Tanzania Social Action Fund; TCP: tratamiento con pago (treatment with payment); TKP: Takaful and Karama Program; TMRI: Transfer Modality Research Initiative; TRT: targeted resource transfer; TSP: tratamiento sin pago: treatment without payment; TVIP: Test de Vocabulario en Imagenes Peabody; UCT: unconditional cash transfer; UMKD: ; UNHCR: United Nations High Commissioner for Refugees; UNICEF: United Nations Children's Fund; UP: Union Parishad; UPP: Urban Poverty Program; USAID: United States Agency for International Development; USDA: United States Department of Agriculture; VC: village cluster; VDC: village development cluster; VMF: village model farm; VSL: village savings and loan; WAZ: weight‐for‐age z‐score; WDDS‐10: Women's Dietary Diversity Score; WEG: Women Empowerment Group; WFP: World Food Program; WFP‐CO: ; WG: women's group; WHO: World Health Organization; WHZ: weight‐for‐height z‐score; WINS: Women and Children/Infants Improved Nutrition in Sindh; WLZ: weight‐for‐length z‐score; XOF: West African CFA franc; YER: Yemeni rial; ZMW: Zambian kwacha.