Kanté 2019a.

Methods	Design: cluster‐randomized trial, including continuous health and demographic surveillance through the Health and Health and Demographic Surveillance System of the Ifakara Institute Unit of randomization: village
Participants	Inclusion criteria: population in intervention and control villages Exclusion criteria: none stated
Interventions	Intervention Training lay health workers (CHW) to provide iCCM for diarrhoea, malaria (in high‐risk areas), pneumonia (ARI) and malnutrition among children aged 2–59 months. CHWs were also trained on a broader package of promotive, preventive and curative interventions across the life cycle, including for neonates, postneonates, infancy and childhood, adolescence and adulthood Providing incentives for lay health workers (CHW were paid an annual salary in Tanzanian Shillings amounting to USD 1348.21) Providing iCCM providers (CHW) with drugs and equipment Implementing simplified IMCI‐adapted clinical guidelines for iCCM providers (CHW) Implementing referral of children aged < 2 months and children with severe disease to health facilities Training supervisors (Council Health Management Team, consisting of project field co‐ordinator, village authorities and health workers posted in a nearby health facility) of iCCM providers (CHWs) on supportive supervision Providing supervision (Council Health Management Team) to iCCM providers (CHWs); frequency, content and approach of supervision not reported Comparison Usual facility services
Outcomes	Mortality Neonatal mortality (deaths between birth and day 28 of life) Infant mortality (deaths between birth and day 365 of life) Under‐5 mortality (deaths between birth and age 5 years) Note: data for other outcomes were collected but not reported in the publication, including maternal mortality ratio and adult mortality rates, childhood morbidity, cause of death distribution for children under‐5 years, life years gained, coverage of health services (e.g. rates of antenatal care, skilled attendance at birth, facility delivery, postnatal care, immunization, treatment with ORS, antimalarial medicines, and antibiotics and contraceptive prevalence) the total fertility rate, parental health‐seeking behaviours during child illness, and other parental health behaviours such as prevalence of immediate and exclusive breastfeeding.
Notes	Objective: to evaluate the childhood survival impact of deploying paid CHWs to provide doorstep preventive, promotional and curative antenatal, newborn, child, and reproductive health care in 3 rural Tanzanian districts. Location: 3 districts, including Ifakara and Ulanga districts – 2 rural, remote and poor districts of Morogoro region of southwestern Tanzania – 500 km by road from Dar‐es‐Salaam in communities covered by the Ifakara Health Institute and Rufiji district in Coast region, about 150 km by road from Dar‐es‐Salaam. The economies of the 3 districts are dominated by farming, fishing and petty trade. The population was approximately 380,000 people, residing in 101 villages in 2015. Prior to intervention, the main causes of childhood mortality were malaria (7.8 deaths per 1000 person‐years), ARIs including pneumonia (2.8 deaths per 1000 person‐years) and prematurity and low birthweight (1.9 deaths per 1000 person‐years) and other preventable causes such as diarrhoeal diseases, birth injuries and asphyxia, anaemia and malnutrition. Funding source: the US‐based Doris Duke Charitable Foundation (DDCF) and Comic Relief in the UK financed the trial. Advisors to the DDCF commented on the study design prior to implementation.