Methods	Study design: Cluster‐randomized controlled trial
	Unit of randomization: Cluster‐randomised
	Type of study: Food Distribution Program
Participants	Location/setting: 2 provinces in Eastern Burundi (Cankuzo and Ruyigi)
	Population: Not specified
	Sample size: 2505
	Drop outs/withdrawal: Not specified
	Socio‐demographics
	Mean (SD) age/age range:
	Total: 28.5 (6.5), Intervention: 28.7 (6.4), Control: 28.2 (6.5)
	Occupation: Farming, agriculture and labor
	Race: Not specified
	Education:
	Education % (At follow‐up)
	Treatment
	None/preschool: 42.9
	Primary incomplete: 52.2
	primary complete: 0.8
	Secondary education: 4.1
	Control
	None/preschool: 52.5
	Primary incomplete: 44.7
	primary complete: 1.0
	Secondary education: 1.8
	Family income: Not specified
	Inclusion criteria:
	All pregnant women (at or after the fourth month of gestation) and mothers of children aged <6 months living in these 2 provinces
	Exclusion criteria: Not specified
Interventions	Intervention (sample size):
	2 arms
	T24: program benefits during pregnancy and until 23.9 months of the child
	T18: program benefits received during pregnancy and until 18 months of child's age
	The food component aimed to increase household food security in terms of both quantity and quality (through a family ration containing micronutrient‐fortified foods) and maternal and child nutrition (through the individual micronutrient‐fortified food rations targeted at pregnant and lactating mothers and children from 6 to 24 months of age) Corn‐soy blend (CSB) and fortified vegetable oil were the 2 commodities provided in household and individual rations. Intervention was delivered by tubaramure health promoters (n = 1662)
	Control (sample size):
	Standard care. The control group did not receive any program benefits but continued to have access to the standard care provided by the Ministry of Health (n = 843)
	Concomitant interventions:
	The core program package included 3 components: the distribution of food rations, improvements in the provision and use of health services, and a behavior change communication (BCC) strategy focused on improving health, hygiene, and nutrition practices
	Training:
	Repeated testing was done to assess who had acquired the required skills to conduct the fieldwork
	Follow‐up:
	In 2012 to assess the impact on maternal and child anaemia and on maternal knowledge and practices. In 2014, anthropometric measuring was conducted in 2014
Outcomes	Primary outcomes: None
	Secondary outcomes:
	Anemia (pregnant women)
	Stunting
	Haemoglobin (child)
	Iron deficiency anaemia of child
	Timing of outcome assessment: Follow‐up
Notes	Study start date: October 2010
	Study end date: 2016
	Time period: 6 years
	Study country: Burundi
	Study limitations:
	One limitation of our study is the lack of biomarker information to determine the etiology of anaemia in this population. In addition, the process evaluation found that some aspects of the care group sessions could have been strengthened. For example, leader mothers did not always have the required technical expertise or teaching skills to adequately transfer knowledge to beneficiary mothers. In addition, many beneficiaries were not exposed to messages on complementary feeding practices because of delays in the rollout of this BCC component
	Funding source:
	Supported by the Office of Food for Peace, Bureau for Democracy, Conflict, and Humanitarian Assistance and the Office of Health, Infectious Diseases, and Nutrition, Bureau for Global Health, US Agency for International Development (USAID), under terms of cooperative agreement AID‐OAA‐A‐12‐00005, through the Food and Nutrition Technical Assistance III Project (FANTA), managed by FHI 360. This study also received support from the CGIAR Research Program on Agriculture for Nutritionmand Health (A4NH), led by the International Food Policy Research Institute
	Conflict of interest: None