Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk
Allocation concealment (selection bias)	Unclear risk	Quote: “…designed, implemented and evaluated DISHA in two Indian states: Bihar and Jharkhand.” Comment: the program evaluation mentions the use of a control group but whether these groups were villages in these states or outside is unclear
Similar baseline characteristics	Unclear risk	Comment: insufficient information to permit judgement
Similar baseline outcome measurement	Unclear risk	Comment: there were differences between participant outcomes between the two states at baseline—however both these outcomes were reported for the intervention, with minimal information on the control cohort's baseline outcomes.
Blinding of participants and personnel (performance bias)	Unclear risk
Blinding of outcome assessment (detection bias)	Unclear risk
Incomplete outcome data (attrition bias)	Unclear risk	Comment: greater sample size following the intervention (at end line)
Prevention of knowledge of allocated intervention	Unclear risk	Comment: insufficient information to permit judgement
Protection against contamination	Unclear risk	Comment: it is unclear whether the control sites were within the same states/villages as the intervention sites, which may have led to contamination
Selective reporting (reporting bias)	Unclear risk	Comment: insufficient information to permit judgement; and no protocol was found
Other bias	Low risk	Comment: study seems free from other bias