Table 11 Challenges faced regarding “visit schedules” by assessors during the feasibility study

Mothers not available for a second visit on the scheduled day

• Teams should plan a revisit before the set time limit ends

• A dashboard needs to be developed to schedule children for the next day to prevent missing any child

If a child sleeps during or before administration of GSED LF

• Wait for the child to complete their nap; the caregiver-reported questionnaires can be filled during that time

• Alternatively, teams can schedule another visit if the time limit allows

• Visits should always be scheduled after discussing with the caregiver their availability, convenient time, and the child’s nap time

Anthropometry took a lot of time in the current sequence of the form

Height/length, weight, HC, and MUAC

A change in the sequence was suggested: MUAC, HC, weight, and height/length were agreed to be followed

Hesitance from caregivers while answering CPAS and PHQ9

• CPAS and PHQ9 are recommended to be administered in complete privacy

• A short script needs to be added before starting the set of questions. For example, the script below has been added before asking questions related to the conflict at home: “Now, I would like to ask you some questions about your relationship with other people in your home. Even when people in a home get along well, sometimes they disagree with each other, get angry, expect different things from each other, or fight… People have different ways to manage their differences. This is common. You are safe to share these things here, and they are confidential. Please remember that if you do not feel comfortable with any of the questions, you can refuse to answer”

The presence of a camera posed a constant distraction for the child. Additionally, the camera position needed shifting many times, especially during the motor component

Video recording was used to assess inter-rater reliability, but after discussing many disadvantages of video recording, it was decided that inter-rater reliability should be assessed live in-person by the supervisor

Maintaining a quiet and distraction-free environment

Family members were counselled about the study and requested a quiet space for administration. This helped a lot to get the child’s attention with minimal distraction

Rapport build-up with child

Two visit schedules allowed the assessor to build rapport with the child

Performing interviews during the COVID-19 pandemic

Teams were instructed to get tested for COVID-19 if members had COVID-like illness (CLI). Teams also asked the participants during and before the visit whether any family members or neighbors were suffering from CLI and, if so, rescheduled the visit

Poor network connection in some rural places

In some rural areas, due to poor network connections, teams faced problems sending the eligibility data, which was needed to know the subsample category of the participant. In these conditions, teams were advised to move to a place with a good network connection

Long duration of visits

Emphasis was placed on further clarifying the time commitment for study participation at the consent stage