<p>Sample characteristics.</p>

Parenting interventions integrating nutrition, stimulation, and responsive caregiving promote child development but face challenges to scale in low-resource settings. This study describes implementation and effectiveness of Aalana Palana, a facilitated video-viewing intervention on responsive parenting, embedded in routine maternal and child care services in India. Aalana Palana was delivered by Anganwadi workers (AWWs) in Telangana, India. A quasi-experimental, non-randomized controlled design was used to evaluate its effectiveness. Intervention group were caregivers of children aged <3 years who reported seeing at least one intervention video in the three months preceding data collection; controls included caregivers who hadn’t seen videos in this period. The primary outcome was child development measured using the CREDI, a caregiver report of child’s development used extensively in LMICs. We analysed moderation by baseline socio-demographic characteristics and mediation of home environment on CREDI. 30 AWWs delivered Aalana Palana sessions; 361 sessions were observed by supervisors for quality assessment, reporting high fidelity. 1824 caregivers (91·5% eligible caregivers) gave consent. Aalana Palana improved overall child development (exposed: -0·58 (0·90), unexposed: -1·0 (0·92); β = 0·16, p < 0·001); improvements were observed across all CREDI domains. Home environment mediated the effect of the intervention (β = 0·027 (0·014,0·044)). Intervention effects were larger for children aged <1 year compared to older age groups. Aalana Palana is an effective strategy for scaling up parenting interventions for child development in low-resource settings. This study was funded by the UNICEF office of Andhra Pradesh, Karnataka and Telangana. Registration Number: NCT07004608.