This policy brief outlines the cost-effectiveness and investment case in Malawi, Africa, to transition from iron-folic acid (IFAS) to multiple micronutrient supplementation (MMS).

This article outlines the strong evidence that supports multiple micronutrient supplementation (MMS) and argues that implementation should be scaled up rapidly while addressing service delivery barriers.

A  3-arm cluster-randomized trial was conducted that evaluated the efficacy of prenatal multiple micronutrient supplementation (MMS), lipid-based nutrient supplementation (LNS), as compared to routine iron–folic acid (IFA) supplementation among pregnant women in the rural district of Madarounfa, Niger, from March 2015 to August 2019. Results demonstrated that there was no benefit of prenatal MMS on child development outcomes up to 2 years of age as compared to IFA. There was evidence of an apparent positive effect of prenatal LNS on cognitive development trajectory and time to achievement of selected gross motor milestones.

The World Health Organization (WHO) Department of Nutrition for Health and Development, in collaboration with the United Nations Children’s Fund (UNICEF) and Nutrition International (NI), convened a technical consultation “Multiple micronutrient supplements in pregnancy: Implementation considerations for successful incorporation into existing programmes.” The objectives of the technical consultation were to (a) examine implementation experiences of micronutrient supplementation interventions in pregnant women, lessons learned, and best practices; (b) discuss programmatic and technical considerations of interventions on multiple micronutrient supplementation (MMS) in pregnant women in low-, middle-, and high-income countries; and (c) identify implementation considerations that can be useful to scale up efforts by national policymakers and their advisors considering MMS as part of existing antenatal care programs as well as other delivery platforms.  This paper provides the background and rationale of the technical consultation, synopsizes the presentations, and summarizes the primary considerations and conclusions reached during plenary discussions.

The Social Marketing Company (SMC) in Bangladesh is implementing a countrywide, market-based roll-out of multiple micronutrient supplementation (MMS) for pregnant women. This study evaluated the implementation of the supplementation program and its impact on reducing low birth weight (LBW).

This session on maternal nutrition, ‘The unfinished agenda of maternal malnutrition and its impact on birth outcomes“ was organized by HMHB at the FIGO World Congress 2021. This is an on-demand pre-recorded session (S-178). This session aimed to increase awareness and understanding of the relationship between maternal malnutrition and birth outcomes, share the evidence on the impact of maternal nutrition interventions ready to scale up including multiple micronutrient supplementation on birth outcomes, and share country experiences related to the integration of MMS in antenatal care services. It features global experts in maternal nutrition, who will each focus on one key area of maternal malnutrition and MMS.

Topics and Speakers

The framing of the discussion and closing remarks are by Dr. Saskia Osendarp, Executive Director, The Micronutrient Forum. Speakers and topics are as follows –

1. The evidence on maternal nutrition & multiple micronutrient supplements – Dr. Parul Christian, Director, Human Nutrition Program, and Associate Chair, Department of International Health at the Bloomberg School of Public Health, Johns Hopkins University
2. MMS Policy and Program experience of Bangladesh – Dr. Mustafizur Rahman, Line Director, NNS, HPNSP, Directorate General of Health Services, Ministry of Health and Family Welfare, Bangladesh
3. Implementation research to enhance introduction and effectiveness use of MMS in four countries – Nita Dalmiya, Maternal Nutrition Specialist, UNICEF New York
4. Policies and practice related to nutrition-quality in Antenatal Care- Dr. Amy Pollack, Director Maternal, Newborn, Child Health, The Bill and Melinda Gates Foundation.

This short film shows how Makenge Thethe from the Democratic Republic of Congo (DRC) in her ninth month of pregnancy struggles with her workload, nutrition and health care needs and how multiple micronutrient supplements (MMS) can help improve her health.

This short film depicts the struggles of Jahanara from Tongi Township, Bangladesh, during her pregnancy in accessing nutrition-rich food and health services.

HMHB hosted an online side event at the 7th Annual Agriculture Nutrition and Health (ANH) Academy Week during the Research Conference from  28 to 30 June, which covered a range of hot-topic discussions. The HMHB session, titled, ‘Accelerating the integration of prenatal multiple micronutrient supplementation (MMS) into antenatal care services’ was held on 30 June. The aim of this session was to increase understanding regarding policy advocacy and implementation research related to the introduction of MMS based on country experiences. The session highlighted the scientific evidence of MMS, an evidence-based, cost-effective, and affordable intervention to improve maternal nutrition and birth outcomes. The event was moderated by Dr. Martin Mwangi, Program Lead, Healthy Mothers Healthy Babies Consortium.

Speakers and topics were as follows:  

1. Maternal nutrition: scope and scale of the issue – Dr. Martin Mwangi, HMHB, Micronutrient Forum 
2. Advocacy & situational analysis, Cambodia – Hou Kroeun, Helen Keller International, Cambodia 
3. Implementation research – Mali – Adama Mamby Keita, JHPiego 
4. Implementation research approach ­– Ashutosh Mishra, Vitamin Angels, India

This film depicts the struggles of Shabana and Parveen from Mumbai, who work outside and inside their homes to provide for their families despite being heavily pregnant. They lack access to adequate food and nutrition, as well as health and nutrition services.