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Knowledge Hub

The Knowledge Hub of the Healthy Mothers Healthy Babies Consortium brings together existing knowledge, guidance, tools, and other useful resources related to women’s nutrition, maternal nutrition, and evidence-based interventions targeting women, such as prenatal Multiple Micronutrient Supplementation (MMS).

It also includes Knowledge Bytes, a series of short videos featuring experts addressing a specific topic related to maternal nutrition and MMS. Click here to watch.

The Knowledge Hub is a dynamic, publicly accessible repository. It will be expanded and further improved over time, and we ask for your help in this. Please share any resources that you believe should be included in this Knowledge Hub, and send them to [email protected].

 

Start Here: Key Resources

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  • Global
  • Supply and manufacturing
  • Scientific publication
Maternal and Child Nutrition Monterrosa, Beesabathuni et al December 2018

Situation analysis of procurement and production of multiple micronutrient supplements in 12 lower and upper middle‐income countries.

This paper is a situation analysis of the market, manufacturing, and policy factors that are driving the production of Multiple Micronutrient Supplementation (MMS) in 12 lower and upper middle‐income countries in Africa, South America and South Asia. Through a self‐administered structured questionnaire by key informants, this study examined the local context of products available in the market, their cost, regulations and policies. It was found that most countries have the capacity to produce MMS locally, the major barriers observed for sustainable and affordable production include (a) poor technical capacity and policies for ensuring quality along the value chain and (b) lack of policy coherence to incentivize local production and lower the manufacture and retail price of MMS. Also, it was determined that better guidelines and government oversight is required because none of the countries were able to match the globally recommended formulation for United Nations International Multiple Micronutrient Antenatal Preparation (UNIMMAP).

  • Global
  • Implementation
  • Implementation tool
Journal of Medical Internet Research Haddad et al October 2020

Building a Digital Tool for the Adoption of the World Health Organization’s Antenatal Care Recommendations: Methodological Intersection of Evidence, Clinical Logic, and Digital Technology

This paper details the systematic and iterative process involved in transforming the WHO Antenatal Care (ANC) guidelines into a digital decision-support and patient-record application for routine use in primary health care settings, known as the WHO digital ANC module. This Open Smart Register Platform (Open SRP) is also being used in Lombok, Indonesia to pilot introduction of multiple micronutrient supplementation (MMS) for pregnant women in ANC.

  • South Asia
  • Research
  • Scientific publication
The Lancet The Supplementation with Multiple Micronutrients Intervention Trial (SUMMIT) Study Group January 2008

Effect of maternal multiple micronutrient supplementation on fetal loss and infant death in Indonesia: a double-blind cluster-randomised trial

This paper assessed the effect of maternal supplementation with multiple micronutrients (MMN), compared with iron folic acid (IFA), on fetal loss and infant death in the setting of routine prenatal care services in a double-blind cluster-randomised trial in Lombok, Indonesia . The outcomes demonstrated that infants of women consuming MMN supplements had an 18% reduction in early infant mortality compared with those of women given IFA and a 14% reduction in risk of low birth weight.

  • Global
  • Research
  • Report
Annals of the New York Academy of Sciences Robert E. Black and Kathryn G. Dewey April 2019

Benefits of supplementation with multiple micronutrients in pregnancy

This special report, prepared by a task force convened by the New York Academy of Sciences,  evaluates the latest evidence to help countries interpret the World Health Organization guidelines for nutrition interventions in pregnancy as they relate to multiple micronutrient supplementation.

  • Global
  • Advocacy
  • Implementation
  • Training material
Vitamin Angels

Vitamin Angels Prenatal Vitamins Resources for Program Partners

Vitamin Angels has created resources for Program Partners to use when educating service providers, stakeholders, and beneficiaries about the benefits of prenatal multivitamins or multiple micronutrients supplements (MMS) and how to best distribute them. Resources include instruction sheets, posters and brochures aimed at beneficiaries, factsheets and FAQ for service providers and are available in English, French, Spanish and other languages. The instruction sheets provide a basic overview of the benefits of vitamin A supplements, deworming, and prenatal multivitamins with visual cues for dosing instructions. The posters are designed to be displayed at distribution sites to provide caregivers and families with nutrition information. The brochure for beneficiaries outlines the importance of good nutrition during pregnancy. It also provides a calendar to help women keep track of taking their daily multivitamin. The fact sheet summarizes the research on multiple micronutrient supplements (MMS) for pregnant women as well as addresses frequently asked questions for potential program partners.  The FAQ sheet is meant to counsel pregnant women during antenatal care and to guide the program.

 

  • Global
  • Research
  • Scientific publication
Annals of the New York Academy of Sciences Megan W. Bourassa May 2019

Review of the evidence regarding the use of antenatal multiple micronutrient supplementation in low‐ and middle‐income countries

The objectives of the review are to (1) review the evidence on the burden of micronutrient deficiencies in women of reproductive age (WRA) and associated adverse pregnancy outcomes; (2) update the evidence base on the effects of Multiple Micronutrient Supplements (MMS) on pregnancy outcomes; (3) assess the costs and cost‐effectiveness of shifting from Iron Folic Acid (IFA) to MMS during pregnancy; and (4) provide indicators based on the updated evidence base that might be considered by governments deciding whether IFA or MMS is the most appropriate supplement for their contexts.

  • South Asia
  • West and Central Africa
  • Implementation
  • Policy and policy development
  • Scientific publication
Annals of the New York Academy of Sciences Reina Engle‐Stone May 2019

Replacing iron‐folic acid with multiple micronutrient supplements among pregnant women in Bangladesh and Burkina Faso: costs, impacts, and cost‐effectiveness

To make decisions about switching from iron folic acid (IFA) to multiple micronutrient supplementation (MMS), policymakers must consider not only the health benefits of such a policy change, but also the costs. To help guide the decisions, the objective of this analysis was to estimate the effectiveness and cost‐effectiveness of hypothetically replacing IFA supplements with MMS for 1 year in the context of an ongoing program to deliver supplements to pregnant women in Bangladesh and Burkina Faso.

  • Global
  • Policy and policy development
  • Supply and manufacturing
  • Scientific publication
World Health Organization WHO, United Nations University & ‎‎UNICEF July 1999

Composition of a multi-micronutrient supplement to be used in pilot programmes among pregnant women in developing countries

The aim of this technical workshop was to propose the composition of a multi-micronutrient supplement (MuMS) for pregnant women from developing countries to be used in effectiveness trials in pilot countries. A secondary issue for consideration at the workshop was the suitability of such a supplement for other groups at risk. This report is commonly used as the basis for the United Nations International Multiple Micronutrient Antenatal Preparation (UNIMMAP) formulation. 

 

  • Global
  • Research
  • Scientific publication
Lancet Global Health Smith et al November 2017

Modifiers of the effect of maternal multiple micronutrient supplementation on stillbirth, birth outcomes, and infant mortality: a meta-analysis of individual patient data from 17 randomised trials in low-income and middle-income countries

This study uses the most detailed approach to analysing existing trial data on multiple micronutrient supplements (MMS). Previous meta-analyses identified overall benefits of multiple micronutrient supplements in terms of birth size, but our findings show that specific subgroups experience mortality benefits, notably female neonates. Women with indicators of malnutrition during pregnancy who took multiple micronutrient supplements also had greater reductions in low birthweight, preterm, and small-for-gestational-age births. We found no evidence that multiple micronutrient supplements significantly increased the risk of stillbirth or neonatal, 6-month, or infant mortality, neither overall or in any of the 26 examined subgroups.

  • Global
  • Policy and policy development
  • Research
  • Scientific publication
Cochrane Library Keats et al March 2019

Multiple‐micronutrient supplementation for women during pregnancy

This Cochrane Review findings suggest a positive impact of multiple micronutrient (MMN) supplementation with iron and folic acid on several birth outcomes. MMN supplementation in pregnancy led to a reduction in babies considered low birth weight, and probably led to a reduction in babies considered small for gestational age (SGA). In addition, MMN probably reduced preterm births. No important benefits or harms of MMN supplementation were found for mortality outcomes (stillbirths, perinatal and neonatal mortality). These findings may provide some basis to guide the replacement of iron and folic acid supplements with MMN supplements for pregnant women residing in low‐ and middle‐income countries.