This article outlines the development and use of the Sight and Life Multiple Micronutrient Supplements (MMS) Supply toolkit. After using the toolkit, it is expected that countries will be able to: determine whether MMS would need to be imported or
produced in the country for use in public health programs; document in-country capacity to procure ingredients and produce an MMS product that can be delivered to the end consumer or institutional buyer (e.g., Ministry of Health); provide guidance on actions needed to ensure competitive and affordable sources of an MMS supply; and assess the impact of shifting from import to local production of MMS and vice versa on countries or regions.

In this article, Vitamin Angels outlines its work with partners to explore national multiple micronutrient supplements (MMS) use in Haiti, including implementation research to inform MMS program introduction and scale-up.

This article shares key learnings and recommendations for the integration of multiple micronutrient supplements (MMS) into health programs of low- and middle-income countries (LMICs). It is a situation analysis that offers a framework on the market, manufacturing and policy enablers and barriers for the local procurement and production of multiple micronutrient supplements (MMS) in three high-burden countries in South Asia and sub-Saharan Africa (Bangladesh, Madagascar and  Tanzania), and includes learnings for other countries interested in introducing MMS into health programs.

This article describes formative research undertaken in Bangladesh, Burkina Faso, Madagascar and Tanzania to inform the context-specific design and implementation of multiple micronutrient supplementation (MMS). Authors conclude that this multi-country MMS project has great potential to improve maternal nutrition and pregnancy outcomes. They believe that investing in collaborative and participatory formative work for the appropriate introduction of MMS in each setting will help ensure MMS does not face the same fate as iron folic acid (IFA), with poor program coverage and compliance globally.

This article describes UNICEF’s support for high-burden countries in South Asia and sub-Saharan Africa in transitioning from iron folic acid (IFA) to multiple micronutrient supplements (MMS). It includes UNICEF ‘s theory of change with respect to MMS, which is adapted for individual countries. MMS offers an important opportunity to improve the quality of pregnancy care as well as survival and development outcomes for women and children using a contextualized and systems approach. Advocacy efforts make use of global evidence, national data, and align with national priorities. The introduction of MMS builds on formative research and is linked to the strengthening of relevant systems. Measuring and documenting success is critical to inform adjustments to implementation approaches and guide scale-up in other countries.  

In this article, Vitamin Angels describes its approach to multiple micronutrient supplementation (MMS) programming and provides short case studies of their work in Haiti, the Dominican Republic, the Democratic Republic of the Congo, and Indonesia.

In this article, authors estimated the impacts, costs and cost-effectiveness of hypothetically replacing iron folic acid (IFA) supplements with multiple micronutrient supplements (MMS) for one year in the context of an ongoing program to deliver supplements to pregnant women in Bangladesh. Authors modeled a scenario with current program coverage, and assuming 100 percent adherence and no tablet ‘wastage’ (i.e., all purchased tablets are consumed and ‘count’ toward health benefits). Authors then extended the analysis to introduce the costs of programmatic transitions and possible tablet distribution scenarios.

This article discusses the global evidence from high-quality, randomized trials demonstrates that daily supplementation with multiple micronutrient supplements (MMS) in pregnancy compared with supplementation with iron and folic acid (IFA) alone improves birth outcomes. Two systematic reviews and meta-analyses show that MMS reduces the risk of babies being born with a low birth weight by 12–14 percent, reduces the risk of small-for-gestational age births by 3–8 percent and may reduce preterm birth by 5–7 percent. New analyses also show that MMS in pregnancy reduces the risk of mortality among female infants. All women and children were found to benefit, but the data suggests that MMS helps undernourished women especially.

Evidence outlined in this paper shows that multiple micronutrient supplements (MMS) are a highly cost-effective way to prevent many adverse antenatal and perinatal outcomes. The article also describes the work of the MMS Technical Advisory Group (MMS-TAG) including: the establishment of a communications hub to advise and document global program implementation; the production of generic technical reference materials that could be adapted to the context of adopting countries; and the provision of technical support when needed to address issues that emerge.

This article describes development and use of the Nutrition International’s multiple micronutrient supplementation (MMS) Cost-Benefit Tool. MMS Cost-Benefit Tool is an open access, user-friendly, online analytical tool that supports governments’ use of country-specific data in their decision-making on whether investing in antenatal MMS rather than iron folic acid (IFA) is better value for money.