The growing demand for United Nations International Multiple Micronutrient Antenatal Preparation (UNIMMAP) MMS is projected to outpace global supply within the next two years. This resource paper provides guidance for global stakeholders to build a strategy to ensure that the global, regional, and national supply of UNIMMAP MMS will meet future demand and reach pregnant women who are at the highest risk of malnutrition.

This strategy was formulated after a series of countrywide consultations with the goal to protect and promote diets, practices, and services that support the optimal nutrition, health, and well-being of all women in Pakistan with a focus on preventing all forms of malnutrition among women during the preconception, pregnancy and postpartum stages of nutritional vulnerability.

On July 14, 2022, Alive & Thrive presented results from its implementation research in Burkina Faso, Ethiopia, and India, during this 90-minute webinar. Speakers included Alison Tumilowicz of the Bill & Melinda Gates Foundation; Sandra Remancus, Director of Alive & Thrive; research partners at IFPRI; and senior staff of Alive & Thrive at the global and country levels.

This article summarizes the current state of knowledge about multiple micronutrient (MMN) interventions from the perspective of program and policy decisions. That perspective requires attention not only to biological benefits but also to the distribution of benefits in a population and to the examination of intervention cost and harm relative to benefits. Research on MMN is not far enough along to address many program and policy concerns, as the focus has been primarily on the potential biological benefit assessed through regimen or delivery efficacy trials.  This article suggests that program efficacy trials, which assess the efficacy of an intervention implemented within a public health program are much more useful for policy and program considerations.

This review summarizes the evidence on using 30mg of iron in multiple micronutrient supplements (MMS) in pregnancy. The available literature shows that MMS containing 30mg iron is comparable to iron-folic acid (IFA) containing 60mg iron for its effects on maternal anemia outcomes. However, the prevalence of anemia was high at the end of supplementation, and the consequence of the supplementation on iron deficiency was equivocal. Considering the high prevalence of anemia and iron deficiency in LMICs, 30mg of iron may be insufficient in pregnancy. This review suggests that a higher dose of iron in the MMS supplement than that present in the UNIMMAP preparation should be considered. Well-designed randomized controlled trials comparing 30mg and 60mg iron in MMS may be prudent to explore the ideal dose of iron in these supplements that can mitigate the high burden of anemia.

This article looks at the role of multiple micronutrient supplementation (MMS) as a simple, cost-effective solution to improve maternal nutrition and reduce adverse pregnancy and birth outcomes in low and middle-income countries.

This study aimed to analyze available experiences of prenatal iron-folic acid (IFA) and multiple micronutrient interventions to distill learning for their effective planning and large-scale implementation in Central America, Southeast Asia, South Asia, and Sub-Saharan Africa. The findings suggest that to successfully implement supplementation interventions and achieve sustainable-permanent solutions efforts must focus on factors and processes related to quality, cost-effectiveness, coverage, utilization, demand, outcomes, impacts, and sustainability of programs including strategic analysis, management, collaborations to pilot a project, and careful monitoring, midcourse corrections, supervision, and logistical-support to gradually scaling it up.

This study examined the situation of maternal micronutrient supplementation before and during pregnancy in Northwest China and the rates of and factors related to the adherence to micronutrient supplementation among pregnant women in this region, where dietary micronutrient intake is commonly insufficient. Results showed that in total, 83.9% of women took at least one kind of micronutrient supplement before or during pregnancy. Folic acid and calcium were the primarily used micronutrient supplements; few participants used multiple micronutrient supplements (MMS) or iron. Adherence to supplementation of all micronutrients was low and well below standards recommended by the Chinese guidelines or WHO. Higher educational levels, higher income levels, urban residence, and better antenatal care (including pregnancy consultation and a higher frequency of antenatal visits) were associated with high adherence to micronutrient supplementation.

This double-blind randomized controlled trial in rural Vietnam assessed individual, household, and programmatic predictors of supplement adherence before conception for iron, iron-folic acid (IFA), and micronutrient supplements and during pregnancy for IFA. Key determinants of adherence included socio-economic status (SES), ethnicity, occupation (farmer), and parity which may be helpful for targeting women for counseling on supplement adherence. Increased contact with village health workers was positively associated with adherence to micronutrient supplementation both before conception and during pregnancy indicating the need for resources to support community outreach to women of reproductive age.

This review identifies key barriers and facilitators to the uptake (or not) of antenatal care (ANC) services by pregnant women and in the provision (or not) of good-quality ANC by healthcare providers. It complements existing effectiveness reviews of models of ANC provision and adds essential insights into why a particular type of ANC provided in specific local contexts may or may not be acceptable, accessible, or valued by some pregnant women and their families/communities.