Multiple Micronutrient Supplementation in Pregnancy Technical Advisory Group (MMS TAG)

The Multiple Micronutrient Supplementation in Pregnancy Technical Advisory Group (MMS TAG) is an interdisciplinary group of experts in nutrition, maternal health, and public health.  Since 2023, the Healthy Mothers Healthy Babies Consortium (HMHB) has hosted the MMS TAG to support its ongoing mission.

The MMS TAG’s mission is to interpret emerging evidence on MMS and provide high-fidelity guidance to governments, non-governmental organizations (NGOs), foundations, multilateral organizations, and the private sector.

In response to the 2016 WHO Guidelines for Antenatal Care, the New York Academy of Sciences (NYAS) assembled a scientific task force comprised of international experts in micronutrient deficiencies, public health, nutrition, pediatrics, and health economics to: 

Compile the evidence on the prevalence of micronutrient deficiencies in pregnant women or women of reproductive age. 
Review the evidence on the benefits and risks of multiple micronutrient supplements on maternal and perinatal outcomes.
Create a roadmap to guide decisions in countries considering the implementation of such programs.

The first phase of this initiative revealed that shifting from iron and folic acid supplementation (IFA) to MMS in antenatal care (ANC) programs could yield substantial benefits in reducing maternal mortality and improving birth outcomes.

After an initial review of the evidence, the MMS TAG was established in 2018 to promote MMS among pregnant women in several low and middle-income countries. This was done in close collaboration with UNICEF, with funding from the Bill & Melinda Gates Foundation.

First MMS Task Force Meeting – November 2017, New York City

Over the years, the MMS TAG has been actively engaged in various activities. The most recent outputs of the MMS TAG include:

Interim Implementation Guidance for Concurrent MMS and Anemia Treatment in Pregnant Women.
Online database, which provides an overview of key randomized controlled trials (RCTs), and systematic reviews or Individual Patient Data (IPD) meta-analyses on prenatal MMS, which have been completed, are ongoing, or are being planned, as of 31 January 2024. It will be updated regularly. If you would like to suggest adding new clinical RCTs or systematic reviews to the database, please contact [email protected].
2023 Update on the Scientific Evidence on the Benefits of Prenatal Multiple Micronutrient Supplements.
Webinar and Technical Brief “MMS: One of the best investments for development”.

Past Activities

Key outputs of the MMS TAG Force and MMS TAG include:

Review of the evidence regarding the use of antenatal multiple micronutrient supplementation in low- and middle-income countries – MMS TAG Force.
The upper level: examining the risk of excess micronutrient intake in pregnancy from antenatal supplements – MMS TAG Force.
Replacing iron-folic acid with multiple micronutrient supplements among pregnant women in Bangladesh and Burkina Faso: costs, impacts, and cost-effectiveness – MMS TAG Force.
A workshop on “Core Product Specification for Multiple Micronutrient Supplement in Pregnancy, hosted by the New York Academy of Sciences and the Micronutrient Forum, in November 2019. 
Technical Reference materials to explain MMS programs and train the health workforce in their implementation. 
Defining research priorities on multiple micronutrient supplementation in pregnancy. 
A systematic review on interventions to increase adherence to micronutrient supplementation during pregnancy.
Publications with meta-analyses designed to address the clinical research gaps identified in the 2020 WHO recommendation on MMS (iron dose analyses and anemia, iron dose analyses, and neonatal mortality, analyses by method of gestational age assessment). 
Interim Country-level Decision-making Guidance for Introducing Multiple Micronutrient Supplementation for Pregnant Women, 2020 in English, French, and Spanish.
Application to include MMS in the WHO Model List of Essential Medicines 2021.   
Summary of iron dose analyses (in MMS vs IFA) on maternal mortality and neonatal mortality.
Letter to the Editor “Micronutrient supplements in pregnancy: an urgent priority.”

The MMS TAG continues to play a vital role in advancing the understanding and adoption of MMS in pregnancy, ultimately contributing to improved maternal health and birth outcomes.

Pictured from left to right: Jennifer Busch-Hallen, MSc (Nutrition International), Parul Christian, DrPH, MSc (Johns Hopkins University), Robert Black, MD, MPH (Johns Hopkins University), Filomena Gomes, RD PhD (The Micronutrient Forum – HMHB Program Team), Clayton Ajello, DrPH, MPH (Vitamin Angels), Klaus Kraemer, PhD (Sight and Life), Sufia Askari, MD, MPH (Sight and Life), Emily Smith, ScD, MPH (George Washington University), Martin Mwangi, PhD (The Micronutrient Forum – HMHB Program Team)

PC: Holland Park Media

Rina Agustina, MSc, PhD (University of Indonesia)

Clayton Ajello, DrPH, MPH (Vitamin Angels)

Shams El Arifeen, MD, PhD (Centre for Health Research and Development, Society for Applied Studies)

Sufia Askari, MD, MPH (Sight and Life)

Obey Assery, MA (Ministry of Agriculture, Tanzania)

Robert Black, MD, MPH (Johns Hopkins University)

Jennifer Busch-Hallen, MSc (Nutrition International)

Parul Christian, DrPH, MSc (Johns Hopkins University)

Kay Dewey, PhD (University of California, Davis)

John Hoddinott, PhD (Cornell University)

Klaus Kraemer, PhD (Sight and Life)

Emily Mates (UNICEF)

Lisa M. Noguchi, PhD, CNM (Jhpiego)

Saskia Osendarp, PhD (Micronutrient Forum)

Anuraj H. Shankar, DSc (Oxford University)

Emily Smith, ScD, MPH (George Washington University)

Declaration of Interests

Clayton Ajello
“Two of my clients, the Vitamin Angel Alliance and Kirk Humanitarian support the introduction of MMS. Both organizations are non-profits seeking to improve women’s nutrition.”

Saskia Osendarp
“Received sponsorship funding for Micronutrient Forum Conference from MMS ingredient supplier DSM.”

Klaus Kraemer
“Sight and Life Foundation has been endowed (unrestricted) by DSM.”

Sufia Askari
“Sight and Life Foundation has been endowed (unrestricted) by DSM.”

Multiple Micronutrient Supplementation in Pregnancy Technical Advisory Group (MMS TAG)

History

Activities

Past Activities

Members

Declaration of Interests

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