Initial implementation supported by implementation research
The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) is exploring a transition from iron-folic acid (IFA) to MMS in its antenatal care (ANC) system. UNRWA serves an estimated 90,000 pregnant women annually in Palestine refugee communities in Jordan, Syria, Lebanon and Palestinian Territories of the Gaza Strip and West Bank, areas where there appear to be high rates of micronutrient malnutrition. With support from Vitamin Angels and Johns Hopkins, UNRWA has developed a comprehensive IR protocol, and strengthened its capacity and readiness to replace IFA with MMS in line with the latest global guidance. Implementation with systems research on MMS is starting in Jordan, with a plan in place to scale up MMS in all territories and countries served by UNRWA by 2025.
MMS piloting with implementation research was launched in Jordan in March 2023, which involves concurrent comparison of MMS vs IFA (current standard of care) delivery each in half of the Agency’s antenatal clinics for 10 months until January 2024. The evaluation team continues to monitor eHealth data entry by midwives and nurses. Trained data collectors conduct exit interviews with pregnant women at 12 mid-to-large-sized clinics, while Clinician Surveys are completed each month by staff providing antenatal care. The lessons learned in Jordan are expected to inform and guide future scale up of MMS for pregnant Palestine refugee women in all 140 antenatal clinics operated by UNRWA in its serviced territories and countries throughout the Middle Eastern Region.