Initial implementation supported by implementation research
Despite national recommendations that support IFA use during pregnancy, coverage remains low in Mali. Data show only 28% of women took IFA tablets for at least 90 days during their last pregnancy. Jhpiego is collaborating with the Center for Vaccine Development in Mali (CVD-Mali), the Mali Ministry of Health, and Johns Hopkins Bloomberg School of Public Health (BSPH) to understand key drivers of low coverage and develop a strategy to support the transition from IFA to MMS for better pregnancy outcomes. Partners are testing different strategies to address barriers to uptake and improve MMS adherence, including new packaging strategies. Previous experience in Mali found that women use many terms to refer to medicines, and pregnant women in particular, have difficulty distinguishing between different medicines with similar appearance. To address this, packaging and counseling strategies are being tailored for the local context using a co-design process. This process engaged closely with pregnant women, mothers, midwives, and graphic designers to create a local name, label, packaging approach, and set of counseling messages and images for MMS. In centering the voices and lived experiences of local pregnant women and midwives, they were able to directly turn participant feedback and input into a tailored, local design and actionable implementation strategies. These strategies were tested through implementation research (IR) and data analysis is ongoing to understand if the strategies were effective and next steps forward to more broadly introduce MMS in Mali.