Initial implementation supported by implementation research
Data from 2016 indicate that the prevalence of anemia – largely due to iron deficiency – in Uganda is still unacceptably high, with 34% of pregnant women, 26% of women of reproductive age, and 53% of children experiencing anemia.
Despite high prevalence of iron deficiency among pregnant women in Uganda, challenges with implementation and uptake of supplementation persist. Adherence to IFA tablets among pregnant women remains low with only 23% who take at least 90+ tablets. Ministry of Health, in conjunction with Child and Family Foundation Uganda (CFU), Makerere University, UNICEF Uganda, Vitamin Angels and Johns Hopkins Bloomberg School of Public Health, are undertaking implementation research to understand how antenatal MMS can be effectively implemented within the Uganda national health system context to support improved maternal nutrition and birth outcomes.
There is very strong government interest in transitioning to MMS and an Advisory Group is in place. MMS is included in the antenatal care register, and a costed roadmap for scaling up is in development. However, it is not yet in national guidelines or the government budget. Local manufacturing is being explored with partners like CHAI and Vitamin Angels. Training materials are being developed, and a national roll-out is planned for January 2025. Challenges include low antenatal care attendance, low IFA adherence and stock-outs, knowledge gaps, and limited budget. Lessons learned include early stakeholder engagement, the importance of a costed roadmap, and strong policies for successful MMS integration.
The initial formative research phase seeks to understand the barriers and enablers to IFA uptake and adherence and will then develop implementations strategies that will be tested during implementation of an MMS intervention. Examination of how an MMS program can be effectively introduced and scaled up in the context of the health system in Uganda will inform the government’s ongoing exploration of adopting a national MMS policy as part of their health strategy.
Last updated: January 2025