The opportunity

Antenatal MMS is more effective and cost-effective than iron and folic acid supplementation.

MMS has shown to be just as effective as iron and folic acid (IFA) in preventing maternal anaemia and more effective at improving birth outcomes. The World Health Organization has recommended that implementation research be conducted in low- and middle-income countries considering a transition from IFA supplementation to MMS.

Implementation research provides insight into how to deliver proven interventions in the real world and identifies problems and barriers to effective implementation. This research is used to identify and investigate problems, and to develop and test solutions.

Our solution

The Government of Pakistan is planning to introduce MMS for pregnant women through antenatal care in selected areas of the country.

We are working with the Ministry of National Health Services, Regulations & Coordination (MoNHSR&C) to introduce MMS in the Swabi district, Khyber Pakhtunkhwa province. A Technical Working Group led by the Nutrition Wing of the MoNHSR&C has been established to advise the project. During the one-year implementation period, all pregnant women accessing public antenatal care in the district will be given MMS instead of IFA.

The implementation research will identify effective implementation approaches for strengthening the delivery of maternal nutrition services and introducing MMS instead of IFA. This research is focusing on tackling key implementation challenges and testing possible solutions with a focus on improved nutrition counselling and nutrition content of the antenatal care contact, involvement of family members in antenatal care and building the capacity of health care providers to provide these services.

The impact

Informing scale-up of MMS in Pakistan

This project aims to inform decision-making and practice relating to maternal nutrition services and MMS in Pakistan, within Swabi district and beyond. By the end of the project, we will have assessed adherence and relevant implementation outcomes such as fidelity, acceptability, feasibility, and cost-effectiveness. This operational information will inform scale-up of MMS in Pakistan and maximize its impact in improving maternal nutrition and birth outcomes.