Islamabad, PAKISTAN – The Government of Pakistan and Nutrition International today launched the Advancing Maternal Health through MMS Implementation Research in Pakistan (AMMI) project, funded by the Government of Canada, that will help to inform the scale-up of multiple micronutrient supplementation (MMS) for pregnant women, improving health outcomes for women and their babies.

Global evidence shows that, in low- and middle-income countries, MMS is more effective and cost-effective than iron and folic acid (IFA) supplementation in improving birth outcomes and equally prevents anaemia during pregnancy. In 2020, the World Health Organization recommended that implementation research be conducted in low- and middle-income countries considering the transition from IFA supplementation to MMS. Implementation research is important to identify program bottlenecks and barriers that will impede successful scale-up, and to test solutions. This is key to improve program effectiveness and maximize the superior health and nutrition benefits of MMS.

“Increasing access to MMS will contribute to improving maternal nutrition, birth outcomes and reducing stunting, which are key objectives of Pakistan’s Stunting Reduction Strategy and part of the National Nutrition Program,” said Dr. Abdul Baseer Khan Achakzai, Director, Nutrition, Ministry of Health, Pakistan. “This MMS implementation research project in Swabi district is an important step towards potentially providing access to MMS to pregnant women across Pakistan, and I’m looking forward to the outcomes.”

A collaborative effort of the Nutrition Wing of the Ministry of National Health Services, Regulations & Coordination, Health Department, Khyber Pakhtunkhwa and Nutrition International, the AMMI project is being implemented in Swabi district. During the one-year implementation period, all pregnant women who are accessing public antenatal care services in the district are receiving MMS instead of IFA supplements for preventative maternal micronutrient supplementation – whether at a government health facility, or through a community lady health worker or midwife. Support is being provided to healthcare workers through training, supervision, program monitoring and job aids.

“The introduction of multiple micronutrient supplementation into antenatal care is an important step in preventing anaemia during pregnancy, which is currently an issue that too many women in Khyber Pakhtunkhwa face,” said Dr. Shaheen Afridi, Director General, Health Services. “The implementation research to come out of this project will go a long way in helping to improve pregnant women’s health here in Swabi and support the scale-up of MMS across the country.”

Based on the formative research findings, the research will focus on critical bottlenecks holding back successful uptake of MMS, improving the quality of nutrition counselling and engagement of family members in antenatal care, and building the capacity of healthcare workers to drive the uptake and adherence to MMS. The project will assess how these approaches improve delivery of care and introduction of MMS, and whether they improve women’s daily adherence to the supplements. The learnings from this research will be key to informing the scale-up of MMS across Pakistan.

“The implementation research pioneer project in Pakistan will inform sustainable transition and scale-up of multiple micronutrient supplementation in the country in accordance with the World Health Organization guidelines,” said Dr. Shabina Raza, Country Director, Pakistan, Nutrition International. “Key policy, program and community stakeholders are being actively involved throughout the process to seek their input and share learnings. The project results will be invaluable in generating evidence to improve maternal health and ultimately a step towards achieving the Sustainable Development Goals.”

Pakistan faces a high burden of malnutrition, with one in 10 children dying before their fifth birthday and a neonatal mortality rate of 49.4 per 1,000 live births, according to the 2017-2018 Pakistan Demographic Health Survey.

“Canada remains committed to improving the health and wellbeing of women, girls and children around the world,” said Wendy Gilmour, High Commissioner of Canada to Pakistan. “We are proud to support the Government of Pakistan and Nutrition International in this important research project that will provide a data driven, evidence-backed pathway to improving antenatal care for millions of women across Pakistan.”

“Nutrition International has been working with the Government of Pakistan since 2001 to improve the health of women, girls and children,” said Dr. Mandana Arabi, Vice-President, Global Technical Services and Chief Technical Advisor, Nutrition International. “This research is a new milestone in our collaboration, which will help Pakistan progress its newly launched Maternal Nutrition Strategy ensuring that women are receiving the best care possible for themselves and their children.”

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