{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T10:22:29Z","timestamp":1783419749764,"version":"3.54.6"},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,30]],"date-time":"2025-11-30T00:00:00Z","timestamp":1764460800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,11,30]],"date-time":"2025-11-30T00:00:00Z","timestamp":1764460800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Maternal &amp;amp; Child Nutrition"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Micronutrient deficiencies affect two\u2010thirds of reproductive\u2010age women globally, with pregnant women in low\u2010 and middle\u2010income countries at higher risk due to greater nutritional needs and limited diets. Multiple micronutrient supplements (MMS) have shown greater benefits than iron\u2010folic acid (IFA) during pregnancy, but WHO currently limits recommendations to humanitarian or research settings. This study synthesises experiences of implementation research designed to support and document the transition from IFA to MMS for pregnant women in Bangladesh, Burkina Faso, Madagascar and Tanzania, providing insights for scaling up MMS programming globally. This qualitative study used key informant interviews and reviews of key policies, proposals, and project materials. Purposive sampling identified 16 key informants involved in the project design, implementation, or funding at country, regional, or global levels. Semi\u2010structured questionnaires guided discussions on themes including project planning, policy environment, community engagement, logistics, and monitoring. Qualitative descriptive analysis of interview transcripts and documents identified key themes and insights. Findings revealed context\u2010specific successes and challenges in transitioning to MMS, highlighting the unique opportunity to strengthen antenatal care (ANC) systems. Key informants emphasised the importance of context specific situational analysis and tailored interventions, strong policy support, community engagement, robust supply chains, sustainable financing, effective monitoring systems, and collaboration among stakeholders. The experiences from this project contribute to the evidence base on MMS implementation. They demonstrate that the transition from IFA to MMS should be leveraged to enhance services and advocate for a health systems\u2010wide approach, moving beyond isolated interventions, to foster more impactful and integrated improvements within ANC.<\/jats:p>","DOI":"10.1111\/mcn.70139","type":"journal-article","created":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T06:30:11Z","timestamp":1764570611000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Introducing Antenatal Multiple Micronutrient Supplements: Lessons Learned From Implementation Research in Bangladesh, Burkina Faso, Madagascar and Tanzania"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7102-446X","authenticated-orcid":false,"given":"Susan","family":"Thurstans\u2010Fuller","sequence":"first","affiliation":[{"name":"Emergency Nutrition Network Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"James","sequence":"additional","affiliation":[{"name":"Emergency Nutrition Network Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachael","family":"Menezes","sequence":"additional","affiliation":[{"name":"Emergency Nutrition Network Oxford UK"},{"name":"UNICEF New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Fleet","sequence":"additional","affiliation":[{"name":"UNICEF Supply Division Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ireen Akhter","family":"Chowdhury","sequence":"additional","affiliation":[{"name":"UNICEF Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanne","family":"Desormeaux","sequence":"additional","affiliation":[{"name":"UNICEF Ouagadougou Burkina Faso"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Onjanarindra Jeannie Nadia","family":"Razafimalaza","sequence":"additional","affiliation":[{"name":"UNICEF Antananarivo Madagascar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Codjia","sequence":"additional","affiliation":[{"name":"UNICEF Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vilma","family":"Tyler","sequence":"additional","affiliation":[{"name":"UNICEF New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Tumilowicz","sequence":"additional","affiliation":[{"name":"Gates Foundation Seattle, Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeina","family":"Sifri","sequence":"additional","affiliation":[{"name":"Gates Foundation Seattle, Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Mates","sequence":"additional","affiliation":[{"name":"UNICEF New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,30]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.13590"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)00354-9"},{"key":"e_1_2_9_4_1","first-page":"13","article-title":"Convention on the Elimination of All Forms of Discrimination Against Women","volume":"1249","author":"UN General Assembly","year":"1979","journal-title":"United Nations, Treaty Series"},{"key":"e_1_2_9_5_1","volume-title":"Resolution 217A (III), Universal Declaration of Human Rights (UDHR)","author":"UN General 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StateUniversity","year":"2022"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/nqac259"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/1098-240X(200008)23:4<334::AID-NUR9>3.0.CO;2-G"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(17)30371-6"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(22)00367-9"},{"key":"e_1_2_9_18_1","unstructured":"UNICEF PennState and S.a. life.Formative Research Guidance: Introducing Multiple Micronutrient Supplements (MMS).2022."},{"key":"e_1_2_9_19_1","volume-title":"Composition of a Multi\u2010Micronutrient Supplement to be Used in Pilot Programmes Among Pregnant Women in Developing Countries: Report of a United Nations Children's Fund (UNICEF), World Health Organization (WHO) and United Nations University Workshop","author":"World Health Organization, United Nations University, United Nations Children's Fund","year":"1999"},{"key":"e_1_2_9_20_1","volume-title":"Implementation research toolkit","author":"WHO\/TDR","year":"2014"},{"key":"e_1_2_9_21_1","unstructured":"WHO.WHO Antenatal Care Recommendations for a Positive Pregnancy Experience: Nutritional Interventions Update: Multiple Micronutrient Supplements During Pregnancy [Internet]. Available from:https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK560384\/. Geneva: World Health Organization 2020."},{"key":"e_1_2_9_22_1","unstructured":"WHO WFP and UNICEF.Preventing and Controlling Micronutrient Deficiencies in Populations Affected by an Emergency Multiple Vitamin and Mineral Supplements for Pregnant and Lactating Women and for Children Aged 6 to 59 Months: Joint Statement by the World Health Organization the World Food Programme and the United Nations Children's Fund2007."}],"container-title":["Maternal &amp; Child Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/mcn.70139","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/mcn.70139","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/mcn.70139","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T10:51:04Z","timestamp":1775818264000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/mcn.70139"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,30]]},"references-count":21,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/mcn.70139"],"URL":"https:\/\/doi.org\/10.1111\/mcn.70139","archive":["Portico"],"relation":{},"ISSN":["1740-8695","1740-8709"],"issn-type":[{"value":"1740-8695","type":"print"},{"value":"1740-8709","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,30]]},"assertion":[{"value":"2025-01-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70139"}}