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RecruitingNot ApplicableNCT06835738

Implementation of Multiple Micronutrient Supplementation (MMS) for Pregnant Women in Uganda

Sponsor

Johns Hopkins Bloomberg School of Public Health

Enrollment

4,077 participants

Start Date

Jun 18, 2025

Study Type

INTERVENTIONAL

Summary

The objective of this research is to understand how antenatal multiple micronutrient supplements (MMS) can be effectively implemented and scaled within the Uganda national health system context to support improved maternal nutrition and birth outcomes. Formative research has been conducted to design the implementation strategies that will be tested in this second phase of the study. The objectives are to: * Describe the implementation of the MMS intervention (which consists of MMS product, a social behavior change communication (SBCC) strategy, capacity building, MMS supply chain support, monitoring, and evaluation) and explore acceptability, feasibility, fidelity, coverage, and potential for sustainability. * Determine the effect of dispensing MMS in different bottle counts on MMS adherence and ANC attendance among pregnant women. * Determine the cost and budget impact of MMS intervention implementation integrated in the Ugandan ANC service delivery system

Eligibility

Min Age: 0 YearsMax Age: 80 Years

Inclusion Criteria16

  • ≤24 weeks of amenorrhea/gestation as verified by health professionals
  • Attending first ANC visit at government or PNFP health facilities.
  • Accepted to take MMS at first ANC visit
  • Currently pregnant woman or a woman who is not more than 8 weeks postpartum.
  • Received MMS at an ANC visit at least 3 months ago or more.
  • Attended at least any 2 monthly ANC visits.
  • Attending/attended ANC at government or private-not-for-profit health facility.
  • Healthcare providers that are currently providing ANC health education (group) or ANC individual counseling at government or PNFP health facilities.
  • Spouse or partner of a pregnant woman or woman with a child less than 8 weeks old who is receiving/ has received ANC services in one of the 8 study districts.
  • Mother or mother-in-law of a pregnant woman or woman with a child less than 8 weeks old who is receiving/ has received ANC services in one of the 8 study districts.
  • Health workers who provide ANC services (e.g., midwives/nurse, medical/ clinical officers, health assistants, and nutrition focal person) at government or private-not-for-profit facilities in one of the 8 study districts.
  • Health facility staff (e.g., Facility In-charge, Maternity In-charge, Pharmacy/Stores In-charge) at government or private-not-for-profit facilities in one of the 8 study districts.
  • National, regional, or district-level decision-makers working in nutrition, maternal, newborn and child health, district health educator or pharmaceutical roles associated with the antenatal care system in Uganda.
  • Implementing partners involved in direct implementation of MMS within the 8 study districts
  • Woman who has been pregnant or delivered within the study period.
  • Household is within one of the 4 selected districts.

Exclusion Criteria7

  • Pregnant women with pre-existing hematological conditions such as sickle cell anemia, thalassemia, hemochromatosis.
  • Pregnant women planning to relocate outside the study district during the study period.
  • Enrolled in study population 1.
  • Women who are more than 8 weeks postpartum.
  • None
  • None
  • Women who moved to the district after delivery.

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Interventions

DIETARY_SUPPLEMENTMultiple Micronutrient Supplement (MMS) - dispensed in six 30-count bottles

MMS is a daily supplement provided to pregnant women. It will be delivered to pregnant women through the specified bottle-count protocol as designated by the 3 study arms. ANC providers will be trained to counsel pregnant women on using MMS using a novel job aid/adherence calendar.

DIETARY_SUPPLEMENTMultiple Micronutrient Supplement (MMS) - dispensed in one 180-count bottle

MMS is a daily supplement provided to pregnant women. It will be delivered to pregnant women through the specified bottle-count protocol as designated by the 3 study arms. ANC providers will be trained to counsel pregnant women on using MMS using a novel job aid/adherence calendar.

DIETARY_SUPPLEMENTMultiple Micronutrient Supplement (MMS) - dispensed in two 90-count bottles

MMS is a daily supplement provided to pregnant women. It will be delivered to pregnant women through the specified bottle-count protocol as designated by the 3 study arms. ANC providers will be trained to counsel pregnant women on using MMS using a novel job aid/adherence calendar.

Locations(1)

Lyantonde GH

Lyantonde, Uganda

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NCT06835738