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

Launched by JOHNS HOPKINS BLOOMBERG SCHOOL OF PUBLIC HEALTH · Feb 14, 2025

Keywords

ClinConnect Summary

This clinical trial is focused on understanding how to effectively provide multiple micronutrient supplements (MMS) to pregnant women in Uganda to improve their nutrition and the health of their babies. The researchers want to see how well these supplements can be integrated into the country's health system, ensuring they are accepted by the women, feasible for health workers to provide, and sustainable in the long run. They will also look at how different ways of dispensing the supplements might influence how often women attend their antenatal care (ANC) visits and how closely they follow the recommended supplement regimen.

To participate in this study, pregnant women need to be in their first trimester (up to 24 weeks pregnant) and attending their first ANC visit at a government or not-for-profit health facility. Women who have recently given birth and received MMS during their ANC visits are also eligible. Participants can expect to receive guidance and support regarding their nutrition and health throughout their pregnancy. This trial aims to gather important information that could help improve maternal and child health in Uganda.

Gender

ALL

Eligibility criteria

• • Inclusion Criteria for Pregnant women- Enrolled for follow-up throughout pregnancy (sample 1)
• • ≤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
• • Exclusion Criteria for Pregnant women- Enrolled for follow-up throughout pregnancy (sample 1)
• • 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.
• • Inclusion Criteria for Pregnant women / Women that have recently delivered (single contact) (sample 2)
• • 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.
• • Exclusion Criteria for Pregnant women / Women that have recently delivered (single contact) (sample 2)
• • Enrolled in study population 1.
• • Women who are more than 8 weeks postpartum.
• • Inclusion Criteria for ANC providers having ANC health education/counseling with pregnant woman(en) observed (sample 3)
• • • Healthcare providers that are currently providing ANC health education (group) or ANC individual counseling at government or PNFP health facilities.
• • Exclusion Criteria for ANC providers having ANC health education/counseling with pregnant woman(en) observed (sample 3) • Healthcare providers that are currently providing ANC health education (group) or ANC individual counseling to a woman(en) that have not provided written informed consent to have the ANC session observed.
• • Inclusion Criteria for Influential family members (male partners \& mothers/mothers-in law) (sample 4)
• • 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.
• • Exclusion Criteria for Influential family members (male partners \& mothers/mothers-in law) (sample 4) • None
• • Inclusion Criteria for Healthcare Providers- including facility in-charge, ANC providers, Health Assistants, staff in-charge of records, and stores manager (sample 5)
• • 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.
• • Exclusion Criteria for Healthcare Providers- including facility in-charge, ANC providers, Health Assistants, staff in-charge of records, and stores manager (sample 5)
• • • None
• • Inclusion Criteria for Community Health Workers (VHTs) and Mentor Mothers (sample 6) • Voluntary Health Team (VHT), Mentor Mothers, or Para-socials attached to at least one of the study facilities.
• • Exclusion Criteria for Community Health Workers (VHTs) and Mentor Mothers (sample 6) • None
• • Inclusion Criteria for National, regional, and district-level stakeholders (sample 7)
• • 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
• • Exclusion Criteria for National, regional, and district-level stakeholders (sample 7)
• • • None
• • Inclusion Criteria for Pregnant women - interviewed during post-intervention Household Coverage Survey (sample 8)
• • Woman who has been pregnant or delivered within the study period.
• • Household is within one of the 4 selected districts.
• • Exclusion Criteria for Pregnant women - interviewed during post-intervention Household Coverage Survey (sample 8)
• • • Women who moved to the district after delivery.