Micronutrient deficiencies and malnutrition in pregnant women contribute to poor pregnancy outcomes such as low birth weight, small for gestational age, prematurity, and high rates of early neonatal mortality. In Tanzania, despite successful reduction of maternal mortality from 530 per 100,000 live births in the 2015-16 Tanzania Demographic and Health Survey and Malaria Indicator Survey (TDHS-MIS) to 104 per 100,000 live births in the 2022 TDHS-MIS, prevalence of multiple micronutrient deficiencies among pregnant women remains high.

Multiple micronutrient supplementation (MMS) in pregnancy is an evidence-based intervention that leads to improved birth outcomes and maternal micronutrient status when compared to the current standard of care, iron and folic acid (IFA) supplementation.  MMS in comparison has 13 to 15 micronutrients including iron and folic acid. With this MMS provides broader benefits both in supporting maternal health and improving newborn outcomes. For this, the national scale up of MMS during pregnancy aiming to reduce the risk of maternal and newborn adverse outcomes is vital.

The overarching goal of this project is to provide technical support to the Government of Tanzania towards developing a National Roadmap for the Introduction and Scaling up of MMS as part of the recommended maternal nutrition essential services delivered through the antenatal care (ANC) services.

The implementation of this project is led by the Government of Tanzania through a consortium including Africa Academy for Public Health (AAPH) as the prime, Tanzania Food and Nutrition Centre (TFNC), Ifakara Health Institute (IHI), and Muhimbili University of Health and Allied Sciences (MUHAS) providing technical assistance and support.

The national roadmap for introducing and scaling up of MMS will include a strategic focus on the following pillars:

  • Supply chain for commodities: This pillar will outline strategies for strengthening the supply chain for relevant supplies across the country.
  • Health financing and costing: A sustainable and long-term adoption of MMS to all pregnant women is key to achieving the intended objectives. This section will map out the expected demand and recommend resource mobilization approaches.
  • Governance, policies and guidelines: Integration of MMS into the existing frameworks is key for adoption. So, this pillar will guide specific policy and guidelines amendments - making MMS a standard of care to pregnant mothers.
  • Health Management Information Systems (HMIS), and Monitoring, Evaluation and Learning (MEL): This section will provide details on inclusion of relevant MMS indicators into the existing HMIS to ensure MEL and tracking.

For Tanzania, having MMS as part of ANC services package aligns with global best practices and presents an opportunity to improve maternal and neonatal health outcomes. The adoption of MMS is especially relevant and a priority in regions with high rates of anemia, undernutrition, and food insecurity. The implementation of MMS will therefore contribute to reducing maternal mortality, improving birth outcomes, and strengthening progress toward Sustainable Development Goal (SDG) target 2 (Zero Hunger) and SDG target 3 (Good Health and Well-being).