Ach Lat

Researchers are evaluating the impact of switching from iron-folic acid supplementation IFA to multiple micronutrient supplementation MMS during pregnancy on newborn birthweight in Ethiopia. This program effectiveness study uses a two-arm cluster randomized trial to compare MMS to IFA as part of routine antenatal care. The study aims to provide evidence for the Ministry of Health of Ethiopia to guide large-scale implementation decisions and contribute to global knowledge on MMS effectiveness. The study involves districts randomized to either continue IFA supplementation or replace it with MMS, which includes 15 essential vitamins and minerals such as iron, vitamin A, vitamin D, and zinc. This trial runs for 42 months starting in March 2022, with birthweight data collected continuously from January 2023 to December 2024. Facility surveys to assess process, cost, acceptability, adherence, and implementation challenges will be conducted at baseline, midline, and endline. Participants include women aged 15 to 49 who deliver liveborn infants in enrolled health facilities across 42 districts in Ethiopia. Birthweight is measured routinely by trained midwives using digital scales. Additional data collection includes facility readiness, antenatal care details, costs, and interviews with staff and health care users. The primary outcome is mean birthweight, with secondary outcomes covering cost-effectiveness, adherence, and acceptability. The study concludes with primary analysis in April 2025.