Aware

Researchers are evaluating the effect on newborn birthweight of switching from iron-folic acid supplementation (IFA) to multiple micronutrient supplementation (MMS) as part of routine antenatal care in Ethiopia. This program effectiveness study uses a cluster randomized trial design to compare the impact of MMS versus IFA on birthweight. The study addresses recommendations from the World Health Organization to assess MMS in real-world settings and aims to inform the Ethiopian Ministry of Health about the benefits and feasibility of MMS implementation in multiple districts. The trial involves 42 districts randomized to either continue IFA supplementation or switch to MMS, which contains 15 essential vitamins and minerals including iron. The program started in March 2022, with birthweight data collected continuously from January 2023 to December 2024 using digital scales in health facilities. Facility surveys assessing process, costs, acceptability, and adherence will be conducted at baseline, midline, and endline, with additional interviews planned to explore implementation challenges. Participants include women aged 15 to 49 who deliver liveborn infants in enrolled health facilities. Data collection focuses on birthweight measured as part of routine maternity care. Secondary measures include the cost and cost-effectiveness of MMS, adherence rates, acceptability to women and providers, and implementation fidelity. The total study duration is 42 months, with final analysis expected in April 2025.