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

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.