Applying Implementation Science to Secure a Sustainable Supply of UNIMMAP MMS for National Antenatal Care Services in Indonesia.

Background: The United Nations International Multiple Micronutrient Antenatal Preparation of a multiple micronutrient supplement (UNIMMAP MMS or MMS) is replacing iron and folic acid supplementation (IFAS) in antenatal care (ANC) in low- and middle-income countries (LMICs). An investigation into det...

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Published in:Nutrients Vol. 18; no. 13; pp. 2162 - 2182
Main Authors: Holik, Holis Abdul, Santika, Otte, Suwantika, Auliya, Atwater, John, de Lange, Jarno, Thaha, Abdul Razak, Achadi, Endang Laksminingsih, Nurlita, Hera, Rahmawati, Erni, Rimbawan, Ajello, Clayton
Format: research tables/charts Journal Article
Published: MDPI Jul2026
Online Access:View this record in EBSCOhost
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        atl: Applying Implementation Science to Secure a Sustainable Supply of UNIMMAP MMS for National Antenatal Care Services in Indonesia.
      aug:
        au:
          Holik, Holis Abdul
          Santika, Otte
          Suwantika, Auliya
          Atwater, John
          de Lange, Jarno
          Thaha, Abdul Razak
          Achadi, Endang Laksminingsih
          Nurlita, Hera
          Rahmawati, Erni
          Rimbawan
          Ajello, Clayton
        affil: Center of Excellence for Pharmaceutical Care Innovation (PHARCI), Faculty of Pharmacy, Padjadjaran University, Jl. Ir Soekarno KM 21, Jatinangor Sub-District, Sumedang Regency 45363, West Java Province, Indonesia
      sug:
        subj:
          Dietary Supplements Supply and Distribution
          Implementation Science
          Micronutrients Supply and Distribution
          Prenatal Care
          Maternal Health Services Indonesia
          Human
          Funding Source
          Female
          Pregnancy
          Indonesia
          United Nations
          National Health Programs
          Government Programs
          Nutrition Policy
          Iron Compounds Administration and Dosage
          Folic Acid Administration and Dosage
          Maternal Nutritional Physiology
          Legislation, Drug
          Cost Effectiveness Analysis
          Cost Benefit Analysis
          Descriptive Statistics
          Comparative Studies
          Female
      ab: Background: The United Nations International Multiple Micronutrient Antenatal Preparation of a multiple micronutrient supplement (UNIMMAP MMS or MMS) is replacing iron and folic acid supplementation (IFAS) in antenatal care (ANC) in low- and middle-income countries (LMICs). An investigation into determining how to secure a sustainable supply of MMS began in response to the Indonesian Ministry of Health (MOH)'s decision to introduce MMS into its national health services. Objective: We aimed to identify and test sustainable strategies for securing MMS supplies. Methods: A three-phase implementation science framework was applied to (1) foster an enabling environment for securing MMS supplies, (2) undertake implementation research (IR) to compare sourcing strategy options, and (3) plan and execute actions to scale MMS supply availability and distribution. The MOH assumed ownership of the initiative and guided policy, procurement, and program decisions. Results: (1) Landscaping resulted in recommendations that triggered supply-related policies, an accommodating regulatory framework, integration of MMS into key government support systems (i.e., budget, finance, procurement, and distribution), and identification of supply strategy options. (2) IR resulted in the selection of a local manufacturing and sourcing strategy for acquiring a sustainable supply of high-quality MMS product while retaining an option to import a limited supply of MMS during scaling. (3) A multi-year plan was developed to scale MMSs within ANC services. Conclusions: Applying implementation science provided an evidence-based framework with which to identify, establish, and test a sustainable strategy for securing MMS supplies and yielded insights useful for other countries introducing MMS into their national health systems.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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