Goalkeepers Accelerator

The Opportunity

Improved maternal nutrition can help ensure that women have healthy pregnancies and their children are born healthy.

While iron and folic acid (IFA) supplementation has long been part of antenatal care services provided to pregnant women in low- and middle-income countries (LMICs), they are not the only micronutrients that pregnant women need.

During pregnancy, women require a range of vitamins and minerals to support their own health and the development of their children before birth. To address these needs, multiple micronutrient supplements (MMS), containing 15 vitamins and minerals, were developed and MMS became a standard component of antenatal care in high-income countries.

Despite clear and consistent evidence behind MMS, they are often unavailable to women who could benefit from them the most.

Recent systematic reviews and studies* show that, compared to IFA supplementation alone, MMS significantly decrease the risk of low birth weight by 12% and very low birth weight by 22% – which are known to increase the risk of infant deaths. MMS has the potential to reduce six-month mortality by 7% overall and by 15% for girls. Additional important benefits include reductions in preterm birth, small-for-gestational age and stillbirth.

However, MMS are not readily available to many women in LMICs. The result is that women in LMICs have a higher risk of poor birth outcomes than women in high-income countries, especially because many do not have access to foods rich in micronutrients or adequate antenatal care.

* Cochrane Library, The Lancet and the Annals of the New York Academy of Sciences

The Healthy Mothers, Healthy Babies Accelerator

To correct this inequity, the Micronutrient Forum leads the Healthy Mothers, Healthy Babies Accelerator – a coordinated initiative launched at the 2019 Goalkeepers Event – to advance the introduction and implementation of MMS over the next three years.

The Accelerator leverages new investments from the private sector, philanthropies, NGOs and country leadership to save lives and improve the health of millions of women and newborns, address inequity in access to MMS and make progress toward the Sustainable Development Goals (SDGs).

The Accelerator brings together nearly $50 million in financial and in-kind contributions.

Over the next three years, this Accelerator will reach more than 17.5 million pregnant women and their newborns in multiple countries including Bangladesh, Indonesia and Myanmar. More than 10 partners from the private sector, academia, civil society and the UN have committed to increasing demand, supply and delivery of high-coverage MMS.

Partners across sectors and expertise are working together though this Accelerator:

Organizing Partner: The Micronutrient Forum

The Micronutrient Forum is a coordinating micronutrient expert organization that facilitates dialogue and collective action to ensure efforts to support micronutrient health are evidence-based, comprehensive, cost-efficient, and effective.  As the tentpole of the Accelerator, the Micronutrient Forum oversees the Healthy Mothers, Healthy Babies Accelerator. In this role, the Forum coordinates pledges from research, implementation and advocacy groups to maximize progress and monitor the impact. In addition, the Forum works with stakeholders to dismantle technical barriers to MMS supply and drive advocacy, so MMS increasingly becomes a standard component of antenatal care in LMICs.

Pledging Partners

• Children’s Investment Fund Foundation (CIFF)
  CIFF is developing an investment that will set a model for expanding MMS access in LMICs. 
• DSM
  DSM, a pharmaceutical manufacturer, has contributed a multi-faceted pledge to drive global support of MMS adoption and generate demand for and supply of MMS in Indonesia. Along the global support track, DSM is developing a standardized MMS premix to equip manufacturers to produce safe, high-quality MMS, which it will donate or subsidize the cost of to start local production of MMS in-country. Additionally, DSM is working with retailers, and other players to develop their own MMS product and partnering with NGOs to advocate for MMS scale up at global and regional events.

  In Indonesia, DSM has committed to providing technical support to local manufacturers beginning MMS production. DSM is also working to reach women and midwives directly via HaloDoc, Indonesia, a telemedicine service. Through HaloDoc, DSM will raise awareness of antenatal nutrition and deliver MMS to women and midwives, even in remote places of the country.

• The Eleanor Crook Foundation
  The Eleanor Crook Foundation has pledged research and advocacy funds to create the necessary evidence-base and momentum for MMS adoption in East African countries. The foundation is assessing the need for implementation research and pilot activities, as well as local and global advocacy to generate clear MMS policies and recommendations to support adoption in the region. 
• Kirk Humanitarian
  Kirk Humanitarian has committed to provide 5 million cycles of MMS for each year of the Accelerator – for a total of 15 million cycles over three years, providing a foundational supply of MMS to LMICs that are introducing MMS programs or pilot projects. The organization has also pledged funding for advocacy, market development and implementation support for MMS introduction and scaling in LMICs. 
• Nutrition International
  Nutrition International is helping to inform policy- and decision-makers on MMS, developing an MMS Cost-Benefit Tool with country specific data on the cost effectiveness of MMS and the potential benefits of MMS introduction. In addition, Nutrition International, together with UNICEF is providing technical support and resource mobilization support to 10 countries to facilitate MMS adoption. 
• The New York Academy of Sciences (NYAS)
  NYAS is expanding its role in the MMS space, having first developed a Special Issue on MMS. As a part of the Accelerator, the organization is providing technical and information support to countries exploring MMS adoption though its MMS Technical Advisory Group (TAG). 
• The Republic of the Union of Myanmar
  The government of Myanmar has committed to implement MMS as a component of standard antenatal care with the goal of reaching all pregnant women in the country. Simultaneously, the government will conduct implementation research with Harvard to inform how MMS packaging and presentation and counseling impacts uptake.
• Sight and Life
  Sight and Life has dedicated their technical expertise and financial resources to leading market shaping efforts and purpose-driven advocacy for MMS. In Bangladesh, Sight and Life will support the design of a sustainable model and provide technical support to implementation research led by Johns Hopkins Bloomberg School of Public Health. It will also develop production and procurement strategies for high quality MMS in 27 low and middle income countries and conduct research on adherence and uptake of MMS in Bangladesh, Burkina Faso, Madagascar and Tanzania. Through their global advocacy efforts, Sight and Life is disseminating the evidence-base on and creating momentum for MMS adoption. It has pledged to compile the latest evidence, learnings and tools for decision-makers in 80+ countries in a Special Report on MMS.
• The United Nation’s Children’s Fund (UNICEF)
  UNICEF’s commitment, too, takes a multi-pronged approach, cutting across internal prioritization of MMS, implementation, market shaping and evidence-sharing.UNICEF had pledged to integrate MMS into its Nutrition Strategy (2020-2030), so that MMS is prioritized and built into its nutrition projects, and will introduce MMS into at least three additional countries that face high levels of micronutrient deficiency during the Accelerator timeframe.

  Additionally, UNICEF will help to create demand and improve adherence by assessing and proposing innovations that would increase uptake. It will also track and share best practices and learnings from four MMS projects to inform subsequent MMS programs.

• Vitamin Angels
  Vitamin Angels is committing funds and expertise across a variety of workstreams. In addition to providing 2.5 million cycles of MMS over three years to hard-to-reach pregnant women in LMICs, Vitamin Angels will also support national-level advocacy for MMS adoption in LMICs and encourage policy change; provide technical assistance support to both health systems and manufacturers to equip them to integrate MMS into antenatal care services and support local production of MMS, respectively; and collaborate with a corporate partner to produce a MMS product under a private label.

Next Steps

All women have a right to get the nutrients they need for themselves and for their babies. Every year, 22.5 million babies are born low birth weight. Healthy Mothers, Healthy Babies aims to reduce this number significantly.

• Advocate: Advocates can help put MMS on the antenatal care agenda and support national governments to lead policy change and increase resources for maternal nutrition, including MMS.
• Implement: Program implementers can provide technical support for health systems strengthening in countries, improving supply chains and delivery platforms for the hardest-to-reach, and developing monitoring systems.
• Create Supply: The private sector can develop high-quality and affordable MMS product.
• Invest: Donors can invest in government led and owned MMS programs for increased adoption, scale up and sustainability.
• To join the effort and learn more, contact us at MMSAccelerator@micronutrientforum.org.
• Read our Accelerator Updates