Indonesia

• First MMS manufacturer on the African continent operational, adding 0.5bn + tablets to global/regional supply capacity.
•  100,000+ doctors sensitized on MMS + Ca during pregnancy, learnings documented on the role of technology ain improving implementation, improving acceptability and adherence to MMS+Ca, local FDA capacity improved for supplement testing.

Project 1: PIN MMS Manufacturing

Funded by CIFF and ECF in 2022, this 4-year grant aims to build regional MMS manufacturing capacity in Africa and Asia. Indonesia has a thriving pharmaceutical market and is well positioned to supply high-quality affordable MMS in the region.

In partnership with a leading micronutrient premix supplier, a local manufacturer is being supported with MMS formulation R&D, stability studies, registration and approval by local FDA as well as UNICEF. Additionally, the manufacturer has been registered for import into the Philippines.

Project 2: SMART MMS + Ca acceleration

In October 2024, the Government of Indonesia adopted Multiple Micronutrient Supplements (MMS) as a national policy. Since then, MMS has been distributed across 15 provinces, with the government aiming to cover all 38 provinces by 2026.

To help achieve this ambitious goal, Sight and Life is partnering with the Summit Institute for Development—a local organization that conducted one of Indonesia’s largest MMS studies in 2001–2004—to implement SMART MMS, a digitally enabled, data-driven, and community-rooted initiative designed to improve MMS and calcium uptake among pregnant women. This implementation research will identify the factors influencing acceptability and adherence, providing actionable insights to strengthen maternal nutrition programs in Indonesia and beyond.

The SMART MMS Study was officially launched on 9 August, with the event attended by the Heads of the Provincial Health and Planning Offices, as well as district government officials—demonstrating strong local government support for this important initiative.

Sight and Life is also partnering with Alodokter, an Indonesian online medical platform for healthcare professionals that offers clinical news, medical education resources, and peer networking opportunities, with over 100,000 doctors registered. Through this collaboration, the medical community is being trained/sensitized on the importance and usage of MMS and Ca during pregnancy.

The Philippines

• 10,000+ health workers sensitized on MMS + Ca during pregnancy

• 180,000+ pregnant women receive MMS through public and private sector distribution models
• Local FDA capacity improved for supplement testing, supply readiness assessment completed, and procurement roadmap developed.

Project 1: SMART MMS + Ca Acceleration

Funded by CIFF (2025 – 2028)

Sight and Life is collaborating with the Philippine Nutri-Foods Corporation (PNFC) to launch the distribution of MMS (Multiple Micronutrient Supplement) and Ca (Calcium) through a multi-channel pilot project across 13 regions in the Philippines. This initiative aims to promote, increase uptake, and ensure the effective utilization of MMS among pregnant women.

The Public Sector MMS pilot project will promote sustained availability and enhanced accessibility of MMS and calcium in the Philippines. Therefore, the activities of SAL and PNFC will address gaps in the supply chain and nutrition programs. By filling these gaps in the nutrition supply chain, and supporting systems strengthening through a cost-effective interventions like MMS – within maternal and child nutrition programs, we expect to improve maternal and child nutrition outcomes in the Philippines over the next five years.

The second workstream of SMART MMS and Ca Acceleration Project will carry out a collaborative MMS Supply Readiness Assessment in the Philippines. Sight and Life will primarily collaborate with World Vision Philippines to co-lead the sub-national situational analysis and generate context-based evidence on the nutrition supply chain focused on MMS. Additionally, Sight and Life is partnering with UNICEF Philippines and Vitamins Angels, with approvals from the Department of Health, to enhance the overall data and evidence generation at the national level. As the overall technical lead, Sight and Life will compile the knowledge generated from the Supply Assessment and identify a budget gap analysis.

The knowledge and evidence generated from this multi-agency effort will help develop a clear National and sub-national procurement roadmap as guide for all national actors supporting MMS. The findings of the activities are also expected to provide a clear set of actions needed to establish a local production if needed, as this will identify local capabilities of manufacturers for MMS. The roadmap will help inform the development and revision of the National Micronutrient Supplementation Guideline or Operations Manual (MS-MOP) currently being developed by the Department of Health.

Bangladesh

• The FullCare initiative has transformed access to maternal nutrition in Bangladesh — selling over 80M tablets within 3.5 years of launch. 

• The model’s integration into SMC’s vast pharmacy and community health networks, including last-mile women entrepreneurs, has positioned it to reach 10-15% of pregnancies annually. 

• Beyond national borders, Bangladesh’s experience now serves as a blueprint for other LMICs seeking sustainable, locally produced solutions to improve maternal health.

Project 1

Technical Assistance for setting up the local MMS value chain, supply, business modelling, demand Creation and knowledge management

Phase 1 (2020 – 2024): Sight and Life partnered with SMC and Renata to bring Multiple Micronutrient Supplements (MMS) to market in Bangladesh under the brand “FullCare.” Our support spanned from securing Drug Authority approval and ensuring product compliance to shaping market strategy through packaging validation, consumer and provider research, and branding inputs.

We strengthened the enabling environment by contributing to national technical advisory groups and advocating with global partners to expand scale and reach. Through strategic market analysis, price negotiations, and digital platform guidance, we helped optimize operations and drive demand creation.

By documenting and sharing best practices in global forums, we amplified Bangladesh’s MMS experience as a model for other countries, ensuring that FullCare not only reached the market but gained a strong foothold in both policy and practice.

Phase 2 (2025 – 2029): The Scaled Up and Sustainable Market-Based Model for MMS in Bangladesh (MMS 2.0) seeks to build on the successes of Phase 1, where locally produced Multiple Micronutrient Supplements (MMS) under the brand name FullCare were introduced and distributed through pharmacy networks nationwide. Backed by CIFF, and implemented with SMC, GAIN, and Sight and Life, the new phase will focus on scaling pharmacy networks, strengthening community-based ANC services, and leveraging technology for better monitoring of sales, adherence, and pregnancy outcomes. By expanding the provider network and deepening engagement with private sector ANC services, the project aims to make MMS more accessible, while reducing the per-woman cost of ANC and MMS from over USD 13 in Phase 1 to under USD 4 by 2029.

If successful, MMS 2.0 could transform maternal nutrition in Bangladesh by ensuring over 44 million tablets sold annually, reaching between 1.5–2.0 million pregnant women across urban and rural areas by 2029. The model will drive a 40% expansion in the pharmacy network, significantly boosting access points for pregnant women and their families. At the same time, the reduced per-woman cost of MMS and ANC services will make supplementation more affordable and sustainable, while competition among local pharmaceutical manufacturers will help ensure quality and price stability.

Through policy advocacy and public-private partnerships, MMS 2.0 aims not only to embed MMS into national nutrition guidelines but also to demonstrate a replicable and sustainable market-based model for other LMICs. Ultimately, the initiative will strengthen maternal health outcomes, reduce maternal mortality risks, and create a pathway for long-term sustainability of MMS access in Bangladesh.

South Africa

• 10,000+ health workers sensitised on MMS + Ca during pregnancy

• Local FDA capacity improved for supplement testing, clinical trial completed to build evidence on acceptability and feasibility of MMS programming and building momentum on policy change

Project 1: PIN MMS Manufacturing

Funded by CIFF and ECF in 2022, this 4-year grant aims to build regional MMS manufacturing capacity in Africa and South East Asia. South Africa has a thriving pharmaceutical market and is well positioned to supply high-quality affordable MMS in the region.

In partnership with a leading Micronutrient premix supplier, a local manufacturer is being supported with MMS formulation R&D, stability studies, registration and approval by local FDA. The site received UNICEF approval in August 2025. Additionally, the manufacturer has been registered for import into Nigeria.

Project 2: SMART MMS + Ca acceleration

Funded by CIFF (2025 – 2028)

This project addresses the need to provide the National Department of Health with the required local data in terms of cost-effectiveness of MMS over IFA, feasibility of introducing MMS, studying its acceptability (new intervention) contrasting IFA (routine policy).

SAL will partner with local FDA on testing of multivitamin supplements. The partnership will aim to test prenatal supplements for their quality and stability, generate evidence to support strengthening of regulations for prenatal supplements, ensuring better quality assurance.

Nigeria

• The project will increase local manufacturing capacity for Multiple Micronutrient Supplements (MMS) in Nigeria, reducing dependence on imported products and improving supply chain reliability. 
• Collaboration with DSM Firmenich will provide technical expertise and raw material supply, ensuring high-quality and affordable MMS production.
• Engagement with federal and state stakeholders, development partners, and local manufacturers will strengthen partnerships and regulatory alignment. 
• The initiative will support sustainable industry growth, accelerate MMS adoption, and improve maternal nutrition and birth outcomes nationwide.

Project 1: PIN MMS Manufacturing

As part of the Product Innovation Nutrition project, Sight and Life has been working to accelerate MMS adoption in Nigeria since 2022. SAL has engaged with federal & state level stakeholders, development partners and local manufacturers to work on local production of MMS in Nigeria. SAL aims to explore a direct partnership with a local pharmaceutical manufacturer (s) to support product development / local manufacturing of MMS in Nigeria through direct financial support and or technical support. 

Project 2: SMART MMS + Ca acceleration

The Smart MMS and Calcium acceleration project is aimed at complementing the ongoing efforts in Nigeria to support the sustainable scale-up of MMS in Nigeria. This project will work on country specific models to support the transition from using IFA to MMS using the SMART approach.

The overall outcome of the SMART MMS is to improve maternal nutrition, birth outcomes and improve overall maternal and child health in the country. 

The three workstreams in Nigeria include – 

Training and Sensitization of doctors and healthcare workers 

SAL has a partnership with the Nigeria Medical Association to train and sensitize doctors and health care workers. This partnership aims to train 40,000 healthcare professionals, including doctors, nurses, midwives, and community health workers, on the importance of MMS and calcium supplementation during pregnancy to improve maternal and birth outcomes over a four-year period (2025–2029).

The training and sensitization will equip health workers with the knowledge and skills to integrate MMS and calcium supplementation into routine antenatal care, improve maternal nutrition, counsel pregnant women effectively. Thus, reduce maternal anemia, prevent pre-eclampsia, lower low birth weight rates, and decrease neonatal mortality. This initiative will create a multiplier effect with the benefits reaching millions of mothers and children and strengthen Nigeria’s maternal and child health systems.

Improved local FDA Capacity for supplement testing

SAL will partner with the National Agency for Food and Drug Administration and Control (Nigeria local FDA) to improve the capacity of the FDA for testing of supplements. The partnership will aim to test a minimum of 30 shortlisted prenatal supplements and assess the Agency’s current regulatory framework for prenatal supplements. This initiative will include; market assessment, align on testing methodology with NAFDAC, lab testing of samples and result analysis and dissemination of report. 

The Sight and Life–NAFDAC partnership will strengthen Nigeria’s capacity to regulate prenatal supplements. Findings from the market assessment, standardized lab testing, and data analysis will guide quality assurance improvements. This will enhance product quality assurance & safety, protect maternal and child health, and inform national policy on supplementation.

Test self-pay models for MMS through government programs

This will be done in two streams. The first phase will be carried out by a local agency in Nigeria called the ‘development Research and Projects Center’ to conduct an in-depth assessment of the health financing mechanism in Nigeria, with a focus in their capacity to support the introduction and scale up of MMS in the country. This will entail interviews and stakeholder engagement across selected states to provide qualitative and quantitative insights.  The second phase will be a study carried out in partnership with the Federal University of Health Sciences, Azare. The study aims to assess compliance with MMS use in pregnancy, explore women’s preferences for MMS packaging and administration, identify factors influencing uptake, compare compliance with iron–folate users, and provide recommendations based on the findings.

This two-phase initiative will generate critical evidence to inform the sustainable introduction and scale-up of MMS in Nigeria. The health financing assessment will identify the existing financing mechanism, current opportunities and gaps for funding support, while the compliance study will provide practical insights into user preferences, adherence patterns, and factors driving uptake. Combined, these findings will guide policy, optimize program design, and strengthen government/public and non-government/private stakeholder commitment to improving maternal nutrition outcomes.

Rwanda

A five-year national strategy will guide the Government and partners to ensure the sustainable integration of MMS into ANC services, aiming to reach all pregnant women and improve maternal health outcomes.

Project 1: Taking Rwanda towards scale up of MMS

2024-2025 

Funds: ECF and CRI 

Sight and Life is supporting the Government of Rwanda in transitioning from IFA to MMS as part of ANC services. 

MMS Pilot Assessment
SAL, in collaboration with UNICEF, conducted an assessment of a pilot program implemented by UNICEF in seven districts where MMS had been introduced. The assessment aimed to identify barriers and facilitators affecting coverage, adherence, and acceptability of MMS consumption and ANC attendance. A systems approach was applied, targeting 5,000 pregnant women as the primary beneficiaries, along with other key stakeholders involved in service delivery, such as ANC nurses and midwives, heads of health centers, community health workers, and store managers. Both qualitative and quantitative methods were used.

The identified barriers and facilitators informed the prioritization of intervention areas to increase adherence to MMS and ANC services, and to optimize the transition from IFA to MMS in the Rwandan context. The findings from the MMS pilot assessment fed directly into the development of a comprehensive roadmap for this transition.

Roadmap Development
SAL, in collaboration with UNICEF and under the leadership of the Rwanda Biomedical Center (RBC), developed the national roadmap for the transition from IFA to MMS. The roadmap is structured around four pillars: policy and regulations, financing, supply chain, and delivery channels. Through desk research and key informant interviews with relevant stakeholders, a situation analysis was conducted to describe the current ANC system, with a particular focus on IFA provision. Based on this analysis, a set of detailed and costed activities required for the transition from IFA to MMS was developed. The R4D tool was used to estimate the cost of each activity. The roadmap is now in the process of being finalized and endorsed by the Government of Rwanda.

MMS TAG
SAL joined the MMS Technical Advisory Group (TAG), chaired by RBC and UNICEF, and has been an active member since August 2024.