July 2023 — Maternal nutrition and care during pregnancy affect birth outcomes and infant mortality. Recent research shows that multiple micronutrient supplementation (MMS) is more effective and cost-effective than iron and folic acid supplementation (IFAS) in improving perinatal outcomes. Transitioning from IFAS to MMS in Ethiopia is expected to prevent 19,677 child deaths and avert 1,561,983 disability-affected life years and yield benefits that are 171 times greater than the costs.

It is in this context that the joint effort of UNICEF and the FMOH looks to bring about a shift from IFAS to MMS in the country to combat the high prevalence of nutritional deficiencies among women of reproductive age (WRA). However, pregnant and lactating women face numerous motivations and barriers to the uptake of maternal healthcare and nutrition in Ethiopia. This research partnership asked the question: how might we comprehensively encourage the uptake of MMS among pregnant women in Ethiopia? 

The outcomes of this research, which fed into the development of the strategy, drew upon Busara’s experience in SBC for promoting positive health behaviours in Ethiopia. With a contextualized understanding of the existing scenario surrounding maternal nutrition, we found that pregnant and lactating women face various social and cultural barriers, at an individual, interpersonal and structural level, when it comes to accessing adequate maternal healthcare. These behaviours can be shifted through social and behavioural change (SBC) strategies that address women’s, their households and HEW’s capabilities, opportunities and motivations to seek and provide quality healthcare. The pathways of improvement from the demand and supply side that need to be addressed include: 

1. 1. The quality of care and counselling services provided to pregnant and lactating women 

   2. Existing socio-cultural perceptions related to maternal nutrition 

   3. Knowledge, attitudes, skills, agency and self-efficacy of women of reproductive age in relation to their health and nutrition during pregnancy and lactation 

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