New research from Vitamin Angels and our partners shows how evidence, strong systems, and country-led collaboration can expand access to proven nutrition solutions.
Multiple micronutrient supplements (MMS), also known as prenatal vitamins and minerals, provide 15 essential vitamins and minerals to support healthier pregnancies and improve birth outcomes. Research shows that, compared with iron and folic acid supplementation alone, MMS can reduce the risk of low birth weight by 12% to 14%, preterm birth by 6% to 8%, and stillbirth by 8%.
Knowing that MMS works is not enough to ensure that every woman who needs it can easily access it. Countries need reliable systems to produce, finance, and deliver MMS through routine antenatal care.
A new study published in Nutrients, co-authored by Vitamin Angels’ Otte Santika and Jarno de Lange, details how Indonesia is addressing this challenge, offering lessons for other countries working to scale up access to MMS.
The study, entitled Applying Implementation Science to Secure a Sustainable Supply of UNIMMAP MMS for National Antenatal Care Services in Indonesia, was authored by Holis Abdul Holik, Otte Santika, Auliya Suwantika, John Atwater, Jarno de Lange, Abdul Razak Thaha, Endang Laksminingsih Achadi, Hera Nurlita, Erni Rahmawati, Rimbawan, and Clayton Ajello.
From Evidence to Action
Following Indonesia’s transition from iron and folic acid (IFA) supplementation to MMS in 2024, the Ministry of Health set out to build a sustainable supply of MMS to meet the needs of approximately 4.8 million pregnant women each year. Using an implementation science approach, the Ministry of Health and its technical partners, including Vitamin Angels, identified barriers, evaluated supply options, and developed a phased strategy.
Vitamin Angels worked alongside the Ministry of Health, Kirk Humanitarian, and local and global academic partners including Universitas Padjadjaran to identify and address gaps in regulatory guidance, procurement, and long-term financing. Assessments of 38 Indonesian pharmaceutical manufacturers helped identify potential suppliers and clarify the requirements for producing United Nations International Multiple Micronutrient Antenatal Preparation (UNIMMAP) MMS to internationally recognized quality standards.
The resulting strategy prioritized local manufacturing while using donated, imported supplies to help maintain availability during the transition. Researchers estimated that MMS could cost approximately $2.50 per pregnancy, comparable to Indonesia’s existing spending on iron and folic acid supplements.
Stronger Systems, Sustainable Impact
Indonesia’s experience demonstrates that building a reliable supply takes time and coordination. Early support, in the form of supplies and technical assistance provided by Vitamin Angels and Kirk Humanitarian, helped maintain product availability while the government and manufacturers worked to build a sustainable domestic capacity.
Since the study period ended in 2024, Indonesia has made further progress toward a sustainable domestic supply. Local manufacturing has begun, with the first large-scale shipment of locally manufactured UNIMMAP MMS expected to arrive in November.
This work reflects the approach at the heart of Vitamin Angels 2030: Science. Systems. Scale. By applying evidence, strengthening partnerships and health systems, and scaling what works, we can help more women and children benefit from proven nutrition solutions.
Not every country will follow Indonesia’s path. Local manufacturing may be feasible in some settings, while government financing and procurement of imported products may be more practical in others. The goal is to find an approach that fits each country’s needs and sustains long-term access for the women who need it.
Explore the Findings
Several resources offer opportunities to learn more and join the conversation:
- Read the study: Explore the research, methods, and lessons from Indonesia’s experience, published in Nutrients.
- Explore the publication brief: The Micronutrient Forum’s Healthy Mothers, Healthy Babies (HMHB) consortium summarizes the findings and their implications for countries working to expand access to MMS.
- Join the conversation: On Nov. 10, HMHB will host a virtual Coffee & Chai Chat, Building a Sustainable Supply Ecosystem for UNIMMAP MMS: Lessons from Indonesia. Speakers include Vitamin Angels’ Otte Santika, Dr. Auliya Suwantika of Universitas Padjadjaran, and Dr. Clayton Ajello of Kirk Humanitarian.
- Read more: A LinkedIn article by Spencer Kirk of Kirk Humanitarian, co-authored by Dr. Hera Nurlita of Indonesia’s Ministry of Health and Otte Santika of Vitamin Angels, details additional lessons from Indonesia’s experience.
Indonesia’s experience reflects Vitamin Angels’ approach: working alongside governments and local partners to turn evidence into lasting access to proven nutrition solutions, so more women and children have the health they need to thrive.