(P07-031-25) Exploring Antenatal Multiple Micronutrient Supplementation (MMS) Implementation and Use by Pregnant Women in Low-Resource Settings in Vietnam

Objectives: Micronutrient deficiencies persist in Vietnam, especially among pregnant women (PW). UNIMMAP multiple micronutrient supplementation (MMS) was distributed to PW in 28 low-resource provinces. This study aimed to understand MMS delivery strategies and messaging, as well as common facilitators and barriers to MMS uptake and adherence.

Methods: A cross-sectional, mixed method study was conducted among health care providers (HCP) in two provinces, selected based on a high percentage of PW residence of low socioeconomic status. 54 HCP’s were surveyed about MMS delivery, and 20 in-depth interviews (IDIs, a sub-set of the 54) were conducted to further explore how delivery strategies might influence PW’s uptake and adherence to MMS. Interviews were conducted and transcribed in Vietnamese and translated into English. Themes were identified based on deductive coding.

Results: Most (79.6%, n=43) HCP’s surveyed reported communicating messages to PW about MMS use and adherence. All delivered 30 tablets of MMS at the PW’s first ANC visit, with 79.6% (n=43) and 20.4% (n=11) reporting “over half” or “approximately half”, of PW respectively, returning to the commune health stations for more MMS. A main reason PW reported for not returning was due to the long distance to clinics (35.2%, n=19). The majority of HCP’s (65%, n=26) reported that PW cited sideeffects as a reason for discontinuing MMS use. Fewer HCP’s (10%, n=4) cited hearing other reasons for discontinuation from PW such as the presence of a “better” MMS products in the market. IDI’s with HCP’s revealed that MMS delivery strategies are dependent on community awareness about MMS efficacy, active direction from national and local authorities and organizations, stability of antenatal services, participation of the village health network, and adequate resources and personnel to deliver MMS, including presence of medical staff and frontline health workers.

Conclusions: Micronutrient deficiencies in PW persist in Vietnam, but UNIMMAP MMS is only provided in a few low resource provinces. Findings from this study will inform the government’s subsequent MMS introduction and scale-up efforts, including the co-design and testing of MMS delivery strategies and messaging targeting optimal MMS coverage and adherence.

Funding Sources: National Institute of Nutrition, Ministry of Health, Hanoi, Vietnam