Top

Wits RHI

Multiple Micronutrient Supplementation (MMS) SA 2025 Clinical Trial

MMS SA 2025 Clinical Trial: Advancing Maternal Nutrition Through Multiple Micronutrient Supplementation (MMS) in South Africa

Overview

The MMS SA 2025 Clinical Trial is a maternal nutrition research study led by Wits RHI’s Maternal and Child Health Directorate in partnership with Sight and Life Foundation (SAL), DG Murray Trust (DGMT) and Hold My Hand (HMH), with support from the Children’s Investment Fund Foundation (CIFF). The study is evaluating the acceptability and adherence of the United Nations International Multiple Micronutrient Antenatal Preparation (UNIMMAP) Multiple Micronutrient Supplementation (MMS) compared with the current standard of care Iron and Folic Acid (IFA) supplementation among pregnant women receiving antenatal care in inner-city Johannesburg.

Up to 795 pregnant women will be enrolled and offered a choice of either MMS or IFA supplementation, with follow-up throughout pregnancy and qualitative interviews conducted with participants, healthcare workers and key influencers. The findings will generate critical local evidence to inform future maternal nutrition policy and strengthen antenatal care programmes in South Africa.

Rationale

Maternal malnutrition remains a significant public health challenge in South Africa and contributes to maternal anaemia, low birth weight, preterm birth, childhood undernutrition and poor developmental outcomes. While Iron and Folic Acid (IFA) supplementation remains the current standard of care, growing international evidence demonstrates that Multiple Micronutrient Supplementation (MMS) provides a broader range of essential vitamins and minerals needed during pregnancy and is associated with improved maternal and newborn health outcomes.

The World Health Organization recognises the importance of multiple micronutrient supplementation in pregnancy, and increasing global evidence suggests MMS is more effective than IFA in reducing adverse birth outcomes, particularly among women with nutritional deficiencies. The MMS SA 2025 Clinical Trial will provide locally generated evidence to determine whether MMS can be effectively introduced within South Africa’s public health system and contribute to national efforts to improve maternal and child health.

Primary Objectives

  • Evaluate the acceptability of Multiple Micronutrient Supplementation (MMS) among pregnant women.
  • Assess adherence to MMS compared with Iron and Folic Acid (IFA) supplementation.
  • Generate implementation evidence to support future maternal nutrition policy in South Africa.

Secondary Objectives

  • Explore pregnant women’s experiences and perceptions of MMS.
  • Assess healthcare worker and community perspectives on maternal micronutrient supplementation.
  • Examine factors influencing supplement adherence during pregnancy.
  • Generate evidence to inform future implementation of MMS within routine antenatal care services.
  • Strengthen South Africa’s evidence base for improving maternal and newborn health outcomes.

Partners

The MMS SA 2025 Clinical Trial is led by Wits RHI in partnership with:

  • Sight and Life Foundation (SAL)
  • DG Murray Trust (DGMT)
  • Hold My Hand (HMH)

with support from the Children’s Investment Fund Foundation (CIFF).

Investigators

Co-Principal Investigators

  • Dr Elizea Horne
  • Dr Mrinmayee Dhar

Latest Updated:

May 2026

For more please email rhicomms@wrhi.ac.za