Multiple Micronutrient Supplementation for Maternal Anemia Prevention in Tanzania

This is an individually randomized controlled trial to assess the effect of multiple micronutrient supplements (MMS) containing 60 and 45 mg iron as compared to MMS containing 30 mg of iron (standard UNIMMAP formulation) on maternal moderate or severe anemia. This study will help inform countries like Tanzania that currently use IFA containing 60 mg of iron regarding the dose of iron to use in MMS.

Inclusion Criteria: * Attending first ANC visit at study clinics * Pregnant women \< 20 weeks gestation by last menstrual period (LMP) * Aged ≥ 18 years old * Intending to stay in Dar es Salaam until 6 weeks post delivery * Provides informed consent Exclusion Criteria: * Severe anemia (defined as hemoglobin \< 8.5 g/dL per Tanzania standard of care) * Sickle cell disease (SS and SC) and hemoglobin C disease (CC) as tested by HemoTypeSC * Concurrently enrolled in another nutritional clinical trial * Pregnant women with disability or condition which would impair their ability to provide informed consent and complete study procedures.