Workshop to review effectiveness trials Bangkok 15-18 June 2004 

This document is the report of a workshop, organized by UNICEF, in collaboration with WHO, to review results of effectiveness trial on supplementation of pregnant women with multiple micronutrients. This workshop was held back to back with a workshop to review preliminary results of efficacy trials using the same multiple micronutrients supplement i pregnancy. These effectiveness trials were undertaken to explore the impact of multiple micronutrient supplementation in pregnancy on outcomes such as birth weight, when used in programme settings. The results of these trials and the recommendations made by the participants of this meeting contribute to the current discussion on how to enhance foetal and infant survival, growth and development. Since the time of the meeting, the results of several efficacy studies on multiple micronutrients supplementation in pregnancy have been published, these include randomized controlled trials in Nepal and New Guinea-Bissau and International Research on Infant Supplementation trials, otherwise known as IRISH. In addition, results from efficacy trials maternal supplementation using alternative supplements have been published, thus increasing the existing data on impact of multiple micronutrients supplementation. As yet however, evidence remains insufficient for WHO to officially recommend a change from the current recommendation of iron-folate during pregnancy, although their use in emergency settings, such as the recent Asian tsunami has been officially recommended.