Consultancy for Improved Forecasting of MMS for Scale-Up in Pakistan

Consultancy Purpose
Nutrition International seeks to engage a consultant or firm to support the development of an improved forecasting models and a forecasting tool for Multiple Micronutrient Supplementation (MMS) at national and five provinces/regions of Pakistan (Punjab, Khyber Pakhtunkhwa (KP), Gilgit-Baltistan (GB), Azad Jammu & Kashmir (AJ&K) and Islamabad Capital Territory (ICT) Rural).
The assignment will build on current utilization data from the MMS scale-up initiated in April 2025, other relevant data and will generate forecasting models/assumptions and a forecasting tool that better reflect service uptake, eligibility criteria and provincial planning needs for MMS.
Project Background Information
1.
Background and context
Maternal and newborn health and nutrition needs in Pakistan remain high, with a neonatal mortality rate of 42 per 1,000 live births and a low birthweight prevalence of 23% (2018)1. Micronutrient deficiencies among women of reproductive age are widespread, driven by food insecurity and limited antenatal coverage. Despite national guidelines recommending iron-folic acid (IFA) supplementation, adherence remains low, approximately 59% took iron tablets or syrup during pregnancy and only 29% for 90 days or more during pregnancy as recommended2.
In 2020, the World Health Organization (WHO) issued updated antenatal care guidelines supporting context-specific use of Multiple Micronutrient Supplementation (MMS) as a safe and cost-effective alternative to IFA, based on evidence of improved birth outcomes.3 In 2020 the WHO updated its Recommendations on Antenatal Care for a Positive Pregnancy Experience4 to a context specific recommendation that supports the use of antenatal Multiple Micronutrient Supplementation (MMS) in the context of rigorous research. In Pakistan, the Advancing Maternal Health through MMS Implementation Research (AMMI) project, led by the Ministry of NHSR&C and Nutrition International, generated valuable implementation insights and tools to support the transition to MMS through the ANC platform.
However, early implementation experience and recent analysis of IFA supplementation programs in Pakistan point to persistent bottlenecks in supply planning, including limited forecasting capacity, reliance on population-level estimates, complexities of private/public use and anaemia treatment and lack of real-time consumption data 5. These gaps have contributed to stock-outs, procurement delays, and inefficiencies that can undermine the credibility of supplementation programs. To ensure that MMS scale-up efforts are both effective and sustainable, it is essential to strengthen forecasting approaches that reflect actual service

delivery trends, accounting for anaemia treatment needs in Pregnant Women and early data from the ongoing rollout. This exercise aligns with the Maternal Nutrition Strategy (2022–2027), which emphasizes improved planning, financing and coverage of MMS as part of strengthened antenatal nutrition service delivery6.
Building on this evidence, the Government of Pakistan, with technical support from Nutrition International and funding from the Bill & Melinda Gates Foundation, is now scaling MMS in five selected districts across AJ&K, GB, KP, Punjab, and ICT Rural. The scale-up is guided by readiness assessments, intensive monitoring, and the development of costed provincial implementation plans and a national roadmap to support a sustainable and context-responsive MMS transition.

DETAILED TORS ATTACHED

Apply By:

Expressions of Interest should be sent by email to Olena Karelina (proposals@nutritionintl.org) with the subject header “Expression of Interest –Forecasting of MMS requirements for Scale-Up in Pakistan”.

The deadline for submission is Friday September 12, 2025 (EST)