Co-administration of calcium and multiple micronutrient supplements for maternal and newborn haemoglobin and iron status: protocol for a randomised non-inferiority trial in Burkina Faso and Pakistan

The WHO recommends antenatal calcium supplementation (1500-2000 mg/day) to prevent pre-eclampsia in settings with low dietary calcium intake. Implementation is limited partly due to the need for three daily doses, although a lower 500 mg dose may be non-inferior. Current guidelines also recommend separating calcium from iron-containing supplements because concurrent intake may inhibit iron absorption. This individually randomised, controlled, non-inferiority trial will test whether co-administration of calcium and multiple micronutrient supplement (MMS) (CaMMS) is non-inferior to separate administration for haematological and iron status.