Opportunities and challenges for introduction of balanced energy protein supplementation through routine antenatal care

The World Health Organization (WHO) recommends balanced energy and protein (BEP) supplementation during pregnancy in contexts where prevalence of maternal underweight, defined as body mass index (BMI) < 18.5 kg/m2, is ≥ 20%. Evidence shows that BEP supplementation in underweight pregnant women reduces the risk of low birthweight, small for gestational age, and preterm birth. Yet little is known about how to introduce BEP through routine antenatal care (ANC). This paper explores challenges, opportunities, and recommendations for successful introduction of BEP supplementation through ANC service delivery.