Providing balanced energy and protein (BEP) dietary supplementation to undernourished pregnant women has been shown to improve birth outcomes compared to the current standard of care, typically iron and folic acid (IFA) supplementation for pregnant women [1, 2, 3].
BEP supplementation is typically administered in specific contexts, such as emergency or humanitarian settings, in undernourished populations (as recommended by the WHO), or low-income populations (e.g., integrated with a social protection program).
Programmatic Considerations to Integrate BEP Dietary Supplementation into Antenatal Care
For countries considering introducing BEP dietary supplementation within the context of antenatal care (ANC) services in line with WHO’s recommendations published in the 2016 Antenatal Care guideline, WHO’s BEP Expert Group, in close collaboration with the BEP Technical Advisory Group, is working towards developing an implementation guidance document.
This document aims to provide guidance to country-level decision-makers (e.g., policymakers, planners, implementers, etc.) who are interested in introducing BEP dietary supplementation in pregnant women in ANC programs with the goal of improving maternal and infant health in undernourished populations, including sub-populations or specific areas within a country.
BEP dietary supplementation can also be given in sub-populations may include emergency or humanitarian settings, which may be identified with the IPC or Cadre Harmonisé systems. The Global Nutrition Cluster report shows that several countries are providing BEP dietary supplementation in emergency or humanitarian settings. The same report also indicates that some countries provide BEP supplementation at the national level but often integrate it with social protection programs.
Resources
Two key resources are available on the targeting of BEP supplementation and using implementation science to introduce and scale up MMS, which can be adapted for BEP implementation.
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WHO Guidance
This document provides information on targeting of BEP supplementation.
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World Food Programme Guidance
An implementation resource specifically focused on the supply management of BEP supplementation, also known as supplementary nutritious foods in emergency contexts.
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Report of an Expert Consultation
This Report of an Expert Consultation held at the Gates Foundation, provides considerations for nutritional composition of BEP dietary supplements.
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Resource paper for practitioners
A resource to help national stakeholders understand how Implementation Science supports MMS introduction and scale-up. This can be applied to BEP supplementation. Available in French, Arabic, Spanish, and Portuguese.
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Programme Guidance to Protect the Nutrition of Women and Adolescent Girls in Humanitarian Settings
The UNICEF guidance provides recommendations for BEP dietary supplementation and MMS for women and adolescent girls in emergency/humanitarian contexts.
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- Ota E, Hori H, Mori R, Tobe-Gai R, Farrar D. Antenatal dietary education, and supplementation to increase energy and protein intake. Cochrane Database Syst Rev. 2015; Jun 2:(6):CD000032. doi:10.1002/14651858.CD000032.pub3.
- World Health Organization. WHO recommendations on antenatal care for a positive pregnancy experience. Geneva: World Health Organization; 2016.
- Members of an Expert Consultation on Nutritious Food Supplements for Pregnant and Lactating Women. Framework and specifications for the nutritional composition of a food supplement for pregnant and lactating women (PLW) in undernourished and low-income settings. Seatle, Washington: Bill & Melinda Gates Foundation; 2017.