Nepal

Summary: Phase 2. Initial implementation supported by implementation research  

The Government of Nepal is preparing to transition from IFA to MMS, with a strong focus on generating evidence on acceptability and adherence to inform national decision‑making. In 2022, Helen Keller International (HKI), with support from Vitamin Angels, conducted a landscape analysis highlighting the need for implementation research to guide this transition, complemented by formative studies examining social norms, product attributes, and delivery platforms influencing MMS uptake and adherence. ECF is funding pilot implementation research led by HKI, and SAL and HKI have jointly conducted supply‑chain assessment work. Nepal was expected to adopt an implementation‑science approach to MMS introduction by 2024. The country conducted advocacy/awareness raising activities related to MMS programmes in 2024.

Several challenges remain, including regulatory classification of MMS, inclusion in the national EML, integration into policies and monitoring systems, and the development of sustainable costing and budgeting plans. Key priorities now include establishing MMS regulations and policies, advancing scale‑up with a sustainable financing plan, and strengthening health‑worker capacity through targeted training and system‑wide support.

(Sources:  HMHB Survey 2025, UNICEF NutriDash , HMHB Survey 2021-2023 )

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Summary: Phase 3. Policy Adoption & Early Implementation

In Nepal’s Integrated Management of Acute Malnutrition (IMAM) guidelines, pregnant women in the second and third trimester and lactating women with a MUAC < 23 cm, who live in areas with insufficient local food availability and access to improve their nutritional status, are provided with a daily BEP supplement (200 g of dry matter of fortified blended foods), alongside counselling on the use of supplementary foods.

Source: Sethi et al. 2021

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