Vitamin Angels bets on systems strengthening to reach 477M women and children

Amid a need for proven, coordinated, and scalable nutrition solutions, Vitamin Angels is aiming to reach 477 million women and children globally with its new five-year strategy to address nutrient deficiencies and expand access to free deworming services. The global nonprofit estimates its work to save the lives of 360,000 children and reduce the risk of infectious disease for 300,000 children across 57 countries. 

Nutrition Insight speaks with its president and CEO, Ana Céspedes, about the strategy’s three pathways: Product Access, Capacity Strengthening, and Country Systems Strengthening. “These pathways allow us to respond to the realities in each country rather than applying one model everywhere,” she says.

Commenting on the strategy, she adds Vitamin Angels’ goals are “ambitious, and they should be.”

“But they are also grounded in what we know is possible. Today, Vitamin Angels reaches more than 74 million women and children each year. We are building on more than three decades of experience delivering proven nutrition interventions at scale.”

“What is changing is how we think about scale. Reaching more people cannot simply mean delivering more products. We have to ask how that access becomes sustainable. This means strengthening local capacity, supporting health workers, improving delivery systems, and working alongside governments so that proven nutrition interventions can become part of the routine standard of care.”

Vitamin Angels partners with industry corporations, retailers, and contract manufacturers in the health, wellness, and nutrition industries. For instance, in 2025 it partnered with Sirio Pharma to improve nutrition and health outcomes for pregnant women, infants, and children.

Pathways through the challenging environment

The shrinking funding environment for aid poses a challenge, notes Céspedes, with its effects felt across health training, supply chains, and service reach.

“Our strategy is built on a strong theory of change and a clear pathway to impact. We recognize that every country has different needs, priorities, capabilities, and opportunities, so we are not applying one model everywhere.”

“In some countries, the greatest need may be expanding access to proven nutrition interventions. In others, it may be strengthening local capacity or working alongside governments to integrate and sustain those interventions within health systems,” explains Céspedes.

She adds that continued investment and cross-sector collaboration is needed to achieve these goals.

“In a constrained funding environment, we have to be even more disciplined about directing resources toward what works and building the systems that can sustain that impact.”

MMS, vitamin A and deworming focus

Vitamin Angels’ strategy relies on Multiple Micronutrient Supplementation (MMS) for pregnant women and vitamin A for children.

“There is a strong body of evidence behind MMS and vitamin A supplementation, and the need remains significant,” Céspedes points out. 

“According to the latest WHO estimates, 35.5% of pregnant women globally were affected by anemia in 2023. Vitamin A deficiency also remains a significant public health problem, with WHO estimating that it affects about one-third of children ages six to 59 months.”

“We have selected these interventions because they are among the most proven and cost-effective maternal and young child nutrition interventions available. MMS costs just US$2 to US$3 per pregnancy, and every US$1 invested is estimated to generate US$37 in economic returns.”

She adds that MMS delivers 15 essential vitamins and minerals for pregnant women and is linked to a “29% reduction in infant mortality,” along with reductions in preterm birth, low birth weight, small-for-gestational-age birth, and stillbirth.

“Additionally, vitamin A supplementation is proven to reduce child mortality by up to 24%, while helping prevent blindness and supporting immune function. Twice-yearly supplementation costs approximately US$1 per child,” says Céspedes.

“Deworming is another important part of our work. It improves nutrient uptake, which helps prevent infection, malnutrition, and stunting, and can contribute to better educational outcomes and economic productivity later in life. One treatment costs approximately US$0.50. But I would not frame this as supplementation versus food. We need both.”

She states that supplementation is not the ultimate goal — better health is.

Systems strengthening for sustained effort

Vitamin Angels is working alongside governments to secure its program in the areas of policy, supply, and financing in nine countries. Céspedes emphasizes that direct product delivery to those in need remains essential.

“In many places, the immediate priority is making sure women or children can access a proven nutrition intervention when they need it. But if we want that access to last, we also have to strengthen the systems around it,” says Céspedes. “Indonesia is a powerful example.”

“Following the country’s national transition from iron and folic acid to MMS in 2024, Indonesia is on track to reach 9.6 million pregnant women and children annually with UN international multiple micronutrient antenatal preparation (UNIMMAP) MMS by 2030. That is an extraordinary opportunity for impact, but adopting a policy is only the beginning.”

Céspedes explains that to sustain reaching millions of women, Vitamin Angels works with the Ministry of Health and local partners.

“We have supported implementation science and technical assistance to help address some of the practical challenges that come with taking an intervention to the national scale. A supply context assessment helped identify opportunities and barriers to sustainable supply, and a subsequent coaching clinic engaged 24 Indonesian manufacturers, six of which moved forward with MMS product development.”

“This year marks another important step forward, with the first large-scale locally manufactured UNIMMAP MMS products expected to be delivered. It is an important milestone in Indonesia’s work to build a national supply model supported by government procurement and domestic manufacturing.”

According to Céspedes, Indonesia’s example is what systems strengthening looks like: going beyond introducing interventions to help create the conditions for countries to deliver sustainably at scale.

“Systems work is complex. Political transitions, economic pressures, conflict, and changing priorities can all affect progress. That is precisely why our strategy is designed to be adaptable.”

Private sector’s role

There is ongoing concern about “health-washing” and creating dependency on supplementation[BF1.1] over prioritizing receiving adequate nutrition from whole foods. Céspedes stresses that the private sector has an important role in public health. 

“Governments have primary responsibility for protecting public health, but the scale and complexity of many public health challenges require collaboration across governments, the private sector, philanthropy, and civil society.”

“The private sector can contribute in many ways, from funding and products to technical expertise, innovation, and supply-chain capabilities. When those resources are aligned with public health priorities, they can help proven interventions reach more people and strengthen the systems needed to sustain that impact,” explains Céspedes.

She adds that there must be clear guardrails where public health comes first, and that commercial interests do not determine which interventions are prioritized, where resources are directed, or how success is defined.

“The goal is not for the private sector to replace governments or create dependency. It is to contribute resources and expertise in ways that support stronger, more sustainable systems and enable governments and communities to lead.”

“When we keep the health and well-being of women and children at the center, I believe the private sector can make an important and lasting contribution to global nutrition.”

Measuring impact

Céspedes shares that Vitamin Angels’ most important challenge is how to define and measure impact.

“It is relatively straightforward to count how many people a program reaches. It is much harder, and much more important, to understand whether that reach is translating into meaningful improvements in health.”

To estimate the impact of reaching 477 million women and children, the organization is using the Lives Saved Tool, which Céspedes says is an evidence-based modeling tool that measures health and nutrition intervention effectiveness and estimates the potential impact on maternal and child health results.

“This allows us to go beyond reporting how many people we reach and understand what that reach could mean in terms of lives saved and improved health,” she adds.

“Maintaining trust also means being transparent about what those numbers represent. Our reach is something we measure; our longer-term health impact is modeled using the best available evidence. We believe it is important to make that distinction clear, continue evaluating what is happening through our programs, and adapt as new evidence and learnings emerge.”