Introduction Maternal nutritional status has profound effects on foetal growth, development, and subsequent infant birth weight. 1 Low birth weight (LBW), as defined by the World Health Organisation (WHO), is the weight at birth <2500g, remains a major public health problem globally and is associated with a range of consequences. 2 LBW is not only a major predictor of prenatal mortality and morbidity, but recent studies have found that it also increases the risk for non-communicable diseases, such as diabetes mellitus (DM) and cardiovascular diseases (CVDs) later in life. 3 Overall, it is estimated that 15-20% of all births worldwide are LBW, representing more than 20 million births a year. 3 In low and middle income countries (LMICs), the intake of micronutrients among women is usually very low, resulting in poor nutritional status. 4 Preferably, it is important to make efforts to improve these low intakes before conception, but increasing intakes during pregnancy may also help improve birth weight and survival chances of newborns. 5 Micronutrient deficiency results from inadequate consumption of meat, fruits and vegetables, and infections can also be a cause. 6 Micronutrients are known to affect birth weight by their interactions with each other, i.e., micronutrient supplementation may improve maternal appetite, leading to increased food consumption, and, thus, reducing morbidity. 5 Prenatal multiple-micronutrients (MMN) supplementation is associated with reduced risk of LBW outcomes and with improved birth weight when compared with iron-folic acid supplementation. There is no significant effect of MMN supplementation on the risk of preterm birth or small-for-gestational-age (SGA) infants. 7 Additional interventions that affect the nutritional status during pregnancy include dietary measures and public health interventions, such as deworming and health education. Although the risk of being born with LBW is significantly more with moderate preconception J Pak Med Assoc 2092 ORIGINAL ARTICLE Effect of multi-pronged interventions in reducing low birth weight and maternal anaemia among pregnant women. A community-based interventions research in non-agrarian resource constrained setting of rural Pakistan Inayat Thaver, 1 Ahsan Maqbool Ahmad, 2 Mariam Ashraf, 3 Syed Kamal Asghar, 4 Muhammad Sarwat Mirza 5 Abstract Objective: To investigate the effect on maternal and infant health of iron plus folate and multiple micronutrient supplements, along with deworming and health education session provided to pregnant women in rural, non- agrarian and food-insecure areas. Methods: The quasi-experimental study was conducted in Tharparker and Umerkot districts, Sindh, Pakistan, in 2013-14, and comprised pregnant women in their earlier weeks of pregnancy. The enrolment and follow-up phase entailed 3 visits to each subject. Areas covered by lady health workers were designated as intervention areas, and those with non-LHW population were labelled as non-intervention areas. Results: Of the 1204 subjects, 600(49.8%) were in the intervention group and 604(50.2%) were in the non- intervention group. By the end of the follow-up phase, significantly more women had increased number of meals in the intervention group compared to the non-intervention group (p<0.001). There was a significantly higher increase in mean haemoglobin levels and body mass index of women in the intervention arm after 3 and 6 months of interventions (p<0.05). Significantly higher mean birth weight was recorded in intervention areas compared to non- intervention areas (p<0.05). Conclusion: Community-based provision of multiple micronutrients to women along with deworming, health education and dietary counselling significantly reduced the prevalence of anaemia and reduced the incidence of low birth weight. Keywords: Maternal anaemia, Low birth weight, Multiple micronutrients, Nutrition. (JPMA 70: 0000; 2020) (DOI: ) 1 Mustashaar Social Development Advisors, Islamabad, 2 Department of Research and Development, Health Services Academy, Islamabad, Pakistan, 3 Department of Community Health, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia, 4 Unicef Sindh, Karachi, 5 Health and Nutrition Development Society, Karachi, Pakistan. Correspondence: Mariam Ashraf Email: maryamashraf@hotmail.com