BackgroundThe program to provide and ensure a minimum of 90 blood supplement tablets (BSTs) during pregnancy has been successful in preventing and treating iron deficiency anemia among pregnant women.ObjectiveThis study offers critical insights into the implementation of the BST policy in Medan City as part of a broader strategy to combat stunting among pregnant women.MethodsThrough qualitative methods, including in-depth interviews, focus group discussions, and document analysis, the study identified key factors influencing policy execution: communication, resources, disposition, bureaucratic structure, and the socio-economic environment. Notably, effective communication across multiple channels emerged as a cornerstone, ensuring that stakeholders, community health workers, and pregnant women were well-informed about BST availability and usage.ResultsThe research highlights the adequacy of resources, including human resources and infrastructure, but notes challenges, such as dual roles for staff and short BST expiration periods, which complicate distribution. A lack of specific standard operating procedures (SOPs) for BSTs was identified as a gap, with existing guidelines embedded within broader antenatal care frameworks.