Objective To review the implementation of existing distribution system of Multiple Micronutrient Powder (MNP) program in relation to coverage in Praya Tengah, Central Lombok District. Design Health System Analysis (HSA) was used to review each essential component of MNP distribution. Methods were in-depth interview health care provider of MNP program, document review, observation and interviewing cadre and mother/caregiver with targeted children (12-59 months old children). Setting Praya Tengah

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... sub-district, Central Lombok District, Indonesia. Subjects A total of 240 randomly selected underfive children (12-59 months old), 48 cadres responsible for MNP program, 2 nutrition staff responsible for MNP program and 1 head of health center, one nutrition staff at district health office (DHO) and head of DHO also a representative person of UNICEF. Results There was no mechanism of requesting system from Posyandu to District Health Office (DHO). Score of resources in Posyandu was 50%, with no records of MNP logistic and only half Posyandu had minimally two trained cadres. Posyandu as main site of MNP distribution was accessible by mostly cadre (95.8%) and mother/caregiver (78.3%). Average score of planning and management in Puskesmas was 50% and lack of effective supervision. Training for cadres only conducted two times since the last three years yielding poor knowledge of trained cadre. Only 30.2% cadre ever trained on MNP program. About 79.2% Posyandu submitted last report of MNP distribution on Posyandu. Most of Posyandu (85.4%) had experienced of over stocking MNP and mostly due to over dropping from Puskesmas. Community participation on MNP distribution especially community leader was not sufficient. The coverage of MNP distribution in the last six months was only 37.9%. Conclusions Almost all of essential components of MNP distribution system were mostly deficient. Since all of them were influenced to each other, any deficiency might give effect to others; hence, coverage of MNP distribution was low.