Anaemia in pregnancy is a major public health burden with a higher incidence in low- and middle-income countries (LMICs) such as Nigeria. It is mostly caused by iron deficiency and has significant implications on maternal and neonatal health. This panel examines initial findings from an ongoing superiority, randomised controlled trial, "Intravenous versus oral iron for iron deficiency anaemia in pregnant Nigerian women (IVON trial)" with both effectiveness and implementation outcomes. In this four-abstract panel, we present recent estimates of prevalence of and risk factors for iron deficiency among pregnant women with moderate or severe anaemia in the two most populated states of Nigeria (Kano and Lagos states). This abstract goes on to describe the characteristics of pregnant women with iron deficiency anaemia in the study sites. In the second abstract, we capture perception of women on intravenous iron treatment for anaemia in pregnancy in the IVON trial. Building on this, we report considerations for acceptability of intravenous iron treatment for iron deficiency anaemia in pregnancy in Nigeria based on insights from a qualitative study with pregnant women, family decision makers and health care providers. Finally, being that large scale trials such as ours are rare in the LMIC maternal health space, we share lessons learnt from the conduct of this trial and how contextual solutions to challenges were generated to assure successful trial implementation.