‘Wider use of MMS can reduce Nigeria’s high maternal mortality’

Maternal health and nutritional experts have said that the use of Multiple Micronutrient Supplements during pregnancy can significantly reduce the risk of anaemia among pregnant women.

They noted that maternal anaemia increases the risk of complications such as premature birth, low birth weight, and poor pregnancy outcomes, making adequate micronutrient intake crucial throughout pregnancy.

The specialists explained that MMS contains a combination of essential vitamins and minerals, including iron and folic acid, which help prevent nutritional deficiencies commonly associated with pregnancy.

Anaemia, according to the World Health Organisation, is a haemoglobin concentration below a specified cut-off point caused by iron deficiency, acute and chronic infections that result in inflammation and blood loss, deficiencies of other vitamins and minerals, especially folate, vitamin B12 and vitamin A; and genetically inherited traits, such as thalassaemia.

The WHO defines anaemia in pregnant women as a haemoglobin concentration 110 g/L at sea level, warning that it increases the risk of maternal and child morbidity and death rates.

Already, Nigeria has one of the highest maternal mortality rates in the world, with an estimated 512 deaths per 100,000 live births according to the Nigeria Demographic and Health Survey 2018.

The United Nations Children’s Fund says MMS is formulated for pregnant women to provide 15 essential vitamins and minerals that are scientifically proven to benefit the overall health of both the mother and the infant.

MMS was adopted based on the 2020 World Health Organisation recommendation on antenatal care for a positive pregnancy experience.

The MMS tablet is packed with critical micronutrients and contains 13 to 15 vitamins and minerals.

Pregnant women are expected to take the tablet once daily for 180 days during the pregnancy.

According to the WHO, MMS is essential for normal physiological function, growth, and development.

Also, evidence from the WHO trials showed that MMS, specifically the UNIMMAP formulation, reduces low birthweight, small‑for‑gestational‑age, preterm birth, and stillbirth more effectively.

In 2021, the Federal Ministry of Health approved the transition from Iron and Folic Acid supplements to MMS for pregnant women in the country.

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The National Food Consumption and Micronutrient Survey in 2024 revealed that many pregnant women in Nigeria suffer from deficiencies in iron, zinc, Vitamin A, folate, and other essential nutrients.

Speaking, the experts urged pregnant women to register early for antenatal care and take MMS only as prescribed by qualified healthcare professionals.

They stressed that improving maternal nutrition through evidence-based interventions such as MMS is essential to reducing pregnancy-related complications and improving maternal and newborn health outcomes.

Speaking exclusively with PUNCH Healthwise, an expert in maternal and child nutrition, Prof. Beatrice Ogunba, said iron and folic acid in MMS can help lower anaemia risk in pregnant women.

“Because Multiple Micronutrient Supplementation (MMS) contains iron and folic acid, two essential nutrients needed for the development of red blood cells, it can help lower the risk of anaemia during pregnancy.

“Other micronutrients that enhance iron absorption, utilisation, and general blood formation are also provided by MMS, including vitamin A, vitamin B12, vitamin C, and riboflavin,” the don said.

Ogunba, who is a Professor of Public Health Nutrition at the Obafemi Awolowo University, Ile-Ife, Osun State, said MMS could fill several nutritional gaps in pregnant women and lower factors predisposing pregnant women to anaemia.

“MMS can enhance maternal haemoglobin levels and lower the risk of anaemia by addressing many nutrient deficits at once, especially in populations where multiple micronutrient shortages coexist.

“However, the degree of current deficits, the existence of infections or other illnesses that could cause anaemia, and adherence to supplementation all affect how successful MMS is at preventing anaemia,” she said.

Also speaking, the Second Vice President of the Society of Gynaecology and Obstetrics of Nigeria, Prof Christopher Aimakhu, said MMS arehighly recommended for pregnant women because they benefit both the mother and the baby.

“They are safe and highly beneficial, especially for women who are undernourished, anaemic, or from poor socioeconomic backgrounds.

“Studies have shown that they contribute to improved maternal health and better child development.

“Long-term studies have shown that children born to mothers who take these supplements generally have better growth, better development and a lower risk of several harmful diseases,” he said.

In an earlier report by PUNCH Healthwise, a Professor of Community Nutrition at the University of Ibadan, Folake Samuel, said that, in addition to a healthy diet, MMS would go a long way in changing the narrative on maternal nutrition in Nigeria.

Samuel said, “Women who are pregnant and who have just given birth and are breastfeeding children have been found to have iron deficiency anaemia.

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“Surveys in Nigeria show that maternal nutrition is poor. More than six out of 10 have deficiencies of various kinds. Iron deficiency anaemia, in particular, is serious. We have about seven in 10 being anaemic. What it means is that their everyday life is affected. To combat this, we need supplements apart from diet.”

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