Professionals from Nigeria’s nutrition and pharmaceutical fields have urged a transition from reliance on donor-funded supplies to domestic production and market-driven financing to support the continued distribution of multiple micronutrient supplements (MMS) for pregnant women.
This appeal was made during a high-profile event held on Tuesday in Abuja, in conjunction with the 7th Nigerian Academy of Science Scientific Conference, orchestrated by the Development Research and Project Centre (dRPC) along with Sight and Life.
The session, titled "Moving Research to Market: Scaling Multiple Micronutrient Supplementation (MMS) for Maternal Health Impact in Nigeria," focused on Nigeria's movement from iron–folic acid (IFA) supplementation to MMS, addressing critical issues relating to supply chains, research findings, financial strategies, and local manufacturing capabilities.
Salisu Abubakar, president of the Nutrition Society of Nigeria (NSN), noted that the country’s shift to MMS is supported by clear evidence indicating improved maternal health outcomes compared to traditional iron–folic acid supplements.
Abubakar explained that MMS is modeled after the United Nations International Multiple Micronutrient Antenatal Preparation (UNIMAP) formulation, which incorporates 15 vital micronutrients to combat anemia and reduce low birth weight and adverse pregnancy outcomes. He mentioned that MMS was officially integrated into health policy through the Nigerian Micronutrient Deficiency Control Guideline established in 2021, allowing for free distribution via public health facilities, mainly aided by governmental and partner entities.
Despite the framework in place, Abubakar highlighted that the current supply fails to meet national demand, pointing out that continuing reliance on donor funding is not a viable solution.
He stated, "The existing shortage of supplies emphasizes the necessity for fostering local production and a strategic focus on market dynamics."
Access to antenatal services, the capacity of healthcare facilities, and the inconsistent availability of necessary products pose significant challenges, even as the acceptance of MMS by pregnant women remains high.
Sunday Okoronkwo, program director at Civil Society Scaling Up Nutrition in Nigeria (CS-SUNN), reinforced that Nigeria’s conversion to MMS has been driven by systematic research aligned with World Health Organization (WHO) standards.
He reported that a national study conducted with the Federal Ministry of Health evaluated the acceptability, adherence, and cost-effectiveness of MMS. Findings revealed robust uptake where early and continuous antenatal care access was provided, with more than half of participants maintaining over 90 percent adherence.
Okoronkwo added that training health workers, ensuring operational supply lines, and offering proper counseling significantly improved adherence rates, while community involvement helped mitigate stockouts during its pilot phase.
CS-SUNN has subsequently assisted states like Katsina and Jigawa in formulating cost-effective rollout plans and training health personnel as donor support for commodities is set to cease in 2024.
Zainab Abubakar, the Nigeria program manager at Sight and Life, mentioned that the organization collaborates with the federal government to promote MMS through increased demand, research financing, and local manufacturing efforts.
She highlighted that, as it stands, a substantial portion of MMS available in Nigeria consists of donations, and even registered products do not always comply with the UNIMAP formulation.
"Producing MMS locally will not only lower costs but also enhance accessibility and lay the groundwork for government procurement and health insurance coverage," she explained while mentioning ongoing research into financing models for antenatal care that include self-pay and insurance approaches for long-term viability.
Frank Muonemeh, representing the Pharmaceutical Manufacturers Group of the Manufacturers Association of Nigeria (PMG-MAN), emphasized the necessity for the government to favor local manufacturers over imported goods. He cautioned that enduring reliance on donations undermines Nigeria’s manufacturing potential and leaves the health system vulnerable to future crises.
"Sustainable health systems cannot be built on a foundation of donations," he stated, reiterating the insights gained from the pandemic and global supply chain interruptions.
He called for solid policies to promote local manufacturers through regulatory incentives and quality assurance, asserting that Nigeria possesses the industrial capacity to produce MMS domestically.
MMS are daily antenatal tablets that combine iron, folic acid, and crucial vitamins and minerals intended to bolster the nutritional status of pregnant individuals and improve their birth outcomes. Unlike conventional iron–folic acid supplements, MMS contains 15 micronutrients, with studies indicating its superior effectiveness in reducing risks of low birth weight and preterm births compared to iron–folic acid alone.
Previously, it was reported that the federal government distributed roughly 1.3 million bottles of MMS to pregnant women across 12 states in 2024 as part of initial rollout efforts, with further distributions planned for later that year.
The government’s initiative to adopt MMS aligns with global recommendations and acknowledges the limitations of relying solely on iron–folic acid, aiming to diminish anemia and enhance birth results among Nigerian expectant mothers.
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