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•Expert alerts, advises govt on way out
By Doris Obinna
Nigeria has a serious challenge with maternal and child malnutrition. This is worsened with weak primary health system, poverty, insurgency and impact of climate change.
In 2022, Nigeria launched Micronutrient Deficiency Control Guideline. This introduced multiple micronutrient supplements alongside other interventions. Multiple micronutrients supplements (MMS), referred to as prenatal multivitamins, are some of the most impactful nutrition interventions that significantly improve maternal health and birth outcomes.
Dr Francis Ohanyido of Vitamin Angels, Nigeria, said: “The first 1000 days of life of the child, from conception to birth, whatever the mother takes has an impact on the child. Nigeria needs to prioritise micronutrient intervention to save lives.
“Nigerians are under-nourished and food insecure. They are at that point where it is important nutrition is on the front burner of national discussions including implementation. It is also important that our leaders understand these issues placed before us.
“United Nations International Multiple Micronutrient Antenatal Preparation Multiple Micronutrient Supplementation (UNIMMAPMMS) contains 15 micronutrients. These include iron and folic acid (IFA) and research supports switching from IFA to MMS, especially for women with poor diets.
“MMS is a formulation of vitamins for pregnant women as identified by the United Nations. It is to help women who are going through pregnancy to have a better value in terms of nutrition for both them and their children. We as a country, is trying to scale up the MMS.
Importance of MMS
“It is important that nutrition is there for the woman who is pregnant because a lot of women suffer anaemia. About 60 per cent of Nigerian women are per-anaemic; they are at that borderline. A little bleeding or challenge in terms of nutrition, they will be driven to full blown anaemia.
“So, because of that, when a woman attends a clinic in Nigeria, especially in primary healthcare setting or underserved setting because of poverty and poor nutrition literacy, It is important that we make sure that providers give these women MMS. We currently use iron and folic acid supplements. But the causes of anaemic are more than iron and folic acid deficiency.
“The World Health Organisation (WHO) and United Nations (UN) said it is imperative that countries begin to move to MMS which has 15 micronutrients. It is made up of vitamins and minerals with inclusive of iron and folic acid that is traditionally given to women at the facility level.
“The benefits of folic acid particularly among pregnant women and those planning to conceive cannot be overlooked. Based on its benefits, manufacturers add it to supplements and fortified foods. It helps produce red blood cells, among others.
“Folic acid may reduce the risk of preterm birth. It is also important for a range of functions in the body. It helps the body make healthy new red blood cells. These carry oxygen throughout the body.
“If the body does not make enough of these, a person can develop anaemia, leading to fatigue, weakness and a pale complexion. Without enough foliate, a person can also develop a type of anaemia called foliate deficiency anaemia.
“Consequently, getting enough foliate during pregnancy is particularly important. Folic acid is crucial for early development, particularly with regard to the spinal cord and because of its importance for health.
Reducing infant, maternal mortality
“If we want to get the Nigeria that we want, people have to be healthy and it starts from pregnancy. A woman should go into pregnancy healthy and with good experience and outcome for her.
“In reducing infant and maternal mortality, a significant part of mortality in Nigeria is around maternal and infant mortality. One of the things MMS does when compared to iron and folic acid is that it reduces stillbirth, small for gestational age and have other advantages in terms of good health for the child.
“One of the things MMS does is give that supplementation in terms of nutrient level. A lot of women going though pregnancy are not rich. They also don’t have the kind of food that will give them the gateway to have good health. It’s very important we introduce MMS and roll it out in a way that will be accessible to everybody in every locality.
Scaling up MMS
“The scale up of MMS for pregnant women as part of routine antenatal commodities is not to be delayed because of the impact it has on mothers and children. There is need for a clear plan of action as the country transits from IFAS to MMS. “Government must consider MMS a critical intervention that must be scaled up quickly as an investment that will have great impact on the quality birth outcomes and the country’s future demographic dividends.
“State and local governments should lead in ensuring that women and children benefit from MMS and ensure that the commodities reach underserved and hard-to-reach communities who are often the most predisposed to the fall out of weakened health systems.
Impact of COVID-19 on malnutrition
“The COVID-19 had increasing rates of malnutrition in mothers and children. It is even predicted that it will continue to be on the rise for the next three years if decisive steps are not taken to provide the necessary supplements.
“Some women have to suffer the effects of malnutrition during pregnancy for the rest of their lives. They include those suffering from conditions such as short stature, impaired cognitive development, anaemia and other micronutrient deficiencies, fatigue, impaired wellbeing and impaired productivity in school performance.”
