Experts urge use of Multiple Micronutrient Supplementation to combat maternal, infant mortality in Nigeria

 

 

By Chibuzo Ihegboro

 

Health experts have recommended regular intake of Multiple Micronutrient Supplements (MMS) before and during pregnancy to reduce maternal and infant mortality rates and other potential complications associated with childbirth.

Nigeria has the second-highest estimated maternal deaths globally and accounts for one of the highest neonatal mortality rates in Africa. Recent World Health Organisation (WHO) data estimates Nigeria’s maternal mortality ratio (MMR) to be over 1047 maternal deaths per 100,000 live births with a neonatal mortality rate of 33 per 1000 live births.

Micronutrient deficiency is identified as a significant cause of health issues for both mothers and babies, leading to complications during pregnancy and adverse birth outcomes. Experts emphasised that food intake alone may not provide all the essential nutrients for a healthy pregnancy. Therefore, they recommend the intake of MMS to fill this gap and reduce the risks of birth defects, anaemia, and other complications.

MMS is a daily pill containing iron, folic acid, and 13 essential vitamins and minerals for pregnant and nursing women. It has been approved by the Federal Ministry of Health as a safe, effective, and essential preventive intervention to improve maternal and infant nutrition.

During a recent media roundtable on MMS reporting in Lagos, experts highlighted the crucial role of micronutrient supplementation in ensuring the development and well-being of both mother and child.

Olawumi Ajayi, Public Health Nutritionist and Lagos State Coordinator for FHI 360/Alive & Thrive cited studies to highlight how poor nutrition during pregnancy and early childhood can lead to severe health consequences, like stunted growth, developmental delays, and increased maternal mortality rates.“Several of our cultural methods of food preparation are flawed, so plenty of nutrients that our bodies should get are lost because of how we prepare our meals.

“When a woman is pregnant, there is an increase in her nutritional needs. Because she needs to meet the physiological conditions for her baby to grow and develop. Her body also needs these nutrients to prepare her for the task of breastfeeding,” she said.

Ajayi lamented the lack of awareness among Nigerians on the crucial importance of micronutrients such as iron, folic acid, plus other vitamins and minerals during pregnancy.

She said, “Despite the importance of these nutrients, many women enter pregnancy with pre-existing nutritional deficits.

“There is minimum dietary diversity that indicates the kind of variety of foods that you must reach as an individual. The Nigeria Food Consumption Metrics Survey (NFCMS) showed a significant decline among non-pregnant, non-lactating women, and the number of pregnant and lactating women who achieved minimum diet diversity. As of 2021, the percentage of pregnant women who meet minimum dietary diversity stood at only 28.8 per cent nationally, while non-lactating is 28.2 per cent.

“According to the Nigeria Demographic and Health Survey (NDHS) in a 2018 survey, it was revealed that maternal underweight nationally is 12.1 per cent. This means that for every 10 women at least one is underweight in Nigeria. Then 58 per cent of women had anemia. Also, this means that over half of the women who attained productive age were iron deficient in Nigeria in 2018. In 2021, 32 per cent of pregnant women had anaemia

“In Nigeria, many women don’t prepare for pregnancy. Many don’t know that the first three months into a pregnancy is the most critical time because that is when the baby begins to form the brain, the spine, and the vital organs. So if a woman should conceive while having a micronutrient deficiency, there is a big problem. if she’s deficient, in folic, for instance, the baby risks having spinal bifida, a condition where the baby’s spine isn’t properly formed.”

Ajayi highlighted the impact MMS can have in cutting down maternal and infant mortality rates and other pregnancy complications. “We cannot review our cooking practices so that is why we urge every pregnant woman to supplement because evidence from research shows that combining all these micronutrients -such as iron, folic acid, calcium, and vitamin D-play a vital role in fetal development, reducing the risk of complications such as preterm birth, low birth weight, and neural tube defects.

“This is because the MMS does not just have iron and folic acid; it has 13 additional micronutrients that will also support the absorption of iron and folic acid. With MMS, we achieve a 40 per cent reduction in stunting for children under five, a 50 per cent reduction of anaemia in women of reproductive age, and a 30 per cent reduction in low birth weight.

“It will reduce the number of infants born with low birth weight by 12 to 14 per cent. it will cut down the number of preterm births by six to eight per cent. It will reduce the number of small gestational ages in newborn infants by two to nine per cent and it will reduce the number of stillbirths by 80 per cent. MMS reduces six months’ infant mortality by 29 per cent,” she added.

To combat these issues, the MMS is being distributed free of charge at Lagos State public health facilities, including general hospitals, Maternal and Child Centres (MCCs), and Primary Health Care Centres (PHCs). According to Mrs. Fadairo Taiwo, the State Nutrition Officer, the Lagos State Ministry of Health has ramped up efforts to increase awareness and promote the use of Multiple Micronutrient Supplements (MMS), especially among pregnant women in the state.

“Lagos State is working with partners to bring in MMS and make it available in our facilities free of charge,” she said. “Our main issue here is MMS uptake in women. The government has done their part, so it is to ensure that we take these supplements. Because when we improve nutrition then maternal mortality and mobility rates will drop.

Mrs. Fadairo disclosed the government’s plan to get MMS to all public facilities in Lagos, and even private health facilities. “We are in partnership with the United Nations Children’s Fund (UNICEF) to provide not only MMS but also ready-to-use therapeutic food for the prevention of malnutrition in children.

“To ensure that these MMS are not sold, there is a task force committee that will be empowered to supervise both public and private facilities. They will look and ensure that MMS is not being diverted,” she added.