By Chioma Obinna

Tokunbo, a 25-year-old pregnant woman from one of the communities in Lagos was feeling unusually tired and weak and often feeling dizzy and having trouble concentrating. Her mother-in-law advised her to rest and eat more, but Aisha’s condition didn’t improve.

Tokunbo’s experience is unfortunately common among pregnant women in Nigeria. Anaemia, a condition characterised by a deficiency in red blood cells, is a significant public health problem in the country. It affects a large number of pregnant women, leading to various health complications for both mother and child.

The high prevalence of anaemia in women of reproductive age and pregnant women in Nigeria is widely recognised as an important public health problem because of its negative consequences for pregnancy outcome and its impact on maternal mortality.

Over the past five decades, iron and folic acid (IFA) supplementation has become a core component of antenatal care for pregnant women in Nigeria to address anaemia.

Experts say that while iron and folic acid are critical nutrients, they are not the only nutrients that pregnant women may need to support their health and the health of their children. Other vitamins and minerals (collectively referred to as micronutrients) – including vitamins A, B1, B2, B3, B6, B9 (folic acid), B12, C, D, E, and the minerals iron, zinc, iodine, copper, and selenium – are essential for a healthy pregnancy and fetal development. Daily intake of these micronutrients during pregnancy increases by up to 50 percent.

According to experts, anaemia during pregnancy can have severe consequences, including increased risk of maternal mortality and women with anaemia are more likely to experience complications such as postpartum haemorrhage and infections, which can lead to death.

In the views of Olawumi Ajayi, the State Coordinator, Lagos, Alive & Thrive Nigeria Maternal, nutrition is critical to ensuring that women have healthy pregnancies and that children grow into healthy adults, yet evidence shows that women in low-resource settings find it difficult to meet their daily dietary requirements leading to high proportion of WRA with low minimum dietary diversity (MDD) across the nation.

She said the minimum dietary diversity is a proxy for micronutrient intake.

According to the National Food Consumption and. Micronutrient Survey, NFCMS 2021, a significant decline as about a third of non-pregnant and non-lactating (28.2)and pregnant  (28.8) pregnant women achieved minimum dietary diversity.

Ajayi explained that to prevent maternal anaemia and other micronutrient deficiencies and decrease the risk of diet-related health conditions, pregnant women are recommended to consume an adequately nutritious diet composed of a variety of foods, with emphasis on iron-rich foods (such as beef, poultry, and iron-fortified foods)

Stating that daily micronutrient supplementation that includes 30-60 mg of iron and 400 mcg of folic acid as recommended by the WHO was required, she added that micronutrient supplementation in low resource constraint countries like Nigeria is key because improvements in the natural diet and behavioural change are difficult to achieve over a short period.

Further, she argued that evidences from current research make it imperative that combining all micronutrients in a multi-supplement and delivery of a multiple micronutrient supplement (MMS) to women in targeted groups is more programmatically feasible and should be embraced rather than the age-long IFAS.

Speaking on the role of Multiple Micronutrient Supplementation, MMS, she explained that MMS was a crucial intervention in addressing anaemia and improving maternal and child health outcomes.

She said it provides pregnant women with a daily dose of essential vitamins and minerals, including iron, folic acid, vitamin A, zinc, and others.

She added that providing these micronutrients, reduces anaemia as iron is a key component of red blood cells, and MMS can help to replenish iron stores in the body.

It also improves fetal development as adequate micronutrient intake is essential for the healthy growth and development of the fetus.   “MMS can help to improve maternal health by reducing the risk of infections and complications during pregnancy.

“It is important for pregnant women in Nigeria to start taking MMS as soon as they become pregnant and to continue taking it throughout their pregnancy.

Early and consistent use of MMS can help to prevent anaemia and improve maternal and child health outcomes.

For women like Tokunbo, MMS is the game changer as they are back to normal within weeks of consuming MMS and they begin to feel stronger and more energetic. Her pregnancy progressed smoothly, and she gave birth to a healthy baby boy.