Stakeholders in Nigeria’s nutrition and pharmaceutical sectors have called for a shift from donor-dependent supply to local manufacturing and market-based financing to sustain the scale-up of multiple micronutrient supplementation (MMS) for pregnant women.
The call was made on Tuesday in Abuja on the sidelines of the 7th Nigerian Academy of Science Scientific Conference, during a high-level session organised by the development Research and Project Centre (dRPC) in partnership with Sight and Life.
The session, titled “Moving Research to Market: Scaling Multiple Micronutrient Supplementation (MMS) for Maternal Health Impact in Nigeria,” examined the country’s transition from iron–folic acid (IFA) supplementation to MMS, with discussions centred on research evidence, supply chains, financing models, and local production.
From evidence to policy
Speaking during the session, Salisu Abubakar, president of the Nutrition Society of Nigeria (NSN), said Nigeria’s adoption of MMS is grounded in evidence showing better maternal and birth outcomes compared to the long-used iron–folic acid supplements.
Mr Abubakar explained that MMS, based on the United Nations International Multiple Micronutrient Antenatal Preparation (UNIMAP) formulation, contains 15 essential micronutrients and has been shown to reduce anaemia, low birth weight and poor pregnancy outcomes.
He said MMS was institutionalised through the Nigerian Micronutrient Deficiency Control Guideline in 2021 and is currently being provided free of charge at public health facilities, largely through government and development partners.
However, he noted that supply remains limited and far below national needs, stressing that donor-funded distribution is not sustainable.
“The gap in supply has made it clear that we must encourage local manufacturing and begin to think seriously about the market,” he said.
He added that while acceptability among pregnant women has been high, access to antenatal care, health facility capacity and consistent commodity availability remain major constraints.
Research shows high adherence
Sunday Okoronkwo, programme lead at Civil Society Scaling Up Nutrition in Nigeria (CS-SUNN), said Nigeria’s transition to MMS has been guided by implementation research, in line with the World Health Organisation’s (WHO) recommendations.
Mr Okoronkwo said a nationwide study conducted in collaboration with the Federal Ministry of Health assessed the acceptability, adherence and cost-effectiveness of MMS.
According to him, the research showed strong uptake where women had early and consistent access to antenatal care, with more than half of participants achieving over 90 per cent adherence.
“We found that when health workers are trained, supply chains are functional and women receive proper counselling, adherence improves significantly,” he said.
He added that community engagement and last-mile distribution helped prevent stock-outs during the pilot phase.
CS-SUNN, he said, has since supported states such as Katsina and Jigawa to develop cost rollout plans and train health workers, following the end of donor-funded commodity support in 2024.
Push for local production
The country programme manager for Nigeria at Sight and Life, Zainab Abubakar, said the organisation is supporting the federal government to scale MMS through demand generation, financing research and local manufacturing.
Ms Abubakar said Sight and Life is working with professional health bodies to train thousands of healthcare workers, while also engaging pharmaceutical manufacturers to support the production of UNIMAP-compliant MMS in Nigeria.
“At the moment, most MMS available in the country are donations, and even registered products are not always UNIMAP formulations,” she said.
She added that locally produced MMS would reduce costs, improve availability and open up access for government procurement and health insurance schemes.
She also noted that Sight and Life is conducting research into existing antenatal care financing mechanisms, including potential self-pay and insurance-based models to support long-term sustainability.
‘Nigeria-first policy’
Frank Muonemeh, representing the Pharmaceutical Manufacturers Group of the Manufacturers Association of Nigeria (PMG-MAN), urged the government to prioritise local producers over imported donations.
Mr Muonemeh warned that reliance on donated commodities weakens national manufacturing capacity and exposes the health system to future shocks.
“No country builds a sustainable health system on donations,” he said, citing lessons from the COVID-19 pandemic and global supply disruptions.
He called for firm policies that incentivise local manufacturers, strengthen regulatory support and ensure quality, arguing that Nigeria already has the industrial base to produce MMS domestically.
MMS
MMS are daily antenatal tablets that combine iron, folic acid and other essential vitamins and minerals designed to improve the nutritional status of pregnant women and enhance birth outcomes.
Unlike traditional iron–folic acid supplements, MMS contains 15 micronutrients, and evidence suggests it can further reduce the risk of low birth weight, preterm birth, and other adverse outcomes compared with iron–folic acid alone.
PREMIUM TIMES had in 2024 reported on the federal government distribution of about 1.3 million bottles of MMS to pregnant women across 12 states as part of early rollout efforts, with additional stockpiles scheduled for delivery later that year.
The government’s decision to adopt MMS was based on global recommendations and the recognised limitations of iron–folic acid alone, aiming to reduce anaemia and improve birth outcomes among Nigeria’s large population of expectant mothers.
Stakeholders at the high-level dialogue on multiple Micronutrient Supplementation (MMS) for Maternal Health Impact in Nigeria held in Abuja on Tuesday
