Will a supplement pill help protect Nigerian women and children from anemia during pregnancy?

“I’m five months pregnant, and I can tell you that sometimes it’s hard for me to eat a balanced diet. Adding fruits and vegetables to my diet doesn’t occur to me, because the prices of local food items have been going up a lot lately,” said Ashia Yusuf, 34 years old from Lagos. Vaccines Work.

To combat the risks of anemia in pregnant women and children under the age of five, Nelson called for the introduction of a Multi-Micronutrient Supplement (MMS), a tiny pill packed with 15 vitamins and minerals.

The latest Nigerian National Bureau of Statistics (NBS) report showed that food inflation in the country rose to 40.01% in March 2024, up again from 37.92% recorded in February 2024. According to NBS, there was a year-on-year increase on food inflation. driven by a rise in the prices of items such as garri, millet, bread, Yam tuber, dried fish, sardine, palm oil, vegetable oil, beef, coconut, watermelon and others.

In January 2024 NBS showed that the average price of 1kg of local rice was 1,021.79 naira (about US$ 0.75), almost double the January 2023 price of 514.83 naira (US$ 0.37). The price of boneless beef rose 37% in the same period, while loose brown beans grew 64% more expensive. Meanwhile, the World Bank reports that about 87 million Nigerians – almost 40% – live below the poverty line.

Ashia Yusuf is one of them. “The nurses at Ifako General Hospital in Lagos, Nigeria always advise me to eat a balanced diet and include fruits and vegetables in my diet to give myself and my body the nutrients it needs my unborn child. However, due to the current state of the economy, I am unable to pay them, as my family and I now struggle to eat twice a day,” she said.

Risk of anemia

Pregnancy significantly increases the calories and micronutrients a woman’s body needs, explained Dr. Francis Ohanyido, a physician and consultant with the public health non-profit Angel Vitamin in Nigeria.

Ohanyido fears that rates of anemia and other diseases linked to deficiencies among pregnant women could rise amid food inflation, as it becomes more difficult for women like Yusuf to access dietary sources of important micronutrients such as vitamins A , C, D, E, B1 (thiamine), B2 (riboflavin), B3 (niacin), B6, B12 and folic acid, and minerals such as iron, zinc, iodine, copper and selenium.

Inadequate nutrition can lead to anemia in mothers, confirmed Chito Nelson, former head of the Food and Nutrition Division, Federal Ministry of Budget and Economic Planning, during the February event on Multinutrient Supplementation (MMS), organized by Civil Society-Scaling. Up Nutrition in Nigeria (CS-SUNN) in Abuja.

Anemia can cause increased fetal morbidity and mortality, as well as preterm delivery, intrauterine growth retardation, congenital malformations and reduced immune competence, Nelson said.

Pregnant women, meanwhile, can experience breathing difficulties, fainting, fatigue, palpitations and sleep difficulties, and are at increased risk of perinatal infection, pre-eclampsia, complications during labour, and even postnatal death and cognitive impairment.

MMS, pill come up

To combat the risks of anemia in pregnant women and children under the age of five, Nelson called for the introduction of a Multi-Micronutrient Supplement (MMS), a tiny pill packed with 15 vitamins and minerals. “MMS has 20 years of research [behind it]providing clear evidence that it is safe and more effective than IFAs in preventing adverse birth outcomes,” said Nelson.

IFAs stand for Iron and Folic Acid supplements, which are given to pregnant women as standard in Nigeria. But Nelson points out that the 2018 Nigeria Demographic and Health Survey (NDHS), showed that 58% of women of reproductive age and 68% of children under five years were anaemic, which indicated shortcomings in that approach.

To remedy this, the Nigerian government, in January 2021, approved MMS as a safe and cost-effective way to meet the micronutrient needs of women during pregnancy. The Federal Ministry of Health has approved the national rollout of MMS in its updated National Guidelines for the Prevention and Control of Micronutrient Deficiencies in Nigeria.

Nutrition and immunity

Nutritional deficiencies can pose a variety of health risks, including leaving the body much more vulnerable to infectious diseases. In fact, malnutrition contributes to about 45% of the deaths of children under the age of five in low-income countries, and most of these deaths are caused by disease.

Where malnutrition is severe, the same disease can cause much higher rates of damage than it would elsewhere. Measles, for example, is expected to kill about 1 in 1,000 unvaccinated but otherwise healthy children. In deprived settings, however, death rates of 15% have been recorded from the virus.

This means that the provision of vaccinations and nutritional supplements is extremely important in constrained economic conditions. A review paper released last year by Gavi and the Eleanor Crook Foundation examined the potential for integrated delivery of the two lifesaving interventions.

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Cost of transfer

Seven states in Nigeria have adopted those national guidelines and have pledged to switch from IFAS to MMS, said Yadika Charles, nutrition officer at UNICEF Vaccines Work.

“Plateau, Kwara, Katsina, Jigawa, Gombe, Adamawa and Borno states have pledged to roll out MMS. Four states have released six hundred million naira as part of the Child Nutrition Matching Fund,” he disclosed.

It will cost Nigeria US$ 26.5 million to get enough MMS to effectively combat anemia in pregnant women and children under the age of five, Charles said. “To be realistic, we have targeted 60% of pregnant women in Nigeria to have access to MMS in three years.”

In any case, the move may come too late for Ashia Yusuf, who told in Lagos Vaccines Work she had never heard of MMS. “It would be great if the Lagos state government would consider switching to MMS,” she said, newly built. “Most pregnant women [I know] also struggling to eat healthy.”

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