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Anaemia: Multiple micro-nutrient supplements provide hope for pregnant women

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By Linus Ogbu

Anaemia among pregnant women remains a serious public health concern in Nigeria as nutrition experts estimate that several millions of pregnant women are suffering from anaemia.

According to World Health Organisation (WHO), Anaemia is a condition in which the number of red blood cells or the haemoglobin concentration within is lower than normal.

Health experts say the micro-nutrient deficiency is a major cause of anaemia among pregnant women, children and adolescent girls in Nigeria.

Micro-nutrient deficiency, according to health experts, is a lack of essential vitamins and minerals that are required in small amounts by the body for proper growth and development.

They further say that pregnant women are likely to be anaemic during pregnancy if they are not getting enough iron from their diet and prenatal vitamins.

According to the UNICEF 4.5 million (58 per cent) of an estimated 7.8 million pregnant women in Nigeria are anaemic.

The UN agency further said that with 512:100,000 Nigeria has the third highest maternal mortality ratio globally, translating to 225 deaths per day with post partum haemorrhage being a key cause.

Nutrition experts predict the present global shock and fragility of Nigeria’s economy might increase anaemia among pregnant women and children if nothing is done urgently.

Yadika Charles, UNICEF Nutrition Desk Officer, said the Multiple Micro-nutrient Supplements (MMS) is a panacea to anemia prevalence among Nigeria’s pregnant women.

He said it contains all necessary vitamins and minerals required to prevent anaemia and adverse birth outcomes.

Charles said UNICEF offered solution through provision of counterpart funding for the procurement of the MMS to scale up reduction of anaemia in pregnancy.

He said it will cost the Nigerian government $26,520,000 for the procurement of MMS, to effectively tackle anaemia in all pregnant women in Nigeria.

“There are about 7.8 million pregnant women in Nigeria, meanwhile, a bottle of MMS containing 180 pills cost $3.4, it will cost Nigeria $26.5 million to ensure that pregnant women have access to a bottle of MMS, ” he explained.

While UNICEF is making efforts to assist Nigeria’s pregnant women, such efforts are expected to be complemented by other stakeholders such as state governments. Unfortunately, that contribution has not hit expected heights.

Charles listed the states that paid their counterpart funding to enable them transit from Iron Folic Acid Supplementation (IFAS) to MMS to include Plateau, Kwara, Kastina, Jigawa, Gombe, Adamawa and Borno.

He called on the states that have to responded to do so as soon as possible.

Mrs Chito Nelson, Head, Food and Nutrition, Federal Ministry of Budget and Economic Planning, said MMS went through 20 years of research and provided clear evidence to be more effective than Iron Folic Acid Supplementation (IFAS) in preventing adverse birth outcomes.

On the effect of anaemia on mothers, Nelson said maternal and fetal well-being are adversely affected as well as increased morbidity and foetal mortality.

She said it also causes experiencing breathing difficulties, fainting, tiredness, palpitation and sleep difficulties among pregnant women.

She further said it increases the risk of developing perinatal infection, pre-eclampsia, complication of labour and even death and post-partum cognitive impairment.

She said the consequence of anaemia on the foetus; could lead to stillbirth, pre-term delivery intrauterine growth retardation, congenital malformations; reduced immuno competence and abnormal organ development.

Nelson, therefore advocated nationwide rollout of MMS to tackle anaemia in pregnant women and adverse birth outcomes in Nigeria.

“Malnutrition remains a serious concern in Nigeria with stunting and wasting of 37 and 7 per cent for children under 5 respectively.

“It is unfortunate that 58 per cent of women of reproductive age and 68 of children are anaemic, wasting and stunting are associated with increased mortality especially when both are present in same child.

“Multiple Micro-nutrient Supplement (MMS) is efficacious, safe, cost effective and affordable, it has 15 vitamins and minerals including iron and folic acid in recommended dosage to prevent adverse birth outcomes.

“So, now is the time to accelerate implementation and address key issues such as ensuring effective and equitable coverage and sustainable supply of high – quality and affordable supplements,” she said.

Ms Beatrice Ali, Nutrition Officer, Federal Ministry of Health, said the Federal Government was committed to the transition from IFAS to MMS.

“The MMS contains 30mg of iron similar benefit on maternal anaemia compared with IFA (Containing 30mmg or 60mg of iron). MMS reduced the risk of Low Birth Weight by 13 per cent in comparison to IFAS’’, she said,

Ali explained further that MMS contain 62 per cent of Vitamin A 800mg; 58 per cent Vitamin C (As ascorbic Acid) 70mg; Vitamin D (as Cholecalcerferol) (200IU); Vitamin E (As Tacophenyl Succinate) among others vitamins and minerals at recommended dosage to prevent adverse birth outcomes.

Mr Sunday Okoronkwo, Civil Society Scaling Up Nutrition in Nigeria (CS -SUNN), Executive Secretary, says anemia’impacts on health, cognitive development and overall productivity, therefore a barrier that must be dismantled.

He urged governments to leverage the Multiple Micronutrient Supplements (MMS) and strengthen Antenatal Care platforms across Primary Health Care centres to deliver high impact maternal nutrition interventions.

This, he said, would fall into government’s plans to reduce anaemia in pregnancy to 40 per cent by 2025, as contained in the “National Multi-sector Plan of action for Food and Nutrition”.

The Master Plan also seeks to reduce anaemia among pregnant women by 50 per cent by 2030 (SDGs 2030).

He appealed to governments and state actors to facilitate and increase in nutritional budget as well as timely release of counterpart funding so as to scale up MMS in the country.

“Today, we stand at the crossroads of an urgent and collective challenge-the reduction of anaemia, a hidden hunger that affects millions, particularly women and children, across our vibrant nation.

“And the scale-up of MMS is a scientifically proven strategy we must embrace to address the menace.

“Let us ensure that every Nigerian, ensure that from the newborn to the expectant mother; from the bustling cities to the rural heartlands, has access to the essential nutrients needed for a healthy and thriving life,” he said.

According to Dr Gaza Gwamna, Nasarawa State Commissioner for Health the state had paid the counterpart fund of $150,000 for nutrition to service MMS and Ready -to Use Therapeutic Food (RUTF).

The health commissioner who spoke through the Director, Public Health in the Ministry, Dr Ibrahim Alhassan, said the commitment was prompted by the support of the UNICEF to match whatever the state contributes.

Gwamna said the state was in the process of collecting data from health facilities across the 13 Local Government Areas on anaemia in pregnancy to be able to ascertain level of the burden of anaemia among pregnant women.

“On Feb. 22, 2024, Nasarawa State Government launched the multi-sectoral plan of action for food and nutrition, where Gov Abdullahi Sule committed to the release of counterpart fund of $150, 000 to MMS and RUTF.

“So Nasarawa state has paid its own counterpart fund; right now we are waiting for UNICEF to match word with action.

“We are also concerned because a lot of people have reported different issues surrounding anaemia in pregnancy’’, the commissioner said.

It is incumbent on stakeholders, including state and federal governments, civil society organisations and the media to scale up their activities to ensure that Nigeria women no longer die from anaemia during pregnancy. (NANFeatures)

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