Improving antenatal nutrition and birth outcomes through the introduction and scale-up of Multiple Micronutrient Supplements (MMS)

MMS is a cost-effective alternative to iron folic acid (IFA), the standard antenatal care supplement, but few women can access this product. R4D is supporting the governments of Ethiopia and Nigeria to create comprehensive costed roadmaps and sustainable financing plans to introduce and scale-up MMS.  

The Challenge

Micronutrient deficiencies and malnutrition in pregnant women contribute to poor pregnancy outcomes such as low birth weight, small for gestational age and preterm births. Anemia in pregnancy is often caused by deficiencies in iron and folic acid and has a prevalence of 46% in Africa. Supplementation of iron and folic acid (IFA) has therefore been recommended by the World Health Organization (WHO) for inclusion in antenatal care (ANC) programs for the prevention of anemia. As a result, IFA supplementation is now the standard of care in many countries, but coverage remains low.

The Opportunity

Studies have shown Multiple Micronutrient Supplements (MMS) to be a more cost-effective option that provides both IFA and additional micronutrients, addressing anemia and other micronutrient deficiencies not addressed by IFA. While there are ongoing efforts at the global level to shape the evidence and market landscapes for MMS, governments need additional support in introducing and scaling up this product. In countries that could benefit from MMS — such as Ethiopia and Nigeria, where maternal malnutrition and adverse neonatal outcomes remain high — support is needed for decision-making, planning, implementation, and market shaping.

The Market Shaping for Multiple Micronutrient Supplements (MMS) for Antenatal Care project, funded by the Bill & Melinda Gates Foundation (BMGF) and led by Results for Development (R4D), aims to support the country-led introduction and scale-up of MMS for pregnant women in Nigeria and Ethiopia and shape global and local markets to increase access to MMS.

R4D’s Work

R4D will support the Governments of Ethiopia and Nigeria, at Federal and State (i.e., Kano and Kaduna) levels, in their efforts to introduce and scale up MMS. At the direction of the governments and in close collaboration with key partners in-country, R4D will provide technical assistance (TA) and support the development of costed roadmaps outlining the market shaping, evidence generation, demand generation and advocacy strategies necessary to introduce and scale-up MMS. R4D will also identify sustainable financing options for roadmap implementation and MMS procurement. In each country, R4D will participate in technical working groups and provide customized support, potentially in the form of TA for sustainable financing and supplier engagement.

R4D will also support MMS introduction and scale-up at the global level by supporting the development of an adaptable framework for costing MMS roadmaps and actively collaborating with other implementing partners and donors to shape global and country MMS markets. By engaging with a coalition of partners and BMGF grantees, R4D will contribute to coordinated efforts to scale up MMS by providing expertise in market shaping and nutrition financing.

The MMS landscape is rapidly evolving, and R4D will continue to respond to the needs of the country governments we are supporting and will support the development of a healthy MMS market at global and country-levels.

Global & Regional Initiatives to Catalyze Stronger Systems

R4D designs and leads global and regional initiatives that connect local leaders and their partners to promote local agendas and achieve locally led results.