The opportunity

Antenatal MMS is more effective and cost-effective compared to iron and folic acid supplementation in improving maternal health.

Research has shown that antenatal MMS, a daily dose of 15 vitamins and minerals, is just as effective as IFA in preventing maternal anaemia and more effective at improving birth outcomes. In 2020, the World Health Organization released updated guidance, which recommended that implementation research be conducted in low- and middle-income countries considering a transition from IFA supplementation to MMS.

Implementation research can inform countries on how to best design and implement effective and sustainable MMS programs.

our solution

The government of Nigeria is interested in undertaking implementation research to effectively introduce MMS as part of antenatal care for pregnant women.

Multiple Micronutrient Supplements

Multiple Micronutrient Supplements

Building upon similar implementation research conducted in Pakistan, Nutrition International is working with the Government of Nigeria, Government of Bauchi State and key stakeholders to introduce MMS as part of ANC in three Local Government Areas in Bauchi State as a means of progressing toward Nigeria’s national health and nutrition goals. This research is critical to exploring solutions to long-standing implementation issues such as adherence and offers an opportunity to guide decision-making and ultimately a path to the scale-up of MMS.

Using a human-centered design (HCD) approach, guided by Program Pathways, the implementation research will identify effective approaches and solutions to improve pregnant women’s adherence to MMS, strengthen the ANC platform and improve gender-based outcomes. The research is based on government priorities, resources, capacity and scalability, and is driven by the voices of women in Nigeria.

  • Implement a woman-centered approach that considers the importance of gender dynamics and segmentation to improve adherence to MMS for vulnerable populations
  • Build upon existing government ANC programming, initiatives and evidence-based best practices to reach women and their influencers
  • Bring together nutrition, public health programming, HCD and implementation research expertise
  • Provide ongoing learning and knowledge sharing


The impact

Increasing adherence to MMS to accelerate maternal nutrition in Nigeria.

This project will explore the operational realities of transitioning from IFA supplements to MMS in Nigeria based on criteria such as acceptability, feasibility, sustainability and cost effectiveness. The findings will inform government decision making around the scaleup and operationalization of MMS as part of public ANC in Nigeria with a focus on how to understand and close the “adherence gap” – the gap between the number of micronutrient supplements a pregnant woman receives compared to the number she consumes – to ultimately strengthen the country’s maternal nutrition programs and improve outcomes for women and their families.