More than 20 years of research [1, 2] have provided clear evidence that MMS is efficacious, safe, cost-effective, and affordable.
Antenatal Multiple Micronutrient Supplementation (MMS) for pregnant women has been proven to improve maternal nutrition status and, in comparison with iron and folic acid supplements (IFAS), further reduce the risk of adverse birth outcomes such as preterm birth, stillbirth, low birth weight, and small-for-gestational-age birth [1, 2, 3]. Providing MMS to women during pregnancy can prevent long-lasting human capital losses in educational years and lifetime income [4].
Scaling up programs that deliver MMS to vulnerable mothers is now an urgent priority. This requires efficient supply chain systems and building awareness of its health benefits among mothers, communities, and maternal healthcare providers.
Pregnancy increases the daily requirement of several vitamins and minerals to meet the nutritional needs of the developing fetus and other metabolic functions. Antenatal MMS is designed to address these heightened demands, which are often not met through diet alone. It is particularly useful for pregnant women in resource-poor settings where micronutrient intake is typically low due to poor dietary diversity, limited access to nutritious food, gender inequity, and prevalent social norms.
MMS is delivered in the form of a tablet, capsule, powder, or liquid that provides a combination of vitamins and minerals in the right amounts. It is often accompanied by nutrition education and counseling to help ensure daily consumption.
The United Nations International Multiple Micronutrient Antenatal Preparation (UNIMMAP) MMS is an internationally accepted and standardized formulation that contains 15 essential vitamins and minerals, including iron and folic acid in recommended doses. In 2021, UNIMMAP MMS was included in the World Health Organization’s Model List of Essential Medicines based on evidence that it is effective and safe.
There is clear and consistent evidence from clinical trials that MMS provides additional benefits over IFAS, which is the existing standard of care for pregnant women in low- and middle-income countries (LIMCs), in reducing adverse pregnancy outcomes.
Compared to IFAS alone, MMS can [1, 2, 3]
Summary of benefits of MMS vs. IFAS on pregnant women overall and in anemic (hemoglobin <110g/L) or underweight (BMI <18.5 kg/m2) pregnant women [1, 2, 3]:
Given the greater health benefits of MMS, transitioning from IFAS to MMS is highly cost-effective. This is despite the small incremental cost for MMS over IFA because of the additional micronutrients [5, 6, 7].
A tool to calculate the incremental benefits and costs of transitioning from IFAS to MMS has been developed by Nutrition International using rigorous methodology. It has data available for 32 countries and can be used to aid national decision-making.
