Why Multiple Micronutrient Supplements (MMS)

Many pregnant women in low- and middle-income countries (LMICs) don’t receive UNIMMAP MMS – they receive a less complete and less effective product, IFA. For many years the World Health Organization (WHO) recommended IFA as a standard component of antenatal care. In October 2021, WHO included MMS in the Model List of Essential Medicines based on the strong evidence that it is a safe and effective intervention and is available now for inclusion in antenatal care programs. However, IFA is still used in many countries who have not yet integrated MMS into their health systems. MMS has significant benefits over IFA, which makes scaling up programs that deliver MMS to pregnant women an urgent priority.

While UNIMMAP MMS contain 15 vitamins and minerals, IFA contains just two. And while IFA does help to improve birth outcomes, evidence shows UNIMMAP MMS are superior. Compared to IFA, UNIMMAP MMS reduce the risk of a child being born underweight, too small, or too soon. For children born to underweight and anemic mothers — and in low- and middle-income countries, a very high percentage of women are anemic — the benefits are even more pronounced. Compared to IFA alone:  

• The risk of infant mortality (from 0-6 months of age) decreases by 29% when a mother with anemia takes MMS during pregnancy.
•  UNIMMAP MMS reduce the risk of a child being stillborn by 26% among anemic, pregnant women.
•  UNIMMAP MMS reduce the risk of a child being born underweight to anemic pregnant women by 19%.
•  UNIMMAP MMS reduce the risk of a child being born pre-term by 8%. Among pregnant, underweight women, the risk decreases by 16%.

The 1,000 days between conception and a child’s second birthday are not only foundational – they are transformational. And ensuring a child receives good nutrition throughout is of the utmost importance to support proper development. A child’s nutrition is contingent on his or her mother both before and after birth – during pregnancy, it is essential for women to receive high-quality nutrition from both their diet and supplementation. And after birth, a child should begin breastfeeding within an hour of birth, followed by exclusive breastfeeding for six months, and continued breastfeeding and the introduction of complementary feeding until two years of age.

These interventions for malnutrition, among others, are some of the core tenets of good health.

During pregnancy, women need higher levels of certain vitamins and minerals to support their health and their child’s development – and diets alone often cannot deliver enough of these nutrients. 

The consequences of not meeting these nutrient demands can be severe.  

Half a billion women of reproductive age and four out of 10 pregnant women worldwide suffer from anemia, which can lead to impaired health, decreased productivity, and unfulfilled earning potential. Anemia is estimated to contribute to 20 percent of maternal deaths and, during pregnancy, increases the risk of fetal death, prematurity, and low birth weight.  

Each year, approximately 20 million babies are born underweight, 23 million are born too small, and 15 million are born too soon. These children are born at a disadvantage. They are born with an increased risk of death during their first few months of life, and if they survive, they are more likely to have decreased cognition and be physically stunted – and are less likely to escape the cycle of poverty.