The Challenge
For many women, pregnancy begins not only with joy, but also with crushing fatigue and dizziness.
Anemia quietly robs pregnant women of their strength. It makes even simple tasks exhausting and puts both mother and baby at risk. Babies are more likely to be born too small, too early, or with lifelong health complications.
In Nigeria, these risks are magnified. Many women must pay fees just to attend prenatal appointments, and most are only able to visit a clinic a handful of times before giving birth — far fewer than recommended. Each visit that’s actually made is an important opportunity to detect and treat anemia, offer counseling, and provide the nutrients mothers need.
The standard approach — iron and folic acid supplementation — only contains two nutrients and gaps in delivery undermine its impact. Women often receive too few tablets, struggle to manage multiple pills, or receive inconsistent guidance due to the constraints of busy health facilities.
Existing tools are not reaching women reliably or early enough.
The Solution
Multiple micronutrient supplementation (MMS) offers a better, simpler option: 15 essential vitamins and minerals in a single daily tablet. Research shows MMS reduces low birth weight and other adverse outcomes more effectively than iron and folic acid supplementation alone.
At just over two dollars per woman for a full pregnancy course, MMS is highly cost-effective. The challenge lies not in the product itself, but in ensuring that women receive it consistently and that health systems are equipped to deliver it well.
Our Approach
From February 2024 to September 2025, Evidence Action worked with Nigeria's Federal Ministry of Health to pilot a comprehensive maternal anemia package - MMS delivery coupled with strengthened anemia screening and treatment - at 90 health facilities across Oyo State and the Federal Capital Territory (Abuja). We reached over 5,000 pregnant women while rigorously testing delivery approaches that work within Nigeria's health system realities.
Read more about our MMS pilot in NigeriaWhat We're Learning
- Mothers feel the difference. Women report having more energy and less nausea with MMS.
- Mothers are receiving sufficient supply. Previously, women would only receive 30 days worth of iron and folic acid supplementation at a given visit, which would mean they often would not have enough supply to last until their next doctor’s visit. Updated packaging in 180 count bottles means that they no longer experience supply gaps.
- Health workers are empowered. With one clear regimen to explain, and aided by a flipchart, frontline staff can spend their time counseling pregnant women on the benefits of MMS.
The Path to Nationwide Impact
This pilot generates the feasibility data Nigeria's Federal Ministry of Health needs to make informed decisions about nationwide adoption.
Incorporating MMS into routine care for all pregnant women in Nigeria would mean:
- Fewer mothers lost to preventable causes.
- More babies born at a healthy weight, with a stronger start to life.
- A model that other countries can adapt, multiplying the impact far beyond Nigeria’s borders.