Maternal deaths related to pregnancy and childbirth continue to pose a significant global health challenge, particularly in low- and lower-middle-income countries. Each year, approximately 260,000 women die from complications surrounding childbirth, with more than two-thirds of these deaths occurring in sub-Saharan Africa. A leading cause of maternal mortality worldwide is severe postpartum hemorrhage (PPH), which recent research indicates is closely linked to anaemia—a condition affecting a large proportion of pregnant women in vulnerable regions.
Although iron and folic acid supplements have long been the standard nutritional intervention to combat anaemia in pregnancy, experts highlight that this approach addresses only one type of anaemia. According to Dr. Martin Mwangi, lead of the Healthy Mothers, Healthy Babies programme at the Micronutrient Forum, there are six varieties of nutritional anaemia, and current public health strategies have largely neglected this complexity. As a result, anaemia rates have remained stubbornly high, contributing to preventable maternal complications.
Research and modeling published earlier this year suggest that multiple micronutrient supplements (MMS), which include iron, folic acid, and an additional 13 vitamins and minerals, could significantly improve maternal and newborn outcomes. A study covering 25 low- and middle-income countries estimated that replacing iron and folic acid with MMS might prevent 3.5 million low-birthweight births and 186,000 stillbirths over five years. The World Health Organization reports that MMS reduces maternal anaemia at term by 12 percent compared to the standard iron and folic acid regimen.
Beyond anaemia reduction, MMS has been associated with decreased incidence of small-for-gestational-age newborns, who face a heightened risk of infant mortality. Emerging research also links maternal anaemia to impaired brain development in infants, affecting motor skills and learning, which underscores the broader implications of adequate micronutrient intake during pregnancy.
Despite these findings, MMS is only beginning to be introduced in antenatal care programs in some countries. In May, officials from Sierra Leone, Rwanda, Nigeria, and Pakistan pledged to integrate MMS into their national maternal health policies. Over 30 other countries are currently considering or trialing the supplement. The relative affordability of MMS, with a full pregnancy course costing around $2 per woman, coupled with its potential to save lives and improve long-term health outcomes, supports calls for wider adoption.
Health experts emphasize the need for national governments to revise policies to routinely provide MMS during pregnancy, viewing it as a critical step toward reducing maternal mortality rates driven by anaemia and related complications. However, while MMS shows promise in improving pregnancy outcomes, some health authorities note that there is, to date, no direct evidence from clinical trials demonstrating its impact on maternal mortality itself, indicating a need for further research.
As international aid budgets fluctuate and progress on maternal health slows, the push for incorporating comprehensive micronutrient supplementation into prenatal care continues to gain momentum in efforts to address one of the most pressing yet preventable causes of maternal deaths worldwide.