Prof. Kola Anigo, a nutrition expert, has advocated an integrated approach combining Multiple Micronutrient Supplements (MMS), dietary improvement, food fortification and stronger community engagement to tackle anaemia among pregnant women.
Anigo, National Coordinator of the Academic and Research Network, Scaling Up Nutrition in Nigeria (ARN-SUNN), made the call in Abuja during a media roundtable organised by Civil Society-Scaling Up Nutrition in Nigeria (CS-SUNN).
He discussed the technical implications of scaling up MMS through routine antenatal care (ANC).
Anigo explained that anaemia should not be viewed solely as an iron-deficiency condition, noting that inadequate diets, food insecurity and infections also contributed significantly to the problem.
“It’s not all anaemia that is a result of iron deficiency,” Anigo said, adding that broader nutritional causes made it necessary to move beyond interventions focused exclusively on iron.
He said MMS offered a superior advantage because it contained 15 different micronutrients, compared with traditional iron-folic acid supplementation, which provided only two essential nutrients.
According to him, the Federal Ministry of Health and Social Welfare, through its Nutrition Department, has developed a roadmap for integrating MMS into ANC as part of standard care.
He said successful integration, however, required states to develop localised implementation plans, including arrangements for procurement, distribution and delivery of the supplements through appropriate healthcare facilities.
The expert emphasised that making MMS available within the health system would not, by itself, guarantee that pregnant women would use the supplements consistently and correctly during pregnancy.
“The issue of demand generation is a key activity, a key component of the implementation plan,” he said, stressing the importance of creating awareness and encouraging uptake.
Anigo said communities must be actively involved in generating awareness and demand, particularly among women at the grassroots.
He added that healthcare workers required adequate training to provide appropriate counselling.
Anigo described effective MMS delivery as a complete package involving procurement, service readiness, community participation, demand generation and trained health workers capable of providing appropriate information and support.
He urged states and local governments to take greater ownership of nutrition interventions, noting that the Federal Government could provide national policy direction while implementation required action at the local level.
“It’s not just because when it comes to the issue of policy and plan, Nigeria can stand at number one. But the critical issue is implementation,” he said.
On food fortification, Anigo said it remained an important medium-term strategy for addressing micronutrient deficiencies, while dietary modification represented a longer-term approach to improving nutritional outcomes.
He noted, however, that conventional food fortification might not adequately reach many rural households because significant numbers of Nigerians, particularly subsistence farmers, relied heavily on food they produced themselves.
According to him, fortified foods can be available in markets without reaching vulnerable populations that lack the economic capacity to purchase them, thereby limiting the intervention’s potential impact.
He therefore suggested that Nigeria explore context-specific approaches, including fortification at local milling points, to reach communities that process and consume their own staple foods.
Anigo emphasised that interventions should reflect Nigeria’s peculiar food systems and socio-economic realities rather than simply replicate approaches adopted in other countries without considering local circumstances.
“Every country must look at its own problem and be intentional in trying to solve that problem,” he said, urging policymakers to develop locally appropriate solutions.
He said dietary diversification remained fundamental to addressing micronutrient deficiencies, but acknowledged that improving food consumption patterns required sustained efforts to make nutritious foods accessible and affordable.
Anigo maintained that Nigeria’s response to anaemia should combine supplementation with measures addressing its underlying nutritional and health determinants, particularly among vulnerable pregnant women across the country.
He urged policymakers and programme implementers to move beyond policy formulation and focus on translating existing nutrition strategies into effective services that could reach pregnant women, especially those in underserved communities.
