Nigeria faces high levels of malnutrition, non-communicable diseases as well as micronutrient deficiencies, integrating nutritional concerns in developmental policies and governance is yet to gain significance across the country.
From poverty to lack of functional primary health care centers, illiteracy, women, and children are the most affected due to poor access to basic micronutrients needed for the effective growth of the foetus during pregnancy.
To improve awareness as well as provide access to Multiple Micronutrient Supplements (MMS), for pregnant women, non-governmental organisation (NGO) support, and public-private partnerships are critical elements that can ensure deepening access and integration of nutrition within health systems.
This means leveraging reviews on shaping government policy to scale up MMS, advocating for the inclusion of MMS in the national Micronutrient Deficiency Control Guidelines, and committing to those goals, which will strengthen collaboration and coordination between governments and program partners.
Other areas of improvement that requires attention are the criticality of shortage of human resource for the delivery of nutrition interventions, poor nutrition financing, scarce commodities, poorly coordinated service delivery, weak nutrition information systems and lack of community voice and accountability, and the political commitment needed to translate policy goals into reality.
Additionally, for the problem of malnutrition that occurs when a person lacks sufficient intake of energy and nutrients to meet an individual’s needs to maintain good health, the formalisation of Social and Behavioural Change (SBC) interventions is seen to have the potential of dramatically improving MMS uptake and adherence, and maternal diet quality.
Also, scaling up health services through expanded training to government front-line healthcare workers and improving the inclusion of data sets for MMS and Vitamin A uptake at community and primary healthcare facilities will provide the country with robust data for decision-making and planning.
Addressing these specific necessities will present an opportunity to rapidly and safely provide supply chain solutions like Bi-annual vitamin A doses, Albendazole, and MMS when properly supervised and supported.
Over time, the failures of access to multiple micronutrient supplements (MMS) and poor primary health care systems have created an overburden on the private health sector and made Non- governmental organisations (NGOs) more prominent. This necessitates the need for government to hasten to strengthen health care capacity and support advocacy efforts to create an enabling environment for optimal nutrition outcomes.
The Federal Government of Nigeria should prioritise the national guidelines for the prevention and control of micronutrient deficiency diseases in Nigeria to improve knowledge and awareness of micronutrient deficiency control and effective implementation, delivery of evidence-based and effective micronutrient interventions, and strengthen research, monitoring, and evaluation of Micronutrient Deficiency Control (MNDC) programs.
In Nigeria, the most common micronutrient deficiencies are Iron, folate, iodine, vitamin A, and zinc. Four main strategies are employed to address micronutrient deficiencies in the country which include; dietary improvement increased production and consumption of micronutrient-rich foods, food fortification, supplementation, and public health and other disease control measures.
Reports show that dietary diversification in Maternal, Infant, and Young Child Nutrition (MIYCN) and proper feeding of infants and young children can increase their chances of survival, development, and growth.
Adolescents, pregnant women, postpartum, and children 6-23 months of age are the priority target groups for iron and folic acid supplementation (IFAS) based on the likelihood of both iron deficiency and the public health benefits.
However, due to the high prevalence of anaemia in the country, adolescents, especially girls and women of childbearing age are to be targeted with this strategy- MMS.
To strengthen Nigeria’s health system by increasing access to nutrition interventions with an emphasis on ensuring underserved populations, the work of initiatives, such as the Vitamin Angels’ model integration would guarantee success.
Vitamin Angels is a proof of concept that a public health non-profit organisation working to improve nutrition across Nigeria, can work directly with local and national organisations, including governments, to reach the most underserved, nutritionally vulnerable populations – pregnant women, infants, and young children – with evidence-based nutrition interventions and technical assistance.
This framework utilises Vitamin Angels focusing on improving nutrition because it is proven to break the intergenerational cycle of poverty and poor health, and leads to greater economic success for individuals and entire communities.
In Nigeria, the Vitamin Angels model engages in advocacy and advisory services to create an enabling environment, provides technical assistance to ensure effective delivery, implementation of science, learning solutions, monitoring, and evaluation, and increases the availability of evidence-based nutrition interventions in Nigeria.
The strategic approach of the model has significant coverage and support partners in 33 States out of the 36 States, and so far, beneficiary states include; Kano, Kaduna, Plateau, Niger, Kwara, Oyo, Kogi, Gombe, Akwa-Ibom and Nasarawa.
Vitamin Angels are increasing the availability of evidence-based nutrition interventions by providing program partners with grants for vitamin A,
Albendazole, and MMS globally. In addition, they partner with NGOs and state governments in very rural areas as well as very urban locations.
The Vitamin Angels program, implemented partnerships with government partners, including key Ministries, Departments and Agencies (MDAs), FMOH, and the SUNN Secretariat Programmes with States to augment Primary Health Care service deliveries.
According to Christian Ugbo, pharmaceutical logistic specialist, at Vitamin Angels, “Before now, MMS is not known widely in Nigeria but with this project, I can say the technical services that we provide, strengthening of the health system by building the capacity of health workers and community volunteers have increased their knowledge about evidence-based nutrition interventions.
“Ordinarily, knowledge transfer helps raise awareness and increase nutrition interventions’ acceptability. Our program efforts have made significant progress over the last year despite Covid-19. We convened the first community of practice for nutrition with the Federal Ministry of Health,” he said.
Dr. Francis Ohanyido, Country Director of Vitamin Angels, Nigeria, and public health consultant says malnutrition is still a major problem in Nigeria and lack of micronutrients is critical for mothers.
“Pregnant women in low- and middle-income countries (LMICs), including Nigeria are at increased risk of being deficient in multiple, critically important, micronutrients. However, poor maternal nutrition has dire consequences for women and children.”
Ohanyido, while speaking at a 2 -day media engagement and capacity-building workshop on MMS in pregnancy stated that micronutrient deficiencies can have lifelong impacts on a child’s physical, mental, and emotional development.
“Vitamin Angels have been in Nigeria as a pilot study for years but have been in operation offically for four years now. One of the things done in public health which is important is giving supplements to vulnerable groups who need certain micronutrients.
“A lot of children are vulnerable to infections like measles. As a sort of preventative measure in public health, micronutrients are given to prevent chances of deficiencies.
“Because a mother is carrying a foetus, the demand on her body nutrients increases which needs proper supplements to help the immune system response. Multiple micronutrient supplements (MMS), commonly referred to as prenatal multivitamins, are one of the most impactful nutrition interventions that significantly improve maternal health and birth outcomes.”
Dr. Ohanyido goes on to say that “MMS contains 15 essential vitamins and minerals for pregnant and nursing women and meets micronutrient requirements that poor diets cannot meet. It has significant benefits compared to Iron and Folic Acid (IFA) which contains just 2 essential vitamins and minerals.”
In Nigeria, MMS is a part of an inclusive strategy by the federal government to reduce the prevalence of malnutrition. The programme progress of Vitamin Angels is a call for increased improvement of maternal malnutrition possibility and accessibility of MMS in Nigeria, increased funding, as well as investment by the government at all levels.
