Empowered Women, Transformed Generations: The Global Impact of Maternal Nutrition

What does scaling-up MMS look like on the ground?

The Nutrition For Growth (N4G) Summit took place in Paris 27-28 March 2025. It brought together governments, civil society organisations and philanthropists working on malnutrition. On March 27, In the margins of the summit, the Eleanor Crook Foundation (ECF) was pleased to co-host a side event entitled Empowered Women, Transformed Generations: The Global Impact of Maternal Nutrition alongside the Children’s Investment Fund Foundation (CIFF) with support from the Gates Foundation and Kirk Humanitarian.  During a discussion moderated by Shawn Baker, Chief Programme Officer at Helen Keller Intl, government leaders from Côte d’Ivoire, Ethiopia, Ghana, Nepal and Uganda shared their experiences on tackling maternal malnutrition through multiple micronutrient supplementation (MMS). 

Scaling-up MMS: a journey of conviction

What have we learnt so far about how to roll out MMS, and its impact on maternal and newborn nutritional health? 

• The first take-away from the panel discussion is that there is clear excitement and momentum around MMS. Countries are actively taking steps for transitioning to or introducing MMS, conducting research, developing costed roadmaps for transition, updating health protocols or essential medicines lists.
• Scaling-up MMS has proven a cost-effective way to address malnutrition and improve antenatal programmes. This helps make the case for investment with key stakeholders as well as reassuring expectant mothers in following guidelines on the recommended dose.
• Successful roll-out of MMS also depends on capacity and coordination across local, regional and national levels - including integration of MMS in antenatal care and, where appropriate or cost-effective, enabling local production.
• In addition, implementation involves long-term, fully-costed planning to anticipate challenges and facilitate resource mapping of domestic and external financial support.
• Faced with these challenges, coordinated and sustainable support from international partners remains essential especially in the short-term, especially faced with the current challenging political and financial contexts for investment in health and human development. 

These points are developed in more detail by the panellists below.

Lessons learned from the field

Dr. Patricia Yoboue N’Goran-Theckly, Advisor and National Coordinator of the National Council for Nutrition and Food for the Government of Côte d’Ivoire, said that MMS is seen as an essential tool by the Ivorian government for continued efforts to address maternal malnutrition. Anemia in expectant mothers is the biggest cause of hemorrhaging and maternal mortality, as well as being strongly linked to preterm and low-weight births. MMS is now on Côte d’Ivoire’s essential medicines list, with the two-fold aim of prevention and treatment. However, one of the key challenges is reaching women early in their pregnancies, as well as acceptability - ensuring that women are not just provided with MMS, but are actively taking it. A multisectoral plan is essential to coordinating stakeholders and enabling primary health care services to look after women before, during and after their pregnancies.  

The importance of working together was also highlighted by Namukose Samalie, 

Assistant Commissioner at the Health Services and Nutrition Division in the Ugandan Ministry of Health. A strong coordination mechanism in Uganda includes different government and international stakeholders to provide evidence-based recommendations on the comparative advantage of MMS over Iron and Folic Acid (IFA) supplements, and for the introduction, integration and scaling-up of MMS. These recommendations are also supported by data on procurement and resource mobilisation mapping. This approach helps to reassure senior leadership that MMS is cost-effective and impactful, and secure their buy-in. However, like in Côte d’Ivoire, it is seen as essential to anticipate and facilitate demand creation. Uptake of MMS is not just a question of supply, but of social behavior change.     

This perspective resonates with the experience of the Federal Democratic Republic of Ethiopia. Mrs Hiwot Darsene, Lead Executive Officer of the Nutrition Coordination Office at the Ministry of Health, explained that IFA is already free as part of the national antenatal care programme, but only 1 in 5 mothers take those supplements for 90 days. A pilot launched in 2022 enabled Ethiopia to provide MMS to 250,000 pregnant women and an additional 400,000 in emergency affected areas. The pilot also yielded essential data for research on uptake and evidence generation (supported by the London School of Hygiene & Tropical Medicine) to inform wider roll-out in the future. Findings include the importance of coordination between supply/procurement actors - in particular to stimulate production in local areas, if possible - as well as community perceptions to boost demand and compliance. Again, costed plans for MMS are essential to identify both the funding gaps and potential partners or funding solutions to respond to those gaps, such as ‘matching’ co-financing mechanisms.  

Dr. Bibek Kumar Lal, Director of Family Welfare Division at the Department of Health Services in Nepal, described MMS as a potential ‘game-changer’ given a levelling-out of progress on maternal and newborn health through other interventions. Having clear data to demonstrate the impact of MMS for public health interventions is essential, given the fact that public policy is always led by science in Nepal. The question of cost is also central. Making the switch from IFA to MMS must be cost-neutral for both governments and the end-user. To achieve this, all partners must be open to a variety of funding sources and mechanisms, such as subsidies, catalytic pool funding, or co-financing - even if the current climate makes additional domestic financing particularly challenging. Once again, landscape analysis to assess both the technical and social challenges to implementation is essential. In Nepal, this detailed planning will enable a much smoother roll-out, with all parties prepared for challenges or concerns that might be raised. 

Olivia Timpo, Deputy Director, Nutrition at the Ghana Health Service, explained that Ghana started introducing MMS in guidelines and protocols for antenatal clinics from last year, building on traditionally high rates of antenatal attendance (at least one antenatal visit for 98% of pregnant women; four visits for 88% of pregnant women) and IFA administration.  For Ghana, therefore, the key learning point so far is to anticipate successful demand from the outset, and ensure supply meets that demand with no time delays.  Local production must be assessed in supply chains. In parallel, it is important to invest in stock management systems in the demand-supply balance to avoid expired products and wastage.

MMS: a roadmap toward empowering women and transforming generations

The Eleanor Crook Foundation and CIFF are grateful to country partner panelists for presenting some of the lessons learned on their journey to scaling up MMS and improving maternal nutrition worldwide. Their testimony is an optimistic reminder of what can be achieved, collectively, by bringing together technical solutions, political will, and funding. ECF continues to investigate partnerships and opportunities to support the growing movement of countries interested in bringing MMS to scale. As announced during our event in Paris, we are calling on other public and private donors to join us in supporting a roadmap to reach 260 million women by 2030 mobilizing $1 billion by the UN General Assembly in September 2025. ECF and our partners are determined to seize this moment to bring about the next child survival revolution and ensure that women and children everywhere can survive, and thrive.