Oyo State in south-western Nigeria has launched a statewide multiple micronutrient supplementation programme for pregnant women, targeting around 160,000 women a month across all 33 local government areas, in partnership with the non-profit Evidence Action. The programme distributes a single daily tablet combining iron, folic acid and 13 other vitamins and minerals through antenatal care at government health facilities, replacing the standard iron-folic acid tablet with a broader formulation that evidence from clinical trials shows further reduces complications during pregnancy.
National estimates put anaemia among pregnant women in Nigeria at around 45 percent as of 2023, a level that raises risks of low birthweight, maternal complications and impaired child development. Evidence from trials of multiple micronutrient supplementation elsewhere has shown it reduces low birthweight by 12 percent and stillbirths by 8 percent compared with iron-folic acid supplementation alone, the basis for Oyo’s decision to switch its antenatal programme to the broader formulation statewide rather than continuing with the narrower standard tablet.
Built on an earlier pilot
Oluwaserimi Ajetunmobi, Oyo State’s commissioner for health, said the state prioritises the health of mothers and newborns in explaining the rollout. The expansion follows a smaller feasibility pilot run in 2024 across Oyo State and Nigeria’s Federal Capital Territory, which tested distribution logistics and health worker training before the state committed to scaling the programme statewide this year, after reviewing uptake and adherence data from the pilot sites.
Muideen Olatunji, executive secretary of the Oyo State Primary Health Care Board, is overseeing implementation alongside Evidence Action, whose south-west regional manager, Maryann Edeh, represented the organisation at the programme’s public launch. The state has recruited additional health workers across its 33 local government areas specifically to support distribution and monitoring, alongside training for antenatal care staff, nutrition counselling for pregnant women and a referral pathway for women found to have severe anaemia requiring treatment beyond supplementation.
Funding beyond the pilot remains the challenge
Oyo officials say the state is working to establish a dedicated nutrition budget line to keep the supplement supply chain funded beyond the initial rollout period, addressing a common failure point for health programmes in Nigeria’s states, where federal or donor-funded pilots frequently struggle to secure sustained state financing once initial grants expire. The state has separately worked with UNICEF and US-backed partners on a related malnutrition prevention programme covering 20 local government areas, part of a wider cluster of nutrition initiatives the state is trying to coordinate rather than run as isolated, donor-specific projects.
The Oyo rollout is one of several moves across the Global South this month aimed at tackling diet-related health gaps through policy rather than treatment alone, alongside a separate push in Bangladesh for mandatory warning labels on unhealthy packaged foods.
Nigeria’s federal government has separately promoted fortified rice and other staple foods as a parallel strategy against micronutrient deficiencies, though state-level programmes such as Oyo’s remain central to reaching pregnant women specifically, since fortified staples alone do not close the gap for women with elevated iron needs during pregnancy and the months immediately after childbirth.
The World Health Organization has recommended multiple micronutrient supplementation as an alternative to standard iron-folic acid tablets in antenatal care since updating its guidance in recent years, prompting a wave of pilot programmes across sub-Saharan Africa and South Asia as governments and donors weigh whether to scale the approach nationally. Oyo’s statewide rollout is among the largest sub-national programmes of its kind to move from pilot to full implementation so far, and health officials elsewhere in Nigeria say they are watching its progress closely before deciding whether to replicate it in their own states.
