26 May 2026 – A new study published in BMJ Global Health, “Costs and benefits of replacing preventive antenatal iron and folic acid with multiple micronutrients in 25 low- and middle-income countries,” examines the health and economic impact of replacing preventive iron-folic acid (IFA) supplements with multiple micronutrient supplementation (MMS) in countries with the highest burden of low birthweight (LBW).
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Maternal undernutrition remains a critical challenge in low- and middle-income countries (LMICs), contributing to high rates of LBW, stillbirths, and neonatal deaths. Although IFA supplementation during pregnancy has long been the standard intervention in many LMICs, emerging evidence indicates that MMS provides greater benefits for both mothers and newborns.
Using updated 2025 procurement cost data and modeling different costing and coverage scenarios, the study demonstrates that MMS could prevent millions of adverse birth outcomes and deliver substantial economic returns. Findings show that 7,272,320 LBW births, 473,471 stillbirths, and 541,591 newborn deaths could be averted over five years if MMS reached all pregnant women who made at least one antenatal care (ANC) visit (84% coverage). MMS is highly cost-effective, with benefit–cost ratios ranging from 11 to over 200, depending on the coverage scenario and the value of statistical life used. The study also highlights that commitments in advance to purchase at scale
This paper calls for policy integration, ANC strengthening, and sustainable financing to scale up MMS as a high-impact intervention to improve maternal and newborn outcomes globally.