The assessment examined financing capacity, demand patterns, supply systems and implementation readiness across six states.
Lagos and Kano have emerged as the most prepared states for the large-scale rollout of Multiple Micronutrient Supplements (MMS) for pregnant women in Nigeria, according to a new market landscaping and segmentation study.
The assessment examined financing capacity, demand patterns, supply systems and implementation readiness across six states.
Presenting the findings in Abuja on Thursday, Stanley Ukpai, Director of Projects at the development Research and Projects Centre (dRPC), said both states were classified as Tier One because of strong antenatal care (ANC) utilisation, health system capacity, financing commitments, and logistics readiness.
He explained that while both states ranked highest, their strengths reflected very different health system structures.
In Lagos, the researchers found that readiness for scale-up is driven largely by a strong private-sector health system and high utilisation of antenatal care services.
Private facilities account for 82.5 per cent of health service delivery in the state, making Lagos the most privately driven maternal health market among the six states assessed.
The study noted that this structure, combined with a dense network of health facilities and well-developed logistics systems, positions the state for rapid MMS expansion.
Kano’s ranking, on the other hand, is anchored in a dominant public health system and strong government commitment to maternal nutrition.
Primary healthcare centres (PHCs) account for 75.6 per cent of health facilities in the state, reflecting reliance on public service delivery for maternal health care.
Despite this, Kano matched Lagos in readiness due to sustained political commitment and significant public financing for nutrition interventions.
The state is the only one among those assessed with explicit budget lines for both Iron-Folic Acid (IFA) and MMS.
It also recorded ₦500 million in co-financing under the Community and Nutrition Financing mechanism, alongside N144 million earmarked specifically for MMS procurement.
Beyond Lagos and Kano, the study classified Bauchi and Imo as Tier Two states. At the same time, Niger and Bayelsa were placed in Tier Three due to structural and geographic constraints affecting service delivery.
Bauchi recorded the highest PHC dominance at 93.7 per cent, but was limited by low antenatal care coverage and dependence on donor-supported programmes.
Imo, with a 49.7 per cent PHC mix, showed a more balanced public-private system and relatively high ANC utilisation. Still, MMS access remains largely dependent on private pharmacies and retail distribution.
Niger State, with 81.2 per cent PHC dominance, faces insecurity, long travel distances and low ANC uptake, all of which limit effective supplementation coverage.
Bayelsa, with 60 per cent PHC coverage, is constrained by its riverine geography and recurring flooding, which disrupts supply chains and makes supplementation largely campaign-driven rather than routine.
The assessment, conducted in 2025, was led by the Federal Ministry of Health and Social Welfare through its Nutrition Department, in collaboration with Sight and Life and dRPC.
It covered Lagos, Kano, Bauchi, Imo, Niger and Bayelsa, using a mixed-methods approach guided by a market-shaping framework that examined both demand and supply-side factors.
In total, 162 stakeholders were interviewed, including government officials, health workers, development partners, HMOs, Patent and Proprietary Medicine Vendors, facility managers and pregnant women.
70 of the respondents were pregnant women across the six states and the Federal Capital Territory (FCT).
Seven million pregnancies, rising anaemia burden
Mr Ukpai said Nigeria’s maternal nutrition challenge is anchored in a large and persistent burden, with about seven million pregnancies recorded annually.
Drawing on the 2024 Nigeria Demographic and Health Survey (NDHS), he noted that maternal anaemia affects about 50 per cent of pregnant women, translating to roughly 3.5 million cases annually.
He said this dual burden highlights both a public health urgency and a significant market opportunity for maternal supplementation interventions.
Nigeria’s transition from IFA to MMS is supported by global evidence and recommendations from the World Health Organisation (WHO).
The federal government first endorsed MMS through a ministerial directive in 2021 and later reinforced the policy through the National MMS Roadmap 2025–2029.
The roadmap targets 40 per cent coverage in the initial phase and 60-70 per cent by 2039.
According to Mr Ukpai, MMS provides broader nutritional benefits and is generally better tolerated than IFA because it causes fewer side effects, including nausea.
However, he warned that successful scale-up would depend on sustainable financing, strong consumer demand and reliable supply systems.
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