How does a new multiple micronutrient supplement make a 13th pregnancy easier?
In this account, Josiane talks about the benefits of the new multiple micronutrient supplement for her pregnancy
Rasoarimanana Josiane, aged 40, arrives home after working all day in the fields under the sun. We are in the village of Anovo, in southern Madagascar. Josiane grows maize, sweet potatoes, cassava and peas. She is surrounded by her children, including her youngest, Natovolahy, her two-year-old son. Josiane is also pregnant for the thirteenth time. Yet, unlike during her previous twelve pregnancies, she does not return home exhausted.
With every pregnancy, Josiane attended regular antenatal check-ups and was given iron and folic acid. She gave birth without complications at the health centre. Yet she felt constantly tired. Even the simplest tasks, such as picking cassava leaves, quickly exhausted her.
Currently, for her thirteenth pregnancy, Josiane is taking a new product instead of iron and folic acid: a multiple micronutrient supplement (MMS), in addition to the usual health care she receives at health centres during her antenatal consults. This product is provided by UNICEF and its partners, with funding from Mohammed Bin Rashid Al Maktoum Global Initiatives (MBRGI) and the Child Nutrition Fund (CNF). Josiane takes one tablet every evening. She has not noticed any difference in taste or smell compared to the iron and folic acid she used to take. But the effects on her body are very different.
“Since I’ve been taking these multiple micronutrient tablets, I’ve had a much better appetite and I feel stronger,” she explains. “I can now work in the fields even during my pregnancy.”
At every antenatal appointment, she is weighed and told that her weight gain is within the normal range. She feels well looked after and in good health. Josiane concludes that the vitamins and minerals provide her with extra support that she didn’t have during her previous twelve pregnancies. She also follows the dietary advice provided by her midwife during her antenatal appointments: she increases her intake of rice, maize, fish, pulses, leafy greens and fruit. Her husband, aware of the challenges of feeding a large family, encourages her every evening to take her tablet.
“He knows we’re struggling to find enough nourishing food and that this supplement can help meet my increased nutritional needs and support both my health and our child’s healthy growth.”
During this pregnancy, Josiane is being cared for by her mother and mother-in-law, who sometimes prepare special meals for her and encourage her to follow all the advice given to her. Thanks to the commitment of various stakeholders, the use of multiple micronutrient supplements among pregnant women is now becoming more widespread in Madagascar.
In the village, Josiane shares her experience with her pregnant friends. “We all have a lot of children and our bodies have used up a lot of vitamins because of our frequent, closely spaced pregnancies,” she explains. “These tablets are good for our health and for that of our babies.” Thanks to this new multiple micronutrient supplement, Josiane is experiencing her thirteenth pregnancy with more energy, less tiredness and a sense of calm she has never felt before.
