Strengthening communities from the inside out
In Pakistan, Multiple Micronutrient Supplements are transforming the health of mothers – and their children.
Rozan remembers how she used to feel when she was pregnant. After long days working in the fields, she would come home to look after her family and take care of the house. But she felt weak, low on energy, and unable to do even simple household tasks. Rozan’s first four children had all been born with low birthweight and she was fearful the same fate awaited her unborn baby.
“I used to feel dizzy and have full body aches,” Rozan says. “I didn’t feel like doing the household chores.”
However, a routine visit from a Lady Health Worker during Rozan’s third trimester transformed the future of both mother and child.
Roshan serves the Thatta community in Sindh Province as a Lady Health Worker – female health workers who have received training in basic first aid and healthcare guidance and who conduct community-based health interventions, particularly in remote areas. Last year, Roshan started distributing Multiple Micronutrient Supplements (MMS) as part of a package of essential nutrition services for women in the community.
MMS contain 15 vitamins and minerals proven to boost the health of pregnant women, breastfeeding mothers, and their babies, while also helping to reduce low birthweight, stillbirth, and pre-term birth. It’s most effective when taken as part of an adequately nutritious diet and as part of a range of services, including nutrition education, healthy weight gain monitoring, nutrition screenings and regular antenatal checkups.
“I discussed [how I was feeling] with the Lady Health Worker, and she advised me to take MMS,” Rozan says. “I have two bites of my food, then I take the tablet with water, and then I finish my meal.”
Now, clutching her one-week-old baby boy, Rozan beams proudly as she announces that Zameer was her first child to weigh more than 3 kg at birth, compared to less than 2 kg for her other children.
Rozan, who was born deaf and communicates with her family using sign language, adds that she also gained 7 kg in the last three months of her pregnancy.
“MMS has had a huge impact,” explains Roshan, who has distributed the tablets to more than 300 women in the city of Thatta over the last few months.
“Before they had access to these tablets, a lot of women were losing their babies, or the babies would die after birth. Many would have low birthweight,” Roshan says. “Now that’s not happening. I’ve seen a positive impact in at least 35 women in this village alone.”
Rozan’s home, in the rural village of Ramzan Mallah, Thatta, was badly damaged by the catastrophic floods that affected much of Pakistan in 2022 and which exacerbated the poverty, poor access to services and food insecurity that so many in the province already faced. But even before the recent climate-related and economic hardships that have impacted many communities, Pakistan had one of the highest burdens of low birthweight. Children experiencing low birthweight are more likely to die during their first month of life, while those who survive face lifelong consequences including a higher risk of stunted growth.
As part of a campaign led by UNICEF and the Ministry of National Health Services, Regulation and Coordination to reach 2 million women with MMS in Pakistan, many of Pakistan’s network of Lady Health Workers were trained on the benefits of taking the supplements. Roshan now routinely administers MMS to pregnant and breastfeeding women while also providing advice on the benefits of breastfeeding and infant feeding practices, as well as supporting screenings for malnutrition.
“If they were sceptical, I counselled them. I know many of the women from previous polio and family planning campaigns, so they trust me,” Roshan says. “I told them MMS has more vital minerals and vitamins than just iron and folic acid, that it’s more beneficial. Now they’re less weak, have less back and knee pain, and they’re stronger.”
“Seeing healthy babies being born and not dying – that’s the most rewarding part for me.”
This work has been made possible with the generous in-kind donation from the Junaid Family Foundation and Kirk Humanitarian.
