In a developing country like Pakistan, maternal nutrition remains a persistent challenge that continues to affect the lives and well-being of women and children. Maternal nutrition includes the nutritional needs of women before, during and after pregnancy, and can extend as early as adolescence in contexts where early childbearing occurs. Despite progress, the issue of maternal nutrition in Pakistan has been slow to improve, with significant negative effects on women's health and well-being, as well as on children's growth and development.
Maternal nutrition indicators remain poor, with a triple burden of malnutrition including undernutrition, overweight and obesity, and micronutrient deficiencies. The National Nutrition Survey (NNS) 2018 confirms that macro and micronutrient deficiencies are alarming in women of reproductive age. 14.4% are underweight, 24% are overweight, and 13.8% are obese. A high prevalence of anemia (41.7%) and Vitamin A deficiency (22.4%) has also been observed. These high rates of undernutrition and micronutrient deficiencies among women of reproductive age indicate a vicious cycle of malnutrition in the country.
Maternal nutrition is crucial for mother and child health. Children of malnourished women are at a higher risk of cognitive impairments, short stature, lower resistance to infections, and a higher risk of disease and death throughout their lives, as well as physical disabilities leading to dire economic consequences.
Maternal nutrition and breastfeeding behaviours, alongside children being underweight, wasted, or suffering from micronutrient deficiencies, are linked to approximately 177,000 deaths annually in Pakistan, which corresponds to more than one-third of all child mortality in the country. This lost future workforce is valued at US$2.24 billion per year. Additionally, projections indicate that anemia among adult women engaged in agriculture, industry, and other manual labour lowers their economic output by US$657 million per year.
Maternal nutrition and breastfeeding behaviours, alongside children being underweight, wasted, or suffering from micronutrient deficiencies, are linked to approximately 177,000 deaths annually in Pakistan
In this regard, the Pakistan Maternal Nutrition Strategy 2022-2027 aims to prevent all forms of malnutrition among women during the preconception, pregnancy, and postpartum stages of nutritional vulnerability. This strategy aligns with global recommendations, including those from the World Health Organization (WHO), which emphasize the importance of micronutrient supplementation, particularly Maternal Multiple Micronutrient Supplements (MMS), containing 13–15 micronutrients, including iron and folic acid, for pregnant women and adolescents. WHO’s updated antenatal care guidelines from 2020 and 2021 highlight MMS as a crucial intervention to improve maternal nutrition during pregnancy.
Global evidence has also shown that MMS is more effective than iron and folic acid supplementation alone in improving birth outcomes, while also providing equivalent benefits in preventing maternal anemia. Moreover, recent research has revealed that MMS is a cost-effective solution that can be widely implemented in food-insecure areas and households to combat the alarming rates of undernutrition in Pakistan and other developing countries.
National-level efforts are underway to establish the groundwork and pave the way to scale up MMS provision. However, despite its significance and urgent need, achieving full coverage across all districts remains a challenge. At present, 9 million MMS are needed to meet the demand, but unfortunately, only 2.3 million are available, which will cover only 32 out of 166 districts in Pakistan. Moreover, MMS is only been distributed through donations till now since federal and provincial governments have not allocated any funds for MMS provision implementing related policies is a significant challenge. Although MMS is included in the Essential Drug List (EDL), the absence of local production is a serious concern for the sustainable supply of MMS.
In response to these challenges, the Forum for Women Development and Research (FWDR) has recently conducted a National Dialogue titled ‘Enhancing the Coverage and Sustainable Access to Micronutrient Supplements for Women in Pakistan’ on February 25, 2025. This dialogue brought together key stakeholders, including representatives from the Ministry of National Health Services, Regulations & Coordination (MoNHSR&C), UNICEF, Nutrition International (NI), the World Health Organization (WHO), PHC Global, Junaid Family Foundation (JFF), Benazir Income Support Programme (BISP) and other partners, to discuss the challenges and solutions for scaling up MMS in Pakistan.
This dialogue has ignited a powerful call to action to ensure every pregnant woman in Pakistan has access to MMS by eliminating physical, social, and financial barriers. Stakeholders are committed to advocating for government policies that prioritize MMS, developing a robust monitoring system, and fostering collaboration among the government, development partners, and community organizations. Efforts will also focus on raising awareness, empowering communities, and stimulating local production to meet growing demand sustainably.
Only by following through on these commitments can we ensure that our mothers are nourished and our children are secured for a healthier future.