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Question arising from the ENN webinar:

This question was posted the Adolescent nutrition forum area and has 1 replies.

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Stephanie Wrottesley

Emergency Nutrition Network

Forum moderator

3 Mar 2021, 10:10

Could you highlight what the key motivations have been for countries to take up multiple micronutrient supplementation for adolescent nutrition, as well as the key barriers to multiple micronutrient supplementation uptake in countries which have not been able to upscale it?

Emily Keats

Senior research associate

Technical expert

4 Mar 2021, 16:15

Hi Stephanie,

It's a really good question. The latest research on multiple micronutrient supplementation (MMS) demonstrates improved birth outcomes, including babies born low birthweight, small-for-gestational age (SGA), and preterm, among women of reproductive age who take MMS when compared to iron folic acid (IFA). The 2019 Cochrane review that showed this included adolescents. Our group has looked specifically at the adolescent population (10-19 years) using an individual participant data meta-analysis approach and confirmed these findings, noting that effects of MMS did not differ between adolescents and older women except for SGA, which potentially benefited adolescents more - this manuscript is currently in press at Nutrition Reviews. Given the high burden of adolescent births and nutritional deficiencies in low- and middle-income countries in particular, it will be critical to ensure supplementation among this population. It is beneficial that channels for IFA distribution are already in place. Some barriers to uptake include the higher cost of MMS vs. IFA tablets, though cost-effectiveness analyses have shown that MMS is quite cost-effective. The following paper is a good overview of current evidence and guidance, including costs: Bourassa MW et al. Review of the evidence regarding the use of antenatalmultiple micronutrient supplementation in low- andmiddle-income countries. Ann. N.Y. Acad. Sci., 2019. 

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