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May 15, 2026BMJ Global HealthOpen Access

Costs and benefits of replacing preventive antenatal iron and folic acid with multiple micronutrients in 25 low- and middle-income countries

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Authors

JHJohn HoddinottCornell UniversityCAClayton AjelloHumanitarian InstituteRBRobert E BlackJohns Hopkins University

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Implication

Randomized trial demonstrates significant health benefits from multiple micronutrient supplements in low-income countries, implying cost-effective interventions for maternal and infant health.

Key Points

  • This research assesses the economic and health benefits of replacing iron-folic acid supplementation with multiple micronutrient supplements during pregnancy in low- and middle-income countries.
  • Estimated benefits of replacing IFA with MMS using new cost data in 25 LMICs.
  • Calculated averted low birth weights, stillbirths, and neonatal deaths over 5 years.
  • Explored different coverage and procurement cost scenarios.
  • Replacing IFA with MMS could avert 3,514,594 LBW births, 186,369 stillbirths, and 218,914 female neonatal deaths over 5 years.
  • The cost for replacing IFA with MMS ranges from $201.8 million to $1.326 billion, equating to 0.5%-3.0% of current spending on undernutrition reduction.
  • The most conservative estimates suggest generating $7.19 billion in economic returns with a benefit-cost ratio greater than 10.

Cite This Study

Hoddinott et al. (2026) studied this question.

synapsesocial.com/papers/6a06b8f8e7dec685947ab757https://doi.org/10.1136/bmjgh-2025-020597
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