The Case for Promoting Multiple Vitamin And Mineral Supplements for Women of Reproductive Age in Developing Countries

Women in developing countries often consume inadequate amounts of micronutrients because of their limited intake of animal products, fruits, vegetables, and fortified foods. Intakes of micronutrients less than the recommended values increase a woman's risk of having micronutrient deficiencies. the adverse effects of deficiencies in vitamin A, iron, and folic acid, including night-blindness in pregnant and lactating women and iron-deficiency anaemia, are well known. Low intakes of these and other nutrients, including zinc, calcium, riboflavin, vitamin B 6 , and vitamin B 12 , also have consequences for women's health, pregnancy outcome, and the health and nutritional status of breastfed children. Multiple deficiencies coexist, so the benefit of multiple micronutrient supplements is becoming increasingly apparent. Supplementation of women with multiple vitamins and minerals should be one component of a strategy to improve micronutrient status among women in developing countries. However, there are several issues for programme managers to consider before implementing programmes. Which reference standards will be used to determine nutrient levels to include in the supplements? Which nutrients will be included and in what quantities? Which factors need to be considered in purchasing supplements? These issues are discussed, and guidance is provided on the selection of appropriate supplements for pregnant women and women of reproductive age in developing countries.