By Roy Mwangi

The Hidden Toll of Malnutrition in Pregnancy

Did you know that undernourished women are more likely to develop serious complications during pregnancy and childbirth? For example, anaemia caused by iron deficiency affects pregnant women globally and can have negative health outcomes for both mother and child. Malnourished mothers give birth to malnourished children, creating a cycle that impacts health and economic well-being across communities and generations.

This reality is exactly what 36-year-old Rose Mutulu-Mutinda experienced with her first two pregnancies. When she walked into Kitui County Referral Hospital for her first prenatal care visit with her third pregnancy, she did not expect that a small bottle of supplements would dramatically change her experience of motherhood.

Nurse Terry Musangi John hands UNIMMAP multiple micronutrient supplements to Sharon Mwikali, an expectant mother.

One Mother’s Story: “I Was Always Sick”

“With my first and second pregnancies, I was always sick,” she recalls. “But with my thirdborn, I hardly got sick. I didn’t even bleed much during delivery. The only thing I did differently was taking these supplements.” That difference came down to one simple addition to her prenatal care: a daily supplement containing 15 essential vitamins and minerals.

A Simple Addition That Changes Everything

The supplements she refers to are UNIMMAP Multiple Micronutrient Supplements (MMS), a life-saving nutritional intervention distributed by CMMB Kenya through the Access to Medicines Program in partnership with targeted county ministries of health. These supplements, commonly known as prenatal vitamins, are a specifically formulated bundle of 15 vitamins and minerals in recommended doses. The initiative aims to improve maternal nutrition by giving pregnant and breastfeeding mothers essential vitamins and minerals to support healthy pregnancies and safer births. According to the 2022 Kenya Demographic and Health Survey, more than half of pregnant women in Kenya are anaemic, and vitamin deficiencies contribute to complications like low birth weight and preterm deliveries.

Before the UNIMMAP MMS donation, facilities such as the Kitui County Referral Hospital often struggled to maintain a consistent supply of maternal supplements, especially critically important anaemia-fighting supplements.

“Before receiving the supplements, we frequently experienced stockouts of Iron and Folic Acid Supplement (IFAS) tablets,” explains Dr Jackson Munyaka, the hospital’s pharmacist-in-charge. “Sometimes we face delays, which leave mothers without essential supplements for weeks.”

A Timely Donation, A Steady Supply

In August 2024, CMMB, in partnership with Kirk Humanitarian through the Access to Medicines Program, stepped in with a timely consignment of UNIMMAP MMS, ensuring a steady supply across maternal and child health (MCH) departments.

“Since receiving the donation, we’ve not had any stockouts,” Dr Munyaka says. “Every mother who comes for her first clinic visit is initiated on MMS, and we’re seeing more mothers returning for refills. It has really improved the delivery service.”

The pharmacy team now conducts weekly stock counts and redistributes MMS to smaller health centres where women commonly seek antenatal care with logistical support from CMMB Kenya. “We even get help from other counties through CMMB Kenya when stocks run low,” he adds, emphasising how the program has strengthened inter-county collaboration.

Healthier Mothers, Stronger Babies: What the Data Shows

A steady supply is one thing. But what do those supplements actually do for mothers and babies? Nurse Terry Musangi-John sees the answer every day. At the heart of the hospital’s Maternal and Child Health department, Nurse Terry Musangi-John has witnessed firsthand how UNIMMAP MMS is transforming maternal health outcomes.

“We’ve seen significant improvement in haemoglobin levels,” she says enthusiastically. “When mothers come for their first antenatal clinic, we test their blood, and by 34 weeks, their levels have risen remarkably. It’s a huge win for us.”

The benefits extend beyond the mothers. “We’re seeing fewer cases of low birth weight, reduced premature births, and fewer anaemic newborns,” she adds. “Even in our under-five clinics, the children are healthier. The difference is clear.”

Musangi-John also notes that the program has strengthened coordination among departments. “Our nutritionists and community health promoters have less workload because mothers are now better informed about the importance of supplements. They even teach their relatives and friends. At the end of the day, we want a healthy Kitui County, and this program is helping us get there.”

 A Lifeline for Mothers

For mothers like Rose, the supplements have been more than just tablets; they have  been a lifeline.

“I’m grateful to the doctors and CMMB Kenya because I didn’t have to buy the supplements with my limited income,” she says. “I just go for refills. My baby was born healthy, and I didn’t get sick during pregnancy.”

Her story mirrors that of thousands of women across Kitui, Machakos, Makueni, Nairobi, Mombasa, Kwale, Siaya, Homabay, Migori, and Nyamira Counties who now have access to quality nutritional support, free of charge.

Overcoming Small Hurdles With Education

While challenges like packaging preferences and initial nausea persist among some mothers, health workers have learned to address them through education and reassurance.

“We explain why each mineral in the supplement is important; once mothers understand that it’s for their health and their baby’s well-being, they become very receptive.” Musangi-John shares.

Building Trust Through Reliability

For Dr Munyaka and his team, the success of the program lies in one key outcome — reliability. “Since August 2024, every mother has received supplements at her first clinic. That consistency builds trust,” he affirms. That trust is not accidental. It is the result of a carefully built partnership between local health workers, county governments, and international donors.

A Partnership That Works Across 10 Counties

Through partnerships and persistence, the UNIMMAP MMS program has proved that improving maternal nutrition is not only achievable but also sustainable.

By addressing supply chain challenges, empowering healthcare providers, and providing free access to supplements, CMMB Kenya is helping shape a healthier generation, one mother and one child at a time.

“It’s fulfilling. Seeing fewer maternal deaths, healthier babies, and happier mothers reminds us why we do what we do,” says Nurse Musangi-John.

And for Rose, holding her healthy baby in her arms is proof enough. “These medicines helped me a lot,” she says with a smile. “My third-born is strong, and so am I.”

CMMB’s global Access to Medicines Program, in partnership with pharmaceutical companies and Kirk Humanitarian, delivered medicines and supplies valued at $278.9 million to 32 countries, including Kenya, in fiscal year 2024, ensuring that frontline providers had what they needed to care for their communities, including more than 3 million bottles of prenatal vitamins.