Can fortification be implemented in rural African communities where micronutrient deficiencies are greatest? Lessons from Projects in Malawi, Senegal and Tanzania Authors

Fortifying commonly eaten foods with vitamins and minerals is a recognized, effective strategy for decreasing micronutrient deficiencies at a population level. National fortification initiatives often do not impact remote communities who may be unreached by commercially produced food. In this paper, we review the innovative implementation of community based fortification of staple grains in rural communities in three Sub-Saharan African countries. Strong advocacy influenced national policy and the legislation for mandatory national level fortification of staple grains, while piloting community based fortification led to community acceptance of the benefit of consuming fortified foods. Further work is needed to determine contextually feasible and sustainable mechanisms for premix supply, quality control and cost-recovery. Incorporating this work into national fortification frameworks is recommended for countries where a significant proportion of the population may have very limited access to commercially fortified foods.