Going Against the Grain of Optimism: Flour Fortification in Pakistan

Abstract

Food fortification is a popular strategy for addressing 'hidden hunger', and staple foods are seen as promising, if unproven, vehicles for the delivery of essential micronutrients to poor people in developing countries. This article examines wheat flour fortification with iron in Pakistan as a case of technocratic optimism in the face of institutional constraints. An evaluative framework based on the analysis of entire value chains can provide a reality check on technocratic optimism. We find that poor people based their preferences for different types of flour on price as well as perceptions of nutritional value. Many of these flour types are not covered by fortification programmes. Fortification interventions, meanwhile, have attempted to leverage public-private partnerships in a segment of the wheat flour value chain which is beset with regulatory weakness. This article illustrates why technical interventions should support rather than ignore a broader agenda of reforms in food policy.

Viewpoint: Agri-nutrition research: Revisiting the contribution of maize and wheat to human nutrition and health

“…Programmes of biofortification of seed varieties and industrial fortification of processed products are proven and should be continued, accompanied by efforts to integrate biofortification into public and private policies, programmes, and investments, and to evaluate and enhance consumer uptake ( Bouis and Saltzman, 2017 , Bouis, 2018 ). Similarly, programmes of industrial fortification of cereal products should be expanded, considering how to overcome the obstacles to fortification programmes where flour is derived from local milling rather than industrial-scale processing ( Ansari et al, 2018 , Poole et al, 2020 ).…”

Value Chains and Diet Quality: A Review of Impact Pathways and Intervention Strategies

“…Increase the availability of a key micronutrient though fortification Bio-fortification of whole foods through new crop varieties Bio-fortified orange-fleshed sweet potato to address vitamin A deficiency [63]. Bio-fortified iron beans [20] Mandatory industrial fortification of a food commodity National Wheat Flour Fortification Programme in Pakistan [82] Voluntary industrial fortification of a processed food product Iron-fortified glucose biscuits in India [61]. Iron-fortified yogurt in Senegal [64] Increase the availability of nutritious whole food Household and community production of fruits, vegetables and livestock products Home gardening programs in Bangladesh [57].…”

“…In some countries, mandatory vitamin and mineral fortification requirements exist for bread and other widely consumed processed foods. Ansari et al [82] discuss the national wheat flour fortification programme in Pakistan, noting the potential for such programs to bypass vulnerable populations who may access food via informal value chains. There are also various examples of the voluntary fortification of processed food products, including breakfast cereals [61], yogurt [64], and sweet biscuits [72].…”

Biofortification of wheat with zinc for eliminating deficiency in Pakistan: study protocol for a cluster-randomised, double-blind, controlled effectiveness study (BIZIFED2)

“…Over 60% of Pakistan’s wheat harvest is retained by farmers for self-consumption or used as in-kind payments to labourers. 6 Most of this wheat is milled locally and not in the large industrial mills where flour fortification occurs.…”