Impact Evaluation of Food Fortification Programs

Neufeld, Lynnette M.; Friesen, Valerie M

doi:10.1016/b978-0-12-802861-2.00032-8

Cited by 7 publications

(2 citation statements)

References 38 publications

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“…Program impact evaluations should be guided by impact pathways, prioritizing impact assessment in programs with an appropriate design and implementation to substantially increase the quality of evidence. 80 Although the effectiveness of food fortification on nutrient intakes and nutrient status is largely established, there is still insufficient evidence of effectiveness on functional outcomes, including growth, cognitive development, morbidity, and mortality, especially in LMIC. 18 , 81 This is especially an issue, as much emphasis is currently being placed on the prevention of stunting.…”

Section: Resultsmentioning

confidence: 99%

Large-Scale Food Fortification and Biofortification in Low- and Middle-Income Countries: A Review of Programs, Trends, Challenges, and Evidence Gaps

et al. 2018

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In the last 17 years, large-scale food fortification initiatives have been reaching increasingly larger segments of populations in LMIC. Large-scale food fortification and biofortification should be part of other nutrition-specific and nutrition-sensitive efforts to prevent and control micronutrient deficiencies. There are remaining technical and food system challenges, especially in relation to improving coverage and quality of delivery and measuring progress of national programs.

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Section: Resultsmentioning

confidence: 99%

Large-Scale Food Fortification and Biofortification in Low- and Middle-Income Countries: A Review of Programs, Trends, Challenges, and Evidence Gaps

et al. 2018

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“…Taken together, a limitation of our study is the inability to link impact of LSFF to coverage and utilization data. Further evaluations of outcomes should be considered only where program design has been appropriate to context, and where coverage and compliance data would suggest that impact is possible and, as discussed above, where programs have been given reasonable time to mature (83).…”

Section: Discussionmentioning

confidence: 99%

Improved micronutrient status and health outcomes in low- and middle-income countries following large-scale fortification: evidence from a systematic review and meta-analysis

Keats

Neufeld

Garrett

et al. 2019

The American Journal of Clinical Nutrition

143

138

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Background Micronutrient malnutrition is highly prevalent in low- and middle-income countries (LMICs) and disproportionately affects women and children. Although the effectiveness of large-scale food fortification (LSFF) of staple foods to prevent micronutrient deficiencies in high-income settings has been demonstrated, its effectiveness in LMICs is less well characterized. This is important as food consumption patterns, potential food vehicles, and therefore potential for impact may vary substantially in these contexts. Objectives The aim of this study was to determine the real-world impact of LSFF with key micronutrients (vitamin A, iodine, iron, folic acid) on improving micronutrient status and functional health outcomes in LMICs. Methods All applicable published/unpublished evidence was systematically retrieved and analyzed. Studies were not restricted by age or sex. Meta-analyses were performed for quantitative outcomes and results were presented as summary RRs, ORs, or standardized mean differences (SMDs) with 95% CIs. Results LSFF increased serum micronutrient concentrations in several populations and demonstrated a positive impact on functional outcomes, including a 34% reduction in anemia (RR: 0.66; 95% CI: 0.59, 0.74), a 74% reduction in the odds of goiter (OR: 0.26; 95% CI: 0.16, 0.43), and a 41% reduction in the odds of neural tube defects (OR: 0.59; 95% CI: 0.49, 0.70). Additionally, we found that LSFF with vitamin A could protect nearly 3 million children per year from vitamin A deficiency. We noted an age-specific effect of fortification, with women (aged >18 y) attaining greater benefit than children, who may consume smaller quantities of fortified staple foods. Several programmatic/implementation factors were also reviewed that may facilitate or limit program potential. Conclusions Measurable improvements in the micronutrient and health status of women and children are possible with LSFF. However, context and implementation factors are important when assessing programmatic sustainability and impact, and data on these are quite limited in LMIC studies.

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The importance and status of the micronutrient selenium in South Africa: a review

Takata

Myburgh

Botha

et al. 2021

Environ Geochem Health

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Impact Evaluation of Food Fortification Programs

Cited by 7 publications

References 38 publications

Large-Scale Food Fortification and Biofortification in Low- and Middle-Income Countries: A Review of Programs, Trends, Challenges, and Evidence Gaps

Large-Scale Food Fortification and Biofortification in Low- and Middle-Income Countries: A Review of Programs, Trends, Challenges, and Evidence Gaps

Improved micronutrient status and health outcomes in low- and middle-income countries following large-scale fortification: evidence from a systematic review and meta-analysis

The importance and status of the micronutrient selenium in South Africa: a review

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