Medium-scale fortification: a sustainable food-based approach to improve diets and raise nutrition levels.

Abstract

This chapter examines the success and sustainability potential of medium-scale fortification (MSF) and small-scale fortification (SSF) to increase rural access to and usage of fortified flours within the Canadian International Development Agency (CIDA)-funded Micronutrient and Health (MICAH) Programme in Malawi. World Vision implemented the MICAH programme (1996-2005) to address anaemia and micronutrient malnutrition of women and children in Malawi. MICAH consisted of a package of community-based multi-sectoral interventions implemented with multiple partners. SSF and MSF of maize flour consumed by the general population, and a specially formulated local complementary food (likuni phala), were part of an anaemia control package that also included small animal production and consumption, backyard gardens, community-based iron supplementation, deworming of children and malaria control. Project evaluations provided strong evidence of impact over the 9 years of implementation. For example: anaemia in children under 5 years decreased from 86% (1996) to 60% (2004); anaemia in non-pregnant women decreased from 51% (2000) to 39% (2004). The Domasi Fortification Unit, the MSF operation initiated by MICAH, has continued (to date, 2010) as a self-sustaining, fully commercialized producer of fortified foods, supplying other fortification units and feeding programmes throughout Malawi. Linking SSF sites with MSF operations is a promising approach to successful scale up and sustainability of community-based fortification.

Relatório sobre a nutrição mundial 2015 Iniciativas e responsabilização para o progresso da nutrição e desenvolvimento sustentável

“…Essas atuações podem ter implicações positivas e negativas sobre a mesma. Um exemplo disto são os estudos de caso revisados por pares que mostram que empresas locais de pequeno e médio porte ajudam a aumentar o acesso a alimentos enriquecidos localmente 1 (Nwuneli et al, 2014;Piccoli et al, 2012;Yiannakis et al, 2014), embora haja muitas questões a superar para assegurar a sustentabilidade deste mercado (Humphrey e Robinson, 2015). Já outras atividades empresariais são negativas.…”