scholarly journals Food Fortification: The Advantages, Disadvantages and Lessons from Sight and Life Programs

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1118
Author(s):  
Rebecca Olson ◽  
Breda Gavin-Smith ◽  
Chiara Ferraboschi ◽  
Klaus Kraemer
Keyword(s):  
Large Scale ◽  
Cost Effective ◽  
Economic Benefits ◽  
Cognitive Capacity ◽  
Nutritional Deficiencies ◽  
Food Fortification ◽  
Public And Private ◽  
Middle Income ◽  
Point Of Use ◽  
Public And Private Sector

Deficiencies in one or more micronutrients such as iron, zinc, and vitamin A are widespread in low- and middle-income countries and compromise the physical and cognitive capacity of millions of people. Food fortification is a cost-effective strategy with demonstrated health, economic and social benefits. Despite ongoing debates globally and in some countries regarding the performance and safety of food fortification, the practice offers significant benefits across each of the main vehicles for food fortification (large-scale food fortification, biofortification and point-of-use or home fortification) ranging from reducing the prevalence of nutritional deficiencies and economic benefits to societies and economies. Using Sight and Life’s global and national experiences in implementing food fortification efforts, we demonstrate how different programs in LMICs have successfully addressed challenges with food fortification and in doing so, find that these efforts are most successful when partnerships are formed that include the public and private sector as well as other parties that can provide support in key areas such as advocacy, management, capacity building, implementation and regulatory monitoring.

scholarly journals The Unfinished Agenda for Food Fortification in Low- and Middle-Income Countries: Quantifying Progress, Gaps and Potential Opportunities

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 354 ◽  
Author(s):  
Penjani Mkambula ◽  
Mduduzi N. N. Mbuya ◽  
Laura A. Rowe ◽  
Mawuli Sablah ◽  
Valerie M. Friesen ◽  
...  
Keyword(s):  
Data Exchange ◽  
Large Scale ◽  
Population Level ◽  
Cost Effective ◽  
Food Fortification ◽  
Maize Flour ◽  
Fortified Foods ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Coverage

Large-scale food fortification (LSFF) is a cost-effective intervention that is widely implemented, but there is scope to further increase its potential. To identify gaps and opportunities, we first accessed the Global Fortification Data Exchange (GFDx) to identify countries that could benefit from new fortification programs. Second, we aggregated Fortification Assessment Coverage Toolkit (FACT) survey data from 16 countries to ascertain LSFF coverage and gaps therein. Third, we extended our narrative review to assess current innovations. We identified 84 countries as good candidates for new LSFF programs. FACT data revealed that the potential of oil/ghee and salt fortification is not being met due mainly to low coverage of adequately fortified foods (quality). Wheat, rice and maize flour fortification have similar quality issues combined with lower coverage of the fortifiable food at population-level (<50%). A four-pronged strategy is needed to meet the unfinished agenda: first, establish new LSFF programs where warranted; second, systems innovations informed by implementation research to address coverage and quality gaps; third, advocacy to form new partnerships and resources, particularly with the private sector; and finally, exploration of new fortificants and vehicles (e.g. bouillon cubes; salt fortified with multiple nutrients) and other innovations that can address existing challenges.

scholarly journals BioLPG for Clean Cooking in Sub-Saharan Africa: Present and Future Feasibility of Technologies, Feedstocks, Enabling Conditions and Financing

Energies ◽  
2021 ◽  
Vol 14 (13) ◽  
pp. 3916
Author(s):  
Kimball C. Chen ◽  
Matthew Leach ◽  
Mairi J. Black ◽  
Meron Tesfamichael ◽  
Francis Kemausuor ◽  
...  
Keyword(s):  
Agricultural Waste ◽  
Sub Saharan Africa ◽  
Green Economy ◽  
Energy Access ◽  
Liquefied Petroleum Gas ◽  
Public And Private ◽  
Middle Income ◽  
Private Sector Investment ◽  
Sub Saharan ◽  
Public And Private Sector

Energy supply for clean cooking is a priority for Sub-Saharan Africa (SSA). Liquefied petroleum gas (LPG, i.e., propane or butane or a mixture of both) is an economically efficient, cooking energy solution used by over 2.5 billion people worldwide and scaled up in numerous low- and middle-income countries (LMICs). Investigation of the technical, policy, economic and physical requirements of producing LPG from renewable feedstocks (bioLPG) finds feasibility at scale in Africa. Biogas and syngas from the circular economic repurposing of municipal solid waste and agricultural waste can be used in two groundbreaking new chemical processes (Cool LPG or Integrated Hydropyrolysis and Hydroconversion (IH2)) to selectively produce bioLPG. Evidence about the nature and scale potential of bioLPG presented in this study justifies further investment in the development of bioLPG as a fuel that can make a major contribution toward enabling an SSA green economy and universal energy access. Techno-economic assessments of five potential projects from Ghana, Kenya and Rwanda illustrate what might be possible. BioLPG technology is in the early days of development, so normal technology piloting and de-risking need to be undertaken. However, fully developed bioLPG production could greatly reduce the public and private sector investment required to significantly increase SSA clean cooking capacity.

scholarly journals Scaling Up Delivery of Biofortified Staple Food Crops Globally: Paths to Nourishing Millions

2021 ◽  
pp. 037957212098250
Author(s):  
Jennifer K. Foley ◽  
Kristina D. Michaux ◽  
Bho Mudyahoto ◽  
Laira Kyazike ◽  
Binu Cherian ◽  
...  
Keyword(s):  
Pearl Millet ◽  
Large Scale ◽  
Scale Up ◽  
Lessons Learned ◽  
Raw Material ◽  
Micronutrient Deficiencies ◽  
Seed Systems ◽  
Public And Private ◽  
Context Specific ◽  
Public And Private Sector

Background: Micronutrient deficiencies affect over one quarter of the world’s population. Biofortification is an evidence-based nutrition strategy that addresses some of the most common and preventable global micronutrient gaps and can help improve the health of millions of people. Since 2013, HarvestPlus and a consortium of collaborators have made impressive progress in the enrichment of staple crops with essential micronutrients through conventional plant breeding. Objective: To review and highlight lessons learned from multiple large-scale delivery strategies used by HarvestPlus to scale up biofortification across different country and crop contexts. Results: India has strong public and private sector pearl millet breeding programs and a robust commercial seed sector. To scale-up pearl millet, HarvestPlus established partnerships with public and private seed companies, which facilitated the rapid commercialization of products and engagement of farmers in delivery activities. In Nigeria, HarvestPlus stimulated the initial acceptance and popularization of vitamin A cassava using a host of creative approaches, including “crowding in” delivery partners, innovative promotional programs, and development of intermediate raw material for industry and novel food products. In Uganda, orange sweet potato (OSP) is a traditional subsistence crop. Due to this, and the lack of formal seed systems and markets, HarvestPlus established a network of partnerships with community-based nongovernmental organizations and vine multipliers to popularize and scale-up delivery of OSP. Conclusions: Impact of biofortification ultimately depends on the development of sustainable markets for biofortified seeds and products. Results illustrate the need for context-specific, innovative solutions to promote widespread adoption.

scholarly journals Cost-Effectiveness Analysis of a Large-Scale Crèche Intervention to Prevent Child Drowning in Rural Bangladesh

2021 ◽  
Author(s):  
Y. Natalia Alfonso ◽  
Adnan A Hyder ◽  
Olakunle Alonge ◽  
Shumona Sharmin Salam ◽  
Kamran Baset ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Societal Perspective ◽  
Large Scale ◽  
Operating Cost ◽  
Cost Effective ◽  
Economic Benefits ◽  
Program Cost ◽  
Rural Bangladesh ◽  
Life Years ◽  
The Cost

Abstract Drowning is the leading cause of death among children 12-59 months old in rural Bangladesh. This study evaluated the cost-effectiveness of a large-scale crèche intervention in preventing child drowning. Estimates of the effectiveness of the crèches was based on prior studies and the program cost was assessed using monthly program expenditures captured prospectively throughout the study period from two different implementing agencies. The study evaluated the cost-effectiveness from both a program and societal perspective. Results showed that from the program perspective the annual operating cost of a crèche was $416.35 (95%C.I.: $222 to $576), the annual cost per child was $16 (95%C.I.: $9 to $22) and the incremental-cost-effectiveness ratio (ICER) per life saved with the crèches was $17,803 (95%C.I.: $9,051 to $27,625). From the societal perspective (including parents time valued) the ICER per life saved was -$176,62 (95%C.I.: -$347,091 to -$67,684)—meaning crèches generated net economic benefits per child enrolled. Based on the ICER per disability-adjusted-life years averted from the societal perspective (excluding parents time), $2,020, the crèche intervention was cost-effective even when the societal economic benefits were ignored. Based on the evidence, the creche intervention has great potential for reducing child drowning at a cost that is reasonable.

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

2018 ◽  
Vol 39 (2) ◽  
pp. 315-331 ◽  
Author(s):  
Saskia J. M. Osendarp ◽  
Homero Martinez ◽  
Greg S. Garrett ◽  
Lynnette M. Neufeld ◽  
Luz Maria De-Regil ◽  
...  
Keyword(s):  
Large Scale ◽  
Food System ◽  
Food Fortification ◽  
Micronutrient Deficiencies ◽  
Middle Income ◽  
Middle Income Countries ◽  
Essential Components ◽  
Quality Of Delivery ◽  
And Control ◽  
Low And Middle Income

Background: Food fortification and biofortification are well-established strategies to address micronutrient deficiencies in vulnerable populations. However, the effectiveness of fortification programs is not only determined by the biological efficacy of the fortified foods but also by effective and sustainable implementation, which requires continual monitoring, quality assurance and control, and corrective measures to ensure high compliance. Objective: To provide an overview of efficacy, effectiveness, economics of food fortification and biofortification, and status of and challenges faced by large-scale food fortification programs in low- and middle-income countries (LMIC). Methods: A literature review of PubMed publications in English from 2000 to 2017, as well as gray literature, targeting nongovernmental organizations whose work focuses on this topic, complemented by national reports and a “snowball” process of citation searching. The article describes remaining technical challenges, barriers, and evidence gap and prioritizes recommendations and next steps to further accelerate progress and potential of impact. Results: The review identifies and highlights essential components of successful programs. It also points out issues that determine poor program performance, including lack of adequate monitoring and enforcement and poor compliance with standards by industry. Conclusions: 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.

The Intersection of Data Analytics and Data-Driven Innovation

2020 ◽  
pp. 317-343
Author(s):  
Marcus Tanque ◽  
Harry J. Foxwell
Keyword(s):  
Private Sector ◽  
Data Analytics ◽  
Large Scale ◽  
Data Driven ◽  
Public And Private ◽  
Managerial Practices ◽  
Project Completion ◽  
Technological Advances ◽  
Private Sector Organizations ◽  
Public And Private Sector

This chapter discusses businesses, key technology implementations, case studies, limitations, and trends. It also presents recommendations to improve data analysis, data-driven innovation, and big data project implementation. Small-to-large-scale project inefficiencies present unique challenges to both public and private sector institutions and their management. Data analytics management, data-driven innovation, and related project initiatives have grown in scope, scale, and frequency. This evolution is due to continued technological advances in analytical methods and computing technologies. Most public and private sector organizations do not deliver on project benefits and results. Many organizational and managerial practices emphasize these technical limitations. Specialized human and technical resources are essential for an organization's effective project completion. Functional and practical areas affecting analytics domain and ability requirements, stakeholder expectations, solution infrastructure choices, legal and ethical concerns will also be discussed in this chapter.

scholarly journals Insulin price components: case studies in six low/middle-income countries

2019 ◽  
Vol 4 (5) ◽  
pp. e001705
Author(s):  
Douglas Ball ◽  
Margaret Ewen ◽  
Richard Laing ◽  
David Beran
Keyword(s):  
Private Sector ◽  
Value Added ◽  
Capital City ◽  
Selling Price ◽  
Public And Private ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Health Action ◽  
Public And Private Sector

IntroductionUnderstanding price components for insulin products can help design interventions to improve insulin affordability in low/middle-income countries.MethodsAn adapted WHO/Health Action International standardised methodology was used in Brazil (Rio de Janeiro), China (Hubei and Shaanxi Provinces), Ghana, India (Haryana State), Indonesia and Uganda. Selected insulin products had their prices traced backwards through the supply chain from public and private sector retail outlets in the capital city and a district town, supplemented with key informant interviews.ResultsCumulative mark-ups ranged from 8.7% to 565.8% but the magnitude of mark-ups was country specific and variable within and across sectors and regions. The proportion of the patient price attributed to the manufacturer’s selling price varied from 15.0% to 92.0%. Pricing regulations in China, India and Indonesia reduced wholesale and retail mark-ups but did not guarantee low prices. Most countries had removed import duties (Ghana, India, Indonesia, Uganda), but additional tariffs of 3.5% were still applied in Ghana. Value-added tax in the private sector ranged from 5% to 20% across the countries.ConclusionThere are no clear trends in the mark-ups applied to insulin or specific differences in the price structure. A uniform approach to improving insulin access through regulating price components is unlikely to be successful, but elimination of duties and taxes, price regulation and greater price transparency could help influence prices and hence affordability.

scholarly journals Cost and cost-effectiveness of a parenting programme to prevent violence against adolescents in South Africa

2019 ◽  
Vol 4 (3) ◽  
pp. e001147 ◽  
Author(s):  
Alice Redfern ◽  
Lucie D Cluver ◽  
Marisa Casale ◽  
Janina I Steinert
Keyword(s):  
South Africa ◽  
Cost Effectiveness ◽  
Low Income ◽  
Emotional Abuse ◽  
Controlled Trial ◽  
Cost Effective ◽  
Cluster Randomised Controlled Trial ◽  
Economic Benefits ◽  
Parenting Programme ◽  
Middle Income

IntroductionThis paper presents the costs and cost-effectiveness of ‘Parenting for Lifelong Health: Sinovuyo Teen’, a non-commercialised parenting programme aimed at preventing violence against adolescents in low-income and middle-income countries.MethodsThe effectiveness of Sinovuyo Teen was evaluated with a cluster randomised controlled trial in 40 villages and peri-urban townships in the Eastern Cape of South Africa from 2015 to 2016. The costs of implementation were calculated retrospectively and models of costs at scale estimated, from the perspective of the programme provider. Cost-effectiveness analysis considers both the cost per incident of abuse averted, and cost per disability-adjusted life year averted. Potential economic benefits from the societal perspective were estimated by developing a framework of possible savings.ResultsThe total implementation cost for Sinovuyo Teen over the duration of the trial was US$135 954, or US$504 per family enrolled. Among the 270 families in the treatment group, an estimated 73 incidents of physical and emotional abuse were averted (95% CI 29 to 118 incidents averted). During the trial, the total cost per incident of physical or emotional abuse averted was US$1837, which is likely to decrease to approximately US$972 if implemented at scale. By comparison, the economic benefits of averting abuse in South Africa are large with an estimated lifetime saving of US$2724 minimum per case.ConclusionParenting programmes are a cost-effective intervention to prevent the abuse of adolescents by their caregivers in South Africa, when compared with existing violence prevention programmes and cost-effectiveness thresholds based on GDP per capita.

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