scholarly journals Examining Heterogeneity of Food Fortification and Biofortification Business Models: Emerging Evidence for a Typology

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1233
Author(s):  
Baqir Lalani ◽  
Rania Hassan ◽  
Ben Bennett
Keyword(s):  
Large Scale ◽  
Business Models ◽  
Food Fortification ◽  
Micronutrient Deficiencies ◽  
Middle Income ◽  
Middle Income Countries ◽  
Comprehensive Literature Review ◽  
Business Conditions ◽  
Staple Foods ◽  
Measurement Of Success

Efforts to address Micronutrient deficiencies (MNDs) in lower-and middle-income countries (LMICs) have been gaining pace in recent years. Commodities such as staple foods (e.g., cereals, roots, and tubers) and condiments (e.g., salt) have been targeted as ‘vehicles’ for fortification and biofortification through numerous projects and initiatives. To date, there have been mixed experiences with delivery and coverage with very little documented on the range of business models applied in different geographies, business conditions and polities and this makes classification and measurement of success and failure difficult. This research aims to address this gap in knowledge through proposing a typology that clarifies similarities (internal heterogeneity) and differences (external heterogeneity) between models and that can allow all types to be defined by the combination of attributes. Building on a comprehensive literature review; NVivo was used to code initiatives from 34 key references (955 cases in total) which have been grouped into 17 categories. Using non-metric multidimensional scaling (NMDS) we find evidence of four business model groupings that typify fortification initiatives: (1) Large-scale private, unregulated, (2) Mixed-Scale, private, unregulated (3) Large-scale, public-private, regulated; and (4) Large-scale, private, regulated. We characterise these four groups with country examples and suggest that this typology can help the discourse around viability of food fortification initiatives.

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.

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 Which Choice of Delivery Model(s) Works Best to Deliver Fortified Foods?

Nutrients ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 1594 ◽  
Author(s):  
Baqir Lalani ◽  
Aurélie Bechoff ◽  
Ben Bennett
Keyword(s):  
Business Models ◽  
Keyword Search ◽  
Dietary Diversity ◽  
Initial Structure ◽  
Food Fortification ◽  
Micronutrient Deficiencies ◽  
Middle Income ◽  
Relevant Evidence ◽  
Fortified Food ◽  
Business Cases

Micronutrient deficiencies (MNDs) occur as a result of insufficient intake of minerals and vitamins that are critical for body growth, physical/mental development, and activity. These deficiencies are particularly prevalent in lower-and middle-income countries (LMICs), falling disproportionately on the poorest and most vulnerable segments of the society. Dietary diversity is considered the most effective method in reducing this deficiency but is often a major constraint as most foods rich in micronutrients are also expensive and thereby inaccessible to poorer members of society. In recent years, affordable commodities such as staple foods (e.g., cereals, roots, and tubers) and condiments (e.g., salt and oil) have been targeted as “vehicles” for fortification and biofortification. Despite efforts by many countries to support such initiatives, there have been mixed experiences with delivery and coverage. An important but little understood driver of success and failure for food fortification has been the range of business models and approaches adopted to promote uptake. This review examines the different models used in the delivery of fortified food including complementary foods and biofortified crops. Using a keyword search and pearl growing techniques, the review located 11,897 texts of which 106 were considered relevant. Evidence was found of a range of business forms and models that attempt to optimise uptake, use, and impact of food fortification which are specific to the ‘food vehicle’ and environment. We characterise the current business models and business parameters that drive successful food fortification and we propose an initial structure for understanding different fortification business cases that will offer assistance to future designers and implementors of food fortification programmes.

scholarly journals Enablers and Barriers of Zinc Fortification; Experience from 10 Low- and Middle-Income Countries with Mandatory Large-Scale Food Fortification

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2051
Author(s):  
Ann Tarini ◽  
Mari S. Manger ◽  
Kenneth H. Brown ◽  
Mduduzi N. N. Mbuya ◽  
Laura A. Rowe ◽  
...  
Keyword(s):  
Zinc Deficiency ◽  
Large Scale ◽  
Public Health Problem ◽  
Child Growth ◽  
World Health ◽  
Food Fortification ◽  
Middle Income ◽  
Middle Income Countries ◽  
Zinc Fortification ◽  
Low And Middle Income

Adequate zinc nutrition is important for child growth, neurodevelopment, immune function, and normal pregnancy outcomes. Seventeen percent of the global population is estimated to be at risk for inadequate zinc intake. However, zinc is not included in the fortification standards of several low- and middle-income countries with mandatory fortification programs, despite data suggesting a zinc deficiency public health problem. To guide policy decisions, we investigated the factors enabling and impeding the inclusion of zinc as a fortificant by conducting in-depth interviews with 17 key informants from 10 countries. Findings revealed the decision to include zinc was influenced by guidance from international development partners and enabled by the assessment of zinc deficiency, mandatory regional food fortification standards which included zinc, the World Health Organization (WHO) guidelines for zinc fortification, and the low cost of zinc compound commonly used. Barriers included the absence of zinc from regional fortification standards, limited available data on the efficacy and effectiveness of zinc fortification, and the absence of national objectives related to the prevention of zinc deficiency. To promote zinc fortification there is a need to put the prevention of zinc deficiency higher on the international nutrition agenda and to promote large-scale food fortification as a key deficiency mitigation strategy.

scholarly journals Childhood Malnutrition: Time for Action

Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 103
Author(s):  
Tonia Vassilakou
Keyword(s):  
Burden Of Disease ◽  
Personal Development ◽  
Overweight And Obesity ◽  
Poor Health ◽  
Human Potential ◽  
Micronutrient Deficiencies ◽  
Middle Income ◽  
Childhood Malnutrition ◽  
Middle Income Countries ◽  
Major Impediment

Childhood malnutrition of every form, including undernutrition (wasting, stunting and underweight), micronutrient deficiencies, as well as overweight and obesity, consists a triple burden of disease, especially for low- and middle-income countries, and is one of the leading causes of poor health and a major impediment to personal development and achievement of full human potential worldwide [...]

scholarly journals Farming with Alternative Pollinators benefits pollinators, natural enemies, and yields, and offers transformative change to agriculture

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Stefanie Christmann ◽  
Youssef Bencharki ◽  
Soukaina Anougmar ◽  
Pierre Rasmont ◽  
Moulay Chrif Smaili ◽  
...  
Keyword(s):  
Large Scale ◽  
Transformative Change ◽  
Net Income ◽  
Land Sharing ◽  
Pollinator Decline ◽  
Middle Income ◽  
Land Sparing ◽  
Middle Income Countries ◽  
Small Grant ◽  
Wildflower Strips

AbstractLow- and middle-income countries cannot afford reward-based land sparing for wildflower strips to combat pollinator decline. Two small-grant projects assessed, if an opportunity-cost saving land-sharing approach, Farming with Alternative Pollinators, can provide a method-inherent incentive to motivate farmers to protect pollinators without external rewards. The first large-scale Farming-with-Alternative-Pollinators project used seven main field crops in 233 farmer fields of four agro-ecosystems (adequate rainfall, semi-arid, mountainous and oasis) in Morocco. Here we show results: higher diversity and abundance of wild pollinators and lower pest abundance in enhanced fields than in monocultural control fields; the average net-income increase per surface is 121%. The higher income is a performance-related incentive to enhance habitats. The income increase for farmers is significant and the increase in food production is substantial. Higher productivity per surface can reduce pressure on (semi)-natural landscapes which are increasingly used for agriculture. Land-use change additionally endangers biodiversity and pollinators, whereas this new pollinator-protection approach has potential for transformative change in agriculture.

scholarly journals Food fortification: good to have or need to have?

2004 ◽  
Vol 10 (6) ◽  
pp. 771-777
Author(s):  
A. Verster
Keyword(s):  
Developing Countries ◽  
Folic Acid ◽  
Food Fortification ◽  
Micronutrient Deficiencies ◽  
Vicious Cycle ◽  
Child Bearing ◽  
Large Populations ◽  
Life Threatening ◽  
Iron And Folic Acid ◽  
Staple Foods

Only very small quantities of vitamins and minerals are needed for human health but deficiencies can have disproportionately large, often life-threatening, effects. Micronutrient deficiencies lead to a vicious cycle of malnutrition and infection in poorly nourished populations. Fortification of staple foods is the cheapest, most efficient and most effective way to supply large populations with essential micronutrients. This paper reviews the case for fortification of flour supplies with iron and folic acid and concludes that it is the best way to provide daily doses of these nutrients to populations in developing countries, especially for women of child-bearing age

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