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Food Fortification
Dept. Food & Civil Supplies, GoG
India

The Problem

The problem of micronutrient deficiencies are rampant in the developing countries and so is true to a country like India, effecting millions of women and children . Food fortification has been one of the most effective strategies to address the problem in a most cost effective way. The Micronutrient Initiative (MI), an international not for profit organization working across the globe have been supporting programs in the area of micronutrient supplementation and food fortification, including in the State of Gujarat in India. The concept of fortifying flour with the essential nutrients like iron and folic acid to address the problem of iron deficiency anemia (IDA) was introduced to Dr. S.K.Nanda, Secretary, Food & Civil Supplies, Government of Gujarat. He had taken the leadership in moving forward this concept to reach millions of vulnerable people with fortified flour across the State. This has been done with the concept of a public private partnership between the Government, the industry and the non governmental organization.

Solution and Key Benefits

 What is the initiative about? (the solution)
The Government of Gujarat, under the leadership of Dr. S.K.Nanda, Secretary, Food & Civil Supplies has recently made it compulsory to fortify all the wheat flour that is sold in the State by bringing in the concept of public private partnership with the Roller Flour Millers Association of Gujarat, with technical support from the Micronutrient Initiative. Under he able guidance and leadership, the Government has provided an enabling regulatory environment for the industry to reach millions of women and children in the state with fortified flour, which stems from a strong belief in the importance of this measure to control anemia in the country, and Gujarat has been the first state in the country to initiate this process.

Actors and Stakeholders

 Who proposed the solution, who implemented it and who were the stakeholders?
Dr. SK Nanda spearheaded the achievements within a span of ONE year, beginning with a tripartite discussion between the Government, Millers Association and the MI in October, 2005, launching the program in January 2006 and scaling up to reach the masses with fortified flour through various channels by October 2006.

(a) Strategies

 Describe how and when the initiative was implemented by answering these questions
 a.      What were the strategies used to implement the initiative? In no more than 500 words, provide a summary of the main objectives and strategies of the initiative, how they were established and by whom.
India is today moving from a concept of food security to one of nutrition security. The health of people is measured not at the apex level society but at the bottom line. There is recognition that as well as enabling sufficient quantities and varieties of food for all, there is a need to ensure that the food provides sufficient micronutrients that people need for normal health, well being and productivity. There is a need to move well beyond looking at the issue simply as food security based on per capita calorie availability to comprehensive nutrition security, based on an affordable diet of high nutritional quality.

(b) Implementation

 b.      What were the key development and implementation steps and the chronology? No more than 500 words
Even as India races towards becoming an economic superpower, its march forward is retarded by the fact that it hosts 90 per cent of South Asia’s poorest of the poor. It has been estimated that micronutrient deficiencies costs India 1 percent of its GDP. More than 6,000 children in below the age of five die every day in India. More than half of these deaths are caused by malnutrition mainly the lack of vitamin A, iron, iodine, zinc and folic acid. Combating anemia and folic acid deficiencies is perhaps the biggest challenge to day and the purpose of any health program should target to eliminate these problems.

(c) Overcoming Obstacles

 c.      What were the main obstacles encountered? How were they overcome? No more than 500 words
Food fortification has been shown to be a viable and cost effective strategy to control micronutrient malnutrition. The main advantage of food fortification over supplementation is wider and more efficient coverage of the target population. Foods can be fortified with several nutrients to overcome multiple deficiencies. Iodization of salt has been found to be effective in controlling iodine deficiency disorders. Multiple fortification of foods can address deficiencies of two or more micronutrients at the same time in a cost effective manner. Progress has been made with fortification of wheat flour with iron and folic acid in many developed countries in the world. The MI has shown the impact of fortified flour on the prevalence of iron deficiency anemia on a pilot project in the State of West Bengal. This success story was shared by MI with the Ministry of Food & Civil Supplies, Government of India and Dr. SK Nanda, Principal Secretary, Food & Civil Supplies, Govt of Gujarat. This concept has been adopted by the Government of Gujarat, State wide through a public private partnership with the Roller Flour Millers Association of Gujarat, with technical and part financial support from the MI. Under the able leadership of Dr. Nanda, The Government created an enabling environment by providing a brand logo for reaching fortified flour to the population through open markets as well as through public programs like the Public Distribution System, Integrated Child Development Services etc. The millers have the responsibility to fortify the flour, maintain quality standards and reach the fortified flour at an affordable price and the MI providing technical support. The premix manufacturing industries are also supporting by providing opportunities to fortify flour through the small scale chakkis too.

(d) Use of Resources

 d.      What resources were used for the initiative and what were its key benefits? In no more than 500 words, specify what were the financial, technical and human resources’ costs associated with this initiative. Describe how resources were mobilized
The impact of flour fortified with iron and folic acid has been tested by the government on children. The performance of these children in terms of efficiency in sports increased significantly, which was substantiated by biochemical assessments which showed a significant increase in serum hemoglobin levels. Similar studies have been undertaken on pregnant and lactating women and children, beneficiaries of the ICDS program, wherein a decrease in anemia prevalence was observed to an extent of 15 to 20 %.

Sustainability and Transferability

  Is the initiative sustainable and transferable?
Dr. Nanda’s leadership in putting the systems in place would make the program sustainable by itself. He has brought in a commitment from the Government by providing the logo and putting a monitoring system in place. The awareness generation actitivities undertaken by the government and the industry goes a long way in creating a public awareness and demand creation for a quality product resulting in better health. The linkages with other departments like the Education Department to use fortified flour through the Mid Day Meal programs, and the Women & Child Development Department to use it through ICDS Department makes it full proof to reach the vulnerable people in every nook and corner of the state. The concept is easily replicable to other states in the country, which is presently being undertaken by the Government of India with support from the MI.

Lessons Learned

 What are the impact of your initiative and the lessons learned?
(i) Good leadership is the first stepping stone to the success of any program. (ii) Government support is a critical component for success. (iii) Public private partnership is the backbone for successful implementation, scalability and replicability of any program. (iv) The MI's activities in the country have further received a boost with the success of this project in Gujarat, with the type of support and motivation shown by Dr. Nanda and is helping the MI to fulfil the objectives of alleviating micronutrient malnutrition in India.

Contact Information

Institution Name:   Dept. Food & Civil Supplies, GoG
Institution Type:   Government Department  
Contact Person:   Sudip Kumar Nanda
Title:   Principal Secretary  
Telephone/ Fax:   00917923251163
Institution's / Project's Website:   23251199
E-mail:   secfcs@gujarat.gov.in  
Address:   Bl. 14, Floor 6, Sachvalaya
Postal Code:   382010
City:   Gandhinagar
State/Province:   Gujarat
Country:   India

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