Problem
In India, Iron deficiency Anaemia is a pervasive public health crisis, affecting over 52% of pregnant women and 67% of young children.
Severe long-term impacts include impaired cognitive and physical development, poor reproductive outcomes, a higher risk of depression, and diminished work capacity.
This widespread micronutrient deficiency not only harms the lives of children and pregnant women but also affects economic progress in the long term.
Solution
One promising strategy for preventing or reducing iron deficiency anaemia is through food fortification. This approach involves enriching staple foods—such as rice, milk, edible oil, salt, and flour—with essential micronutrients to combat iron deficiency anaemia on a large scale.
Extensive research has shown that fortifying wheat flour, in particular, can significantly lower rates of iron deficiency anaemia.
Evidence:
Fortification is recognised as one of the most cost-effective public health measures by the World Health Assembly.
In a resolution adopted in May 2023, delegates at the World Health Assembly described large-scale food fortification as a powerful, evidence-informed and cost-effective intervention to fight the consequences of vitamin and mineral deficiencies.
In India, an RCT in 2012 found that food fortification reduced iron deficiency rates among students from 62% to 21%.
A global meta-analysis of several studies from 2021 found that consumption of iron-fortified wheat flour reduced rates of anaemia by 27%, and prior studies have indicated rates as high as 41%.
Fortify Health is helping solve the Iron deficiency Anaemia by supporting millers and state governments in India to fortify chakki atta with iron, folic acid and Vitamin B12, in line with standards set by the Food Safety and Standards Authority of India (FSSAI).
FAQs
How can fortifying food help to tackle anaemia and micronutrient malnutrition?
Food fortification is the addition of essential micronutrients to food staples, such as rice, flour, salt, milk and cooking oil. There are several benefits to food fortification, including:
Cost-effectiveness - food fortification has been recommended by the World Health Organisation as a highly cost-effective way of combating anaemia (because it is relatively cheap to fortify staple foods like wheat flour, WHO, 2023);
Reliance on existing supply chains - that it can be implemented through the private sector, without substantial changes to current production or distribution dynamics or processes; and
Low or no need for behavioural change - fortification generally does not require consumers to significantly change their consumption patterns because micronutrients are added to foods that are already widely consumed.
How is wheat flour regulated in India?
The Food Safety and Standards Authority of India (FSSAI) has published comprehensive standards for the fortification of wheat flour, which are administered by the Food and Drug Administration of India (FDA). We work closely with our partners to help them to fortify wheat flour in accordance with those standards set by the FSSAI.
What has been Fortify Health's impact?
Fortify Health was founded in 2017 to tackle the growing problem of iron-deficiency Anaemia in India. Since its inception, Fortify Health has consistently scaled the implementation of food fortification in India, helping reduce the prevalence of Anaemia. Through partnerships with more than 100 flour mills in India, Fortify Health is helping fortify 28,237 Metric tonnes of flour with essential micronutrients each month, impacting the health ~6.5 MN beneficiaries in India.
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