Wheat Flour Fortification for prevention and control of iron deficiency anemia in Latin America: Issues to consider in a systematic evaluation
Pena-Rosas JP, Sinclair BM.
Reference Rev Med Minas Gerais 2007;(1/2 Supl 1):S66-S73.
Iron deficiency continues to be a public health concern in many regions including Latin America. Various interventions such as routine supplementation with iron and folic acid to various target groups, fortification of staple foods such as wheat flour and corn meal, control of parasitic infections and improvement of sanitary conditions are implemented worldwide to address this micronutrient deficiency. Wheat flour fortification has been a common intervention to almost all countries in Latin America. Although this strategy has been underway for several years, it seems critical to evaluate the program achievements in a systematic way in order to assess the intended and unintended outcomes and recommend actions for the future. The evaluation should include the assessment of dietary habits and the availability, access and consumption of new iron-fortified food products in the marketplace, and should consider the newer knowledge in food fortification science and technology. A systematic program evaluation can identify key issues affecting performance and provide recommendations that can be applied to improve program effectiveness. The CDC framework for evaluation of public health interventions can be used as a guide to lead the design and implementation of this task. A review of all the current and potential stakeholders involved is needed to renew and invigorate political commitment to food fortification as a strategy for iron deficiency prevention and control, in conjunction with other interventions. Reassessing the context of the fortification program, the country's food vehicle products market trends, understanding possible changes in dietary habits and micronutrient consumption, and supplement usage could be done in order to better focus the program and provide useful recommendations to the stakeholders.
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