2009年-世界发展银行全球_Moroccos_National_Food_Fortification_Program_3页_746kb

Morocco's National Food Fortification Program Summary

Core Content

Morocco's National Food Fortification Program was a successful initiative aimed at addressing micronutrient deficiencies through the fortification of staple foods. Supported by a $2.92 million grant from the Global Alliance for Improved Nutrition (GAIN), the program focused on improving the nutritional status of vulnerable populations by fortifying wheat flour and edible oils with essential micronutrients such as iron, vitamins A and D, and others.

Main Objectives

• Reduce Iron Deficiency Anemia (IDA) by one third from 1995 levels.
• Eliminate problems due to Vitamin A and D deficiency in the population.

These objectives were pursued through the engagement of:

• 50 flour mills to fortify a total of 3 million metric tons (MT) of flour annually with iron.
• Three oil producers to fortify oil with vitamins A and D.

Key Activities and Outcomes

• The program was fully implemented within its three-year period, thanks to the efforts of the National Fortification Alliance (NFA), led by the Ministry of Health and executed by UNICEF.

• The NFA played a central role in:

  • Developing the food fortification strategy.
  • Coordinating all partners to ensure synergy and complementarity in activities.
  • Monitoring and evaluating the program's effectiveness.

• Pre-program nutritional status in Morocco was alarming:

  • 32% of children under 5 had IDA.
  • 33% of women in childbearing age had anaemia.
  • 41% of children under 6 had Vitamin A deficiency.
  • 22% of children aged 6–12 had iodine deficiency (goitre).
  • 2.5% of children had Vitamin D deficiency (rickets).

• The program achieved significant results:

  • A 13% point reduction in IDA among pregnant women, from 45.5% in 1995 to 32.5% in 2008.
  • Improvements in Vitamin A deficiency and serum folate levels.
  • 80 flour mills were fortifying flour at the end of the project, representing 63% of national production.
  • Five oil producers were fortifying oil with vitamins A and D, up from three, covering 79% of national production.

Key Lessons Learned

• Cooperative partnerships are critical to the success of food fortification programs. The collaboration between the government, private sector, and international agencies like UNICEF was essential.
• Quality assurance remains a challenge, as there is wide variability in the fortification levels of products.
• Sentinel site data collection is necessary to monitor trends in micronutrient deficiencies over time.
• Fortification levels need to be increased to reach more vulnerable groups who may not consume fortified products.
• Marketing campaigns should continue to raise awareness about the benefits of fortified foods, especially as their market share grows.
• Bakeries should be targeted to increase the consumption of fortified bread and pastries, particularly in urban areas.
• Reinforcement of birth defects registries is vital to track and address Neural Tube Defects.
• Data triangulation is needed to improve accuracy, especially with production figures for fortified flour and oil.

Future Recommendations

• Strengthen quality control mechanisms to ensure consistent fortification levels.
• Expand data collection efforts to include serum retinol and other relevant biomarkers.
• Increase fortification levels to ensure broader population coverage.
• Continue marketing and communication campaigns to promote the benefits of fortified foods.
• Expand the private sector's involvement in fortification and ensure transparency in production data.
• Maintain the National Fortification Alliance as a central institution for coordinating and monitoring food fortification efforts.

Logos Used on Fortified Products

• « Siha Wa Salama » – A symbol used to indicate fortified products in Morocco.

Contact Information

• Emmanuel Mbi, Director, MNA Operational Core Services Unit
• David Steel, Manager, MNA Development Effectiveness Unit
• Regional Quick Notes Team: Omer Karasapan, Dina El-Naggar, Roby Fields, Najat Yamouri, and Aliya Jalloh
• Tel #: (202) 473 8177

Note: The MNA Quick Notes summarize lessons learned from MNA and other Bank Knowledge and Learning activities. They do not necessarily reflect the views of the World Bank, its Board, or its member countries.