Analyze the content of documents used to guide mandatory fortification programs for cereal grains.
Legislation, regulations, and monitoring guidelines were collected from 11 countries with mandatory wheat flour, maize flour, and/or rice fortification. A criteria checklist of elements that should be included in fortification documents was created. Two reviewers independently scored each document set for a given country and food vehicle (e.g. Philippines-wheat flour) using the checklist, and then reached a consensus. For each element on the checklist, the percentage of countries containing that element was calculated.
Based on a preliminary subsample of 11 country-grain combinations, all countries have documentation stating the food vehicle(s) to be fortified and the micronutrients, fortificants, and fortification levels required. Most (91%) state that labeling is required to indicate a product is fortified. Many countries describe systems for external (91%) and import (82%) monitoring, and state that industry is required to follow quality assurance/quality control (82%), though roles and responsibilities (55%), and sampling procedures (55%) are frequently not described.
Based on preliminary results, it appears that countries document the technical specifications for fortification and have systems in place for internal, external, and import monitoring. However, documentation of other elements such as roles and responsibilities between agencies, cost regulation, and enforcement strategies was less frequent. Reviews of 70 additional countries is pending and will provide a more complete picture of the information that guides national fortification programs where food fortification is mandatory.