Effectiveness of Public Awareness interventions towards fortified food – Experience From Pakistan Mariam Ashraf1, Lucy Palmer2, Javaid Iqbal1, Laila R. Jaskani1 1. Food Fortification Pakistan, Islamabad, Pakistan, 2. Mott MacDonald, London, United Kingdom
2. STUDY DESIGN
1.BACKGROUND AND INTRODUCTION In Pakistan 42 % women of reproductive age group (WRA) & 54 % children under 5 are anaemic 18 % WRA are iron deficient 27 % WRA & 52 % children under 5 are vitamin A deficient 10 % WRA & 63 % children under 5 are vitamin D deficient Source: Pakistan National Nutrition Survey 2018
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The Food Fortification Programme (FFP) adopted a multipronged approach in improving the micronutrient deficiencies across Pakistan. A comprehensive awareness-building communication campaign was implemented in selected districts to raise awareness of food fortification, delivered in a phased manner once fortified flour and oil/ghee was produced and distributed in these locations. The study was conducted to provide a qualitative assessment of the effectiveness of the FFP’s communication campaign.
3. FINDINGS 1. 2.
3. 4. 5.
Beneficiaries
Communication Channels Integrated reproductive maternal newborn and child health department H
District Health Officers and School Health and Nutrition Supervisors
Lady Health Workers & Supervisors
Traders, Retailers, Wholesalers
WRAs and Pregnant women
Fathers of school children & adolescent girls
Figure 1: Target Audience
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6% 3%
Qualitative Key Informant Interviews (KIs) and Focus Group Discussions (FGDs) Total of 27 KIs and 113 FGDs in 20 targeted districts across Pakistan
Community based health care providers Lady Health Workers (LHW) were the key 25% Awareness session 9% channels through which public awareness and understanding was raised (Fig 2) Brochures Participants had a positive response to food fortification, even if they have not Posters 13% encountered the concept before. Cable TV When the benefits of food fortification where explained almost all agreed that they Billboards 23% Social media / Facebook would be willing to use fortified food. Mobile text / SMS 21% Key drivers of the change in improving knowledge and attitudes is face to face interaction with the target population. Figure 2: Campaign recall from the target Changes in behavior of target population will be a function of availability and beneficiaries perceptions of the relative benefits versus the cost of fortified products.
Awareness Low awareness among audience not directly exposed to the campaign Availability No or limited availability of fortified wheat flour in certain districts Price
Uncertainty around cost of fortified products
Figure 3: Barriers to uptake of fortified wheat and oil/ghee
4. CONCLUSION The large-scale qualitative study indicates that the potential for the FFP’s work to be successful is high: there is latent demand for fortified foods, little negative response from target audiences, and an enthusiastic network of LHW who are willing to help and catalyse demand