Capacity building of millers on fortification and government regulatory staff on enforcement led to improved adequacy of edible oil fortification in Pakistan Zameer Haider1, Bisma Imran1, Noor Khan1 , Manpreet Chadha2 Food Fortification Programme, Islamabad, Pakistan 2 Nutrition International, Headquarters, Ottawa, Canada 1
BACKGROUND
OBJECTIVES
• Pakistan mandated edible oil fortification in 1965 as a strategy to address malnutrition but owing to weak implementation of the legislation, the coverage and adequacy of fortification remained limited. • Mott MacDonald with Nutrition International started supporting food fortification under DFID funded Food Fortification Programme (2016-21). • The programme focuses on improving the capacity of millers as well as government partners to ensure adequate fortification.
The FFP envisages to reduce the burden of vitamin A deficiency in Pakistan and achieve the following key objectives: 1. Improve capacity of private sector millers to ensure adequate fortification of edible oil. 2. Build capacity of government departments for effective enforcement of the oil fortification standards. 3. Develop market led mechanism for sustainable supply of fortification premix 4. Increase availability and consumption of edible oil fortified with vitamin A.
APPROACH & METHODOLOGY The program worked with national and provincial food regulatory bodies to amend and harmonize edible oil fortification standards to create an enabling environment for fortification. It established market-led premix supply chain system to ensure availability of high-quality premix to the mills. The FFP trained millers/staff from 118 (out of 136 total) oil mills on fortification processes and internal quality assurance; and provided testing kits to mills to check fortification levels. The FFP also trained government regulatory staff on quality control and build their laboratories for enforcement of standards for fortification. The FFP provided incentive to mills upon adequate fortification through reimbursement of the partial cost of premix used for fortification. The FFP signed MOUs with millers, miller's association, government food regulatory bodies to implement this programme. 1. Signing of MOU between FFP and oil mill
2. Assessment of mill’s current capacity and fortification needs
3. Training of mill staff on fortification process & QA
6. Testing each batch for vit A&D fortification using RTKs
7. Testing (2 samples/month) at i-Check cluster lab
5. Identify gaps in fortification process by millers
8. Testing (2 samples/month) at 3rd party lab
4. Provision of Rapid Testing Kits (RTKs) and ICheck equipment for QA
Harmonizing fortification standards across provinces
Supporting market-led premix supply chain
Capacity building of food regulatory bodies
Strengthening public sector labs for enforcement
9. Give feedback to mills to take corrective measures
Figure 2: Support to create an Enabling Environment
Figure 1: Support to Edible Oil Mills
RESULTS The FFP support to build capacity of millers and government staff, establishment of premix supply systems led to improvement in the adequacy of fortification of edible oil from around 9% in 2017 to over 90% in 2019 in Pakistan. Parameter Reduction in Vitamin A Deficiency
Pre-Intervention 42.5% women and 54% children in Pakistan Vitamin A deficient (National Nutrition Survey 2011)
Post-Intervention Vit. A deficiency reduced to 27.3% in women (↓35.7%) and 51.5% in children (↓4.6%) (NNS 2018) likely due to a variety of factors including oil fortification, Vit. A supplementation and improved diet.
Sustainable Supply Limited suppliers of of Fortification fortification premix Premix
Prequalified supplier to provide high quality premix at mill level.
Increased adequacy of oil fortification
92% samples (out of 2,537) from enrolled mills found to be adequately fortified with Vit A at production level – (FFP Fortis Data).
Market-level study found only 9% of edible oil brands adequately fortified (GAIN 2017)
Pre-Intervention Fortified
Not Fortified
POST- Intervention Fortified
Not Fortified
9.00% 18.00%
91.00%
82.00%
Figure 3: Comparison of adequacy of fortification of oil pre and post intervention (Source: Rolling District Study - Phase 2)
139% increase in import of premix for fortification.
Market sampling in 8 districts indicated 82% (out of 201) of oil adequately fortified – in 2019. (Rolling District Study Phase 2).
Figure 4: Imports of Premix (MT) to Pakistan for Oil Fortification
Table 1: Comparison of Results
CONCLUSION Capacity building of millers on fortification processes and internal quality assurance; uninterrupted supply of premix; training of government food regulatory bodies and ownership of private sector are imperative for successful implementation of large-scale food fortification interventions, including that of the edible oil fortification.