Food Fortification in Kenya, Partnerships with Achievements

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Food Fortification in Kenya, Partnerships with Achievements By Gladys Mugambi Ministry of Health Kenya

OUTLINE Background Nutrition Situation in Kenya Objectives of Fortification Partnership,Sequence and Linkages Achievements Outcomes Challenges Conclusion

Background Food Fortification is one of the strategies used to control micronutrient deficiencies in Kenya. The foods that have been selected for fortification are maize, wheat and oil. Maize is consumed by 78.8% of women and 77.3% of children. Maize is eaten across the entire population

Background Wheat bread is consumed throughout the country and 75% of wheat flour is centrally processed (CMA) Vegetable oils and fats are consumed by 77.1% of women and 22.8% of children,(fcs, Kenyatta University /Unicef 2005)

Nutrition Situation 73% 76% 55% 48% 35% 6% Stunting <5 yrs Goitre Anaemia Pregnant women Anaemia Women (15-49 yrs) Anaemia < 5 yrs Vitamin A Deficiency < 5 yrs

Objectives in Fortification Project in Kenya To achieve annual production of 1,000,000 MT of fortified maize flour, 750,000MT of fortified wheat flour and 200,000MT of fortified vegetable oil, To establish a reliable system for monitoring the quality of fortified food samples, To raise awareness and consumption of fortified foods, To reach 27 million individuals in Kenya with fortified foods, to achieve mandatory fortification of staple foods.

Partnership, Sequence and linkages MOH Research, Coordination and Formation of Alliance GAIN, PSI, MOH, Industry Communication and Social Marketing MOH, KEBS, GAIN Capacity Building for Industry ECSA Development of Regional Standards and capacity Building KNFFA Resource Mobilization INDUSTRY Production of Wheat, Maize and oil KEBS Development of Standards NPHL and KEBS Development of Testing Systems INDUSTRY Marketing and Distribution

Members of the Alliance Ministry of Health (Nutrition, Laboratory, Food Safety, Kenya Bureau of Standards Industry (Flour, Oil, Sugar, Salt) Development Partners (Unicef, GAIN, MI, PSI) Premix Suppliers Consumer Organizations

Achievements Mandatory Fortification through an amendment to the Food Drugs and Chemical Substances Regulations 38 companies signed an agreement with the Ministry to start procurement of equipment, installation and roll out fortification. The Ministry conducted an assessment to establish industry requirements.

Achievements A training package on production, quality assurance was developed by MOH and KEBS. A logo that helps to identify the fortified foods was developed and a social marketing and communication campaign was launched

Food Fortification Logo

Standards Fortification Standards were developed for wheat and maize flour, sugar, oils and fats between 2005 to 2008

Maize Flour Fortification Levels B-2 Riboflavin(1.5-5), B-1Thiamin Mononitrate (1.5-6), Vit. A Vit. A Palm. SD (0.2-1.0) Niacin Niacinamide(15-30) Maize Flour Total iron, Zinc Zinc oxide (20-40) Pyrodoxine (2.0-7.5 Iron NaFeEDTA (5-15) B-12 Vitamin B12 0.1% WS (0.002-0.010) Folate Folic acid (1) B-6

Wheat Fortification Levels B-1 Thiamin Mononitrate (5.0-15), Vit. A Vit. A Palm. SD (0.5-3.0), Zinc Zinc oxide (30-50) B-2 Riboflavin (2.5-9), Niacin Niacinamide (40-75) Wheat Flour Total Iron (40-60), Iron Ferrous Fumarate (30-50) Folate Folic acid (1) B-6 Pyrodoxine (3-10) B-12 Vitamin B12 0.1% WS(0.005-0.025)

FATS AND OILS FORTIFICATION LEVELS Vitamin A palmitate 10-20 ppm 15

Communication Launch

Billboards

On-ground Activation

Onground activation

OUTCOMES The systems for testing and certification in place. Companies that are fortifying their products increased from 4 to 38 between 2011 and 2013, The number of fortified brands increased from 4 to 150 within the same period.

Fortified maize MT (Feb Dec 2013 Fortified Maize flour in MT 40000 35000 39484.17 30000 25000 28914 29360 20000 19263.8 27852.82 MT 15000 17299.4 21682.6 32415.52 10000 16495.1 5000 16125 21008.7 0 Feb March April May June July August Sept Oct Nov Dec

Fortified wheat (Feb-Dec 2013) Total Production Fortified wheat 35000 30363.95 30000 25000 20300 30720.21 20000 16547.6 17843.48 WHEAT 15000 17615.9 19902.63 10000 5000 12755.61 13144.9 14518.2 14381.6 0 Feb March April May June July August Sept Oct Nov Dec

Fortified edible fats and oils (Feb- Dec 2013) - Total Production Fortifed edible fats and oils 35000 30000 31112.49 32850.86 25000 20000 24981 32940.019 34533.15 15000 20530.3 20618.9 30214.09 MT 10000 18123.3 22267.4 14975.94 5000 0 Feb March April May June July August Sept Oct Nov Dec

Challenges in Implementation Initially uptake was slow especially in the first year due to lack of reliable suppliers of vitamins and minerals, long processes of importing the required equipment, inadequate capacity for internal quality assurance and control at regulatory level and production. Government under pressure to build systems for certification and monitoring at market and household level

Conclusion The Ministry of Health and the Bureau of Standards is left with the task of monitoring the quality of fortified foods in the market and at household level. The strong partnership between government and private sector led to the achievements made this far

THANK YOU ASANTE SANA