Indian social safety net programs as platforms for introducing wheat flour fortification: A case study of Gujarat, India:

Micronutrient deficiencies exact an enormous health burden on India. The release of the National Family Health Survey results—showing the relatively wealthy state of Gujarat having deficiency levels exceeding national averages—prompted Gujarat officials to introduce fortified wheat flour in their so...

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Main Authors: Fiedler, John L., Babu, Sunil, Smitz, Marc-Francois, Lividini, Keith, Bermudez, Odilia I.
Format: Journal Article
Language:Inglés
Published: SAGE Publications 2012
Subjects:
Online Access:https://hdl.handle.net/10568/153109
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author Fiedler, John L.
Babu, Sunil
Smitz, Marc-Francois
Lividini, Keith
Bermudez, Odilia I.
author_browse Babu, Sunil
Bermudez, Odilia I.
Fiedler, John L.
Lividini, Keith
Smitz, Marc-Francois
author_facet Fiedler, John L.
Babu, Sunil
Smitz, Marc-Francois
Lividini, Keith
Bermudez, Odilia I.
author_sort Fiedler, John L.
collection Repository of Agricultural Research Outputs (CGSpace)
description Micronutrient deficiencies exact an enormous health burden on India. The release of the National Family Health Survey results—showing the relatively wealthy state of Gujarat having deficiency levels exceeding national averages—prompted Gujarat officials to introduce fortified wheat flour in their social safety net programs (SSNPs).To provide a case study of the introduction of fortified wheat flour in Gujarat's Public Distribution System (PDS), Integrated Child Development Scheme (ICDS), and Mid-Day Meal (MDM) Programme to assess the coverage, costs, impact, and cost-effectiveness of the initiative.India's 2004/05 National Sample Survey data were used to identify beneficiaries of each of Gujarat's three SSNPs and to estimate usual intake levels of vitamin A, iron, and zinc. Comparing age- and sex-specific usual intakes to Estimated Average Requirements, the proportion of the population with inadequate intakes was estimated. Postfortification intake levels and reductions in inadequate intake were estimated. The incremental cost of fortifying wheat flour and the cost-effectiveness of each program were estimated.When each program was assessed independently, the proportion of the population with inadequate vitamin A intakes was reduced by 34% and 74% among MDM and ICDS beneficiaries, respectively. Both programs effectively eliminated inadequate intakes of both iron and zinc. Among PDS beneficiaries, the proportion with inadequate iron intakes was reduced by 94%.Gujarat's substitution of fortified wheat flour for wheat grain is dramatically increasing the intake of micronutrients among its SSNP beneficiaries. The incremental cost of introducing fortification in each of the programs is low, and, according to World Health Organization criteria, each program is “highly cost-effective.” The introduction of similar reforms throughout India would largely eliminate the inadequate iron intake among persons participating in any of the three SSNPs and would have a significant impact on the global prevalence rate of inadequate iron intake.
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spelling CGSpace1531092024-11-15T08:53:03Z Indian social safety net programs as platforms for introducing wheat flour fortification: A case study of Gujarat, India: Fiedler, John L. Babu, Sunil Smitz, Marc-Francois Lividini, Keith Bermudez, Odilia I. cost analysis food policies fortified foods household consumption expenditure micronutrient deficiencies nutrition Micronutrient deficiencies exact an enormous health burden on India. The release of the National Family Health Survey results—showing the relatively wealthy state of Gujarat having deficiency levels exceeding national averages—prompted Gujarat officials to introduce fortified wheat flour in their social safety net programs (SSNPs).To provide a case study of the introduction of fortified wheat flour in Gujarat's Public Distribution System (PDS), Integrated Child Development Scheme (ICDS), and Mid-Day Meal (MDM) Programme to assess the coverage, costs, impact, and cost-effectiveness of the initiative.India's 2004/05 National Sample Survey data were used to identify beneficiaries of each of Gujarat's three SSNPs and to estimate usual intake levels of vitamin A, iron, and zinc. Comparing age- and sex-specific usual intakes to Estimated Average Requirements, the proportion of the population with inadequate intakes was estimated. Postfortification intake levels and reductions in inadequate intake were estimated. The incremental cost of fortifying wheat flour and the cost-effectiveness of each program were estimated.When each program was assessed independently, the proportion of the population with inadequate vitamin A intakes was reduced by 34% and 74% among MDM and ICDS beneficiaries, respectively. Both programs effectively eliminated inadequate intakes of both iron and zinc. Among PDS beneficiaries, the proportion with inadequate iron intakes was reduced by 94%.Gujarat's substitution of fortified wheat flour for wheat grain is dramatically increasing the intake of micronutrients among its SSNP beneficiaries. The incremental cost of introducing fortification in each of the programs is low, and, according to World Health Organization criteria, each program is “highly cost-effective.” The introduction of similar reforms throughout India would largely eliminate the inadequate iron intake among persons participating in any of the three SSNPs and would have a significant impact on the global prevalence rate of inadequate iron intake. 2012-03 2024-10-01T13:55:38Z 2024-10-01T13:55:38Z Journal Article https://hdl.handle.net/10568/153109 en Limited Access SAGE Publications Fiedler, John L.; Babu, Sunil; Smitz, Marc-Francois; Lividini, Keith; Bermudez, Odilia I. 2012. Indian social safety net programs as platforms for introducing wheat flour fortification: A case study of Gujarat, India. Food & Nutrition Bulletin 33(1): 11-30 https://doi.org/10.1177/156482651203300102
spellingShingle cost analysis
food policies
fortified foods
household consumption
expenditure
micronutrient deficiencies
nutrition
Fiedler, John L.
Babu, Sunil
Smitz, Marc-Francois
Lividini, Keith
Bermudez, Odilia I.
Indian social safety net programs as platforms for introducing wheat flour fortification: A case study of Gujarat, India:
title Indian social safety net programs as platforms for introducing wheat flour fortification: A case study of Gujarat, India:
title_full Indian social safety net programs as platforms for introducing wheat flour fortification: A case study of Gujarat, India:
title_fullStr Indian social safety net programs as platforms for introducing wheat flour fortification: A case study of Gujarat, India:
title_full_unstemmed Indian social safety net programs as platforms for introducing wheat flour fortification: A case study of Gujarat, India:
title_short Indian social safety net programs as platforms for introducing wheat flour fortification: A case study of Gujarat, India:
title_sort indian social safety net programs as platforms for introducing wheat flour fortification a case study of gujarat india
topic cost analysis
food policies
fortified foods
household consumption
expenditure
micronutrient deficiencies
nutrition
url https://hdl.handle.net/10568/153109
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