Guest Blog Post by Sarah Zimmerman with the Flour Fortification Initiative
Unless diets have changed dramatically in 11 years, people in Tonboronkoto, Senegal, rarely eat commercially processed foods. I was a Peace Corps volunteer in this village in 2000, and people there mainly ate the maize, sorghum, peanuts and rice that they grew, such as the rice and corn pictured at left. They would occasionally buy sugar, tea and perhaps cooking oil, but their staple food never entered an industrial mill where it might be fortified with additional vitamins and minerals.
Villages like this dot every paved road and dirt path throughout Senegal and much of Africa. Should these countries exclude food fortification from their public health strategy, since so many residents do not eat commercially processed foods? Absolutely not. Food fortification is a viable part of a comprehensive approach to improving the health and well-being of a country’s population, even in Africa.
Earlier this year, the Flour Fortification Initiative (FFI) completed a six-month analysis on the prospects of fortifying wheat and maize flours in Africa. Knowing that people living in and near cities tend to eat more foods made with commercially milled flour than their rural peers, urbanization was a key factor in the FFI analysis. Here are some of the facts discovered:
- In 18 countries in Africa, the urban population is more than half the total population.
- From 2005 to 2010, the urban population in every African country increased from 1 to 7 percent.
- The following six countries increased their urban population by 5 percent or more from 2005 to 2010: Burundi, Liberia, Eritrea, Malawi, the Democratic Republic of Congo, and Burkina Faso.
- Seven countries are successfully fortifying commercially milled flour in Africa. The urban population of these countries accounts for 43 percent of the continent’s total urban population.
Senegal is one of the seven countries with a flour fortification program. Admittedly, flour fortification will probably have very little impact in villages like Tonboronkoto. But 42 percent of Senegal’s 12.8 million people live in urban areas such as Dakar, St. Louis, Tambacounda, Kedougou, and Thies. That’s more than 5 million people living in cities where baguettes are commonly consumed with breakfast. Fortified flour here will very likely improve the population’s iron status and reduce the number of children born with disabling or fatal neural tube defects such as spina bifida.
Senegal requires fortifying flour with iron and folic acid, fortifying vegetable oil with vitamin A, and it promotes the use of iodized salt. Working with international partners, Senegal leaders obviously realized that they need multiple strategies to improve the nutritional status of their diverse population.
Micronutrient powders, supplements, bed nets, deworming, and safe drinking water programs are all pieces of a comprehensive health improvement strategy in countries with a large rural population. Food fortification is sometimes overlooked in such countries where many people do not get their staple foods from the market, but these same countries very likely have large numbers of people in or near cities. As their urban population increases, so should the emphasis on food fortification as a public health intervention.
See a summary of the FFI analysis and a detailed presentation.
Sarah Zimmerman is the communications coordinator for the Flour Fortification Initiative, a network of public, private, and civic sector partners working together to make flour fortification standard milling practice around the world.
