National Fortification Programs

We are a small nonprofit that functions as a team of consultants to help governments design and implement countrywide, market-based, mandatory food fortification programs. The entire fortification process takes us between three to five years for each country.

Setting Fortification Levels

We start with a door-to-door survey of the population by sending teams of women across the country with the latest electronic surveying technology to interview hundreds of mothers. We learn what foods are eaten, how they are prepared and stored, the quantities consumed, and how the food is purchased. If already-existing surveys exist that can provide this data (e.g. HCES, CFNS, other), we utilize this data where appropriate to obtain inferred consumption in an effort to avoid duplicative efforts. Finally, we collect the information to quantify what micronutrient deficiencies exist.
With this data, we use our expertise to recommend

what foods should be fortified, with which micronutrients, and at what quantities. All our work is under the direction and guidance of the local government. During this phase, there’s often a need to pass legislation or governmental decrees, which play an important role.

Industry Implementation

Once the levels are determined, we work with industry to assist them in implementing the policies mandated by the government. Most food manufacturers are already familiar with the concept of food fortification; the long-term costs are insignificant, and industry recognizes the enduring benefit of helping the country they work in.

Monitoring and Evaluation

Finally, we help the country design and implement a monitoring and evaluation system to ensure appropriate amounts of premix are being added to the food and to assist governments to ensure that years from now the policies adopted by their country are still being implemented and are having an impact.
Specifically in terms of monitoring, we work with national bureaus of standard or the equivalent to create an appropriate sampling plan; train market, border, and industry inspectors; map the flow of data from inspector to lab; ensure proper equipment and reagents are sourced and available; and establish an in-country means of effectively monitoring compliance. PHC has designed a comprehensive, single-platform, excel-based monitoring tool for this purpose, which houses all collected fortification data. The tool can be adapted to any country program and appropriate staff trained on its use and maintenance. The graphs below are a few examples of disaggregated outputs the tool is capable of generating.