Roopa Darwar, Laura A. Rowe, Manpreet Chadha, Ana M. S. Rosas, and Mandana Arabi, MD, PhD.
Maternal & Child Nutrition, e13571.

Published: December 28, 2023


Multiple food fortification frameworks exist to guide the design, implementation, scale-up and monitoring of mandatory large-scale fortification programs. Consequently, countries my face challenges in determining the optimal framework to use to combat mineral and vitamin deficiencies, especially without additional technical support. Following a comprehensive literature review and key informant interviews, this study reviews the 19 existing frameworks to determine their consistencies, differences, strengths and weaknesses, and based on the findings formulates an enhanced, streamlines fortification framework.

The reviewed frameworks comprehensively cover topics including determining fortification need and feasibility, industry engagement, quality assurance and control, and impact evaluations and surveillance. Additionally, they had limited information about harmonizing food fortification with existing micronutrient interventions, fortification policy and strategy, enforcement and periodic program reviews and reassessment. Based on these findings, a comprehensive fortification blueprint was developed to provide structured guidance and a library of tools and resources.