Field Stories
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December 18, 2023
Government endorses large scale mandatory food fortification to prevent high burden of neural tube defects in Ethiopia
The Ethiopian Standard Council endorsed the mandatory fortification of edible oil and wheat flour, a decision that will save millions of lives and prevent the country's high burden of neutral tube defects (NTDs).
Posted on August 23, 2022
ADDIS ABABA, ETHIOPIA: The Ethiopian Standard Council endorsed the mandatory fortification of edible oil and wheat flour on 10th June, 2022, a decision that will save millions of lives.
Ethiopia is one of the countries with the greatest burden of micronutrient deficiencies. According to the Ethiopian Public Health Institute Micronutrient Survey report (2016), the prevalence of anaemia adjusted for altitude among pre-school children, school age children and non-pregnant women of reproductive age was 34.4%, 25.6% and 17.7%, respectively. Additionally, the prevalence of sub-clinical vitamin A deficiency was 14% in pre-school age children, 10.9% in school age children and 3.4% women of reproductive age. The national prevalence of zinc deficiency was 35% in pre-school age children and higher (40.3%) in children 12 to 23 months, 36% in school age children and 34% in women of reproductive age. Finally, the prevalence of vitamin B12, serum and RBC folate deficiency in women of reproductive age was 15.1%, 17.3% and 32% respectively.
Malnutrition in Ethiopia is a public health problem, the Global Nutrition Report in 2018 classified the country as experiencing two forms of malnutrition – anaemia and stunting. In addition, Ethiopia faces a particularly high level of folate deficiency and insufficiency among women of reproductive age, which contributes to high rates of anaemia and can result in neural tube defects (NTDs), which are severe birth defects of the brain and spine and neonatal mortality.
Malnutrition contributes to increased morbidity and mortality, poor learning and productivity at work, which as a result affects the country’s economic development. The cost of undernutrition on education, productivity, and health is estimated to be 16.5% of Ethiopia’s gross domestic product.
In a statement on mandatory fortification, Ethiopia’s Minister of Health, H.E Dr. Lia Tadesse noted that micronutrient deficiencies are among major public health concerns in the country. “There is enough evidence on why Ethiopia needs the mandatory food fortification,” the Minister added.
Approximately 131 in 10,000 live births in Northern Ethiopia, 126 in 10,000 live births in Addis Ababa and 107.5 in 10,000 live births in Eastern Ethiopia were born with NTDs, which exceeds the WHO’s maximum allowable rate of five in 10,000. The deficiency of folic acid contributes to up to 75% of NTDs. Inadequate intake of zinc occurs in more than 90% in all of the population groups, and its deficiency is devastating to the health, growth, development and wellbeing of the Ethiopian population. Vitamin A inadequate intake in children and among women of reproductive age is 80% and 82%, respectively.
“This is an exciting development and a big step towards addressing the problem of micronutrient deficiencies. Nutrition International is fully committed to supporting the government ministries and agencies, in collaboration with other partners, in the operationalization of the mandatory food fortification.
— Dr. Richard Pendame, Regional Director, Nutrition International, Africa
The government and non-governmental organization officials lauded the Ethiopian Standard Council for ensuring the endorsement of the mandatory fortification of edible oil and wheat flour. “The endorsement of the mandatory fortification by the Council of Ministers is indeed historic and ground-breaking,” said Dr. Meseret Zelalem, Maternal, Child and Nutrition Directorate Director, Maternal, Child & Nutrition Directorate, Federal Ministry of Health, Ethiopia.
“I convey Nutrition International’s gratitude to the Council of Ministers for approving the mandatory food fortification,” remarked Dr. Richard Pendame, Regional Director, Nutrition International, Africa. “This is an exciting development and a big step towards addressing the problem of micronutrient deficiencies. Nutrition International is fully committed to supporting the government ministries and agencies, in collaboration with other partners, in the operationalization of the mandatory food fortification.”
Nutrition International Ethiopia’s Country Director, Dr. Amare Deribew welcomed the new development. “We have seen strong commitment by the Ministry of Industry and other key government sectors to endorse the mandatory edible oil and wheat flour.”
The State Minister of Industry, H.E Ato Shisema Gebreselassie called for unity and coordination among civil society organizations and donors, to provide financial and technical support to the government and private sector to implement the mandatory fortification program in Ethiopia.