Coverage and Seasonality Use of Fortifiable Maize Flour in Morogoro, Tanzania

Abstract

ObjectivesMaize flour is a staple consumed by 93% of the population in Tanzania. In 2011, Tanzania aimed to reduce micronutrient deficiencies and neural tube defects by introducing mandatory fortification of large-scale industrially produced wheat and maize flour. However, maize production is often fragmented (produced at smaller commercial mills) that are not required to fortify under the existing mandate. Objective: 1. Ascertain the proportion of the population of Morogoro region, Tanzania, that consumes packaged maize flour from commercial, ills; 2. understand if consumption of packaged maize flour is affected by changes in seasons and 3. determine who might potentially be reached by point-of-milling fortification in smaller packaging mills. MethodsIn 2018, a regional, multistage cluster probability study was conducted among residents in Morogoro region, Tanzania, living in households that reported consuming maize flour as the main staple. Interviews collected information on socio-demographic factors and patterns of household flour consumption. Weighted medians estimated daily individual flour intake [g/day/Adult Male Equivalent (AME)]. Daily estimated intake of folic acid was reported in μg and as percentages of the estimated average requirements (EAR) according to age. ResultsInformation was collected on 711 households (out of 984 households selected). Use of wheat flour was reported by 49.5% of households. Package maize flour was purchased 10–12 months, 6–9 months, and 1–5 months of the year by 22.9%, 17.6% and 25.1% of households, respectively; and 34.4% of households never purchased package maize flour. Per capita median daily consumption of any maize flour (including non-packaged flour) was 209.7 g/d/AME. Median daily intake was 230.1 g/d/AME among females. If all packaded maize flour were fortified according to mandate standards, those consuming packaded maize flour 10–12 months of the year would intake 199.9 μg folic acid/d representing 49.7% of daily EAR requirements. ConclusionsFortifying maize flour at small- and medium-packaging scale mills is a promising strategy for increasing household access to micronutrients including folic acid in Tanzania. Funding SourcesN/A.