Linking Fortification Compliance Metrics With Decision Making Needs: From Brand Level Data to Market Share Weighted Information

Abstract

Abstract Objectives A fortification program can only be effective if (1) each brand producer complies with fortification standards (i.e., adequately fortified), and (2) the adequately fortified products are consumed by a large proportion of the population. We quantified fortification quality (extent to which levels of fortification align with food standards) of oil, salt and wheat flour products; and ascertained the degree of food brand penetration and market share in Tanzanian markets. Methods Food inspectors collected multiple samples of food products at the production and/or market and laboratory analysts quantified the micronutrient content. We compared the average content for each individual brand product to the national fortification standards considering lab measurement uncertainty and classified into one of 4 fortification status categories (not fortified, fortified below, according to, or above the fortification standard). To establish penetration and market share, we visited 1500 retail outlets across regions in Tanzania to ascertain brand product availability and sales volumes. We applied weights using the market share estimates to extrapolate the fortification quality of the food market volume in the country. Results Of the different brand products of salt (26), wheat flour (25), and oil (68) found in the market, samples were collected and micronutrient content analyzed in the main oil (30%), salt (62%), and wheat flour brand products (85%). While 12% of salt, 35% of wheat flour, and 22% of oil brand products were fortified above the fortification standard minimum, when weighted by their market share, these represent 90% of the salt, 86% of wheat flour, and only 2% of the oil market volume respectively. Conclusions Fortification compliance of brand products provides important data for industry and regulatory authorities to identify where corrective action is necessary. Health and development staff are concerned about the extent to which additional nutrients are delivered to the population to anticipate public health impact, for which adjustment using reliable market share data is key. Weighted brand data can help resource constrained regulatory staff prioritize monitoring and enforcement activities to industries/producers with greatest influence. Funding Sources Bill and Melinda Gates Foundation (BMGF).