Methods and Outcomes of an Assessment of Foods Available to the Nigerian Population That Are Compliant with the Mandatory National Vitamin A Fortification Standards

Abstract

Abstract Objectives The fortification program in the Nigeria can only be effective if the food brands consumed by most of the population comply with the vitamin A fortification standards. We conducted two market assessments designed to, (1) quantify the fortification quality (extent to which levels of fortification align with food standards) of key food brands, (2) establish the degree of food brand penetration into Nigerian markets, and (3) estimate the market share weighted availability of fortified oil, margarine, & sugar in Nigeria. Methods We visited 3500 retail outlets across zones in Nigeria to ascertain oil, margarine & sugar availability and volumes sold. In parallel, government regulators collected 10 samples from different batches of the main packaged food brands across 20 market hubs. The vitamin A content was quantified using HPLC, the average content by brand computed, and compared to the national fortification standards considering labs’ measurement uncertainties. The brand level results were weighted using the availability and market volume data to estimate fortified food coverage in the country and the proportion of the fortified food volume. Results We found 98% of margarine, 86% of oil and 85% of sugar available in Nigeria to be fortified with vitamin A. In comparison, 96%, 71% and 87% of all brands analyzed, respectively were fortified. The main 3 margarine brands (of 56) make up 90% of the margarine market and are fortified according to standard (min. 7.5 mg/kg). The main 3 oil brands (of 145) represent 75% of the oil market and are also fortified to standard (min. 6 mg/kg). The main 3 sugar brands (of 39) making up 70% of the sugar market are fortified but below the standard minimum (7.8 mg/kg). The main 3 main brands are available across all 6 geographic zones, except for the second and third sugar brands that are available in 4–5 zones. Conclusions Focus on fortification quality improvements should be directed mainly to sugar fortification. Data on brand availability and penetration permits (a) focused performance monitoring towards brands and producers reaching most consumers and geographic areas at greatest need, (b) extrapolation of brand fortification quality to estimate epidemiologic risk and benefit in the population that can be linked to one food or across multiple food vehicles providing the same micronutrients. Funding Sources Bill and Melinda Gates Foundation.