Consumption of fortified wheat flour especially with iron and B vitamins is found to be an ideal and cost-effective medium to supplement the diets of general population with essential nutrients. Wheat flour fortified with iron (NaFeEDTA) was found to be efficacious in reducing iron deficiency anaemia (IDA) and iron deficiency (ID) prevalence among school aged children in Bengaluru and Pune. Gujarat’s model provided evidence that multi-micronutrient deficiencies can be dealt with the provision of fortified wheat flour through the government’s social safety-net schemes.
India's first wheat flour fortification programme started in Darjeeling, a district of West Bengal in 2000 as a pilot project in PDS, which was expanded in almost all districts of the state in different phases, except Kolkata city. The West Bengal flour fortification programme was sustained for 16 years, initially supported by Micronutrient Initiative (MI) and, later on, financed by the West Bengal State Government.
The Government of Karnataka has initiated distribution of vitamin and mineral fortified rice under the Midday Meal Scheme in 2538 government schools in the state benefitting more than 450,000 children across three districts. The project was rolled out on October 24th 2016. In rice fortification, this is the biggest ever initiative in terms of reach in the safety net programmes of the government.
There are two components of the initiative:
a. Supplying fortified rice through cooked mid-day-meals; and
b. Imparting nutrition and hygiene education among students.
In order to implement the initiative, the Government of Karnataka has signed an MOU with Akshaya Patra Foundation.
The Akshaya Patra Foundation will distribute the cooked fortified rice to the schools through their existing channels under the Midday Meal Scheme and impart nutrition and hygiene education at school level. The Government of Karnataka will oversee the entire project and provide guidance for evaluation of the project.
The Food Safety & Standards (Fortification of Foods) Regulations 2016 will be followed for the purpose of this project.
A rice fortification project was launched in the Gajapati district of Odisha in collaboration with World Food Programme in December 2012. Government of Odisha has been implementing the project with its own resources from January 2016.
This programme serves 97,790 school children aged 6-14 years in 1449 schools. Between January 2013 and October 2015, 5352 MT of fortified rice was consumed in schools. Currently, 174 MT rice per month is being consumed by school children.
Under this initiative, rice is fortified with fortified rice kernels, which are manufactured by combining rice powder with iron and then converting this powder into rice-like kernels using extrusion technology. The micronutrient fortified rice kernels closely resemble the sheen, consistency and flavour of regular rice. The fortified kernels are then blended with ordinary rice at a ratio of 1:100. Every 100 grams of fortified rice provides 10 mg of iron.
NABL accredited laboratories render services to check the quality of both, cooked and uncooked rice, ensuring that iron is supplied in the required quantity.
Prevalence of anaemia has reduced by 20% among school going children in Gajapati. Out of this total reduction, a significant 6% reduction can be directly attributed to consumption of fortified rice under the MDM. The morbidity profile of children has been reduced by 1.8% (in terms of children falling sick in the 6 months) and thus attendance of children in school has increased by 11.6 percent points.
As a way forward, Government of Odisha is in the process of collaboration with World Food Programme for operationalisation of fortification of MDM using multi-vitamin and micronutrient fortificants in two different modalities – fortification of rice through blending with Fortified Rice Kernel and of curry dish accompanying MDM using micronutrient powder in Dhenkanal district and in the Central Kitchen, Cuttack.
Global Alliance for Improved Nutrition (GAIN) and Indian Institute of Health Management Research (IIHMR), Jaipur, initiated a large-scale food fortification project in Rajasthan in order to reduce the high burden of micronutrient malnutrition. This project was implemented from 2011 to 2015 to fortify several staple food items like wheat flour, edible oil, milk and lentils with multiple nutrients.
These fortified food items were made available through both open market channels and public-funded programmes such as the ICDS, MDM and PDS. Around 1 lakh MT of wheat flour was fortified with iron, folic acid, and vitamin B-12 annually by associated flour mills benefitting around a million people in the state. More than 5 lakh MT of milk and around 3 lakh MT of edible oil was fortified with vitamin A and D annually benefitting around 8 million and 40 million people respectively.
The centralized kitchens operated by Akshaypatra Foundation, Nandi Foundation and Adamya Chetna Foundation improved the health and nutritional status of around 1 million school children, serving them with mid-day meals prepared using dal fortified with iron and folic acid; wheat flour fortified with iron, folic acid and vitamin B 12 and edible oil fortified with vitamin A and D.
Following the initial fortification of staple foods and their positive impact, the Government of Rajasthan announced the universal fortification of edible oil with vitamin A and D through PDS and open market channels across the state in the budget speech for the financial year 2015-2016. The Food and Civil Supplies Department was given the responsibility of smooth implementation of this project.
Meetings with Oil Millers’ Association, sensitization workshops, awareness campaigns and capacity building sessions in all 33 districts of Rajasthan were organised. Personnel at each oil processing and packaging unit were oriented on quality control and assurance processes through hands-on training and on internal and external quality control measures.The programme was launched on July 1st, 2016 and all 189 functional edible oil mills and repacking units, which sell oil in Rajasthan, started fortification by September 2016. These units produce mostly mustard oil, soyabean oil and groundnut oil.
Rajasthan has become the second state after Gujarat to voluntarily start fortification of edible oil.
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